By Rajnish Mago, MD (bio)
What is “performance anxiety”?
Performance anxiety, sometimes called “stage fright,” is not the name of a specific mental disorder in DSM-5.
Anxiety before and while speaking or playing a musical instrument in front of an audience is quite anxiety-provoking for almost anybody. But, for some persons, anxiety related to some type of performance can be a severe, distressing, and disabling condition.
The symptoms may include:
– a peaking of anxiety immediately before the performance
– palpitations and rapid heartbeat
– increased blood pressure
– tremors
– sweating (especially of the palms)
– dry mouth
– an urge to urinate, and so on.
In many cases, performance anxiety is only one aspect of a broader problem—either generalized anxiety disorder or social anxiety disorder.
But, for some people, especially those whose profession or hobby (e.g., musicians) requires repeated performances, the performance anxiety can be a specific problem that needs to be treated specifically.
Why is performance anxiety important?
It has been estimated that about 2% of the US population suffers from “debilitating performance anxiety” (Powell, 2004). That’s a lot of people!
It worsens the person’s performance and can severely affect the person’s career if speaking or performing on stage is a central part of their career. As one author noted, “An organ recitalist cannot play Max Reger’s “Fantasy and Fugue
on BACH” with shaking hands (Brantigan et al., 1982). My immediate thought on reading this was, “I cannot play that piece even without shaking hands!” 
We should not assume that performance anxiety becomes less as the person gets more experience with performing. Sometimes it does and sometimes it doesn’t. In fact, performance anxiety can sometimes be WORSE in accomplished musicians compared to amateur musicians (Brantigan et al., 1982). We can speculate that this may be because they hold themselves to very high standards. It is also been speculated that “inability or unwillingness to tolerate a high degree of stress is a leading reason why capable musicians leave the profession” (Brantigan et al., 1982).
Next, please read this article:
Clinical tips on using a beta-blocker for performance anxiety (“stage fright”)
Related Pages
Clinical tips on using a beta-blocker for performance anxiety (“stage fright”)
References
Brantigan CO, Brantigan TA, Joseph N. Effect of beta blockade and beta stimulation on stage fright. Am J Med. 1982 Jan;72(1):88-94. PubMed PMID: 6120650.
Copyright 2019, Simple and Practical Medical Education, LLC. All rights reserved. May not be reproduced in any form without express written permission.
Disclaimer: The content on this website is provided as general education for medical professionals. It is not intended or recommended for patients or other laypersons or as a substitute for medical advice, diagnosis, or treatment. Patients must always consult a qualified health care professional regarding their diagnosis and treatment. Healthcare professionals should always check this website for the most recently updated information.