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  • Writer's pictureRebecca Karu

Performance Anxiety: The Nitty-Gritty Behind the Symptoms

When it comes to performing, I really would have never considered myself a nervous person. However, I have had my ups and downs with Performance Anxiety in the Instrumental Music Field, both in and out of school. My Freshman year I had very little if any performance anxiety, then I had a lot of generalized anxiety my sophomore year. I began to manage this anxiety during my junior year, only to then further problems my senior year; this is a topic meant for us to cover, more in depth, another day!

Performance Anxiety is one of the most common problems amongst performers. It ranges from mild stage fright, to full blown shakes, racing heart beat, sweats, and relentless, negative thoughts. It is not only one of the most common problems, it is also one of the most complex to treat. Everyone’s performance anxiety stems from different places, and can be caused by different things; e.g. generalized anxiety, “stage fright”, past trauma, environmental factors, genetics, etc. Along with the different causes comes different ways to treat performance anxiety. There are a million different methods of coping, which we will be getting into in the coming weeks, but today we will start with performance anxiety itself. How and why does it happen to us?

No performer of any kind is safe from the wrath that performance anxiety unleashes on us. Some people are more prone to it, while others may not experience it at all, or not until later in life. Regardless. Why does performance anxiety happen to us, and why do these symptoms arise, severe or not?

Let’s get into it. There are different causes and types of Performance Anxiety (PA).

“Stage Fright”: Some will argue that performance anxiety is not stage fright, but stage fright can be performance anxiety. Stage fright usually stems from a general fear of performing for others, and tends to not be as severe as those with PA. The term stage fright can feel like it has a demeaning intention behind it, especially towards those who’s anxiety is intolerable and debilitating. Stage Fright is not a mental disorder. As per the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5, Anxiety is considered to be a mental disorder and can be accompanied by other comorbidities such as depression, trauma, or PTSD. Treatments for Stage Fright should begin with simple cardio exercise, meditation or other relaxation techniques, and as a last resort, medications such as low dose beta blockers or CBD can be used.

Past Experience/Trauma Induced Performance Anxiety: Trauma is trauma. Many times, performers won’t experience any type of performance anxiety until they experience a performance that may not have gone so well, or one that was so detrimental to their mental state of mind which made them begin to question their capabilities as an artist. Following a traumatic performance experience, it’s common for people to develop performance anxiety. From that point on, every time they perform, they’re riddled with the anxiety and fear of failure, as well as the physical symptoms such as the shakes.

Generalized Anxiety: Sometimes, we are already dealing with an underlying mental disorder such as Generalized Anxiety Disorder (GAD). It is also possible to have a genetic predisposition to GAD. This can in and of itself, can be challenging to manage and it’s important to seek professional help. If you’re experiencing symptoms such as extreme worry or anxiety, that may be rational and/or irrational, irritability, excessive tiredness, or difficulty sleeping, you should reach out to your primary care physician to get a referral to a psychologist or psychiatrist. It’s important to remember that there is NO shame in professional help and that these people are experts in helping you get back to your best mental state.

Environmental Factors: Anxiety, including performance anxiety, can be caused or worsened by stress from environmental factors. These include, but are not limited: personal relationships, financial struggles, work, and/or school stress. These external stresses can cause strain on your mind and body, leading to the experience of heavy anxiety when placed in certain social situations. If there are stresses at school, you may have a tendency to have more performance anxiety playing school concerts, or recitals in front of your colleagues and faculty. It is also important to be able to identify these environmental factors that trigger your anxiety so you can learn to better cope with these situations. Again, the help of a licensed professional is strongly recommended.

What if I’m unsure if I’m experiencing Performance Anxiety? What are some things or symptoms to look for and be aware of?

Performance Anxiety has a variety of symptoms that people can experience. Some are more obvious than others. The following is a list of the most common performance anxiety symptoms:

  • Physical Shaking

  • Racing Heart Beat

  • Nausea or Vomiting

  • Excessive Sweating

  • Elevated Blood Pressure

  • Dry Mouth

  • Negative Thoughts

  • Avoidance, or trying to flee the scene

  • Irritability

  • Brain Fog, or your mind going blank; forgetfulness

  • Excessive worrying

  • Caring too much about the audiences opinions, or worrying about what they think

  • Increased amount of errors

  • And more…

Symptoms such as forgetfulness, increased errors, and worrying about the audience's opinions can be common symptoms of anxiety, however, they can also be unrecognizable symptoms since they can occur during other events. For example, when a person is forgetful or makes more errors than usual they may think they are having “an off day”, or maybe they didn’t get enough sleep and are having trouble focusing. If you're unsure why you are having these “off days”, you should look at the patterns of your performance. Do these symptoms occur frequently on or during performances? Have you noticed that it has become a consistent issue or has worsened over time? The best thing to do is contact your teacher and talk about what you’re experiencing. Seeking help from a mental health professional and talking things through can also be very helpful.

Symptoms including shakes, nausea, racing heart beat, and dry mouth are common in people who experience Performance Anxiety. Many people who have performance anxiety will tell you that they experience one or more of these common symptoms each time they go to perform, whether it be at a recital, a chamber performance, or even when taking an audition. How come our bodies react the way they do to these situations?

We’ve all heard of the fight or flight response. It’s now often referred to as Fight-Flight-Freeze. This is our body’s response to situations when we feel threatened. We begin to develop physical symptoms based on the psychological fear we are facing. Responses in parts of the brain such as the Amygdala (the center for perceived fear), and the Hypothalamus send signals to the Autonomic Nervous System (ANS). The ANS begins to release adrenaline and cortisol in response to the stressful situations, which then affects bodily functions involving your heart, lungs, and more.

Your Autonomic Nervous System has two parts to it; Your Sympathetic Nervous System and your Parasympathetic Nervous System, both of which control the different reactions of the fight-flight or freeze response in stressful and/or threatening situations. These are the key parts of your internal system that affect your responses to stress, threats, and dangerous situations. These also set off the physical symptoms that you experience during bouts of Performance Anxiety.

Even though our bodies send out the signals that create the physical symptoms we feel, we can’t forget about the effects this reaction has on our mental health and well-being. As I stated earlier, Performance Anxiety is still a type of anxiety. Oftentimes Performance Anxiety is made worse by how we think about things. For instance, sometimes people begin to think about making a mistake, or that they aren’t good enough, and that the audience is going to think that they aren’t good or cut out for this. These thoughts and feelings not only increase physical symptoms because we feel more threatened, but they also cloud our judgement and mind. This will lead to higher anxiety levels and maybe even depression. For some people, they might begin to avoid performing opportunities at all costs, especially when they remember and are aware of the reaction they had towards the last performance. This is not a healthy mindset towards performing. As artists, we should want to share our craft with the world, knowing how hard we work day in and day out towards being the best we can be. Performance Anxiety can be ruthless, causing our mindset to leave us in a dark place, even with the thoughts of potentially never performing again.

Okay, let's take a breather since this is A LOT of information to process.

In the following weeks, I’ll be covering many different options for treatment of Performance Anxiety. I know that there are so many options out there -- books, medications, meditation or calmness practices, and sometimes we as artists, have no idea where to start because there’s no clear cut path to healing. Throughout the next few weeks, will we be discussing some treatment methods which have either worked for me or someone I know. These entries will also feature many interviews with performers of all ages, career paths, and experiences with performance anxiety, as well as methods that have worked for them.


Stay tuned for the coming weeks on more Performance Anxiety Topics! Questions, Comments, or Want Advice? Feel free to contact me at or follow me on instagram at @mindoverpractice.

I hope you enjoyed this week's entry and for now, have a productive week of positive practicing!

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