speech anxiety symptoms

Understanding And Overcoming Public Speaking Anxiety

Most of us might experience what is commonly known as stage fright or speaking anxiety, nervousness and stress experienced around speaking situations in front of audience members. Even for experienced speakers, this can be a normal response to pressurized situations in which we are the focus of attention—such as we might encounter in front of an audience. For some people, though, the fear of public speaking and nervous energy can be much more severe, and can be a sign of an anxiety disorder. 

Speaking anxiety is considered by many to be a common but challenging form of social anxiety disorder that can produce serious symptoms, and can possibly impact an individual’s social life, career, and emotional and physical well-being. 

In this article, we’ll explore what speaking anxiety is, common symptoms of it, and outline several tips for managing it.

Identifying public speaking anxiety: Definition, causes, and symptoms

According to the American Psychological Association,  public speaking anxiety  is the “fear of giving a speech or presentation in public because of the expectation of being negatively evaluated or humiliated by others”. 

Often associated with a lack of self-confidence, the disorder is generally marked by severe worry and nervousness, in addition to several physical symptoms. The fear can be felt by many, whether they are in the middle of a speech or whether they are planning to speak at a future point. They may also generally fear contact with others in informal settings.

Public speaking anxiety can be a common condition, with an with an  estimated prevalence of 15-30%  among the general population.

Public speaking anxiety is considered by many to be a form of social anxiety disorder (SAD). The Diagnostic and Statistical Manual of Mental Disorder (DSM-V) includes a  performance specifier that allows a SAD diagnosis to relate specifically to anxiety surrounding public speaking or performing. For some extreme forms of this mental health condition, a medical professional may prescribe medication that can help overcome severe symptoms—although for most people this won’t be necessary.

The symptoms of performance-type social anxiety can include:

• Worry or fear surrounding public speaking opportunities or performing, even in front of friendly faces
• Avoiding situations in which public speaking or performing may be necessary
• Shaky voice, especially when one has to speak in public
• Stomach pain or gastrointestinal discomfort
• Rapid breathing

There are several strategies for addressing the symptoms of this and feeling more confident with your oratory skills, whether you need to use them at work, in formal social settings or simply in front of friends. 

The following are several strategies you can employ to address the fear of public speaking and manage your fear when it arises.

While the primary concern for those who experience speaking anxiety might typically be the fear of judgment or embarrassment when speaking publicly, there can be other causes contributing to distress. To figure out how to address this, it can help to understand potential contributing factors—as well as how others may be dealing with it on their own. 

First, it can be helpful to determine where the fear came from in the first place. Here are some  common sources of public speaking anxiety :

• Negative past experiences with public speaking
• Lack of preparedness
• Low self-esteem (this possible cause can cause feelings of overwhelm if one has to give a speech) 
• Inexperience with public speaking 
• Unfamiliar subject matter
• Newness of environment
• Fear of rejection (such as from an audience) 

Practice deep breathing

Public speaking anxiety might often be accompanied by feelings of stress, and also often affects physical factors such as increased speed of heart rate, tension, and rapid breathing. If you’re dealing with speaking anxiety and want to calm your nerves before a public speaking event, it can be helpful to practice deep breathing exercises. Deep breathing is considered by many to be a widely utilized technique  that can help bring your nervous system out of fight-or-flight mode, relax your body, and quiet your mind. Many find it to be one of the most convenient ways to manage symptoms, as many can do it anywhere as needed. 

To practice deep breathing prior to speaking, consider using a method called box breathing: breathe in for a four count, hold for a four-count, breathe out for a four count and hold again for a four count. You can repeat this process three to four times, possibly incorporating it with other relaxation techniques. It can also help to be mindful of your breathing as you’re presenting, which can help you steady your voice and calm your nerves.  

Practice visualization

When we experience nervousness, we can sometimes focus on negative thoughts and worst-case scenarios, despite the reality of the situation. You can work to avoid this by practicing positive visualization—such as imagining friendly faces in the crowd or you acing the main content of your speech. Positive thinking can be an effective technique for managing performance anxiety. 

Visualization is generally regarded as a research-backed method of addressing speaking anxiety that involves imagining the way a successful scenario will progress in detail. 

Having a clear idea of how your presentation will go, even in your mind’s eye, can help you gain confidence and make you feel more comfortable with the task at hand.

Understand your subject matter 

The fear of speaking in front of others can be related to potential embarrassment that may occur if we make a mistake. To reduce the risk of this possibility, it can help to develop a solid understanding of the material you’ll be presenting or performing and visualize success. For example, if you’re presenting your department’s sales numbers at work, familiarizing yourself with the important points and going over them multiple times can help you better retain the information and feel more comfortable as you give the presentation. 

Set yourself up for success

Doing small things to prepare for a speech or performance can make a big difference in helping to alleviate public speaking anxiety. If possible, you may want to familiarize yourself with the location in which you’ll be speaking. It can also help to ensure any technology or other media you’ll be setting up is functional. For example, if you’re using visual aids or a PowerPoint deck, you might make sure it is being projected properly, the computer is charged and that you can easily navigate the slides as you present.

You might even conduct run-throughs of the presentation for your speaking experience. You can practice walking the exact route you’ll take to the podium, setting up any necessary materials, and then presenting the information within the time limit. Knowing how you’ll arrive, what the environment looks like and where exactly you’ll be speaking can set you up for success and help you feel more comfortable in the moment.

Practicing your presentation or performance is thought to be a key factor in reducing your fear of public speaking. You can use your  practice time  to recognize areas in which you may need improvement and those in which you excel as a speaker. 

For example, you might realize that you start rushing through your points instead of taking your time so that your audience can take in the information you’re presenting. Allowing yourself the chance to practice can help you get rid of any filler words that may come out during a presentation and make sure all your points are clear to keep the audience’s interest. Additionally, a practice run can help you to know when it is okay to pause for effect, take some deep breaths, or work effective body language such as points of eye contact into your presentation. 

It may also be helpful to practice speaking in smaller social situations, in front of someone you trust, or even a group of several familiar people. Research suggests that practicing in front of an audience of supportive, friendly faces can improve your performance—and that the larger the mock audience is, the better the potential results may be. 

To do this, you can go through the process exactly like you would if they were real audience. Once you’re done, you can ask them for feedback on the strengths and weaknesses of your presentation. They may have insights you hadn’t considered and tips you can implement prior to presenting, as well as make you feel confident and relaxed about your material. 

Self-care leading up to the moment you’re speaking in public can go a long way in helping you reduce nervousness. Regular physical activity is generally considered to be one proven strategy for reducing social anxiety symptoms . Exercise can help to release stress and boost your mood. If you’re giving a big presentation or speech, it may be helpful to go for a walk or do some mild cardio in the morning. 

Additionally, eating a healthy diet and drinking enough water can also help promote a sense of well-being and calm. You may choose to be mindful of your consumption of caffeinated beverages, as caffeine may worsen anxiety. 

How online therapy can help

If you experience anxiety when you need to speak in front of other people and want additional support for your communication apprehension, it can help to talk to a licensed mental health professional. According to the American Psychiatric Association, a therapist can work with you to find effective ways to manage public speaking anxiety and feel more confident performing in front of others.

Is Online Therapy Effective?

Studies suggest that online therapy can help individuals who experience anxiety related to presenting or performing in public. In a study of 127 participants with social anxiety disorder, researchers found that online cognitive behavioral therapy was effective in treating the fear of public speaking , with positive outcomes that were sustained for a year post-treatment. The study also noted the increased convenience that can often be experienced by those who use online therapy platforms. 

Online therapy is regarded by many as a flexible and comfortable way of connecting with a licensed therapist to work through symptoms of social anxiety disorder or related mental disorders. With online therapy through  BetterHelp , you can participate in therapy remotely, which can be helpful if speaking anxiety makes connecting in person less desirable. 

BetterHelp works with thousands of mental health professionals—who have a variety of specialties—so you may be able to work with someone who can address your specific concerns about social anxiety.

Therapist reviews

“I had the pleasure of working with Ann for a few months, and she helped me so much with managing my social anxiety. She was always so positive and encouraging and helped me see all the good things about myself, which helped my self-confidence so much. I've been using all the tools and wisdom she gave me and have been able to manage my anxiety better now than ever before. Thank you Ann for helping me feel better!”

Brian has helped me immensely in the 5 months since I joined BetterHelp. I have noticed a change in my attitude, confidence, and communication skills as a result of our sessions. I feel like he is constantly giving me the tools I need to improve my overall well-being and personal contentment.”

If you are experiencing performance-type social anxiety disorder or feel nervous about public speaking, you may consider trying some of the tips detailed above—such as practicing with someone you trust, incorporating deep breathing techniques and visualizing positive thoughts and outcomes. 

If you’re considering seeking additional support with social anxiety disorder, online therapy can help. With the right support, you can work through anxiety symptoms, further develop your oratory skills and feel more confidence speaking in a variety of forums.  

Studies suggest that online therapy can help individuals who experience nervousness related to presenting or speaking in public. In a study of 127 participants with social anxiety disorder, researchers found that online cognitive behavioral therapy was effective in treating the fear of public speaking , with positive outcomes that were sustained for a year post-treatment. The study also noted the increased convenience that can often be experienced by those who use online therapy platforms.

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How to Manage Public Speaking Anxiety

Arlin Cuncic, MA, is the author of The Anxiety Workbook and founder of the website About Social Anxiety. She has a Master's degree in clinical psychology.

Amy Morin, LCSW, is a psychotherapist and international bestselling author. Her books, including "13 Things Mentally Strong People Don't Do," have been translated into more than 40 languages. Her TEDx talk,  "The Secret of Becoming Mentally Strong," is one of the most viewed talks of all time.

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Speech Anxiety and SAD

How to prepare for a speech.

Public speaking anxiety, also known as glossophobia , is one of the most commonly reported social fears.

While some people may feel nervous about giving a speech or presentation if you have social anxiety disorder (SAD) , public speaking anxiety may take over your life.

Public speaking anxiety may also be called speech anxiety or performance anxiety and is a type of social anxiety disorder (SAD). Social anxiety disorder, also sometimes referred to as social phobia, is one of the most common types of mental health conditions.

Public Speaking Anxiety Symptoms

Symptoms of public speaking anxiety are the same as those that occur for social anxiety disorder, but they only happen in the context of speaking in public.

If you live with public speaking anxiety, you may worry weeks or months in advance of a speech or presentation, and you probably have severe physical symptoms of anxiety during a speech, such as:

• Pounding heart
• Quivering voice
• Shortness of breath
• Upset stomach

Causes of Public Speaking Anxiety

These symptoms are a result of the fight or flight response —a rush of adrenaline that prepares you for danger. When there is no real physical threat, it can feel as though you have lost control of your body. This makes it very hard to do well during public speaking and may cause you to avoid situations in which you may have to speak in public.

How Is Public Speaking Anxiety Is Diagnosed

Public speaking anxiety may be diagnosed as SAD if it significantly interferes with your life. This fear of public speaking anxiety can cause problems such as:

• Changing courses at college to avoid a required oral presentation
• Changing jobs or careers
• Turning down promotions because of public speaking obligations
• Failing to give a speech when it would be appropriate (e.g., best man at a wedding)

If you have intense anxiety symptoms while speaking in public and your ability to live your life the way that you would like is affected by it, you may have SAD.

Public Speaking Anxiety Treatment

Fortunately, effective treatments for public speaking anxiety are avaible. Such treatment may involve medication, therapy, or a combination of the two.

Short-term therapy such as systematic desensitization and cognitive-behavioral therapy (CBT) can be helpful to learn how to manage anxiety symptoms and anxious thoughts that trigger them.

Ask your doctor for a referral to a therapist who can offer this type of therapy; in particular, it will be helpful if the therapist has experience in treating social anxiety and/or public speaking anxiety.

Research has also found that virtual reality (VR) therapy can also be an effective way to treat public speaking anxiety. One analysis found that students treated with VR therapy were able to experience positive benefits in as little as a week with between one and 12 sessions of VR therapy. The research also found that VR sessions were effective while being less invasive than in-person treatment sessions.

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If you live with public speaking anxiety that is causing you significant distress, ask your doctor about medication that can help. Short-term medications known as beta-blockers (e.g., propranolol) can be taken prior to a speech or presentation to block the symptoms of anxiety.

Other medications may also be prescribed for longer-term treatment of SAD, including selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). When used in conjunction with therapy, you may find the medication helps to reduce your phobia of public speaking.

In addition to traditional treatment, there are several strategies that you can use to cope with speech anxiety and become better at public speaking in general . Public speaking is like any activity—better preparation equals better performance. Being better prepared will boost your confidence and make it easier to concentrate on delivering your message.

Even if you have SAD, with proper treatment and time invested in preparation, you can deliver a successful speech or presentation.

Pre-Performance Planning

Taking some steps to plan before you give a speech can help you better control feelings of anxiety. Before you give a speech or public performance:

• Choose a topic that interests you . If you are able, choose a topic that you are excited about. If you are not able to choose the topic, try using an approach to the topic that you find interesting. For example, you could tell a personal story that relates to the topic as a way to introduce your speech. This will ensure that you are engaged in your topic and motivated to research and prepare. When you present, others will feel your enthusiasm and be interested in what you have to say.
• Become familiar with the venue . Ideally, visit the conference room, classroom, auditorium, or banquet hall where you will be presenting before you give your speech. If possible, try practicing at least once in the environment that you will be speaking in. Being familiar with the venue and knowing where needed audio-visual components are ahead of time will mean one less thing to worry about at the time of your speech.
• Ask for accommodations . Accommodations are changes to your work environment that help you to manage your anxiety. This might mean asking for a podium, having a pitcher of ice water handy, bringing in audiovisual equipment, or even choosing to stay seated if appropriate. If you have been diagnosed with an anxiety disorder such as social anxiety disorder (SAD), you may be eligible for these through the Americans with Disabilities Act (ADA).
• Don’t script it . Have you ever sat through a speech where someone read from a prepared script word for word? You probably don’t recall much of what was said. Instead, prepare a list of key points on paper or notecards that you can refer to.
• Develop a routine . Put together a routine for managing anxiety on the day of a speech or presentation. This routine should help to put you in the proper frame of mind and allow you to maintain a relaxed state. An example might be exercising or practicing meditation on the morning of a speech.

Practice and Visualization

Even people who are comfortable speaking in public rehearse their speeches many times to get them right. Practicing your speech 10, 20, or even 30 times will give you confidence in your ability to deliver.

If your talk has a time limit, time yourself during practice runs and adjust your content as needed to fit within the time that you have. Lots of practice will help boost your self-confidence .

• Prepare for difficult questions . Before your presentation, try to anticipate hard questions and critical comments that might arise, and prepare responses ahead of time. Deal with a difficult audience member by paying them a compliment or finding something that you can agree on. Say something like, “Thanks for that important question” or “I really appreciate your comment.” Convey that you are open-minded and relaxed. If you don’t know how to answer the question, say you will look into it.
• Get some perspective . During a practice run, speak in front of a mirror or record yourself on a smartphone. Make note of how you appear and identify any nervous habits to avoid. This step is best done after you have received therapy or medication to manage your anxiety.
• Imagine yourself succeeding . Did you know your brain can’t tell the difference between an imagined activity and a real one? That is why elite athletes use visualization to improve athletic performance. As you practice your speech (remember 10, 20, or even 30 times!), imagine yourself wowing the audience with your amazing oratorical skills. Over time, what you imagine will be translated into what you are capable of.
• Learn to accept some anxiety . Even professional performers experience a bit of nervous excitement before a performance—in fact, most believe that a little anxiety actually makes you a better speaker. Learn to accept that you will always be a little anxious about giving a speech, but that it is normal and common to feel this way.

Setting Goals

Instead of trying to just scrape by, make it a personal goal to become an excellent public speaker. With proper treatment and lots of practice, you can become good at speaking in public. You might even end up enjoying it!

Put things into perspective. If you find that public speaking isn’t one of your strengths, remember that it is only one aspect of your life. We all have strengths in different areas. Instead, make it a goal simply to be more comfortable in front of an audience, so that public speaking anxiety doesn’t prevent you from achieving other goals in life.

A Word From Verywell

In the end, preparing well for a speech or presentation gives you confidence that you have done everything possible to succeed. Give yourself the tools and the ability to succeed, and be sure to include strategies for managing anxiety. These public-speaking tips should be used to complement traditional treatment methods for SAD, such as therapy and medication.

Crome E, Baillie A. Mild to severe social fears: Ranking types of feared social situations using item response theory . J Anxiety Disord . 2014;28(5):471-479. doi:10.1016/j.janxdis.2014.05.002

Pull CB. Current status of knowledge on public-speaking anxiety . Curr Opin Psychiatry. 2012;25(1):32-8. doi:10.1097/YCO.0b013e32834e06dc

Goldstein DS. Adrenal responses to stress . Cell Mol Neurobiol. 2010;30(8):1433-40. doi:10.1007/s10571-010-9606-9

Anderson PL, Zimand E, Hodges LF, Rothbaum BO. Cognitive behavioral therapy for public-speaking anxiety using virtual reality for exposure . Depress Anxiety. 2005;22(3):156-8. doi:10.1002/da.20090

Hinojo-Lucena FJ, Aznar-Díaz I, Cáceres-Reche MP, Trujillo-Torres JM, Romero-Rodríguez JM. Virtual reality treatment for public speaking anxiety in students. advancements and results in personalized medicine .  J Pers Med . 2020;10(1):14. doi:10.3390/jpm10010014

Steenen SA, van Wijk AJ, van der Heijden GJ, van Westrhenen R, de Lange J, de Jongh A. Propranolol for the treatment of anxiety disorders: Systematic review and meta-analysis . J Psychopharmacol (Oxford). 2016;30(2):128-39. doi:10.1177/0269881115612236

By Arlin Cuncic, MA Arlin Cuncic, MA, is the author of The Anxiety Workbook and founder of the website About Social Anxiety. She has a Master's degree in clinical psychology.

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Glossophobia (Fear of Public Speaking)

Causes and How to Overcome Your Fear

Glossophobia, or the fear of public speaking, is the most common phobia among people. The good news is that there are ways to cope and learn to overcome your fear, such as using strategies to calm your nerves, practicing the presentation frequently, and engaging your audience with questions.

Public speaking causes feelings of anxiety in 15% to 30% of the general population, and it can sometimes hinder a person's day-to-day life. This is especially true regarding school- or work-related situations involving speaking in front of others.

This article discusses the symptoms, causes, treatment, and healthy ways to cope with glossophobia.

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What Is Glossophobia?

"Glossophobia" is the official term used to define a fear of public speaking. It may sometimes also be referred to as public speaking anxiety.

Phobias are categorized into one of three categories:

• Specific phobia : A fear related to a specific object, like spiders or confined spaces, or a situation, such as flying
• Social phobia : A fear that involves a significant and persistent feeling of social anxiety or performance-based anxiety
• Agoraphobia : A fear of being in situations where escape might be difficult or that help wouldn't be available if things go wrong. This term is most often used to describe a fear of crowded spaces.

Glossophobia is a social phobia that causes more intense feelings than are normal to experience when it comes to public speaking. Instead of just butterflies in their stomach, those with glossophobia can feel extreme distress in situations that involve speaking in public, interacting with new people, or talking in a group.

Symptoms of Glossophobia

People with glossophobia may experience a variety of symptoms depending on the severity of their condition. They may only experience a fear surrounding performance and public speaking, but they may also have other social anxieties.

Symptoms of glossophobia typically include:

• A significant fear or dread of public speaking
• Avoidance of situations that require speaking publicly, either formally in front of an audience or informally via small talk

Those with glossophobia may have other symptoms of social phobia, as well. These may occur before, during, or after a social situation.

Symptoms may include:

• Avoidance of group conversations
• Avoidance of parties
• Avoidance of eating with others
• Worrying about activities like speaking on the phone or in work meetings
• Worrying about doing something embarrassing
• Worrying about blushing or sweating
• Difficulty doing tasks with others watching
• Avoiding eye contact
• Having low self-esteem
• Worrying about being criticized or judged

Those with social phobia are more likely to experience anxiety and depression than the general public.

As with many phobias, glossophobia may also cause a variety of physical symptoms. Panic attacks are also possible and may lead to increased heart rate, chest pain or tightness, and trembling. Other symptoms include:

• Hot flushes
• Feelings of choking
• Feeling short of breath
• Feeling light-headed or faint
• Feelings of pins and needles
• An urgency to go the bathroom
• Ringing sound in the ears
• Upset stomach
• Feeling disorientated

Causes of Glossophobia

A fear of public speaking often begins in adolescence. Social phobias like glossophobia can be caused by a range of factors.

Biological Factors

Glossophobia may be due in part to genetics. Genetics can determine how the brain regulates feelings of anxiety, stress, nervousness, and shyness.

Some people may be born naturally shy, and find social situations difficult to navigate. Most people who have a social phobia have had a shy temperament their whole life.

Learned Behavior

A fear of public speaking can develop after learning the fear from a role model. A child with shy parents who avoid social interactions or speaking in public may be influenced to have the same fear.

A child who witnesses such avoidance may grow up to think speaking in public or socializing with others is upsetting and to be avoided.

Likewise, if a parent overprotects a child who is shy, the child won't have opportunities to become used to situations that involve new people or speaking in public. This can result in a social phobia like glossophobia later in life.

Past Experiences

A life event or past experience that is stressful or upsetting can cause people to associate negative emotions with situations that involve public speaking or interacting with others.

If someone has been criticized or feels humiliated, they may develop a social phobia. If a person is pressured into interacting in a way they are not comfortable with, they may also develop a social phobia.

Those who are bullied are more likely to hide away from others and be afraid of opening themselves up to more criticism by speaking in public.

Since the fear of public speaking is a social phobia, it is typically diagnosed as a nongeneralized type of social anxiety disorder. One study indicated that the fear of public speaking is a common feature of social anxiety disorder, but it may also be present without other signs of social anxiety.

For a person to be diagnosed with social anxiety disorder, a mental health professional will perform a psychological evaluation using criteria in the fifth edition of the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders" ( DSM-5) .

You may also undergo a physical exam or lab tests to look for any irregularities in physical health, which will often check a person's hormone, vitamin, and blood levels.

Overcoming a Fear of Public Speaking

Dealing with a fear of public speaking isn't easy. Many people feel nervous if they have to deliver a speech in front of an audience, but there are ways to cope.

The American Psychological Association suggests the following tips to cope with nerves when speaking in public:

• Begin your speech or presentation with a discussion question : This gets the audience involved and talking and takes the pressure off you for a while.
• Recognize where your anxious feelings are coming from : Nervousness can be due to excitement. Remember that even if you feel nervous, you can still speak in public without failing.
• If giving a presentation, remember it's about the topic : The people you are speaking to are focusing less on you personally and more on what you're saying.
• Try to make eye contact : You may find that making eye contact with the individuals in the group you are addressing allows you to interact with them, and they may nod or smile as you speak, which can help boost your confidence.
• If giving a formal presentation, rehearse a lot beforehand : It may help to rehearse in the actual space you will be giving a speech. Practicing in front of a group beforehand may help calm your nerves.
• Experiment with different strategies to calm your nerves : Try deep breathing exercises, visualization techniques, or smiling during your presentation (it releases endorphins, which lowers stress). Find out what works for you and then prepare in the same way every time you need to speak in public.

Treating social phobias like glossophobia can be complex, and it may require a number of approaches. Psychological interventions like therapy are known to be effective in the treatment of fear of public speaking.

Treating social phobias involves talk therapies, such as:

• Cognitive behavioral therapy : Also referred to as CBT, this type of psychotherapy (talk therapy) is used to change unhealthy behaviors, particularly those that are related to anxiety, trauma, and depression.
• Exposure therapy : This type of therapy can help a person overcome their avoidance of a certain object or situation by gradually exposing them to their phobia.

Typically, medication is not used in the treatment of phobias. However, a healthcare provider may prescribe medication for people experiencing significant symptoms of anxiety.

These may include:

• Beta-blockers
• Tranquilizers
• Antidepressants

The fear of public speaking is a social phobia and may be caused by several factors, including genetics, learned behavior, and past experiences. It is the most commonly held fear, and people with glossophobia may experience anxiety surrounding either interaction with others, performing in public, or a combination of both. Using coping techniques and treatment involving psychotherapy can help people overcome the fear of public speaking.

Ebrahimi OV, Pallesen S, Kenter RMF, Nordgreen T. Psychological Interventions for the Fear of Public Speaking: A Meta-Analysis.   Front Psychol . 2019;10:488. Published 2019 Mar 15.

Tejwani V, Ha D, Isada C. Observations: Public Speaking Anxiety in Graduate Medical Education--A Matter of Interpersonal and Communication Skills? J Grad Med Educ. 2016 Feb;8(1):111. doi: 10.4300/JGME-D-15-00500.1

American Psychological Association.  Specific phobia.

American Psychological Association. Social Phobia.

National Health Service. Overview - Agoraphobia .

Johns Hopkins Medicine. Social Phobia .

National Health Service. Social anxiety (social phobia) .

National Health Service.  Symptoms - phobias . 

Heeren A, Ceschi G, Valentiner DP, Dethier V, Philippot P.  Assessing public speaking fear with the short form of the Personal Report of Confidence as a Speaker scale: confirmatory factor analyses among a French-speaking community sample.   Neuropsychiatr Dis Treat . 2013;9:609-18. doi:10.2147%2FNDT.S43097

American Psychological Association. How to keep fear of public speaking at bay .

National Health Service.  Overview - Phobias

By Elizabeth Pratt Pratt is a freelance medical and mental health journalist with a master's degree in health communication.

How to Reduce the Anxiety of Public Speaking

Most people hate it. here's one way to hate it less..

Posted November 22, 2021 | Reviewed by Gary Drevitch

• What Is Anxiety?
• Find a therapist to overcome anxiety

Anxiety and stress go with public speaking for all but a lucky few. Now a recent study underscores the importance of recognizing and accepting those emotions rather than trying to deny them. According to the study, if you journal about your anxieties and stress, and accept them, letting them run their course, the result is improved mental health compared to the rest of us who judge ourselves. The negative moods don’t last as long and are not as powerful.

I like this strategy. Denying that I was anxious was certainly my standard operating procedure when I was beginning in the business, first as an actor and then as a speaker on speaking, communications, storytelling, and body language . Denial didn’t help me, of course, just as it has helped no one else, and it wasn’t long before my anxiety was reaching epic proportions and the beginnings of speeches were going by in a blur of adrenaline. I had to do something, and so began my lifelong pursuit of ways to reduce the pain of public speaking for myself and others.

In these early days, it never occurred to me to look straight into the heart of darkness: the anxious core of public speaking, the self-consciousness that intrudes when we feel exposed standing before a group of people. Most of my methods involved tricking or distracting my brain long enough to give the speech and get to the bar. For example, getting some moderate exercise before a speech allows some of the nervous energy to dissipate so that you are calmer than you otherwise would be. Meditating can work, too, for those who have some experience with that form of mental discipline. My favorite distraction from those days turned out to be having the airline lose my luggage – with my speaking suit in it – so that I had to go shopping at 9:00 before the speech at 10:00. Good thing I could walk right into a 42 Long. I was so distracted by the suit crisis that I never got nervous for the speech.

That’s an expensive distraction, however, and I don’t recommend it as a long-term solution. Also, I started carrying my suit in my carry-on luggage, so the tactic no longer worked in any case.

My father passed away the day before a speech years ago, and I was too distraught to be nervous. But again, I don’t recommend that as a permanent solution, since our supply of fathers is generally limited to one or two.

Eventually, I focused on three truly helpful strategies.

1. A simple physical exercise that helps control anxiety: deep, slow breathing. The key is to breathe out on a longer count than the in-breath.

2. Positive self-talk . Find your mantra and repeat it ad infinitum. Whenever you have a dull moment, whenever you are nervous or anxious about an upcoming speech, and whenever you have trouble sleeping . I’ve used this technique for years, and I’m pleased to say I’ve just about wiped my mental slate clean of debilitating negative patterns of thinking. I’ve also witnessed many clients and friends benefitting from this technique. If it sounds New-Agey to you, get over yourself and get to work. In the long run, you’ll thank me.

3. Finally, the most powerful technique for getting over stage fright is to realize that a speech is not about you, but about the audience. Put yourself in service to the audience in front of you, get out of your own way, and think about them. You will be liberated and even find the joy in public speaking, and that is indeed a good place for both audience and speaking to be.

Now we can add journaling to our arsenal of mental weapons designed to keep anxiety and stress at bay. May we all write our way to the calm after the storm.

Nick Morgan, Ph.D. , is president of Public Words Inc., a communications consulting company, and the author of books including Can You Hear Me?: How to Connect with People in a Virtual World.

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Overcome your public speaking anxiety with these 10 tips

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What’s public speaking anxiety?

10 symptoms of public speaking anxiety, 10 common public speaking stressors, how to overcome public speaking anxiety: 10 tips, diagnosing and treating public speaking anxiety, speak with confidence.

Your opinion and expertise matter, so it can be frustrating when public speaking nerves leave you speechless. Maybe your heart races and you trip over your words, or you spend most of your presentation hoping no one asks questions. Fear not. Public speaking anxiety is a common experience that impacts even the most confident people — and it’s manageable.

The intense nerves associated with public speaking aren’t reserved for being on stage in front of a large audience. Discomfort might occur during small team presentations , a sales pitch with a client, or group brainstorming sessions . The stress may be so potent that you avoid important opportunities to showcase your expertise and advance your career. 

But identifying triggers and understanding your physiological response will help you overcome your anxiety. With practice and support, you’ll fearlessly share your important thoughts and opinions with others. 

Public speaking anxiety, or glossophobia, is the most common subset of social anxiety, affecting about 3–5% of the general population and 80% of people with social phobias . Those with glossophobia feel anxiety symptoms , like a racing heartbeat and stressful thoughts, when sharing ideas or asking questions in front of others. And those who experience public speaking anxiety often feel more general performance anxiety during activities like striking up a conversation with a stranger or eating in public.

But why does public speaking cause anxiety? According to an article by the Harvard Business Review, our ancestors perceived being watched as a predatory threat , so our brains evolved to have a fight-or-flight response . This is the body’s physiological response to danger, activating the nervous system to encourage us to return to safety.

While public speaking doesn’t present real physical dangers, social anxiety can trigger your stress response . Worrying about people judging you, making a mistake , or messing up an important professional opportunity are visceral fears that send messages to the brain to seek protection. 

In some cases, an acute fear can be motivating . Worrying about underperforming during a client presentation or making the right first impression at a face-to-face networking event could compel you to practice and perfect your speech. 

But a chronic and debilitating fear of public speaking can disrupt your career. You may become avoidant and miss important opportunities to show off your expertise, establish your personal brand , and achieve professional development goals . 

Publi c speaking anxiety is so all-encompassing you may not be conscientious of all the ways this type of stress affects the body. Acute anxiety symptoms are widespread and vary between people , but here are 10 common signs to be aware of:

Increased heart rate

Lack of concentration 

Avoidant behaviors like social isolation

Shortness of breath

Panic attacks

Intrusive thoughts

Shaky hands and legs

While you might associate public speaking anxiety with delivering a Ted Talk or corporate event presentation, plenty of everyday situations can trigger your fear of performing. Here are 10 common stressors of public speaking anxiety: 

Meeting new colleagues or coworkers

Job interviews

Sharing ideas in a brainstorming session

Giving a small presentation

Training new coworkers

Debriefing your team or managers on an ongoing project

Offering your opinion during a virtual meeting

Delivering an elevator pitch

Participating in a board meeting

Offering someone constructive criticism

Like any other challenge, thoughtful practice, care, and patience will help you approach public speaking confidently. Here are 10 tips for public speaking anxiety sufferers looking to improve.

1. Don’t expect perfection

Perfection is an unrealistic expectation that distracts from your good work and amplifies your anxiety. Instead of aiming for perfection , celebrate your improvements and seek out continuous learning opportunities . Every chance to speak in front of others is a chance to learn and grow — even if it means a few awkward pauses or stumbling over your words occasionally. 

2. Be yourself

While keeping your body language and humor professional, be your most authentic self and stick with what feels comfortable. Imitating others’ speaking styles could make you overthink each gesture or appear unnatural and insincere. And the more you step into your authenticity at work , the more comfortable you’ll feel being yourself in every area of your life. 

3. Remember your purpose

Whether delivering a presentation or making a sale, you’re speaking in public for a reason. Think about why you’re there — be it to share your experience or teach others — and focus on this core purpose. Doing so might get you out of your head and into the situation at hand so you can concentrate less on your anxiety symptoms and more on accomplishing your task.

4. Prepare and practice

The best way to feel comfortable speaking in front of others is to practice. Speech anxiety often focuses on the unknown, like audience questions or complex presentation materials. But subject-matter-familiarity quiets some of these questions and offers answers. 

You can jot down and prepare for questions you expect or memorize your materials so they feel less overwhelming. And p racticing your delivery and body language can take away the shock of talking to a group because you have less to worry about. 

5. Let your coworkers know

Consider informing coworkers and managers about your stage fright so they know to support you. They might make adjustments like offering you additional notice regarding presentations they’d like you to make or taking your questions last in a meeting so you have more time to calm your nerves. And you can also ask team members for feedback and encouragement on your public speaking skills . 

6. Visualize success

Use visualization , positive self-talk , and other manifestation methods to picture yourself confidently speaking in public. These positive projections can become a self-fulfilling prophecy as you do what’s necessary to make your vision a reality. You could also try anxiety journaling to shake negative automatic thoughts and track your positive thinking progress. 

7. Make eye contact

If you fear public speaking, you may instinctively avoid eye contact because it feels intimate or intimidating. But chances are everyone wants to encourage you, and you can feed off the room’s energy by looking your audience in the eye. If you see heads nodding and people paying attention, you may gain the confidence boost you need to continue nerves-free. 

8. Pose for success

Standing i n power poses (body postures expressing strength and assertiveness ) signals to audience members that you’re confident and comfortable. And embracing these postures can make you feel that way, too. For in-person speaking, try keeping your feet hip-distance and your shoulders back. And if you’re on a virtual call and have the option to stand, you can still carry yourself confidently to boost your own self-esteem. If you must sit, you can still hold your head high and posture straight. 

9. Create a plan

Feel in charge of your public speaking journey by creating an improvement plan. Start by outlining small objectives, like starting two conversations with colleagues each week or contributing an idea at a team meeting. Then, define larger goals further down your improvement timeline, like leading a brainstorming session or training a new coworker. You could also work with a career coach t o build the right plan for you and track your success.

10. Take a class

Structured learning might be the best way to reduce your public speaking anxiety and gain practice. Try asking your employer whether they subsidize professional development opportunities like a public speaking course or mentorship programs . Or invest in yourself by signing up for an after-hours class with a friend so you can hold each other accountable . 

According to the Diagnostic and Statistical Manual of Mental Disorders, public speaking anxiety is classified as a social anxiety disorder that causes symptoms like intense distress and panic attacks. While it’s common to feel nervous in social situations, a mental health professional might diagnose someone with public speaking anxiety if that person experiences symptoms that affect their day-to-day health, like missing out on job opportunities or having to leave a meeting due to nerves.

While social anxiety may feel overwhelming, the good news is that it’s treatable. The first step is finding a diagnosis. Treatment generally begins by identifying the root cause and any related medical conditions to ensure a larger issue isn’t causing your symptoms . Then, you’ll work with your mental health professional to determine the best treatment plan. Common remedies include psychotherapy, medication, or both. In some circumstances, you may also seek the help of a support group or work with a life coach to build an action plan . 

What you have to say matters, and you deserve to feel confident and comfortable when expressing yourself. While public speaking anxiety might quiet your voice, it doesn’t have to define your professional future. 

Now that you have some public speaking tips for anxiety, it’s time to start working toward easing your symptoms. Depending on the severity of your nerves, consider consulting with a mental health professional, career coach, or support group. From there, you can build an appropriate plan and begin speaking — one small speech at a time — with newfound confidence.

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Elizabeth Perry is a Coach Community Manager at BetterUp. She uses strategic engagement strategies to cultivate a learning community across a global network of Coaches through in-person and virtual experiences, technology-enabled platforms, and strategic coaching industry partnerships. With over 3 years of coaching experience and a certification in transformative leadership and life coaching from Sofia University, Elizabeth leverages transpersonal psychology expertise to help coaches and clients gain awareness of their behavioral and thought patterns, discover their purpose and passions, and elevate their potential. She is a lifelong student of psychology, personal growth, and human potential as well as an ICF-certified ACC transpersonal life and leadership Coach.

Speaking up for yourself is important — 11 steps to get it right

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Chapter 1: The Speech Communication Process

Speech Anxiety

What is it.

Speech anxiety is best defined as the nervousness that a speaker feels before and/or during a presentation.  Sweating palms, a shaky voice, a dry throat, difficulty breathing, and even memory loss are all common symptoms of anxiety. The symptoms you, as an individual, will feel are hard to predict. But it helps if you remember that nearly every speaker has experienced some degree of speech anxiety. Even professional speakers occasionally feel a small amount of apprehension at times. Anxiety levels vary. Some speakers will report little to no anxiety while speaking; others will confess that they are petrified at the thought of speaking in public. Jerry Seinfeld used to joke that “at a funeral, the average person would rather be in the casket than giving the eulogy. ” Now that is fear!

Why Anxiety and Public Speaking?

Scholars at the University of Wisconsin-Stout (“Public Speaking Anxiety,” 2015) explain that anxiety in public speaking can result from one of several misperceptions:

•  “all or nothing” thinking—a mindset that if your speech falls short of “perfection” (an unrealistic standard), then you are a failure as a public speaker;

•     overgeneralization—believing that a single event (such as failing at a task) is a universal or “always” event; and

•     fortune telling—the tendency to anticipate that things will turn out badly, no matter how much practice or rehearsal is done.

Likewise, many new college students operate under the false belief that intelligence and skill are “fixed.” In their minds, a person is either smart or skilled in something, or they are not. Some students apply this false belief to math and science subjects, saying things like “I’m just no good at math and I never will be,” or even worse, “I guess I am just not smart enough to be in college.” As you can tell, these beliefs can sabotage someone’s college career. Also unfortunately, the same kind of false beliefs are applied to public speaking, and people conclude that because public speaking is hard, they are just not “naturally good” at it and have no inborn skill. They give up on improving and avoid public speaking at all costs.

There is more to Dr. Dweck’s research. We would recommend her book Mindset . Many students enter a public speaking class thinking “I’m just no good at this and never will be,” just like some students feel about college algebra or science. Dr. Dweck and other learning psychologists show that learning a new skill might be hard work, but the difficulty is not a sign that learning is impossible. Modern research by Stanford University psychologist Carol Dweck (2007) and others shows that intelligence and related skills are “malleable,” meaning that they are open to change and growth. Understanding and accepting that your intelligence and skill in different areas is not fixed or “stuck,” but open to growth, will have a significant influence on your success in life. It will also help you see that just because learning a subject or task is hard does not mean you are not or cannot be good at it. Obstacles and barriers that make learning hard are opportunities for growth, not “getting off places.”

Along with the wrong way of thinking about one’s learning and growth, two other fears contribute to anxiety in public speaking. The first is fear of failure. This fear can result from several sources: real or perceived bad experiences involving public speaking in the past, lack of preparation, lack of knowledge about public speaking, not knowing the context, and uncertainty about one’s task as a public speaker (such as being thrown into a situation at the last minute).

It is not the goal of this book to belittle that fear. It is real and justified to some extent because you might lack understanding of the public speaking task or lack good speaking experiences upon which to build. One of the goals and fringe benefits of this course is that you are not just going to learn about public speaking, but you are going to do it—at least four or five times—with a real audience. You will overcome some of your fears and feel that you have accomplished something of personal benefit.

The second fear is fear of rejection of one’s self or one’s ideas. This one is more serious in some respects. You may feel rejection because of fear of failure, or you may feel that the audience will reject your ideas, or worse, you as a person. Knowing how to approach the public speaking task and explain your ideas can help. However, you should ask yourself deep and probing questions as to why you believe that your audience will reject you because this fear is rooted in a belief. You should ask yourself what possibly false belief is causing your anxiety.

One of the core attitudes an effective and ethical public speaker must have is respect for and empathy with the audience. Your audience in this class is your peers who want to learn and want to get through the class success- fully (just like you do). Your audience also includes your instructor who wants to see you succeed in the course as well. Believe me, public speaking teachers get a lot of pleasure from hearing successful student speeches!

Your audience wants you to succeed if for no other reason than a good speech is much easier and pleasant to listen to than a poor one. Again, gaining practice in this class with a real, live audience can help you work through the roots of your fear of rejection.

Beyond dealing with the root fears that may cause you to have a “fright or flight” response when it comes to public speaking, there are some practical answers to dealing with fears about public speaking. Of course, fear responses can be reduced if you know how public speaking works, as you will see throughout this textbook. But there are some other strategies, and most of them have to do with preparation.

How Do I Overcome My Fear?

There are many reasons why a speaker might feel anxious, but there are several steps you can take to reduce your anxiety. First, remember that everyone has experienced some level of anxiety during a presentation. Knowing that you are not the only one feeling nervous should help a bit. Keep in mind that most listeners won’t even be aware of your anxiety. They often don’t see what you thought was glaringly obvious; they’re busy preparing themselves for their turn up front. It is perfectly normal to feel nervous when you find yourself in an unfamiliar setting or situation. You probably felt nervous the first time you had to shoot a foul shot in front of a large crowd of basketball fans. Or you might recall the anxiety you felt during your first piano recital as a child, or that first job interview. Think of this nervous feeling as your body readying itself for an important activity.

Also, you might feel anxious if you have not adequately prepared for the presentation. Preparing and practicing your presentation are two of the surest ways to minimize nervousness. No one wants to feel embarrassed in public, but knowing that you have done everything possible to ensure success should help you feel more confident. Do your research and organize your ideas logically. Then practice several times. Try to find someone to listen as you practice -your family, your friends, your roommate -and listen to their feedback. Even if they don’t know your topic, they know you. They may even be able to point out some areas in your presentation that still need improvement. The more you prepare and practice, the more successful your presentation will likely be.

Finally, be optimistic and focus on the positives. Use positive self-talk as you prepare. Don’t tell yourself that you’ll perform horribly or that you can’t do it. Have you ever heard of a self-fulfilling prophecy? What you expect to happen may be exactly what does happen. So tell yourself that you’re well prepared and that you will improve every time you speak. Remind yourself that you are calm and in control of the situation and be sure to take a deep breath whenever necessary. Imagine yourself speaking clearly and effortlessly. Find a couple of friendly faces in the crowd and focus on them. If they’re sending positive energy your way, grab it!

Addressing Public Speaking Anxiety

Mental Preparation

If your neighbor’s house were on fire, getting to the phone to call the fire department would be your main concern. You would want to get the ad- dress right and express the urgency. That is admittedly an extreme exam ple, but the point is about focus. To mentally prepare, you want to put your focus where it belongs, on the audience and the message. Mindfulness and full attention to the task are vital to successful public speaking. If you are concerned about a big exam or something personal going on in your life, your mind will be divided, and that division will add to your stress.

The main questions to ask yourself are “Why am I so anxiety-ridden about giving a presentation?” and “What is the worst that can happen?” For example, you probably won’t know most of your classmates at the beginning of the course, adding to your anxiety. By midterm, you should be developing relationships with them and be able to find friendly faces in the audience. However, very often we make situations far worse in our minds than they actually are, and we can lose perspective. One of the authors tells her students, “Some of you have been through childbirth and even through military service . That is much worse than public speaking!” Your instructor will probably try to help you get to know your classmates and minimize the “unknowns” that can cause you worry.

Physical preparation

The first step in physical preparation is adequate sleep and rest. You might be thinking such a thing is impossible in college, where sleep deprivation and late nights come with the territory. However, research shows the extreme effects a lifestyle of limited sleep can have, far beyond yawning or dozing off in class (Mitru, Millrood, & Mateika, 2002; Walker, 2017). As far as public speaking is concerned, your energy level and ability to be alert and aware during the speech will be affected by lack of sleep.

Secondly, you would be better off to eat something that is protein-based rather than processed sugar-based before speaking. In other words, cheese or peanut butter on whole grain toast, Greek yogurt, or eggs for breakfast rather than a donut and soft drink. Some traditionalists also discourage the drinking of milk because it is believed to stimulate mucus production, but this has not been scientifically proven (Lai & Kardos, 2013).

A third suggestion is to wear clothes that you know you look good in and are comfortable but also meet the context’s requirements (that is, your instructor may have a dress code for speech days). Especially, wear comfort- able shoes that give you a firm base for your posture. Flip- flops and really high heels may not fit these categories.

A final suggestion for physical preparation is to utilize some stretching or relaxation techniques that will loosen your limbs or throat. Essentially, your emotions want you to run away, but the social situation says you must stay, so all that energy for running must go somewhere. The energy might go to your legs, hands, stomach, sweat glands, or skin, with undesirable physical consequences. Tightening and stretching your hands, arms, legs, and throat (through intentional, wide yawns) for a few seconds before speaking can help release some of the tension. Your instructor may be able to help you with these exercises, or you can find some on the Internet.

Contextual preparation

The more you can know about the venue where you will be speaking, the better. For this class, of course, it will be your classroom, but for other situations where you might experience “communication apprehension,” you should check out the space beforehand or get as much information as possible. For example, if you were required to give a short talk for a job interview, you would want to know what the room will be like, if there is equipment for projection, how large the audience will be, and the seating arrangements. If possible, you will want to practice your presentation in a room that is similar to the actual space where you will deliver it.

The best advice for contextual preparation is to be on time, even early. If you have to rush in at the last minute, as so many students do, you will not be mindful, focused, or calm for the speech. Even more, if you are early, you can make sure equipment is working, and can converse with the audience as they enter. Professional speakers often do this to relax themselves, build credibility, and gain knowledge to adapt their presentations to the audience. Even if you don’t want to “schmooze” beforehand, being on time will help you create a good first impression and thus enhance your credibility before the actual speech.

Speech preparation

Procrastination, like lack of sleep, seems to just be part of the college life. Sometimes we feel that we just don’t get the best ideas until the last minute. Writing that essay for literature class at 3:00 a.m. just may work for you. However, when it comes to public speaking, there are some definite reasons you would not want to do that. First, of course, if you are finishing up your outline at 3:00 a.m. and have a 9:00 speech, you are going to be tired and unable to focus. Second, your instructor may require you to turn in your outline several days ahead of the speech date. However, the main reason is that public speaking requires active, oral, repeated practice before the actual delivery.

You do not want the first time that you say the words to be when you are in front of your audience. Practicing is the only way that you will feel confident, fluent, and in control of the words you speak. Practicing (and timing yourself) repeatedly is also the only way that you will be assured that your speech meets the assignment’s time limits, and speaking within the expected time limits is a fundamental rule of public speaking. You may think your speech is five minutes long but it may end up being ten minutes the first time you practice it—or only two minutes!

Your practicing should be out loud, standing up, with shoes on, with someone to listen, if possible (other than your dog or cat), and with your visual aids. If you can record yourself and watch it, that is even better. If you do record yourself, make sure you record yourself from the feet up- or at least the hips up—so you can see your body language. The need for oral practice will be emphasized over and over in this book and probably by your instructor. As you progress as a speaker, you will always need to practice but perhaps not to the extent you do as a novice speaker.

As hard as it is to believe, YOU NEVER LOOK AS NERVOUS AS YOU FEEL.

You may feel that your anxiety is at level seventeen on a scale of one to ten, but the audience does not perceive it the same way. They may perceive it at a three or four or even less. That’s not to say they won’t see any signs of your anxiety and that you don’t want to learn to control it, only that what you are feeling inside is not as visible as you might think. This principle relates back to focus. If you know you don’t look as nervous as you feel, you can focus and be mindful of the message and audience rather than your own emotions.

Also, you will probably find that your anxiety decreases throughout the class (Finn, Sawyer, & Schrodt, 2009). In her Ted Talk video , Harvard Business School social psychologist Amy Cuddy discusses nonverbal communication and suggests that instead of “faking it until you make it,” that you can, and should, “fake it until you become it.” She shares research that shows how our behavior affects our mindsets, not just the other way around. Therefore, the act of giving the speech and “getting through it” will help you gain confidence. Interestingly, Dr. Cuddy directs listeners to strike a “power pose” of strong posture, feet apart, and hands on hips or stretched over head to enhance confidence.

Final Note: If you are an audience member, you can help the speaker with his/her anxiety, at least a little bit. Mainly, be an engaged listener from beginning to end. You can imagine that a speaker is going to be more nervous if the audience looks bored from the start. A speaker with less anxiety is going to do a better job and be more interesting. Of course, do not walk into class during your classmates’ speeches, or get up and leave. In addition to being rude, it pulls their minds away from their message and distracts the audience. Your instructor will probably have a policy on this behavior, too, as well as a dress code and other expectations on speech days. There are good reasons for these policies, so respect them.

Fundamentals of Public Speaking Copyright © by Lumen Learning is licensed under a Creative Commons Attribution 4.0 International License , except where otherwise noted.

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Difficulty Talking, Speaking, Moving Mouth and Tongue Anxiety Symptoms

Difficulty speaking and talking, or moving the mouth, tongue, or lips are common symptoms of anxiety disorder , including generalized anxiety disorder , social anxiety disorder , panic disorder , and others.

This article explains the relationship between anxiety and the difficulty talking symptom.

Difficulty speaking, talking, moving mouth, tongue, or lips anxiety symptoms descriptions:

• Having difficulty or unusual awkwardness speaking; pronouncing words, syllables, or vowels.
• Having difficulty moving your mouth, tongue, or lips.
• Suddenly become self-conscious of your problems talking, speaking, moving your mouth, tongue, or lips.
• Uncharacteristically slurring your speech.
• You are uncharacteristically speaking much slower or faster than normal.
• You are uncharacteristically jumbling up words or fumbling over your words when speaking.
• You find that your mouth, tongue, or lips aren’t moving the way they normally would.
• Your mouth, tongue, lips, or facial muscles aren’t responding the way they normally do.
• It can feel as if your face muscles are unusually stiff, which is making talking difficult and forced.
• It can feel as if your face has been anesthetized somewhat, making speaking or moving your mouth, tongue, or lips difficult.

This symptom is often described as “slurred speech.”

This symptom can persistently affect just the mouth, lips, or tongue only, can affect more than one at the same time, can shift from one to another, and can involve all of them over and over again.

Having difficulty speaking can come and go rarely, occur frequently, or persist indefinitely. For example, you might have difficulty speaking once in a while and not that often, have difficulty speaking or moving your mouth, tongue or lips off and on, or have difficulty all the time.

Difficulty speaking can precede, accompany, or follow an escalation of other anxiety sensations and symptoms, or occur by itself. It can also precede, accompany, or follow an episode of nervousness, anxiety, fear, and elevated stress, or occur “out of the blue” and for no apparent reason.

This symptom can range in intensity from slight, to moderate, to severe. It can also come in waves where these mouth and speaking symptoms are strong one moment and ease off the next.

This symptom can change from day to day and from moment to moment.

All of the above combinations and variations are common.

Difficulty speaking or moving your mouth, tongue, or lips can seem more troublesome when in social, professional, or public settings.

To see if anxiety might be playing a role in your anxiety symptoms, rate your level of anxiety using our free one-minute instant results Anxiety Test , Anxiety Disorder Test , or Hyperstimulation Test .

The higher the rating, the more likely it could be contributing to your anxiety symptoms, including having difficulty talking or moving your mouth, tongue, or lips.

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Why does anxiety cause difficulty speaking, talking, or moving your mouth, tongue, or lips?

Medical Advisory

When this symptom is caused by anxiety, there are many reasons why anxiety can cause this symptom. Here are two of the most common:

1. Stress response

Behaving anxiously activates the stress response , also known as the fight or flight response . The stress response causes body-wide changes that prepare the body for immediate emergency action.[ 1 ][ 2 ] Because of the many changes, stress responses stress the body.

A part of these changes include altering brain function so that our attention is primarily focused on danger detection and reaction, and stimulating the nervous system so that the body is energized and can react quickly.[ 2 ] These changes can affect muscle movements, including the muscles in the mouth, tongue, and lips.

Many people experience difficulty talking and moving their mouth, tongue, or lips when anxious and stressed.

2. Hyperstimulation

Hyperstimulation can keep the stress response changes active even though a stress response hasn’t been activated. Chronic difficulty speaking, talking, and co-ordination problems with the mouth, tongue, and lips are common symptoms of hyperstimulation.

There are many other reasons why anxiety can cause this symptom. We explain these additional reasons under the symptom “Difficulty Speaking” in the Symptoms section (chapter 9) in the Recovery Support area of our website. The Symptoms section lists and explains all of the symptoms associated with anxiety.

How to stop the difficulty talking and moving the mouth, tongue, or lips anxiety symptoms?

When this anxiety symptom is caused by apprehensive behavior and the accompanying stress response changes, calming yourself down will bring an end to the active stress response and its changes. As your body recovers from the active stress response, this anxiety symptom should subside. Keep in mind it can take up to 20 minutes or more for the body to recover from a major stress response. This is normal and shouldn’t be a cause for concern.

When difficulty speaking or moving your mouth, tongue, or lips is caused by chronic stress (hyperstimulation), such as from overly apprehensive behavior, it can take much longer for the body to calm down and recover, and to the point where this anxiety symptom subsides.

Nevertheless, since this symptom is a common symptom of anxiety and stress, it needn't be a cause for concern or worry. This symptom subsides when you’ve eliminated the active stress response or hyperstimulation.

As the body recovers, difficulty speaking and talking, or moving your mouth, tongue, and lips problems disappear and normal functioning returns.

Many of those who struggle with anxiety worry that MS, ALS, a brain tumor, or other neurological condition may be the cause of their symptoms. Checking on the Internet may cause more anxiety, since co-ordination problems are common symptoms of these medical conditions.

But again, these types of symptoms are common for anxiety and stress. Therefore, they needn’t be a cause for concern.

For a more detailed explanation about all anxiety symptoms, why symptoms can persist long after the stress response has ended, common barriers to recovery and symptom elimination, and more recovery strategies and tips, we have many chapters that address this information in the Recovery Support area of our website.

If you are having difficulty containing your worry, you might want to connect with one of our recommended anxiety disorder therapists to help you learn this important skill. Working with an experienced anxiety disorder therapist is the most effective way to overcome what seem like unmanageable worry and problems with anxiety.

Common Anxiety Symptoms

• Heart palpitations
• Dizziness, lightheadedness
• Muscle weakness
• Numbness, tingling
• Weakness, weak limbs
• Asthma and anxiety
• Shooting chest pains
• Trembling, shaking
• Depersonalization
• Chronic pain
• Chronic fatigue
• Muscle tension
• Lump in throat

Additional Resources

• For a comprehensive list of Anxiety Disorders Symptoms Signs, Types, Causes, Diagnosis, and Treatment.
• Anxiety and panic attacks symptoms  can be powerful experiences. Find out what they are and how to stop them.
• How to stop an anxiety attack and panic.
• Anxiety Test
• Anxiety Disorder Test
• Social Anxiety Test
• Generalized Anxiety Test
• Hyperstimulation Test
• Anxiety 101 is a summarized description of anxiety, anxiety disorder, and how to overcome it.

Return to our anxiety disorders signs and symptoms page.

anxietycentre.com: Information, support, and therapy for anxiety disorder and its symptoms, including Difficulty Talking, Speaking, Moving The Mouth Anxiety Symptoms.

1. Selye, H. (1956). The stress of life. New York, NY, US: McGraw-Hill.

2. Folk, Jim and Folk, Marilyn. “ The Stress Response And Anxiety Symptoms. ” anxietycentre.com, August 2019.

3. Hannibal, Kara E., and Mark D. Bishop. “ Chronic Stress, Cortisol Dysfunction, and Pain: A Psychoneuroendocrine Rationale for Stress Management in Pain Rehabilitation. ” Advances in Pediatrics., U.S. National Library of Medicine, Dec. 2014.

4. Justice, Nicholas J., et al. “ Posttraumatic Stress Disorder-Like Induction Elevates β-Amyloid Levels, Which Directly Activates Corticotropin-Releasing Factor Neurons to Exacerbate Stress Responses. ” Journal of Neuroscience, Society for Neuroscience, 11 Feb. 2015.

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PUBLIC SPEAKING ANXIETY

The fear of public speaking is the most common phobia ahead of death, spiders, or heights. The National Institute of Mental Health reports that public speaking anxiety, or glossophobia, affects about 40%* of the population. The underlying fear is judgment or negative evaluation by others. Public speaking anxiety is considered a social anxiety disorder. * Gallup News Service, Geoffrey Brewer, March 19, 2001.

The fear of public speaking is worse than the fear of death

Evolution psychologists believe there are primordial roots. Our prehistoric ancestors were vulnerable to large animals and harsh elements. Living in a tribe was a basic survival skill. Rejection from the group led to death. Speaking to an audience makes us vulnerable to rejection, much like our ancestors’ fear.

A common fear in public speaking is the brain freeze. The prospect of having an audience’s attention while standing in silence feels like judgment and rejection.

Why the brain freezes

The pre-frontal lobes of our brain sort our memories and is sensitive to anxiety. Dr. Michael DeGeorgia of Case Western University Hospitals, says: “If your brain starts to freeze up, you get more stressed and the stress hormones go even higher. That shuts down the frontal lobe and disconnects it from the rest of the brain. It makes it even harder to retrieve those memories.”

The fight or flight response activates complex bodily changes to protect us. A threat to our safety requires immediate action. We need to respond without debating whether to jump out of the way of on oncoming car while in an intersection. Speaking to a crowd isn’t life threatening. The threat area of the brain can’t distinguish between these threats.

Help for public speaking anxiety

We want our brains to be alert to danger. The worry of having a brain freeze increases our anxiety. Ironically, it increases the likelihood of our mind’s going blank as Dr. DeGeorgia described. We need to recognize that the fear of brain freezing isn’t a life-or-death threat like a car barreling towards us while in a crosswalk.

Change how we think about our mind going blank.

De-catastrophize brain freezes . It might feel horrible if it happens in the moment. The audience will usually forget about it quickly. Most people are focused on themselves. We’ve handled more difficult and challenging situations before. The long-term consequence of this incident is minimal.

Leave it there . Don’t dwell on the negative aspects of the incidents. Focus on what we can learn from it. Worry that it will happen again will become self-fulfilling. Don’t avoid opportunities to create a more positive memory.

Perfectionism won’t help . Setting unachievable standards of delivering an unblemished speech increases anxiety. A perfect speech isn’t possible. We should aim to do our best instead of perfect.

Silence is gold . Get comfortable with silence by practicing it in conversations. What feels like an eternity to us may not feel that way to the audience. Silence is not bad. Let’s practice tolerating the discomfort that comes with elongated pauses.

Avoidance reinforces . Avoiding what frightens us makes it bigger in our mind. We miss out on the opportunity to obtain disconfirming information about the trigger.

Rehearse to increase confidence

Practice but don’t memorize . There’s no disputing that preparation will build confidence. Memorizing speeches will mislead us into thinking there is only one way to deliver an idea. Forgetting a phrase or sentence throw us off and hastens the brain freeze. Memorizing provides a false sense of security.

Practice with written notes. Writing out the speech may help formulate ideas. Practice speaking extemporaneously using bullet points to keep us on track.

Practice the flow of the presentation . Practice focusing on the message that’s delivered instead of the precise words to use. We want to internalize the flow of the speech and remember the key points.

Practice recovering from a brain freeze . Practice recovery strategies by purposely stopping the talk and shifting attention to elsewhere. Then, refer to notes to find where we left off. Look ahead to the next point and decide what we’d like to say next. Finally, we’ll find someone in the audience to start talking to and begin speaking.

Be prepared for the worst . If we know what to do in the worst-case scenario (and practice it), we’ll have confidence in our ability to handle it. We do that by preparing what to say to the audience if our mind goes blank. Visualizing successful recovery of the worst will help us figure out what needs to be done to get back on track.

Learn to relax

Remember to breathe . We can reduce anxiety by breathing differently. Take slow inhalations and even slower exhalations with brief pauses in between. We’ll be more likely to use this technique if practiced in times of low stress.

Speak slowly . It’s natural to speed up our speech when we are anxious. Practice slowing speech while rehearsing. When we talk quickly, our brain sees it is a threat. Speaking slowly and calmly gives the opposite message to our brain.

Make eye contact with the audience . Our nerves might tell us to avoid eye contact. Making deliberate eye contact with a friendly face will build confidence and slow our speaking.

Join a group . Practice builds confident in public speaking. Groups like Toastmasters International provide peer support to hone our public speaking skill. Repeated exposure allows us to develop new beliefs about our fear and ability to speak in public.

The fear of our mind going blank during a speech is common. Job advancement or college degree completion may be hampered by not addressing this fear.

How to Get Help for Social Anxiety

The National Social Anxiety Center (NSAC) is an association of independent Regional Clinics and Associates throughout the United States with certified cognitive-behavioral therapists (CBT) specializing in social anxiety and other anxiety-related problems.

Find an NSAC Regional Clinic or Associate which is licensed to help people in the state where you are located.

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• Anxiety disorders

Experiencing occasional anxiety is a normal part of life. However, people with anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations. Often, anxiety disorders involve repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks).

These feelings of anxiety and panic interfere with daily activities, are difficult to control, are out of proportion to the actual danger and can last a long time. You may avoid places or situations to prevent these feelings. Symptoms may start during childhood or the teen years and continue into adulthood.

Examples of anxiety disorders include generalized anxiety disorder, social anxiety disorder (social phobia), specific phobias and separation anxiety disorder. You can have more than one anxiety disorder. Sometimes anxiety results from a medical condition that needs treatment.

Whatever form of anxiety you have, treatment can help.

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Common anxiety signs and symptoms include:

• Feeling nervous, restless or tense
• Having a sense of impending danger, panic or doom
• Having an increased heart rate
• Breathing rapidly (hyperventilation)
• Feeling weak or tired
• Trouble concentrating or thinking about anything other than the present worry
• Having trouble sleeping
• Experiencing gastrointestinal (GI) problems
• Having difficulty controlling worry
• Having the urge to avoid things that trigger anxiety

Several types of anxiety disorders exist:

• Agoraphobia (ag-uh-ruh-FOE-be-uh) is a type of anxiety disorder in which you fear and often avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.
• Anxiety disorder due to a medical condition includes symptoms of intense anxiety or panic that are directly caused by a physical health problem.
• Generalized anxiety disorder includes persistent and excessive anxiety and worry about activities or events — even ordinary, routine issues. The worry is out of proportion to the actual circumstance, is difficult to control and affects how you feel physically. It often occurs along with other anxiety disorders or depression.
• Panic disorder involves repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes (panic attacks). You may have feelings of impending doom, shortness of breath, chest pain, or a rapid, fluttering or pounding heart (heart palpitations). These panic attacks may lead to worrying about them happening again or avoiding situations in which they've occurred.
• Selective mutism is a consistent failure of children to speak in certain situations, such as school, even when they can speak in other situations, such as at home with close family members. This can interfere with school, work and social functioning.
• Separation anxiety disorder is a childhood disorder characterized by anxiety that's excessive for the child's developmental level and related to separation from parents or others who have parental roles.
• Social anxiety disorder (social phobia) involves high levels of anxiety, fear and avoidance of social situations due to feelings of embarrassment, self-consciousness and concern about being judged or viewed negatively by others.
• Specific phobias are characterized by major anxiety when you're exposed to a specific object or situation and a desire to avoid it. Phobias provoke panic attacks in some people.
• Substance-induced anxiety disorder is characterized by symptoms of intense anxiety or panic that are a direct result of misusing drugs, taking medications, being exposed to a toxic substance or withdrawal from drugs.
• Other specified anxiety disorder and unspecified anxiety disorder are terms for anxiety or phobias that don't meet the exact criteria for any other anxiety disorders but are significant enough to be distressing and disruptive.

When to see a doctor

See your doctor if:

• You feel like you're worrying too much and it's interfering with your work, relationships or other parts of your life
• Your fear, worry or anxiety is upsetting to you and difficult to control
• You feel depressed, have trouble with alcohol or drug use, or have other mental health concerns along with anxiety
• You think your anxiety could be linked to a physical health problem
• You have suicidal thoughts or behaviors — if this is the case, seek emergency treatment immediately

Your worries may not go away on their own, and they may get worse over time if you don't seek help. See your doctor or a mental health provider before your anxiety gets worse. It's easier to treat if you get help early.

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The causes of anxiety disorders aren't fully understood. Life experiences such as traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety. Inherited traits also can be a factor.

Medical causes

For some people, anxiety may be linked to an underlying health issue. In some cases, anxiety signs and symptoms are the first indicators of a medical illness. If your doctor suspects your anxiety may have a medical cause, he or she may order tests to look for signs of a problem.

Examples of medical problems that can be linked to anxiety include:

• Heart disease
• Thyroid problems, such as hyperthyroidism
• Respiratory disorders, such as chronic obstructive pulmonary disease (COPD) and asthma
• Drug misuse or withdrawal
• Withdrawal from alcohol, anti-anxiety medications (benzodiazepines) or other medications
• Chronic pain or irritable bowel syndrome
• Rare tumors that produce certain fight-or-flight hormones

Sometimes anxiety can be a side effect of certain medications.

It's possible that your anxiety may be due to an underlying medical condition if:

• You don't have any blood relatives (such as a parent or sibling) with an anxiety disorder
• You didn't have an anxiety disorder as a child
• You don't avoid certain things or situations because of anxiety
• You have a sudden occurrence of anxiety that seems unrelated to life events and you didn't have a previous history of anxiety

Risk factors

These factors may increase your risk of developing an anxiety disorder:

• Trauma. Children who endured abuse or trauma or witnessed traumatic events are at higher risk of developing an anxiety disorder at some point in life. Adults who experience a traumatic event also can develop anxiety disorders.
• Stress due to an illness. Having a health condition or serious illness can cause significant worry about issues such as your treatment and your future.
• Stress buildup. A big event or a buildup of smaller stressful life situations may trigger excessive anxiety — for example, a death in the family, work stress or ongoing worry about finances.
• Personality. People with certain personality types are more prone to anxiety disorders than others are.
• Other mental health disorders. People with other mental health disorders, such as depression, often also have an anxiety disorder.
• Having blood relatives with an anxiety disorder. Anxiety disorders can run in families.
• Drugs or alcohol. Drug or alcohol use or misuse or withdrawal can cause or worsen anxiety.

Complications

Having an anxiety disorder does more than make you worry. It can also lead to, or worsen, other mental and physical conditions, such as:

• Depression (which often occurs with an anxiety disorder) or other mental health disorders
• Substance misuse
• Trouble sleeping (insomnia)
• Digestive or bowel problems
• Headaches and chronic pain
• Social isolation
• Problems functioning at school or work
• Poor quality of life

There's no way to predict for certain what will cause someone to develop an anxiety disorder, but you can take steps to reduce the impact of symptoms if you're anxious:

• Get help early. Anxiety, like many other mental health conditions, can be harder to treat if you wait.
• Stay active. Participate in activities that you enjoy and that make you feel good about yourself. Enjoy social interaction and caring relationships, which can lessen your worries.
• Avoid alcohol or drug use. Alcohol and drug use can cause or worsen anxiety. If you're addicted to any of these substances, quitting can make you anxious. If you can't quit on your own, see your doctor or find a support group to help you.

Anxiety disorders care at Mayo Clinic

• Anxiety disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://dsm.psychiatryonline.org. Accessed Feb. 26, 2018.
• Anxiety disorders. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml. Accessed Feb. 26, 2018.
• Brown A. Allscripts EPSi. Mayo Clinic, Rochester, Minn. March 5, 2018.
• Anxiety disorders. National Alliance on Mental Illness. https://www.nami.org/Learn-More/Mental-Health-Conditions/Anxiety-Disorders/Overview. Accessed Feb. 25, 2018.
• Help with anxiety disorders. American Psychiatric Association. https://www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders. Accessed Feb. 28, 2018.
• Reinhold JA, et al. Pharmacological treatment for generalized anxiety disorder in adults: An update. Expert Opinion in Pharmacotherapy. 2015;16:1669.
• Bandelow B, et al. Efficacy of treatments for anxiety disorders: A meta-analysis. International Clinical Psychopharmacology. 2015;30:183.
• Find support. National Alliance on Mental Illness. https://www.nami.org/Find-Support. Accessed Feb. 26, 2018.
• Bazzan AJ, et al. Current evidence regarding the management of mood and anxiety disorders using complementary and alternative medicine. Expert Review of Neurotherapeutics. 2014;14:411.
• Natural medicines in the clinical management of anxiety. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Feb. 26, 2018.
• Sarris J, et al. Plant-based medicines for anxiety disorders, Part 2: A review of clinical studies with supporting preclinical evidence. CNS Drugs. 2013;27:301.
• Bystritsky A. Complementary and alternative treatments for anxiety symptoms and disorders: Herbs and medications. https://www.uptodate.com/contents/search. Accessed Feb. 26, 2018.
• Bystritsky A. Pharmacotherapy for generalized anxiety disorder in adults. https://www.uptodate.com/contents/search. Accessed Feb. 26, 2018.
• Sawchuk CN (expert opinion). Mayo Clinic, Rochester, Minn. March 21, 2018.

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Speech Anxiety Test

Signs and symptoms of speech anxiety

Speech anxiety, also named as glossophobia, is the fear of speaking in public, which most people have experienced at some point in their lifetimes. When the fear emerges, the person often feels emotionally distraught. Butterflies may develop in their stomach or their palms may become sweaty. People who suffer from speech anxiety, will often shy away from opportunities to speak in public arenas.

Speech anxiety is a form of social phobia and includes a wide variety of fears, when it comes to speaking in public. Some people can’t stand the idea of attending a party where there will be strangers, while others have major issues with giving a presentation at work.

The reasons why people experience speech anxiety varies. Some have experienced a traumatic public event as a child or earlier in life, while others have generally low self-esteem and feel that what they have to say is not important. Therefore, they automatically expect to fail.

The primary symptoms of speech anxiety fall into three main categories:

Physical symptoms

Experiencing physical symptoms when facing speech anxiety is just your body’s natural fight-or-flight reaction to the situation. Adrenalin is pumping through your system and you may experience several symptoms which actually make it even harder to speak;

When experiencing physical symptoms like shortness of breath, it is almost inevitable that you will reveal your nervousness through your voice. Your voice may sound tense; you stutter, use words like “Umm” and “Ahh” frequently and speak fast just to complete the performance as soon as possible. These symptoms are really difficult to control. Once you hear that your voice sounds nervous, it makes it even harder to control your anxiety.

Includes frequent fidgeting, inability to stand still, avoiding eye contact with your audience and wiping your hands on the trousers. All of these symptoms make it even harder to perform as well as you could have.

Further reading: Overcome your speech anxiety with online therapy .

If you suffer from any of the symptoms described above, we recommend that you take this test. Evaluate the statements and select the option that you feel best reflects the way you have felt for the past two weeks . The test is, of course, anonymous and free (see our privacy policy ).

This speech anxiety test is not to be seen as a final diagnosis. If you are uncertain about your result, we suggest that you get professional help as soon as possible.

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• Anxiety Guide
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Other Symptoms

Anxiety and difficulty speaking.

• Trouble speaking is, itself, a form of anxiety, but as a phobia and as a symptom of social anxiety
• Finding difficulty speaking when you have other types of anxiety is also common, since the mechanisms required for speaking are disrupted by anxiety symptoms
• Any form of relaxation has the potential to free up your thoughts to make it easier and more comfortable to speak in public
• Exposure can help limit the anxiety someone feels while speaking
• Addressing anxiety overall is the best way to prevent it from affecting speech

Fact Checked

Micah Abraham, BSc

Last updated September 6, 2022

Anxiety is a type of disorder that prevents you from living your life the way you would like to. One of the symptoms of anxiety is a difficulty with speaking normally. Due to the physical and psychological impact of anxiety, this disorder can make it incredibly difficult for you to get your words out in a manner which is both comfortable and coherent. Read on to learn more.

This difficulty with speaking normally can also create its own problems - problems that may increase your anxiety in the future. We'll explore why these speaking difficulties occur and how you can effectively overcome them.

What it's Like to Have Trouble Speaking

Difficulty speaking is both a psychological problem, where you’re fearful about speaking in social situations; and a physical problem, where it feels like your mouth can't move correctly or like your tongue is too big. These symptoms occur with various types of anxiety. 

The best way to understand this phenomenon is by going over possible reasons that you may have trouble speaking. These include:

• Fear of Being Judged The fear of being judged is an example of a mental and emotional difficulty that can make it hard to speak naturally in front of others. This is extremely common in social anxiety disorder, but it can affect anyone with anxiety to some extent. Many people experience this fear, where they feel that if they talk they'll have people look down on them. 
• Overthinking Some people have difficulty speaking because they're thinking too much about way to say, what they're feeling, etc. The more they think about it, the more they have a hard time putting the words into sentences and sharing them out loud. Often they eventually lose track of the conversation and suddenly the moment has passed and they feel as though they simply can't speak anymore.
• Rushing Thoughts Like overthinking, a person may also have rushing thoughts - thoughts that are rapid and difficult to decipher, jumping from one to the next and often (although not always) relating to stressful topics. Rushing thoughts make it difficult to speak because you’re anxious, overwhelmed, and finding it difficult to coherently plan-out what you want to say and how you want to say it. 
• Mouth Movements Anxiety can affect your physical functioning as well. For example, it can affect your coordination and make it harder for you to move the muscles of your mouth. When you’re anxious, physical tasks that would normally come naturally may be challenging - speaking is one of these. 

These are just a few of many possible examples to explain how anxiety can make it that much more difficult to speak naturally. 

Reinforcing the Anxiety

Unfortunately, difficulty speaking can reinforce the anxiety that stops you from speaking in the first place. For example, if you have social anxiety disorder, you may find that your anxiety stops you from taking up the challenge of speaking in public. 

By avoiding challenging your anxiety, you make your fear of it stronger. This is known as “negative reinforcement”. If you had got up there and spoken, you could have proved to yourself that you were able to do it. This may have reduced your anxiety the next time around. But because you avoided speaking up at all, this reinforced the anxiety that you initially had, also making it more likely that you will turn down the challenge the next time.

Similarly, if you feel like your muscles are not cooperating with you or you can't physically get the words out, it can feel really disturbing as though something is wrong with your muscles or your brain. Nothing is wrong of course - that anxiety is simply contributing to this feeling - but it can feel as though something must be terribly wrong for you to suffer through these problems.

How to Stop Difficulty Speaking From Anxiety

Your ability to feel comfortable speaking is an important part of living a normal life. You don't want to live inside your head, and you certainly don't want to be suffering from so much anxiety that you can't interact with others.

Physical anxiety symptoms are difficult to cure. The only successful way to prevent them is to reduce your anxiety so that it no longer feels overwhelming. The key is to distract your mind so that you don't focus too heavily on the way your body feels so that your automatic processes (like talking) can remain automatic. The more you think about the way they feel, the more you will continue to experience trouble with your mouth movements.

When your own anxiety is stopping you from speaking in front of others, there are several strategies that you can try:

• Embarrass Yourself on Purpose If possible, you need to reduce the issues that are causing you fear. One thing to consider is mildly embarrassing yourself intentionally. This is fairly easy to do in social situations. Consider wearing an outfit that seems a bit unusual. Introduce yourself to someone you don’t know. Tell a joke that you know won’t be funny. These sorts of exercises can be extremely challenging for someone with full-blown social anxiety. However, if you’re able to build yourself up to trying these out, you’re likely to find yourself becoming increasingly comfortable about speaking in social situations. 
• Get Closer to Your Friends Work with your closest friends on getting comfortable talking and start to figure out ways to get closer to them in the process. Close friendships help a great deal with confidence, and the more you can adjust to make closer friends with people and practice talking with them, the easier a time you'll have talking with others.
• Exercise Exercise may not seem like it relates to speaking, but it can actually have some fairly significant effects. When you exercise, your body releases neurotransmitters that improve mood and make it easier to feel comfortable talking. Exercise also seems to improve self-confidence, which can also have a fairly powerful effect on your ability to meet and bond with others. Start exercising today, and you may find that speaking becomes much easier.

These are just a few tips and techniques that can help you overcome difficulties with speaking. Of course, when your trouble talking in public is caused by your anxiety, the solution is going to be curing your anxiety, otherwise, you'll continue to run the risk of it happening again.

SUMMARY:   Social anxiety and fear of public speaking are two types of anxiety that make it difficult to speak in public. But those with all forms of anxiety may also find that they have difficulty finding words as a result of racing thoughts, distractions, fear of being judged, and more. Learning to cope with those anxieties, as well as addressing anxiety overall is the only way to take back control.  

Questions? Comments?

Do you have a specific question that this article didn’t answered? Send us a message and we’ll answer it for you!

Where can I go to learn more about Jacobson’s relaxation technique and other similar methods? – Anonymous patient

You can ask your doctor for a referral to a psychologist or other mental health professional who uses relaxation techniques to help patients. Not all psychologists or other mental health professionals are knowledgeable about these techniques, though. Therapists often add their own “twist” to the technqiues. Training varies by the type of technique that they use. Some people also buy CDs and DVDs on progressive muscle relaxation and allow the audio to guide them through the process. – Timothy J. Legg, PhD, CRNP

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Those struggling with anxiety often have one fear in the back of their mind that won't go away. One fear...

How to Stop Racing Thoughts From Anxiety

Fact Checked by Faiq Shaikh, M.D. Updated on October 10, 2020.

Anxiety changes the way you think. Sometimes it can make you think more negatively. Sometimes it can make you obsess...

Anxiety and the Connection to Body Odor

Fact Checked by Denise Griswold, MSc, LCAS Updated on October 10, 2020.

Many of the physical symptoms of anxiety are particularly troubling as they can cause anxiety themselves. This is just one...

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