Performance anxiety involves an intense feeling of fear or worry and is a form of anxiety that is linked to the ability to do something in particular, or a fear of the implications if one is unable to do well when performing a specific skill. Performance anxiety was added to The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) (2013) in the social anxiety section as a performance only specifier. The definition of social anxiety in the DSM- 5 is described by a persistent fear of a single or plural performance or social incident where the individual is faced with others that they are not familiar with or by potential scrutiny. The individual is scared that their actions will be humiliating or embarrassing. Performance anxiety is often used to describe stage fright which involves worry or fear prior to performing in front of others. This is just one example of performance anxiety and performance anxiety can involve other tasks as well. Performance anxiety can affect anyone regardless of their age or gender and it can develop gradually or appear suddenly.
Symptoms
Performance anxiety symptoms can vary from mild to severe, it may be a one off or it can occur several times or even every time the individual is faced with the specific anxiety provoking task if it is left untreated. The symptoms may vary for each individual and can also vary when the individual is faced with numerous incidents of performance anxiety. The symptoms include cognitive, behavioral, physical and emotional changes. Examples of these are: Shaking Dizziness Feeling light headed Elevated heart rate
Sweating Chills Elevated blood pressure
Shortness of breath
Dry mouth Trouble to control bladder
Stomach pains Changes in vision
Pale skin
Flushed skin
Hyper awareness Thoughts about fear and failure
Thoughts regarding the implications or negative outcomes of perceived failure
Rigidity of thoughts Avoidance of task
Types of performance anxiety
As aforementioned there are different types of performance anxiety. These include stage fright, sexual performance anxiety, athletic performance anxiety, test taking anxiety and interview anxiety. Stage fright refers to performance anxiety linked with performing and can be present in singers, dancers, musicians, and individuals that perform on stage. Stage fright may also be described as a social phobia defined by glossophobia which describes the fear of speaking in public. Sexual performance anxiety describes a worry or fear linked to engaging in sex and can occur prior to or during sex. It can be related to how the individual perceives their body image, to difficulties in the relationship or the individual’s perception of their ability to satisfy their partner or reach climax. Sexual performance anxiety is sometimes used interchangeably with erectile dysfunction but it is important to distinguish that this refers to two different conditions. Erectile dysfunction describes a challenge faced by men in developing or sustaining an erection that may be caused by sexual performance anxiety or other reasons. Athletic performance anxiety also known as performance anxiety in sport describes a worry or a fear linked to athletic competition or training. As well as the aforementioned symptoms this type of performance anxiety carries an elevated risk of injury for athletes. Test taking anxiety involves a worry or a fear around taking tests and the ability to do well in tests. It can adversely affect test results as individuals with test taking performance anxiety may find it difficult to recall materials in a test taking environment that they would otherwise know. Interview anxiety describes a fear or a worry around being interviewed. Similar to test taking anxiety it can have an adverse effect on the interview itself as individuals are unable to present themselves as they would in other situations or environments. Although the above mentioned forms of anxiety describe prevalent types of performance anxiety it is not limited solely to them. Performance anxiety can be linked to the ability to perform any task.
How to break the cycle of performance anxiety
Performance anxiety can feel like a vicious cycle as the anxiety regarding the task can hinder performance which in turn adds to the anxiety and the negative thoughts about one’s ability to perform. Prevention can involve preparing before the situation or task by practicing or training as well as making sure one gets adequate sleep and food, and reducing stimulating substances such as caffeine. Positive visualization such as shifting your focus to what a successful performance would be like can also help reduce nervousness before the task.
Treatment
Treatment of performance anxiety can involve both talking therapy and medication depending on the severity of symptoms. Talking therapy or psychotherapy for performance anxiety can be successful in enabling the individual with ways in which to overcome their difficulties and improve their wellbeing. Cognitive Behavioural Therapy (CBT) is the most effective approach to therapy for treatment of anxiety disorders. CBT is a solution focused approach that initially identifies what is contributing to the performance anxiety and subsequently introduces ways in which to change, whether it involves changing negative thinking patterns or detrimental behaviours.
Medication
Medication for performance anxiety can involve selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRI). Performance anxiety can be difficult to cope with, but it is important to remember that there are ways to improve and to significantly reduce symptoms. If you or someone you care for is experiencing symptoms in line with performance anxiety please contact your GP regarding treatment options or book an appointment with one of our psychologists at Mindler.