Performance anxiety is a common issue, with an estimated 31.2% of adults in the U.S. having dealt with anxiousness at some point. If you’re uneasy about a big presentation, an exam, or a public appearance, the good news is that there are effective strategies and medications to overcome this inconvenience.
We’ll explain how to deal with performance anxiety using beta-blockers like propranolol and atenolol, natural remedies, and easy-to-apply non-pharmaceutical techniques.
Understanding Performance Anxiety—What Is It?
Performance anxiety is typically characterized by intense feelings of worry and fear of failure in situations where you’re required to perform in public, like an exam, interview, sports event, or even in casual social settings. While it’s normal to experience a certain degree of nervousness in such situations, performance anxiety can be debilitating for some people, affecting their performance and overall well-being or even causing panic attacks.
Symptoms of performance anxiety vary among individuals, but the common ones include:
- Rapid heartbeat
- Trembling lips, knees, hands, or voice
- Dry mouth
- Nausea
- Blurry vision
- Sweating
- Lightheadedness
What Causes Performance Anxiety?
Performance anxiety is typically triggered by our body’s natural “fight or flight” response, a basic survival mechanism that prepares us to respond to a perceived threat. When we find ourselves in a situation where we feel judged or scrutinized, our bodies may react as if we’re facing physical danger and release adrenaline, which increases heart rate and blood pressure. In these situations, our dopamine levels can also decrease, dampening our mood.
Learn more about the common causes of performance anxiety in the table below:
The specific causes of situational anxiety can be complex and vary from one person to another. Still, understanding the potential triggers is the first step toward overcoming performance anxiety.
Ways To Overcome Performance Anxiety
There are different ways to approach performance anxiety, from medications to psychological techniques. Some of the popular options are:
- Beta-blockers for occasional relief
- Natural remedies like breathing and physical exercises
- Non-pharmaceutical psychological methods like cognitive behavioral therapy (CBT)
The most effective treatment typically varies depending on several factors, including your overall health status and whether your anxiety is occasional or chronic.
Using Beta-Blockers To Manage Performance Anxiety
Beta-blockers are a class of drugs primarily prescribed for heart problems, including:
- Angina
- Irregular heart rhythm
- High blood pressure
They block the effects of adrenaline, slowing your heartbeat and helping your body remain calm in stressful situations. Several studies show that beta–blockers like propranolol and atenolol can mitigate mild distressing states, such as stage fright, exam nerves, and performance anxiety in musicians, surgeons, and candidates for surgeries.
Even though these medications can be prescribed off-label to alleviate the symptoms of performance anxiety, they don’t treat the underlying causes of anxiety but only reduce its physiological symptoms. Beta-blockers are a viable option for those who need help performing under pressure, but people with general or social anxiety typically require different treatments.
There are numerous beta-blockers on the market, so your doctor will assess your health history before deciding the best fit for you. The two most commonly prescribed ones for performance anxiety are:
- Propranolol—The most famous beta-blocker
- Atenolol—An effective alternative for individuals with respiratory issues
Source: ThisIsEngineering
Propranolol—The Most Famous Beta-Blocker
Sold under brand names like Inderal, Inderal LA, Hemangeol, Inderal XL, and InnoPran XL, propranolol is a prescription-only medication. Its active substance is propranolol hydrochloride, which is classified as a non-selective beta-blocker.
The drug comes in solution, capsule, and tablet forms and is available in nine doses:
- 1 mg
- 4.28 mg
- 10 mg
- 20 mg
- 40 mg
- 60 mg
- 80 mg
- 120 mg
- 160 mg
The average dose for performance anxiety is 10 mg–40 mg in tablet form, typically taken two hours before the performance. You should avoid taking the drug regularly unless recommended by your healthcare provider. For performance anxiety issues, take it as needed.
Atenolol—An Effective Alternative for Individuals With Respiratory Issues
Atenolol, sold under the brand name Tenormin, is a prescription-only beta-blocker approved for hypertension, angina, and myocardial infarction. The drug isn’t a controlled substance and doesn’t carry the risk of addiction. Still, psychological dependence can’t be ruled out.
Atenolol is available in three doses:
- 25 mg
- 50 mg
- 100 mg
The average dose for performance or situational anxiety is typically determined by a healthcare provider. To benefit from the drug, you should take it two hours before the stressful event.
Atenolol is often recommended to individuals with respiratory issues because it’s a selective beta-blocker. Lower doses mainly affect beta1 receptors predominantly found in the heart while having less impact on beta2 receptors located in the airways. Its selectivity can help prevent the constriction of the airways that can occur with non-selective beta-blockers, making it a safer choice for those with respiratory conditions like asthma or chronic obstructive pulmonary disease (COPD).
Still, this selectivity is dose-dependent. At higher doses, atenolol may start to influence beta2 receptors in the airways and potentially affect breathing, so individuals with respiratory issues need to use this medication under the guidance of a healthcare provider.
Before using beta-blockers, you should consult a healthcare professional. In most cases, you’ll have to explain the specific type of anxiety you have. The main challenge is that using these drugs to alleviate the symptoms of performance anxiety is somewhat stigmatized, and most patients may be reluctant to ask their doctors for beta-blockers.
The good news is that with telemedicine clinics like Kick, you can eliminate the wait for an appointment with a regular doctor and the stress of explaining why you need these medications.
Kick—Your Convenient Solution for Performance Anxiety
Source: Alena Darmel
Kick is a telemedicine platform that offers a personalized approach to managing performance anxiety and a safe, convenient, and discreet way to access beta-blockers like propranolol and atenolol from the comfort of your home.
Since the consultations happen remotely, you can access the service wherever you are, whenever you need it. Once you sign up, our expert will assess your health status and determine the most suitable treatment for you. Your medication comes with clear instructions on how to use it, helping you get the best results.
How Kick Works
To benefit from Kick’s program, follow these easy steps:
- Navigate to the signup page
- Fill out a brief questionnaire (it takes only 10 minutes)
- Provide your shipping and payment details
If you choose express delivery, you can receive your medication within two days. The packaging is discreet and functional, adding to your privacy and convenience. If you have any questions while using the medication, you can chat with our doctors through our platform.
Kick is risk-free—if our team decides you’re not the best candidate for the program, you won’t pay for the initial consultation as per our Doctor Guarantee.
Kick’s program has earned numerous positive reviews on Trustpilot, which is a testament to our commitment to helping individuals effectively manage their performance anxiety:
“Kick has helped me tremendously in performing better in doing presentations and making speeches in my role as a bank CEO. It has also helped me with my comedy stand-up routines as part of my instruction at the San Francisco Comedy Club, which is a hobby of mine.”
Source: cottonbro studio
Common Side Effects of Beta-Blockers
While beta-blockers are generally well-tolerated, some individuals may experience unwanted reactions. Common side effects of these medications include:
- Fatigue
- Cold hands and feet
- Weight gain
- Shortness of breath
- Dizziness or lightheadedness
- Depression or mood changes
This list isn’t exhaustive. You should watch out for unwanted reactions and inform your doctor immediately after noticing them. To avoid the risk of side effects, take these medications only as instructed by your healthcare provider.
Alternatives to Beta-Blockers for Performance Anxiety
While beta-blockers are effective in some patients, they’re not suitable for everyone.
Check out who should and shouldn’t use these medications in the table below:
Beyond these medications, you can try two alternatives:
- Natural remedies
- Non-pharmaceutical psychological approaches
Natural Remedies
Natural remedies for performance anxiety don’t involve conventional medications. Instead, they include consuming natural substances or performing actions that promote relaxation. Some popular options are:
- Breathing exercises—Techniques like belly breathing, alternate-nostril breathing, and 4-7-8 breathing exercises can stimulate the parasympathetic nervous system, lowering stress
- Physical exercise—Regular physical activity can help you stay calm in stressful situations, reducing the symptoms of anxiety
- Herbal remedies—Certain herbs and supplements, like chamomile, passion flower, and lemon balm, may help you feel calm during a public performance
- Aromatherapy—Essential oils or scents like lavender can be effective in reducing anxiety and tension
Non-Pharmaceutical Psychological Approaches
Specific psychological techniques can help address the underlying issues contributing to performance anxiety. Some of the most effective methods are:
- Cognitive behavioral therapy (CBT)—It includes changing negative thoughts, exposure therapy (gradually facing the situations that cause your anxiety), and stress inoculation training (practicing coping mechanisms in low-stress situations)
- Mindfulness-based techniques—These involve focusing on the present moment and accepting it without judgment, preventing fear and anxiety from overwhelming you
- Acceptance and Commitment Therapy (ACT)—It involves mindful acceptance and regaining a sense of control in stressful situations
These approaches are extensive and demanding, and they may be more suitable for patients with performance anxiety due to general or social anxiety disorders.
If you only experience occasional anxiety before mildly stressful events like public speaking, job interviews, or exams, Kick’s program may be more efficient.
Source: Tima Miroshnichenko
Can You Manage Performance Anxiety on Your Own?
You can manage performance anxiety on your own through self-care practices and relaxation techniques. Still, self-management may not be as effective as professional help, especially for severe cases, because it may not address the underlying causes of anxiety. To get the best strategies for coping with performance anxiety, you should consult your doctor.
Featured image source: Yan Krukau
