Feeling nervous before speaking in public is very common. Some anxiety even sharpens performance.
When fear is intense, leads to avoidance or affects studies and career, it may be part of social anxiety disorder.
Key concepts
- The audience notices much less than you feel
- Preparation plus practice reduces fear
- Performance-only social anxiety responds well to therapy
Symptoms and signs
- Racing heart, dry mouth, trembling hands or voice
- Mind going blank
- Avoiding vivas, meetings or ceremonies
Causes
- Fear of negative judgement
- Past embarrassing experience
- Perfectionism
Risk factors
- Social anxiety in general
- Speaking in a second language
- Little practice opportunity
Evidence-based management
- Prepare key points, not a word-for-word script
- Practise aloud, then in front of one or two people, then larger groups
- Slow breathing before starting; focus on the message, not yourself
- CBT for persistent fear; occasional medicines may be discussed with a doctor
When to seek professional help
- Avoiding important exams, interviews or roles
- Fear spreading to everyday social situations
- Using alcohol or unprescribed tablets before speaking
Frequently asked questions
Should I take a tablet before my presentation?
Do not take unprescribed sedatives — they can impair performance. Discuss options with a doctor well in advance.
Does stage fright ever go away?
With repeated practice and, if needed, therapy, most people become comfortable.
Medical references
Guidelines and official sources used for this article.
- Author
- Dr. Kuldeep Budania, MBBS, MD Psychiatry
- Medical reviewer
- Dr. Kuldeep Budania, MD Psychiatry
- Last reviewed
This article is for general information and is not a substitute for personal medical advice.
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