Overcoming Severe Anxiety: Strategies for Public Speaking Success

Q: Overcoming Severe Anxiety: Strategies for Public Speaking Success

Hello： The more you care, the more anxious you become; the more anxious you are, the worse the situation gets, leading to a vicious cycle of increased concern. <br>Practicing not to care is easier said than done; it is advisable to engage in other interesting activities to distra

Severe anxiety

Hello, Doctor! I've been struggling with anxiety for a long time.
Whenever I have to give a presentation or speak in public, I start feeling anxious weeks in advance.
In the nights leading up to the event, I often can't sleep.
Even though I've practiced multiple times, I still can't face it calmly.
On stage, my hands shake, my voice trembles, and sometimes I even feel dizzy from the nerves.
It's just a small presentation, like one where I can refer to notes, yet I still can't get through it.
I've read online that practicing more can help overcome this, but I've practiced many times throughout my life and nothing has changed.
It feels exhausting because I spend so much time preparing, only for the final presentation to fall apart.
Not being able to express my thoughts like a normal person makes me feel inadequate.
I've been considering seeing a psychiatrist, but many people say that more practice will solve it.
I feel really powerless because I've been practicing and nothing improves.
I know I will have many more presentations in the future, so I want to ask the doctor if there are any solutions for my situation.

Xiong, 10~19 year old female. Ask Date: 2023/03/30

Dr. Huang Zhijia reply Psychiatry

Hello: The more you care, the more anxious you become; the more anxious you are, the worse the situation gets, leading to a vicious cycle of increased concern.
Practicing not to care is easier said than done; it is advisable to engage in other interesting activities to distract yourself.
What constitutes an interesting activity varies from person to person.
Additionally, the diagnosis of mental disorders requires a multifaceted approach and even long-term observation; it cannot be determined by a single complaint.
While social anxiety disorder is a possibility, it is still recommended to consult a psychiatrist.

Reply Date: 2023/03/30

More Info

Overcoming severe anxiety, especially in situations like public speaking, can be a daunting challenge for many individuals. Your experience of feeling intense anxiety weeks in advance of a presentation, coupled with physical symptoms such as shaking hands, a trembling voice, and even dizziness, indicates that you may be dealing with a significant level of social anxiety disorder (SAD). This condition can severely impact your ability to express yourself in front of others, leading to feelings of inadequacy and frustration, especially when you feel that your preparation does not translate into performance.

First and foremost, it’s important to acknowledge that you are not alone in this struggle. Many people experience similar feelings of anxiety when faced with public speaking or social interactions. The physiological responses you describe—such as increased heart rate, sweating, and the sensation of dizziness—are typical manifestations of the body's fight-or-flight response. This response is a natural reaction to perceived threats, but in the case of public speaking, it can become disproportionate and debilitating.

While practice is often touted as a solution for overcoming public speaking anxiety, it is clear from your experience that simply rehearsing your material may not be sufficient. This is where a more comprehensive approach can be beneficial. Here are several strategies that may help you manage and eventually overcome your anxiety:
1. Cognitive Behavioral Therapy (CBT): This is a highly effective treatment for social anxiety disorder. CBT focuses on identifying and challenging negative thought patterns that contribute to anxiety. For instance, if you find yourself thinking, "I will embarrass myself," CBT can help you reframe this thought to something more constructive, like "I have prepared well, and I can handle this." Working with a therapist can provide you with tailored strategies to address your specific fears and anxieties.

2. Exposure Therapy: Gradual exposure to the feared situation can help desensitize you to the anxiety associated with public speaking. Start with smaller, less intimidating speaking opportunities, such as speaking in front of a trusted friend or family member, and gradually work your way up to larger audiences.

3. Mindfulness and Relaxation Techniques: Incorporating mindfulness practices, such as meditation or deep-breathing exercises, can help calm your mind and body before speaking. Techniques like progressive muscle relaxation can also reduce physical tension and anxiety.

4. Medication: In some cases, medication may be appropriate to help manage anxiety symptoms. This could include selective serotonin reuptake inhibitors (SSRIs) or beta-blockers, which can help control physical symptoms of anxiety. Consulting with a psychiatrist can help determine if medication is a suitable option for you.

5. Join a Public Speaking Group: Organizations like Toastmasters provide a supportive environment where you can practice public speaking regularly. This can help build your confidence and reduce anxiety over time.

6. Focus on the Message, Not the Audience: Shift your focus from how you are being perceived to the message you want to convey. This can help alleviate some of the pressure you feel when speaking in front of others.

7. Seek Professional Help: If you haven’t already, consider reaching out to a mental health professional who specializes in anxiety disorders. They can provide you with personalized strategies and support to help you navigate your anxiety.

In conclusion, while practice is an important component of overcoming public speaking anxiety, it is often not enough on its own. A multifaceted approach that includes therapy, relaxation techniques, gradual exposure, and possibly medication can provide a more effective path toward managing your anxiety. Remember, seeking help is a sign of strength, and with the right support, you can learn to manage your anxiety and improve your public speaking skills.

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