Article 1 Conquering Stage Fright

Public speaking is said to be the biggest fear reported by many American adults, topping flying, financial ruin, sickness, and even death. You may have heard the joke that some people would prefer to be in their own coffins than give a eulogy at a funeral. While this may be an exaggeration, many would agree. Most of us feel a degree of nervous apprehension when preparing to speak up or perform in front of a group. But those who are filled with feelings of dread and panic in such a situationor anywhere the person might be center of attentionmay be suffering from a form of social anxiety disorder (also known as social phobia). The fear of public speaking or performance, often called stage fright, exacts a huge toll on self-confidence and self-esteem and causes some people to leave school or a job or pass up a promotion. Many, including seasoned professional performers, suffer in silent terror. And because they feel embarrassed, people try to keep their fear a secret, even from a spouse or other close family members or friends.

Taking Steps to Overcome Your Fear

Learning to improve your speaking or performance skills is good, but its generally not enough to substantially reduce your fear. You must address and revise any negative perceptions, beliefs, thoughts, images, and predictions related to public speaking or performing. And its often helpful to uncover the deeper fears related to being seen and heard by others, showing vulnerability, and being considered less than perfect. Learning to accept yourself and not feeling that you have to prove yourself to others is at the root of healing. It is recommended that you learn skills to reduce and manage your fear and anxiety and not resort to using medication or natural products alone. Its also critical to learn cognitive-behavioral methods to stop the cycle of avoiding fearful situations. Avoidance may give you immediate relief, but it reinforces your fear in the long run. Some people also choose medication or natural remedies to help reduce their symptoms of performance anxiety. Talk with your physician to find the most appropriate treatment for you. If you are willing stop avoiding your fears and learn new skills to reduce and manage them, you will develop an empowering belief and trust in yourself. In facing your fear, it becomes possible to overcome performance anxiety and find comfort and ease in expressing yourself in front of others. Try these 10 tips to reduce your stage fright: 1. Shift the focus from yourself and your fear to your true purpose contributing something of value to your audience. 2. Stop scaring yourself with thoughts about what might go wrong. Instead, focus your attention on thoughts and images that are calming and reassuring. 3. Refuse to think thoughts that create self-doubt and low confidence.

4. Practice ways to calm and relax your mind and body, such as deep breathing, relaxation exercises, yoga, and meditation. 5. Exercise, eat well, and practice other healthful lifestyle habits. Try to limit caffeine, sugar, and alcohol as much as possible. 6. Visualize your success: Always focus on your strength and ability to handle challenging situations. 7. Prepare your material in advance and read it aloud to hear your voice. 8. Make connections with your audience: Smile and greet people, thinking of them as friends rather than enemies. 9. Stand or sit in a self-assured, confident posture. Remain warm and open and make eye contact. Give up trying to be perfect and know that it is OK to make mistakes. Be natural, be yourself.

Article 2
If you dread the thought of getting up in front of a group of people and performing, you are not alone. Millions of people suffer from performance anxiety, commonly called "stage fright." In fact, most people would rather get the flu than perform. Athletes, musicians, actors, and public speakers often get performance anxiety. Performance anxiety can prevent you from doing what you enjoy and can affect your career. Worst of all, performance anxiety can negatively affect your self-esteem and self-confidence. Although it may be impossible to totally overcome performance anxiety, there are many things you can do to control your emotions and reduce anxiety.
Recommended Related to Anxiety Panic
Understanding Generalized Anxiety Disorder -- Symptoms The hallmark of generalized anxiety disorder (GAD) is excessive, out-of-control worrying about everyday things. Symptoms include: Persistent fear, sometimes without any obvious cause, that is present everyday Inability to concentrate Muscle tension; muscle aches Diarrhea Eating too little or too much Insomnia Irritability Loss of sex drive For school-age children, symptoms include: Fear of being away from the family Refusal to go to school Fear of stranger... Read the Understanding Generalized Anxiety Disorder -- Symptoms article > >

Performance Anxiety Symptoms Being the center of attention and having all eyes on you can be stressful. Your body reacts to this situation in much the same way as it would if you were being attacked. Your body's "fight-or-flight" mechanism kicks in, which is why symptoms of stage fright are similar to symptoms that occur when you are in real danger.

Performance anxiety symptoms may include: 10. Racing pulse and rapid breathing 11. Dry mouth and tight throat 12. Trembling hands, knees, lips, and voice 13. Sweaty and cold hands 14. Nausea and an uneasy feeling in your stomach 15. Vision changes Performance Anxietyp Causes Simply put, stress and anxiety about performing in front of people causes performpance anxiety. Confronting your fears and vulnerabilities, accepting yourself for who you are, and not feeling like you have to prove yourself to others, is the first step toward overcoming performance anxiety. Keep in mind that nobody is perfect, nobody expects you to be perfect, and it is OK to make mistakes.

The second step is learning how to redirect your negative thoughts, beliefs, images, and predictions about performing in public. Doing this is not as difficult as you might think. Performance Anxiety Treatments Here are 10 tips to help you overcome your fears and shine on stage, on the field, or at the podium: Be prepared: practice, practice, practice. Limit caffeine and sugar intake the day of the performance. Eat a sensible meal a few hours before you are to perform so that you have energy and don't get hungry. A low-fat meal including complex carbohydrates -- whole-grain pasta, pizza, or a bean and rice burrito -- is a good choice. Shift the focus off of yourself and your fear to the enjoyment you are providing to the spectators. Close your eyes and imagine the audience laughing and cheering, and you feeling good. Don't focus on what could go wrong. Instead focus on the positive. Visualize your success. Avoid thoughts that produce self-doubt. Practice controlled breathing, meditation, biofeedback, and other strategies to help you relax and redirect your thoughts when they turn negative. It is best to practice some type of relaxation technique every day, regardless of whether you have a performance, so that the skill is there for you when you need it.

 Take a walk, jump up and down, shake out your muscles, or do whatever feels right to ease your anxious feelings before the performance. Connect with your audience -- smile, make eye contact, and think of them as friends. Act natural and be yourself. Exercise, eat a healthy diet, get adequate sleep, and live a healthy lifestyle. Keep in mind that stage fright is usually worse before the performance and often goes away once you get started.

Article 3
What steps should you take first?
Try nondrug approaches. "Cognitive behavioral techniques can help most people and may obviate the need for medicine," Schneier says. That therapy teaches anxiety management and includes performance practice. You can sharpen your public speaking in workshops given by Toastmasters International. "Some people have anxiety because they haven't mastered the skills," he points out. Be evaluated by a doctor before using betablockers. "You should be screened for asthma and have an electrocardiogram to check for heart abnormalities," Schneier says. Your doctor should also look for contributing causes of anxiety, such as alcohol withdrawal, thyroid problems, low blood sugar, mental disorders, and the use of stimulating medication or substances, including caffeine and nicotine. Sample a trial dose before the day of your performance. "Beta-blockers can cause lightheadedness if you have low blood pressure," Schneier warns. "It's a good idea to see how they affect you when you're not up on stage." Bottom line. Many people find beta-blockers to be helpful in managing the physical symptoms of performance anxiety, even though this use is not supported by substantial evidence from well-designed studies. Behavioral or cognitive therapy in addition to medication for performance anxiety could also be beneficial. Our advice: Talk with your doctor about possible causes and all available treatments for performance anxiety. If nondrug approaches don't work, consider beta-blockers only after their risks and benefits have been thoroughly explained to you.

Article 4
Medication

Medication treatment of anxiety is generally safe and effective and is often used in conjunction with therapy. Medication may be a short-term or long-term treatment option, depending on severity of symptoms, other medical conditions, and other individual circumstances. However, it often takes time and patience to find the drug that works best for you. Medications are commonly prescribed by physicians (family practice, pediatricians, OB-GYNs, psychiatrists), as well as nurse practitioners in many states. More than one in 10 Americans take antidepressants, the primary type of medication used by people ages 18 to 44. Learn more about how these drugs work.

Variety of Medications
Four major classes of medications are used in the treatment of anxiety disorders: Selective Serotonin Reuptake Inhibitors (SSRIs) SSRIs relieve symptoms by blocking the reabsorption, or reuptake, of serotonin by certain nerve cells in the brain. This leaves more serotonin available, which improves mood. SSRIs (citalopram, escitalopram, fluoxetine, paroxetine, and sertraline) generally produced fewer side effects when compared with tricyclic antidepressants. However, common side effects include insomnia or sleepiness, sexual dysfunction, and weight gain. They are considered an effective treatment for all anxiety disorders, although the treatment of obsessive-compulsive disorder, or OCD, typically requires higher doses. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) The serotoninnorepinephrine reuptake inhibitor, or SNRI, class (venlafaxine and duloxetine) is notable for a dual mechanism of action: increasing the levels of the neurotransmitters serotonin and norepinephrine by inhibiting their reabsorption into cells in the brain. As with other medications, side effects may occur, including stomach upset, insomnia, headache, sexual dysfunction, and minor increase in blood pressure. These medications are considered as effective as SSRIs, so they are also considered a first-line treatment, particularly for the treatment of generalized anxiety disorder. Benzodiazepines This class of drugs is frequently used for short-term management of anxiety. Benzodiazepines (alprazolam, clonazepam, diazepam, and lorazepam) are highly effective in promoting relaxation and reducing muscular tension and other physical symptoms of anxiety. Long-term use may require increased doses to achieve the same effect, which may lead to problems related to tolerance and dependence. Tricyclic Antidepressants Concerns about long-term use of the benzodiazepines led many doctors to favor tricyclic antidepressants (amitriptyline, imipramine, and nortriptyline). Although effective in the treatment of anxiety, they can cause significant side effects, including orthostatic hypotension (drop in blood pressure on standing), constipation,

urinary retention, dry mouth, and blurry vision. Contact your physician if you experience side effects, even if you are not sure a symptom is caused by a medication. Do not stop taking a medication without consulting with the prescribing physician; abrupt discontinuation may cause other health risks. Medications will work only if they are taken according the explicit instructions of your physician, but they may not resolve all symptoms of an anxiety disorder. 16. Get detailed medication information in this chart.

Discussing Medications: What You Need to Know

Use these guidelines to talk to your health care professional about medications: To avoid potentially dangerous drug interactions, let your mental health care provider know all medications you are taking, including prescriptions and over-the-counter drugs, herbal or dietary supplements, and vitamins. And make sure your family doctor knows you are taking medications for an anxiety disorder. Ask these questions about a new prescription: How will the medication help me? What side effects might occur? Should I avoid any foods or beverages? Are drug interactions with other prescriptions a possibility? Learn when to take a new medication and how, such as on any empty stomach or with food, in the morning or evening, and how frequently. Find out how long it should take for the medication to start working and what you should expect when this happens. Ask for the prescribing physicians after-hours phone number in case you develop side effects. A good source of information about medications and over-the-counter products is your pharmacist, who should have information about all your prescriptions to advise you about possible drug interactions, side effects, and instructions for use. Ask how often you should see the doctor for a medication check-up. If your physician does not want to spend the time to answer your questions, you may need a referral to a different physician.