Performance Anxiety: Symptoms, Diagnosis, & More – Verywell Health

Performance anxiety is a type of anxiety, or strong, excessive feeling of fear or worry, that is related to being able to accomplish something specific, or a fear of consequences of not being able to perform well.

The term is commonly used to describe stage fright, which is stress or fear before performing or speaking in front of people. It is also sometimes used as a shortened version of the term sexual performance anxiety, which is a fear related to having sex. However, these are just two examples.

People can experience performance anxiety with anything, and it can become a pattern. With treatment, this is a challenge that can be reduced and even overcome.

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Who Gets Performance Anxiety and When?

Performance anxiety can impact people of all genders, children and adults. It can begin suddenly or build gradually over time. This is a type of anxiety related to any specific task, so it can happen under many different circumstances.

The symptoms of performance anxiety can range from mild to severe. It can be a one-time occurrence, or it can happen multiple times, possibly even every time a person faces that task if left untreated.


Performance anxiety symptoms may be different from person to person. Symptoms also may be different when the same person experiences multiple episodes of performance anxiety. These symptoms may change in severity, and they include physical, emotional, motor, and cognitive changes.

Symptoms of Performance Anxiety

  • Increased heart rate
  • Increased blood pressure
  • Tremors
  • Dizziness
  • Lightheadedness
  • Headache
  • Fast or shallow breathing
  • Dry mouth
  • Difficulty controlling bladder
  • Unsettled stomach
  • Vision changes
  • Sweating
  • Cold hands or feet
  • Chills
  • Pale or flushed skin
  • Increased alertness
  • Thoughts of fear of failure
  • Thoughts of negative outcomes of perceived failure
  • Difficulty being open to different thoughts
  • Behavior changes
  • Feeling of loss of control
  • Decision not to complete the task


There are multiple types of performance anxiety. These include:

  • Stage fright
  • Sexual performance anxiety
  • Athletic performance anxiety
  • Test-taking anxiety
  • Interview anxiety

Stage Fright

Stage fright is performance anxiety related to performing on stage and can be experienced by actors, musicians, dancers, and other stage performers. Stage fright is also considered a phobia, specifically the social phobia of glossophobia, which is the fear of public speaking. Social phobia is also called social anxiety disorder.

Sexual Performance Anxiety

Sexual performance anxiety is a fear or worry related to having sex and can happen before or during sex. It can be linked to perceived abilities to satisfy a partner, body image, relationship challenges, or other factors. An estimated 9% to 25% of men and 6% to 16% of women experience sexual performance anxiety.

While the terms performance anxiety, sexual performance anxiety, and erectile dysfunction are sometimes used interchangeably, they are three different conditions. Sexual performance anxiety is a fear or worry related to having sex, and performance anxiety can be fear or worry related to any task. Erectile dysfunction is difficulty experienced by men in getting or keeping an erection that can be caused by sexual performance anxiety or a variety of other factors.

Athletic Performance Anxiety

Athletic performance anxiety is a fear or worry related to athletic training or competition. This type of performance has an additional concern beyond the anxiety symptoms. Athletic performance anxiety can increase the risk of injury among athletes.

Test-Taking Anxiety

Test-taking anxiety is a fear or worry related to taking tests or being able to perform well on tests. It often negatively impacts test results, and test-takers score lower than their knowledge of the material and their abilities.

Interview Anxiety

Interview anxiety is a fear or worry related to interviewing for a job or other interview. Increased interview anxiety is related to decreased interview performance and may negatively impact hiring decisions.


Stage fright, sexual performance anxiety, athletic performance anxiety, test-taking anxiety, and interview anxiety are just five examples of performance anxiety. However, performance anxiety is not limited to these five circumstances. It can be related to the ability to perform any task.


Mental health professionals such as psychologists and psychiatrists can diagnose performance anxiety by assessing the symptoms, thoughts, and circumstances.


Performance anxiety prevention involves preparing before events and tasks. This may include practicing, training, and rehearsing skills required to perform well, such as athletic team practices and cross-training, music and dance lessons and rehearsals, memorizing and learning information, and practicing speeches and presentations with notes.

Preparation may also include getting enough sleep, eating a healthy, satisfying meal, regular stress relief, seeking emotional support from others, learning coping techniques ahead of time, pre-performance rituals, and visualizing completing the task, event, or performance well.


Treatment options for performance anxiety depend on severity of symptoms, how often symptoms are experienced, and how they impact daily life. This is something that can be treated by a psychologist or psychiatrist. Performance anxiety can be treated with talk therapy methods or medications.


Psychotherapy or talk therapy is a method of treating performance anxiety without medications.

Psychotherapy Treatment of Performance Anxiety

  • Cognitive behavioral therapy (CBT): This is one of the most effective psychotherapies for anxiety disorders. It is an approach used to identify and change thought and behavior patterns to develop more effective ways of coping, leading to symptomatic change.
  • Counseling: This is a type of talk therapy used to empower people with strategies to overcome challenges and improve their sense of well-being.
  • Coping strategies: These may include pre-performance rituals, deep breathing, and visualization.


Sometimes performance anxiety, particularly social anxiety disorder, is treated with medications. A common option is a type of medication called selective serotonin reuptake inhibitors, or SSRIs. Another option is a serotonin and norepinephrine reuptake inhibitor, or SNRI.

Medications for Performance Anxiety

Medications commonly used for performance anxiety include:

  • Paroxetine or Paxil: SSRI medication
  • Sertraline or Zoloft: SSRI medication
  • Venlafaxine or Effexor XR: SNRI medication
  • Lorazepam or Ativan: Benzodiazepine medication
  • Clonazepam or Klonopin: Benzodiazepine medication
  • Propranolol or Inderal: Beta blocker

A Word From Verywell

Performance anxiety can be a frightening and challenging experience. It’s important to remember that regardless of the type of performance anxiety, the severity, and the frequency, there are things you can do to improve and possibly even eliminate the symptoms. If this becomes a problem for you, speak with your healthcare provider about options to help.