Anxiety is a natural emotion that most people experience every now and then. It refers to intense fear or concern about a real or perceived threat.
When anxiety becomes recurrent and interferes with your daily life or important life events, you may receive a diagnosis of an anxiety disorder.
But performance anxiety is not a type of anxiety disorder. Instead, it may be a symptom of one, or it can be an isolated occurrence based on past experiences.
Performance anxiety involves an intense concern and preoccupation about how well you may be able to perform a task. These feelings may cause you to freeze up or lead you to actively avoid the situation.
You can experience performance anxiety at work, in sports, arts, school, or sexually.
Examples of scenarios that may trigger performance anxiety include:
- taking a test at school
- speaking in front of a lot of people at work
- playing a musical instrument in public (stage fright)
- participating in a sports competition
- having sexual intimacy with a new partner
Performance anxiety is common. Around 10-40% of students may experience some level of performance anxiety when taking a test or doing a presentation.
A 2019 study found that sexual performance anxiety can affect 9-25% of men and 6-16% of women.
Anxiety can be managed, and anxiety disorders are treatable. Relief is possible.
Is performance anxiety a formal diagnosis?
Performance anxiety is not a stand-alone diagnosis listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR). This is a reference handbook that most U.S. mental health professionals use to make accurate diagnoses.
If performance anxiety is severe, persistent, and affecting major life events, you may receive a diagnosis of anxiety disorder. These are the four types:
- Generalized anxiety disorder: Performance anxiety may be one of many symptoms of generalized anxiety disorder. Others may include persistent restlessness, irritability, fatigue, difficulty concentrating, twitching, and a rapid heartbeat. These symptoms may happen with and without an evident trigger.
- Social anxiety disorder: If your performance anxiety continually involves a fear that others will judge you negatively or that you will be embarrassed or humiliated, you may receive this diagnosis. Other symptoms include avoidance of social situations, difficulty following conversations and making eye contact, and extreme physical discomfort in social situations.
- Panic disorder: Panic attacks are at the core of this anxiety disorder. Symptoms of a panic attack may include fear of losing control, a sense of doom or that something bad is going to happen, heart palpitations, shaking and sweating, shortness of breath, and abdominal distress.
- A specific phobia: If your anxiety relates to a specific object or situation and you actively avoid that situation or have intense fear when facing it, you may live with a phobia.
Stress and nervousness about performing sexually is a type of performance anxiety. Sexual performance anxiety may lead to premature ejaculation and erectile dysfunction in males and decreased sexual desire in females, according to 2020 research.
Is performance anxiety the same as anticipatory anxiety?
Performance anxiety and anticipatory anxiety are related, but they are not the same thing.
Anticipatory anxiety is experienced before a future event or situation but does not necessarily involve a fear that you won’t be able to manage said event or situation.
Performance anxiety can show up both before or during an event or task but mainly focuses on your fear of being unable to perform as expected.
Anticipatory anxiety is not limited to task-related situations and may resolve once you face the event. On the other hand, performance anxiety may intensify once you are in the feared situation.
Symptoms of performance anxiety
If you experience performance anxiety, you may develop general anxiety symptoms, including:
- Physical symptoms:
- increased heart rate
- sweating
- dry mouth
- upset stomach
- trembling
- shortness of breath
- a feeling of being light-headed
- Cognitive and emotional symptoms:
- negative self-talk
- racing thoughts
- difficulty concentrating or recalling information
- inability to focus on the task at hand
- worries about being judged negatively by others
- Behavioral symptoms:
- fingernail biting
- excessive rehearsal or preparation
- avoidance of the task
- twitching
- pacing
- asking for reassurance from others
How to manage performance anxiety
It is natural to want to break the cycle of performance anxiety if you feel it impacts your quality of life. It is possible to stop or reduce the symptoms by incorporating some of these tools:
Talk therapy and professional support
Psychotherapy is one of the main treatments for anxiety, and it can help you stop performance anxiety. You can try several different types of therapy, including:
- Cognitive behavioral therapy (CBT): CBT aims to help you reassess how you think, behave, and react to situations so that you can feel less fearful and anxious.
- Acceptance and commitment therapy (ACT): You use tools like goal setting and mindfulness to manage discomfort and anxiety in ACT.
- Exposure therapy: Exposure therapy involves gradually introducing you to the situation that causes you fear so that you feel more comfortable with it.
If your symptoms do not improve with psychotherapy, your mental health professional may recommend medications. These may include:
- selective serotonin reuptake inhibitors, like fluoxetine (Prozac) and sertraline (Zoloft)
- short-term benzodiazepines, such as alprazolam (Xanax)
- serotonin-norepinephrine reuptake inhibitors, like venlafaxine (Pristiq)
- tricyclic antidepressants, like imipramine (Tofranil)
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