Performance anxiety is that intense apprehension you feel when you’re asked to meet expectations — self-imposed or otherwise.

You may experience anxiety every now and then. Maybe you undergo high levels of distress when you give a presentation, take a test, compete in sports, or regale a crowd with a musical number.

You could even experience distress during physically intimate moments.

But what happens if this anxiety comes up again and again as part of a cycle? You may be dealing with performance anxiety.

Performance anxiety may be severe enough to be diagnosed as a mental health disorder. For example, if you experience it during most or all social situations, you could receive a social anxiety disorder diagnosis.

But as with any other type of anxiety, you can learn to manage performance anxiety and stop its cycle.

Performance anxiety vs. generalized anxiety disorder

Performance anxiety isn’t a formal diagnosis. It can be a symptom of generalized anxiety disorder (GAD), but you don’t need to live with GAD to experience it. In other instances, it could be a form of situational anxiety.

You could experience performance anxiety whenever you feel you need to meet a certain standard. It could be the result of internal or external pressure — real or perceived. For example, when you’re expected to do well on a test.

Generalized anxiety disorder, on the other hand, may mean you experience symptoms during different situations, not only performance-related, and sometimes without any apparent cause.

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Performance anxiety is common. In the world of music alone, as many as 60% of professional musicians may experience symptoms.

So, you’re not alone if you sometimes experience symptoms of anxiety when faced with a performance-based task.

Anxiety symptoms can be managed, and help is also available if you feel you need professional support.

In the meantime, consider these tips to overcome performance anxiety:

1. Relaxation techniques

Having a calming go-to strategy when you face performance anxiety can help you get through the episode.

Dr. John F. Tholen, a retired clinical psychologist from Seal Beach, California, recommends circular breathing as an easy option to address episodes of performance anxiety.

“With eyes closed and lips pursed (as when blowing out a flame), slowly exhale for as long as possible,” he advises. “Once your lungs are empty, pause for a count of ten then slowly inhale, taking as much air through your nose as possible. When your lungs are full, pause again before repeating the process.”

Tholen, who is the author of the book “Focused Positivity: The Path to Success and Peace of Mind,” also recommends practicing progressive muscle relaxation whenever you feel your anxiety rising.

“In a comfortable position, slowly tighten and relax the muscles of your feet three times. Repeat this process with each major muscle group, gradually progressing up your body and ending with the face and head,” he says.

Progressive muscle relaxation helps you ground yourself so that your attention and energy are on your body instead of your anxiety-inducing thoughts.

Practicing relaxation techniques on a daily basis can help you stop the cycle of performance anxiety if you notice symptoms keep returning.

2. Guided imagery

Guided imagery is a therapeutic technique that uses a script to help you create positive mental images and thoughts to boost relaxation.

According to Dr. Daniel Sher, clinical psychologist and sex therapy expert in Deerfield Beach, Florida, guided imagery can even help with sexual performance anxiety.

“Guided imagery is a therapy technique that involves envisioning peaceful, positive or successful mental scenarios,” he explains. “By focusing on these … positive images, the brain is able to generate a state of calm and relaxation that promotes sexual health.”

Sher explains that while guided imagery is often done in a professional setting, it’s possible to write and even record your own scripts or to purchase pre-recorded online sessions.

Guided imagery for sexual performance doesn’t necessarily mean thinking positive sexually-oriented thoughts.

The guided imagery can be nonsexual — oriented toward nature, for example — but the relaxation it creates takes your mind off the anxiety-inducing task and allow your body to achieve natural arousal.

In the same way, practicing guided imagery before any event you anticipate will cause you some anxiety can help you manage these symptoms.

3. Positive self-talk

Dr. Paul Greene, a clinical psychologist in New York, cautions that focusing on negative thoughts can make anxiety worse.

“Performance anxiety is exacerbated by negative self-talk,” Greene says. “If you tend to tell yourself how badly you’ll perform or how catastrophic it would be if you don’t do well, your anxiety will be worse.”

Greene recommends reminding yourself of the reasons why you’re likely to do well and how it won’t be the end of the world if you make a mistake.

If inner dialogue isn’t enough, you can write down your positive self-talk. Consider reading them during those moments when your mind is working against you.

4. Facing fears

It’s natural to want to avoid those things that cause you distress. While this may feel good in the moment, Greene cautions that it’s not in your best interest.

“Avoiding a situation that triggers anxiety is understandable. However, doing it repeatedly can worsen the problem,” he explains. “Try to put yourself in situations that scare you a little — often, the more you do so, the less anxiety you’ll have.”

You don’t have to go large-scale. Starting small, like practicing a speech with a group of friends before an important presentation, can help you get the exposure you need to manage your anxiety.

5. Lifestyle changes

Food can bring some sense of comfort when you’re distressed. But any benefits experienced may be short-lived.

Dr. Julia Kogan, a health psychologist in Miami, Florida, specializing in stress and insomnia, recommends focusing on foods that promote stabilized blood sugar levels.

“It’s also helpful to limit caffeine and sugar intake. Too much caffeine or changes in blood sugar can mimic anxiety symptoms, and in turn increase actual anxiety,” she says. “Eating a well-balanced meal can help stabilize blood sugar which can help with performance.”

Try to add whole, non-starchy, unprocessed produce in your diet, including:

  • green beans
  • broccoli
  • tomatoes
  • lettuce
  • cucumbers

6. Excitement

Performance anxiety can sometimes come from things you actually enjoy.

You’re passionate about basketball, for example, so you’ve decided to play with a team in front of spectators. Yet, right before coming out to the court, you experience an episode of anxiety.

Feeling this way is natural. In fact, the excitement you feel about doing something you enjoy can be what helps you overcome performance anxiety, says Dr. Afshan Mohamedali, a clinical psychologist in Oyster Bay, New York.

“Excitement can compete with the feeling of anxiety,” she says. “In finding something that excites you about the task and nurturing this feeling, you can bring down the anxiety — even if it’s just enough to perform.”

If you find it challenging to harness excitement and enthusiasm, you can start by writing down what aspects of the activity you enjoy, or what deeper meaning it has for you.

Even in a sexual performance situation, reminding yourself there are other important aspects of intimacy at hand —such as expressing your feelings of love and bonding — may help you place less emphasis on physical prowess.

If performance anxiety is negatively impacting important areas of your life, you may benefit from professional support.

Cognitive behavioral therapy (CBT) has been supported by scientific research, says Tholen. “CBT works because it is the most efficient method of challenging the dysfunctional thoughts that underlie performance anxiety, and the most efficient form of CBT is focused positivity strategy.”

Focused positivity is a solution-based therapeutic approach that encourages you to focus on flourishing and achieving goals rather than fixating on weakness and the obstacles they create.

Everyone experiences performance anxiety at least once in their lifetime. It’s natural to feel anxious when having to perform in a certain way.

But sometimes, symptoms start manifesting often, turning these isolated episodes into a performance anxiety cycle.

Whether it’s a form of situational anxiety or a symptom of generalized anxiety disorder, managing performance anxiety is possible.

Exposure to what you fear, regular practice of relaxation techniques, positive self-talk, and professional guidance are all ways you can help limit the effects of performance anxiety.