What Is Performance Anxiety? Symptoms & Treatment Options

Performance anxiety is a common psychological phenomenon affecting individuals across various domains, from the stage to the sports field, and even in personal scenarios like interviews or exams. This type of anxiety stems from the fear of not meeting expectations or the potential negative outcomes of a performance. It can manifest in both physical and psychological symptoms, significantly impacting an individual’s ability to perform.

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Understanding Performance Anxiety

Performance anxiety is more than just pre-performance jitters; it is a profound fear or worry related to performing in front of others or meeting specific standards. This anxiety can arise in any situation where there is pressure to perform, leading to an intense fear of failure or judgment. Despite being commonly associated with stage performances, it extends to any scenario requiring an individual to perform under observation.

Identifying the Symptoms

The symptoms of performance anxiety can be broad and varied, impacting individuals differently. Physically, one might experience increased heart rate, trembling, dizziness, or even nausea. Psychologically, symptoms include excessive worry, negative thoughts about one’s abilities, and fear of embarrassment or making mistakes. These symptoms can lead to avoidance behaviors, further impacting performance and confidence.

Exploring the Causes

The root causes of performance anxiety often stem from a fear of judgment or failure. High expectations, either self-imposed or perceived from others, can exacerbate this anxiety. Past experiences of poor performance or lack of preparation can also contribute, creating a cycle of anxiety and avoidance that can be challenging to break.

Physical Manifestations

Performance anxiety is not just in your head; it affects your body too. Symptoms like a racing heart, sweating, and shaking are your body’s response to stress, preparing you for “fight or flight.” Recognizing these as normal responses to stress can be the first step in managing them.

Psychological Symptoms

Negative thoughts and fear of judgment are hallmark psychological symptoms of performance anxiety. These thoughts can spiral, leading to a self-fulfilling prophecy where the fear of failure contributes to a lackluster performance. Breaking this cycle involves addressing these cognitive distortions directly.

Navigating Through Performance Anxiety

One of the first steps in overcoming performance anxiety is acceptance. Acknowledging that you are experiencing anxiety and understanding that it is a normal response to perceived stress is crucial. This acceptance can open the door to seeking effective strategies and treatments to manage and overcome the anxiety.

Treatment Options

Cognitive-Behavioral Therapy (CBT)

CBT is a highly effective treatment for performance anxiety, focusing on identifying and challenging negative thought patterns and behaviors. By addressing the cognitive aspects of anxiety, individuals can learn to reframe their thoughts about performance, reducing the intensity of their anxiety.

Exposure Therapy

Exposure therapy involves gradually and systematically facing the feared performance situation. Starting with less intimidating scenarios and building up to more anxiety-inducing performances can help desensitize an individual to the fear and anxiety associated with performing.

Mindfulness and Relaxation Techniques

Mindfulness and relaxation techniques, such as deep breathing, meditation, and progressive muscle relaxation, can help manage the physical symptoms of anxiety. By focusing on the present and controlling one’s physiological response to stress, individuals can maintain a calmer state during performances.


In some cases, medication may be recommended as part of a treatment plan for performance anxiety. Beta-blockers, for example, can help manage physical symptoms like rapid heartbeat and tremors, while SSRIs and SNRIs may be prescribed for underlying anxiety disorders.

Self-Help Strategies

Preparation and Practice

Adequate preparation and practice can significantly reduce performance anxiety by increasing confidence in one’s abilities. Familiarity with the material and the performance setting can also reduce fear of the unknown, a common trigger for anxiety.

Positive Visualization

Visualizing a successful performance can help shift focus from fear of failure to a more positive outcome. This mental rehearsal technique not only prepares you for the performance but also builds confidence and reduces anxiety.

Develop a Pre-Performance Routine

Creating a consistent routine before performances can provide a sense of control and calmness. This routine might include relaxation exercises, a warm-up, or other rituals that signal to your body and mind that you are ready to perform.

Conquering Performance Anxiety: A Holistic Approach with Dr. Cristina Dominguez 

Performance anxiety is a multifaceted issue that requires a comprehensive approach to overcome. Understanding its symptoms, causes, and treatment options is the first step towards managing and eventually overcoming this form of anxiety. 

I am Dr. Cristina Dominguez, a mental health and performance coach, who values the importance of a holistic approach, incorporating mental, physical, and emotional strategies to tackle performance anxiety effectively. Get in touch today, as I know very well that with the right support and techniques, it is possible to transform anxiety into an opportunity for growth and success.

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Dr. Cristina Dominguez provides compassionate, professional care with no judgment. Elite coaching sessions can help with career advancement, successful relationships, burnout, and more. Reach out today to schedule your free consultation.