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Is performance anxiety a mental illness?

Symptoms of Stage Fright? Stage fright is not a mental disorder. Rather, it is a normal reaction to a stressful situation. Most people experience some degree of anxiety prior to a performance, but some people may experience more extreme anxiety that interferes with their ability to perform at all.

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Performance anxiety is fear about one’s ability to perform a specific task. People experiencing performance anxiety may worry about failing a task before it has even begun. They might believe failure will result in humiliation or rejection. While performance anxiety can occur with any task. Anxiety around a public presentation or show is often called stage fright. A person may also experience performance anxiety regarding sex. Performance anxiety can vary between individuals. Many people experience a mild nervousness before giving a speech or doing a recital. But for some individuals, the thought of performing can cause panic attacks. People who experience severe performance anxiety may wish to get help from a therapist.

Symptoms of Stage Fright?

Stage fright is not a mental disorder. Rather, it is a normal reaction to a stressful situation. Most people experience some degree of anxiety prior to a performance, but some people may experience more extreme anxiety that interferes with their ability to perform at all.

Common symptoms of stage fright include:

Excessive sweating, heart palpitations, chills, and elevated blood pressure

A feeling that there is a knot in the stomach

Increased errors during the performance

Shaking and nausea

Backing out of the performance

What Causes Stage Fright?

Many people experience anxiety before public performances. Even career performers have reported pre-show stress. Before becoming a civil rights leader, Mahatma Gandhi struggled with public speaking for years. Singer Barbra Streisand experienced severe stage fright at the height of her career. Performance anxiety does not indicate a lack of talent. Performing before others can make people feel vulnerable. They may fear that a mistake will damage their reputation and make them seem less than perfect. In group performances, someone may worry how their actions will affect the group. People who already have social anxiety may grow especially self-conscious. Extreme anxiety can activate the body’s fight or flight response. A person may develop sweaty hands, a racing pulse, nausea, and a trembling voice. They may feel an overwhelming desire to leave the situation. Performance anxiety is often a self-fulfilling prophecy. The body’s fight-of-flight response can distract a person and affect their performance. A singer’s voice might shake, or a public speaker might forget their outline. The person may believe these mistakes are evidence their anxiety was warranted. They may avoid future performances. This action prevents the person from finding successes and proving their self-doubt wrong. When the person must perform again, their past “failures” may cause even more anxiety.

Overcoming Stage Fright

Stage fright can cause a large toll on a person. It may lower someone’s self-esteem or self-confidence. When a job requires public speaking, a person’s career may also suffer. For people experiencing chronic performance anxiety, therapy can help. Therapists may discuss a person’s underlying fears and perfectionism. They can help reframe a person’s self-defeating thoughts and normalize the anxiety experience. Treatment for stage fright often includes relaxation techniques. Deep-breathing and meditation can calm a person down immediately before a performance. A person in therapy may also learn mental strategies to reduce stage fright in the moment. These strategies include:

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Standing in a relaxed but confident pose.

Making eye contact with the friendliest faces in the audience.

Maintaining momentum rather than dwelling on mistakes.

Focusing on the act of performing rather than the audience’s reaction.

Visualizing success.

Lifestyle changes can also help ease stage fright. For example, decreasing caffeine intake, remaining hydrated, and eating a good meal before a performance may benefit some people. It can also help to get plenty of sleep the night before.

Helping Children with Performance Anxiety

Performance anxiety is common among children. Kids may grow anxious before a sports game or school play. Many kids show stomach-related symptoms such as nausea or tummy-aches. Parents can reduce this anxiety by helping a child prepare for the event. Rehearsing the task can help build a child’s self-confidence. Parents can also make sure the child eats a nutritious meal a few hours before the performance. A healthy meal can boost energy and focus. Many parents try to reduce their children’s anxiety through pep talks. The following tips can be helpful for encouraging anxious children: Acknowledge your child’s distress : Some parents reject the anxiety entirely, telling kids to “stop worrying” and “just do it.” Yet few people can get rid of their fears so simply. Children may grow more stressed when they cannot control their emotions as instructed. : Some parents reject the anxiety entirely, telling kids to “stop worrying” and “just do it.” Yet few people can get rid of their fears so simply. Children may grow more stressed when they cannot control their emotions as instructed. Acknowledge the importance of the event: Saying that a show or game isn’t “a big deal” can cut down a child’s motivation. Your child may then wish to skip the performance altogether to avoid stress. Saying that a show or game isn’t “a big deal” can cut down a child’s motivation. Your child may then wish to skip the performance altogether to avoid stress. Encourage your child during preparations: Praise can be a much-needed boost to your child’s confidence. Praise can be a much-needed boost to your child’s confidence. Offer unconditional support: Parents who pressure or criticize their child may see the child’s performance suffer due to stress. Let your child know that while you expect them to succeed, you will still love them if they fail. Children with performance anxiety may ask parents to let them skip the event. Parents may be tempted to write a sick note to save their child stress. While avoiding a task can reduce short-term anxiety, it may also prevent children from developing coping skills. Taking a step outside one’s comfort zone often builds resilience. Meanwhile, children who make a habit of running away from tough situations may develop worse performance anxiety over time. In cases of extreme stress, it may be necessary to let a child quit. Yet skipping the performance does not mean letting a child’s work go to waste. A child may benefit from doing a make-up performance on their own terms. For example, if a child misses a music recital, they can record a video of them singing at home and give it to the teacher the next day. Modified tasks can help children get used to performing.

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Sexual Performance Anxiety

Some people experience performance anxiety during sex. This kind of anxiety is often tied to sexual difficulties such as vaginismus or erectile dysfunction. In some cases, body image can also play a role. People of any gender can experience sexual performance anxiety. Yet men are especially susceptible to feelings of inadequacy when they cannot maintain erections. Anxiety may affect sexual performance, which increases anxiety, creating a self-perpetuating cycle. Men with a pre-existing anxiety condition are more likely to have sexual performance anxiety. There is such a strong social stigma attached to sexual difficulties. Even talking about performance anxiety can worsen the problem for some people. That said, the issue is treatable. Therapy for sexual performance anxiety often requires both members of a couple to participate. Therapy may focus on creating a low-stress, low-pressure sexual environment. A therapist may also help a couple reframe assumptions about sexual success or failure.

References:

American Psychological Association. APA concise dictionary of psychology. Washington, DC: American Psychological Association, 2009. Print Conquering stage fright. (n.d.) Anxiety and Depression Association of America. Retrieved from https://adaa.org/understanding-anxiety/social-anxiety-disorder/treatment/conquering-stage-fright# Fundukian, L. J., & Wilson, J. (2008). The Gale encyclopedia of mental health. Detroit, MI: Thomson Gale How to help your child overcome stage fright. (n.d.) New Kids Center. Retrieved from http://www.newkidscenter.com/how-to-help-a-child-with-stage-fright.html Performance anxiety in great performers. (2014). The Atlantic. Retrieved from https://www.theatlantic.com/magazine/archive/2014/01/what-hugh-grant-gandhi-and-thomas-jefferson-have-common/355853 Rajkumar, R. P. & Kumaran, A. K. (2015). Depression and anxiety in men with sexual dysfunction: A retrospective study. Comprehensive Psychiatry, 60(1), 114-118. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/25818906 Stage fright: How to help kids with performance anxiety. (2016, November 16). Today’s Parent. Retrieved from https://www.todaysparent.com/kids/kids-health/performance-anxiety-2 Stage fright (performance anxiety). (2017, August 17). WebMD. Retrieved from https://www.webmd.com/anxiety-panic/guide/stage-fright-performance-anxiety#2

Last Updated: 04-10-2019

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