Mental Health
Performance Anxiety
It’s virtually impossible to go through life without occasionally feeling anxious about certain situations, people and things. Whether it’s about personal health concerns in times of COVID, job security worries or upsetting events in the relationships with our loved ones, in a typical month there can be plenty of things that may give rise to anxiety. It’s the brain’s natural response to perceived future threats and changes. That’s actually what separates anxiety from fear. The latter is a response to a real imminent threat, whereas anxiety is a concern about upcoming and potentially negative events.
Whether these events actually will come true or not (e.g., whether l actually fail a job interview) is not clear yet. Anxiety only anticipates that something negative could happen and gets you ready for dealing with it. Most often the first impulse it triggers is a wish to just escape the situation or abandon the task you find so challenging. It’s a defense mechanism that in our cavemen days protected us from getting into unwinnable confrontations.
In a fight-or-flight situation anxiety indeed is very helpful, but in modern everyday life it often stands in the way of effectively coping with a problem. Your anxiety might tell you: just don’t go to the job interview — just like it would tell you to turn around if on a hiking trip you see a bear in the distance. Of course, skipping the interview isn’t a sensible choice. So, anxiety not only has no constructive solutions to offer, but it actually is counterproductive. Anxiety undermines your self-confidence, affects your sleep the night before the interview, and makes you lose focus.
There are many ways to manage and reduce such anxiety, and we’ll discuss some of these below. However, there also are more serious cases of anxiety that qualify as “disorders” in the clinical sense. This includes social anxiety disorder, OCD (obsessive-compulsive disorder), and severe performance anxiety, to name a few. Such anxiety disorders are chronic long-term conditions (lasting six months and longer) and often are so deeply entrenched that they have far-reaching impacts on a person’s life.
The Anxiety and Depression Association of America (ADAA) believes that in a normal year some 40 million adults in the U.S. are suffering from one or more forms of anxiety disorder. Many of these people require therapy or medication to cure or improve these disorders. We’ll briefly discuss the options here in the last section of this article.
As long as you are not dealing with a deeper anxiety disorder, you likely won’t need professional help to learn how to worry less in daily life. Here are some useful tips for how to do this:
Anxiety often is a diffuse, irrational feeling that’s spinning all over the place. By biological default, anxiety often automatically makes you think about the worst-case scenario. Don’t let your anxiety go wild like this! Make a list of what exactly you worry about, i.e., what precisely could go wrong, why, and how bad the outcome really could be. Once you understand the negative outcomes that realistically can be expected (in most cases they’ll look more manageable and survivable than what your uncontrolled anxiety at first suggested), you then can think of specific coping strategies for each of them.
Being prepared will boost your confidence and allow less space for anxiety to creep back in. Of course, there unfortunately are some things that simply can’t be fixed, such as serious health problems. However, by rationally deconstructing your anxiety, you at least can isolate these legitimate concerns from the ones that aren’t. At least you won’t be wasting your energy worrying about unnecessary or minor things.
Anxiety often sets in well before the event you are afraid of. It can make you lose sleep several nights prior to a big presentation and sap your energy. Keep on reminding yourself that presently you are well and safe. There’s nothing to be concerned about at the moment. Once you start giving the presentation, there will still be enough time to worry and agonize. Until then, enjoy your life! This self-reminding takes some practice and the anxiety may quickly get the better of you again. Therefore, try to schedule several times a day where you take a few minutes to consciously appreciate the here and now and postpone your anxiety.
Deep, slow breathing helps your brain to calm down and cool emotions, whether that’s anxiety, fear or anger. Across different cultures, there are myriad breathing techniques and exercises. But, as simple as it sounds, focused inhaling and exhaling often already is very effective. During the breathing, deliberately take your brain off the anxiety triggering the issue. Instead think of neutral things in your immediate surroundings, such as the color of the wallpaper or the street life outside the window. This combines the breathing exercise with the living-in-the-present-moment thinking discussed above.
Instead of sitting on the couch or office chair with your brain paralyzed by anxious thoughts, get physically active! Any sport or even just a simple walk outside in the parking lot will do wonders in terms of calming the anxiety. Focus on thinking of things around you or on your activity, such as counting steps, as this will distract and free your mind from the negative thoughts.
That’s in line with the previous technique but involves more than physical activity. The purpose is to distract yourself and interrupt the chain of negative thoughts. This may be watching a funny movie, playing with your kids or pets, or deep-cleaning the kitchen. Whatever you do, it most likely will be more useful than sitting around and letting yourself be consumed by worries. A phone call with a close friend or family member can be a particularly effective distraction. Try to talk about things other than the anxiety.
The above-discussed methods work well for simple everyday anxiety, but when it comes to more serious cases, i.e., anxiety disorders, professional help is needed. Many people may not be aware their anxiety already is at such a level where it would qualify as a disorder. Therefore, if you suffer from frequent anxiety or nervousness that you feel you can’t cope with on your own, you may want to seek advice from a psychiatrist or other licensed therapist. The latter can assess your case and tell you whether therapy or medication might be required in your case.
Generally, anxiety treatment first starts with behavioral therapy, which sometimes is complemented with prescription medications. Therapy takes precedence because it tries to resolve the issues underlying your anxiety, while medication only suppresses the anxiety without addressing its causes.
Here’s a brief overview of common therapy and medication options for treating anxiety disorders:
This widely used therapy will take some time but tends to be very effective. CBT teaches you that the problem is your negative thoughts and emotions, not the actual situation that triggers the latter. It also will teach you how to throw out the negative thoughts and put more rational thoughts and strategies in their place.
This therapy aims to expose you to the things you are anxious about. Of course, not in a sudden shock but rather a gradual and careful manner, which is called "systematic desensitization." In the beginning, you only imagine the anxiety triggers and situations. Then, your therapist will let you gradually face real-life situations.
Severe cases of anxiety disorder can be alleviated with selective serotonin reuptake inhibitors (SSRIs) like Prozac and Zoloft. During the course of 4-6 weeks, these prescription drugs raise serotonin levels in the brain, which in most cases successfully suppresses anxiety, panic attacks and depression. Most SSRI users tolerate the drugs well, but there can be moderate side effects, such as lower libido and cardiovascular issues.
This drug, which comes from the beta-blocker class, is a standard treatment option for performance anxiety. Doctors normally prescribe it as an ad-hoc single-use medication that’s taken 30-60 minutes before the anxiety-triggering situation, like an important presentation or exam. Propranolol has few side effects when only used sporadically.
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