Steve Tingley’s promotion came with a new duty he dreaded. When the 52-year-old was appointed director of media services for a Madison, Wis., insurance company, he was expected to make presentations to other divisions and outside groups.
“I’d break out in a sweat, get very nervous, stutter on the stage. I’d lose my concentration, and it all fell apart,” he says.
The first step is to rule out the possibility that your symptoms are being caused by a medical condition that is not psychiatric. Among the conditions that produce symptoms similar to those of anxiety are hyperthyroidism or other endocrine problems, too much or too little calcium, low blood sugar, and certain heart problems. A thorough evaluation by your health care provider will determine if any of these conditions are the cause of your symptoms.
If no other medical culprit can be found and the...
Most of us feel a little twinge at taking the podium, but for some, the anxiety is debilitating. Estimates suggest as many as 35% of Americans quiver at the prospect of public speaking, and as many as 13% have full-blown social anxiety disorder at some point.
Extreme embarrassment seems to be a case of ancient brain systems overreacting to modern life. When you see danger -- a poisonous snake or a room full of people -- the amygdala, an area of the brain that processes emotional reactions, goes into alert. It jolts the body with the stress hormones cortisol and adrenaline, energizing you to flee or stand and fight. This is what causes the sweats and shakes.
If there’s no escape, the prefrontal cortex, the part of the brain that plans and makes decisions, seems to switch off, and you “freeze” as a result. You go on autopilot, which can lead to speaking without making sense or becoming immobilized. Even though running through a PowerPoint isn’t life-threatening, these same reactions kick into gear.
You can learn to train your amygdala not to overreact with a process called extinction. By repeatedly putting yourself in the scary situation minus any negative consequences, the amygdala learns that fear isn’t appropriate. For short-term relief, beta-blocking drugs ease performance anxiety by blocking the effects of adrenaline. And researchers are testing a substance called D-cycloserine to enhance the extinction process for severe cases.
Tingley extinguished his fear by taking a public-speaking workshop with Doug Stevenson, head of Story Theater International, an organization that coaches business people on improving presentation skills. In the weekend seminar, Tingley had to act out personal stories onstage. “The workshop was really scary,” he says. “I was way out of my comfort zone.”
But that marathon weekend seminar helped. Tingley can now give a speech without having to wring out his shirt afterward
Public Speaking Primer: Tips for Calming Your Nerves
Work it out. Speaking coach Doug Stevenson tells his workshop participants to do 15 minutes of aerobic exercise an hour or two before a speech. The extra oxygen makes neurons fire faster, and that boosts your ability to focus.
Love yourself. It may sound corny, but self-affirmation can reduce your stress response. In a UCLA study, people who reflected on their political or spiritual beliefs before an extemporaneous talk had lower cortisol levels afterward.
Get support. Toastmasters, an international organization, lets you practice speaking in small, informal supportive groups.
SOURCES: Steve Tingley, Madison, Wis. Kessler, R. Archives of General Psychiatry, January 1994; vol 51: pp 8-19. Furmark, T. Acta Psychiatrica Scandinavica, February 2002; vol 101: pp 84-93. Stein, M. Archives of General Psychiatry, February 1996: vol 53: pp 169-174. Aggleton, J. The Amygdala. Oxford University Press, 2000. Mobbs, D. Science, Aug. 24, 2007; vol. 317: pp 1079-1083. Medscape Psychiatry & Mental Health: "Social Anxiety: An Expert Interview With Eric Hollander, MD." Walker, D. Journal of Neuroscience, March 2002; vol 22: 2343-2351. Doug Stevenson, speaking coach; founder Story Theater International, Colorado Springs, Colo. Creswell, J. Psychological Science, November 2005; vol 16: pp 846-851.