How to Overcome Performance Anxiety: A Practical Guide
- Dr Paul McCarthy
- 4 days ago
- 15 min read
To really get a handle on performance anxiety, you need a multi-pronged approach. It’s about more than just telling yourself to "calm down." We need to combine mindset shifts with practical, in-the-moment calming techniques and, crucially, build genuine confidence through smart preparation.
It all starts with recognising the feeling for what it is—a normal human response—and then applying proven methods to take back control.
What Is Performance Anxiety, Really?
Let’s first pull back the curtain on what most people call ‘stage fright’. It’s not just a case of pre-performance jitters. Performance anxiety is a powerful psychological response that can unleash a torrent of very real physical, emotional, and cognitive symptoms. At its core, it's an intense fear or nagging worry about your ability to perform a task well enough.
This feeling isn't picky; it can ambush you anywhere, from a high-stakes presentation at work to the starting line of a race. Picture this: you're about to deliver a pitch that could make or break your quarter. Suddenly, your heart is thumping against your ribs, your palms are slick with sweat, and your mind is a loop of worst-case scenarios. That, right there, is performance anxiety making its entrance.
Recognising the Symptoms
The first step to managing this feeling is learning to spot its tell-tale signs. It's not just a battle fought in your mind; your body often sounds the alarm first.
Before we dive deeper, here's a quick look at the common ways performance anxiety can show up.
Common Signs of Performance Anxiety | |
Symptom Category | Examples |
Physical | Racing heart, trembling hands or voice, dry mouth, nausea, sweating, shortness of breath. |
Cognitive | Negative self-talk, catastrophic thoughts ("I'm going to fail"), trouble concentrating, mental blanks. |
Behavioural | Avoiding performance situations, over-preparing obsessively, fidgeting, rushing through the performance. |
Seeing these symptoms laid out makes it clear: this is a full-body experience. This whole reaction is driven by the body’s 'fight or flight' system, which mistakenly flags a high-stakes situation, like public speaking, as a genuine life-or-death threat.
The real breakthrough comes when you realise this is a common human experience, not a personal flaw. Once you can identify these signs as they happen, you stop being a victim of the feeling and become an observer who can take action.
And it’s far more common than you might think. In the UK, performance-related fears are a huge part of wider anxiety issues. In 2022/23, an estimated 37.1% of women and 29.9% of men reported high levels of anxiety, and that figure absolutely includes the pressure to perform in work, sport, and daily life. You can explore the latest anxiety statistics in the UK to see just how widespread this is.
Internalising the fact that these feelings are manageable is the cornerstone of overcoming performance anxiety. You're not alone in this, and there are effective, evidence-based ways to find your composure and deliver when it counts.
Getting to the Root of Your Fear
Before you can learn how to manage performance anxiety, you need to understand where it comes from. It's a bit like pulling up a weed—you have to get to the root of the problem, not just trim the leaves that are showing. This is really a process of self-discovery, digging past the surface-level fear to find out what's really triggering you.
Believe it or not, your anxiety isn't just a random occurrence. It's almost always a learned response, deeply connected to certain beliefs you hold or events you've been through. For most people I've worked with, these roots tend to grow from a few common seeds.
Looking at Common Triggers
The fear you feel today is often an echo from the past. A single negative experience, like fumbling your words during a school presentation or missing that critical penalty in a youth football match, can cast an incredibly long shadow. That memory becomes a blueprint your brain defaults to, predicting future failure and creating a self-fulfilling prophecy.
Another powerful root is the fear of judgement. This goes beyond just worrying about what people might think; it’s a deep-seated fear of being exposed as incompetent, foolish, or simply not good enough. You might worry that one mistake will cause your colleagues to lose all respect for you, or that an audience is silently picking apart your every move. The pressure of this social evaluation can be absolutely paralysing.
"Understanding your personal 'why' is the first real step towards dismantling the fear. When you can name the source of your anxiety—whether it’s a past failure or a fear of what others think—you take away its mysterious power and turn it into a problem with a solution."
Perfectionism is another huge contributor. If you set impossibly high standards for yourself, any situation where you might fall short feels like a monumental threat. This kind of "all or nothing" thinking turns a minor mistake into a complete catastrophe, which only fuels the cycle of anxiety and avoidance.
Questions for Self-Reflection
To start connecting the dots between your past experiences and your present feelings, you need to set aside some time for honest reflection. This isn't about dwelling on negative memories, but about gaining the awareness you need to make a change.
Try asking yourself these questions:
When do I feel most anxious? Pinpoint the exact situations. Is it speaking up in meetings? Playing your sport in front of a crowd? A job interview?
What am I really afraid of? Dig deeper than just "messing up." Are you afraid of looking foolish? Letting people down? Failing to live up to your own high expectations?
Does this feeling remind me of a past event? See if you can trace this specific feeling back to an earlier time in your life when you felt similarly exposed or embarrassed.
Answering these questions honestly gives you the clarity needed to finally break the cycle. By pinpointing the source, you can stop fighting a nameless dread and start tackling the real issue. This self-awareness is the foundation for every other strategy you'll use to overcome performance anxiety.
Rewire Your Mindset with Cognitive Strategies
While calming your body’s physical response to anxiety is a great first step, long-term change comes from tackling the root cause: your thoughts. This is about more than just "thinking positive." It's about fundamentally rewiring the mental habits that feed your fear. The aim here is to build a robust mental toolkit using proven cognitive techniques.
It all starts with becoming a bit of a detective of your own mind. You need to learn to spot those automatic negative thoughts that seem to appear out of nowhere before a big performance. I'm talking about those sneaky, unhelpful thoughts like, “I’m definitely going to mess this up” or “Everyone will think I’m a fraud.”
Challenging Your Inner Critic
Once you get good at catching these thoughts in the act, you can start to challenge them. There's a brilliant technique for this called cognitive restructuring, which is really just a way of putting your anxious predictions on trial. Instead of just accepting a negative thought as gospel, you question its validity.
Start by asking yourself some tough questions:
Is there any real evidence to back up this fear?
What’s a more realistic, balanced outcome?
How have I handled similar situations successfully in the past?
Let's say your automatic thought is, “I’m going to forget everything I need to say.” You can challenge that directly. Remind yourself, “I’ve practised this presentation ten times. I have my notes right here as a backup. Even if I'm nervous, it's far more likely I'll remember all the key points.”
The goal isn't blind optimism; it's about trading catastrophic thinking for realistic evaluation. You're shifting your perspective from one grounded in fear to one based on actual evidence. This puts you back in a position of rational control, not panic.
This approach is a real cornerstone of overcoming performance anxiety. UK mental health advice consistently points to cognitive behavioural methods, particularly managing your self-talk, as a vital skill. Many of us with performance anxiety naturally drift towards worst-case scenarios, so intentionally steering your thoughts towards what’s realistic can really loosen the psychological grip of pressure. You can discover more insights about managing self-talk on Calm Clinic.
Creating Your Performance Script
A powerful way to put all this into practice is to create a 'performance script'. This is simply a set of pre-planned, encouraging statements you can repeat to yourself. These aren't just empty affirmations; they are truths you've chosen to arm yourself with, ready to counter the lies your anxiety tells you.
Your script might include phrases like:
"Nervousness is just energy. I can channel it into my performance."
"I am well-prepared and completely capable of handling this."
"My aim is to connect with my audience, not to be perfect."
Repeat these statements to yourself as you prepare, and especially in the moments before you step into the spotlight. This kind of proactive self-talk helps to drown out that inner critic and set a much more confident and focused tone.
Another fantastic tool is visualisation. Spend a few minutes each day vividly imagining your performance going exactly as you want it to. Don't just see it—feel it. Picture yourself speaking with clarity and confidence. Feel that sense of accomplishment afterwards. Imagine the warm, positive reception. This mental rehearsal makes the real event feel more familiar and less threatening to your brain, essentially building a memory of success before it even happens.
Calm Your Nerves with In-The-Moment Techniques
While shifting your mindset is crucial for lasting change, you also need a toolkit for the moments when anxiety hits you like a physical wave. These are your emergency go-tos—simple, effective techniques you can pull out of your back pocket to calm your body and ground your mind.
Let's be real. You're minutes away from that career-defining presentation. Your heart is hammering against your ribs, and that all-too-familiar sense of panic is creeping in. This is the moment you need a practical, physical intervention to break the cycle.
Master Your Breath
One of the most powerful and discreet tools you have is your own breath. When anxiety takes over, our breathing often becomes shallow and quick, which just pours fuel on the body's 'fight or flight' fire. By consciously slowing your breath down, you're sending a direct message to your nervous system: "It's okay. You're safe."
This is where diaphragmatic breathing, or belly breathing, is a game-changer. Try this: place one hand on your chest and the other on your stomach. Breathe in slowly through your nose for a count of four, focusing on making your stomach expand like a balloon. Hold it for a second, then breathe out slowly through your mouth for a count of six. The hand on your stomach should rise and fall, while the one on your chest stays mostly still.
This isn't just a distraction. It's a physiological reset button. You're activating the parasympathetic nervous system—your body's built-in relaxation response—to counteract that surge of adrenaline.
This process, from finding physical calm to reinforcing it with positive thoughts, creates a powerful upward spiral.
As this shows, calming your physical state with techniques like breathing lays the groundwork, making your mental strategies like visualisation and positive self-talk far more effective.
Ground Yourself in the Present
When your mind is spinning out with a thousand "what-ifs," grounding techniques are your anchor. They wrench you out of anxious future-tripping and plant you firmly back in the present moment. The 5-4-3-2-1 technique is brilliant because it's simple, subtle, and you can do it absolutely anywhere.
Wherever you are, just take a moment to silently notice:
5 things you can see (the pattern on the carpet, a crack in the ceiling, a colleague's bright scarf).
4 things you can feel (the solid ground beneath your feet, the texture of your trousers, the coolness of your watch).
3 things you can hear (the distant hum of the air conditioning, a phone ringing, your own breathing).
2 things you can smell (stale coffee, the scent of your own perfume or soap).
1 thing you can taste (the lingering flavour of your morning toothpaste or a sip of water).
This simple sensory scan forces your brain to shift focus, making it incredibly difficult to keep worrying about what might happen next. To make this even more powerful, some people find that using specific scents, like aromatherapy candles for relaxation, in their prep space can create a strong sensory anchor for calmness.
Sometimes, all you have is a few seconds to regain control. For those high-pressure moments, having a quick-fire technique ready can make all the difference.
Quick Anxiety-Reduction Techniques
This table offers a quick guide to simple exercises you can do anywhere to manage acute anxiety symptoms when they strike.
Technique | How It Helps | When to Use |
Box Breathing | Regulates the nervous system by creating a simple, rhythmic pattern. | Before a meeting, during a stressful phone call, or when you feel overwhelmed. |
Progressive Muscle Relaxation | Releases physical tension you may not even realise you're holding onto. | At your desk, before bed, or while waiting for an event to start. |
Sensory Grounding | Pulls your focus away from anxious thoughts and into the physical world. | When your mind is racing, or you feel a panic attack starting. |
These in-the-moment strategies are your secret weapons for hitting pause on panic and regaining your composure. They might seem almost too simple, but their effect on managing acute anxiety is profound. Athletes, whose careers depend on performing under immense pressure, rely on these skills constantly. For a deeper dive into their methods, you can explore these https://www.drpaulmccarthy.com/post/four-ways-athletes-can-calm-their-nerves.
Build Lasting Confidence Through Smart Preparation
Thorough preparation is without a doubt your best shield against performance anxiety. But here's a secret that many people miss: it’s not about practising more, it’s about practising smarter. Real, lasting confidence isn't just about repeating the same actions over and over. It's forged by methodically getting yourself used to the feeling of pressure.
The best way I’ve seen this work is through a technique called gradual exposure. Think of it like climbing a ladder, taking it one rung at a time. This approach works by slowly and safely introducing you to the thing that makes you anxious, which teaches your nervous system that what you dread isn't actually a life-or-death threat.
Start Small To Build Momentum
The trick is to start somewhere you feel completely safe, in a low-stakes environment. Let's say you have a major presentation looming. Your first step isn't to picture yourself in that intimidating boardroom. Instead, you build a "preparation ladder" that might look something like this:
Rung 1: The Mirror: Stand in front of a mirror and deliver your entire presentation out loud, just to yourself. This is your chance to nail the delivery, gestures, and overall flow without any pressure at all.
Rung 2: The Trusted Friend: Once that feels comfortable, do it again for a close friend or a family member. Pick someone you know will give you supportive, constructive feedback.
Rung 3: The Small Group: Now, it's time to level up. Present to a few friendly colleagues. This ups the ante just enough to feel more like the real thing, but you're still in a controlled, safe space.
With each step, the next one feels far less intimidating. By the time the big day arrives, you’ve already succeeded multiple times. You've built up a bank of positive memories that you can draw on to quiet those anxious thoughts.
Prepare Your Body and Mind
Smart preparation isn’t just about the task itself. It’s about getting your whole self—body and mind—ready to perform at its best. It's easy to overlook these basics, but skipping them can leave you wide open to the physical symptoms of anxiety.
In the days leading up to your performance, really dial in on these three pillars:
Prioritise Sleep: A rested brain is a resilient brain, far better at regulating emotions and recalling information. Aim for 7-9 hours of good-quality sleep. Being sleep-deprived is like pouring fuel on the fire of anxiety.
Nourish Your Body: Keep your energy stable with balanced meals and stay hydrated. Steer clear of heavy, greasy foods that can leave you feeling sluggish and unfocused.
Avoid Anxiety Amplifiers: Caffeine and sugar can be tricky. They can mimic and even worsen the physical jitters of anxiety, like a racing heart. It’s wise to cut back or even avoid them completely on the day of your performance.
Being over-prepared isn't about chasing perfection. It's about building such a solid foundation of competence that fear gives way to a feeling of readiness and control. It’s the quiet confidence that comes from knowing you've done the work.
Making these strategies a habit takes commitment. It’s a skill in itself, and it can be helpful to know how to improve self-discipline to make sure they stick.
Crucially, you have to be kind to yourself through this process. You're unlearning old patterns and building new ones, and that takes time. Self-compassion is a huge part of the journey, a topic we explore more deeply here: https://www.drpaulmccarthy.com/post/the-power-of-self-compassion-how-it-conquers-sports-performance-anxiety-in-hurling.
Build a Supportive Environment Around You
Learning how to overcome performance anxiety isn't something you have to do alone. While working on your mindset and using calming techniques are essential, the people you surround yourself with can either pour fuel on your fears or help build your confidence. Far from being a sign of weakness, creating a strong support network is one of the smartest moves you can make.
This isn't about having a huge circle of friends. It's about intentionally connecting with people who genuinely lift you up. Think about who that could be for you—a trusted friend, a mentor who has been in your shoes, or even a colleague you have a good rapport with. The goal is to find someone you can be completely honest with, someone you can say, "I'm really anxious about this upcoming presentation," and know you won't be judged.
These conversations aren't just for venting; they're a strategic part of your preparation. When you do open up, be really clear about what kind of support would actually help you in that moment.
How to Ask for Support
Being direct about your needs makes it so much easier for people to help you effectively. Instead of just saying you're stressed, try a more specific approach.
For Feedback: "Could you listen to my speech and tell me which bits you think are the strongest? I could really use a confidence boost."
For Reassurance: "I'm feeling incredibly nervous right now. Can you just remind me why you think I'm the right person for this job?"
For a Distraction: "My anxiety is through the roof. Can we please talk about something completely different for ten minutes to take my mind off it?"
This simple shift turns the people in your life from passive listeners into active allies. They become a real part of your strategy, helping you build resilience long before you step into the high-pressure situation.
Seeking support is a proactive step towards building psychological safety. You are consciously creating a space where your anxieties can be acknowledged and managed, rather than suppressed until they become overwhelming.
This idea of psychological safety is especially important at work. It's about creating a culture where people feel they can take risks and be vulnerable without facing negative backlash. This can be tricky, though, as different generations often see workplace stress through very different lenses.
For instance, a recent Burnout Report uncovered a stark generational divide in the UK. It found that younger adults (18-24) were about three times more likely to be absent from work due to stress-related poor mental health compared to their colleagues aged 55 and over. Interestingly, this same group was also less likely to discuss their stress with a manager. This suggests that when people don't feel supported, performance anxiety can become much more debilitating. You can read the full findings on the generational divide in workplace stress on Mental Health UK.
What this data really highlights is the power of an open culture. When you feel safe enough to be honest about the pressure you're under, that pressure starts to lose its hold on you. Whether it’s with your friends, a mentor, or within your team at work, building your own safe space is a powerful way to get a handle on performance anxiety for good.
Common Questions: Overcome Performance Anxiety
As you start putting these strategies into practice, you're bound to have some questions. It's completely normal. Getting to grips with performance anxiety is a process, so let's tackle a few of the most common queries I hear from people.
Can Performance Anxiety Be Completely Cured?
This is often the first thing people ask, and it’s a great question. The honest answer is that it's not something you "cure" like a common cold, but you can absolutely learn to manage it so well that it no longer runs the show.
The real goal isn't to erase the feeling entirely. Instead, it’s about changing your relationship with it. Think of it less as a monster to be slain and more as a source of raw energy that you can learn to harness. Many top performers still get those pre-event jitters; they’ve just become masters at channelling that adrenaline into sharp focus and energy, rather than letting it spiral into dread.
Is Medication a Good Option?
For some, medication can be a really useful piece of the puzzle, especially when the physical symptoms are overwhelming. A doctor might prescribe something like a beta-blocker to help manage a pounding heart or shaking hands by blocking some of the effects of adrenaline.
However, medication rarely works as a magic bullet on its own.
Think of it as a support system, not the entire solution. It can help calm the physical chaos, which then gives you the headspace to actually use the psychological techniques that lead to long-term change. A conversation with a qualified healthcare professional is the only way to know if it's the right path for you.
How Long Does It Take to See Improvement?
There's no magic number here; your journey is your own. Some people feel a sense of relief almost immediately just by using a simple breathing technique or successfully challenging one negative thought. That quick win can be incredibly powerful.
For deeper-seated fears, building confidence through gradual exposure and consistently reframing your thoughts will naturally take more time and effort. The key isn't speed, it's consistency. Celebrate the small victories—like feeling just a little less anxious in a team meeting or getting through a presentation without your voice shaking. Those are the moments that build real, lasting confidence.
If you want to see how this plays out at the highest level, it's worth looking at how elite athletes handle pressure. For a great perspective on this, check out this guide on a pro athlete's mental game.
At Dr Paul McCarthy, we help athletes and professionals develop the mental skills to perform their best under pressure. If you're ready to build lasting confidence and master your mindset, explore our performance coaching services.
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