There is no doubt that public speaking is a fear for many people. It is up there with fear of spiders, heights and clowns. Even if you don’t mind public speaking there are not many people who actually ENJOY the process of public speaking. So many will seek out the fear of public speaking medication to ease the pain.
Here I want to outline the things you can do that you can do before turning to medication to ease your anxiety. However, if you still need to turn to medication – I recommend that you speak to your doctor before making and decisions.
Non-medical interventions for fear of public speaking
1. Prepare before you’re anxious
This is the non-glamorous part of taking care of yourself. All of this preparation advice sounds like a kill-joy parent imparting wisdom.
BUT it does work.
Preparation over a long time frame is better than any last-minute fix and any self-care discipline will pay off in the long run!
These are the things that you should be doing every day to ward off anxiety – public speaking or not!
- Eat well-balanced meals (e.g. three nutritious meals a day). Make sure the meals contain plenty of fresh fruit and vegetables.
- Avoid or reduce alcohol, nicotine, and caffeine intake. The hardest one! Self-medication is a common way we keep anxiety away. I’ve been sober for a year now and it is the most confronting thing I’ve done!
- Exercise regularly, particularly with a cardiovascular or relaxation component. I ride my bike to and from work and it is my primary form of transport. I’ve heard that yoga is an excellent form of exercise – although be prepared to be called a hipster!
- Perform regular self-care – such as relaxing activities and regular planned breaks. We can feel like we need to be all go go go! But that is not sustainable. Take time doing things you enjoy with friends and family!
- Have a good sleep routine. It depends on your age but current recommendations state that for older adults (65+): 7–8 hours and for
Adults (18–64 years): 7–9 hours is optimal.
2. Take a deep breath
Breathing techniques can help a lead when it comes to reducing anxiety. I know that it sounds a little bit too hippy and liberal but you cannot argue with science.
Taking control of your breathing is a fantastic way to control your physiology and reduce all of the anxiety symptoms that you are experiencing.
This has been proven to help overcome public speaking anxiety FAST.
The more that you practice these breathing techniques the more likely you are to feel the benefit of them just as you are going up to give that big presentation.
I often use breathing techniques just as I am going up on stage or standing next to the podium while being introduced. As soon as you start speaking however, you’ll notice the anxiety drop away! I think that is because of the fact you are then focused on what you are saying – not what may or may not happen!
3. Progressive muscle relaxation
Another useful technique is to think about and isolate different muscle groups in your body. This is a two-step process where you notice particular muscle groups and then tense and relax them.
People with anxiety disorders quite often are so tense throughout the day that they don’t notice that their muscles are constantly tense. Through regular practice, you will be able to notice when a certain muscle group is relaxed or not and then use this as a cue to enter a more relaxed state.
Helpful points about progressive muscle relaxation:
- Set aside about 15 minutes to complete this task.
- Find a relaxing place where you can relax without being disturbed.
- For the first week or so, practice this exercise twice a day – it’ll become second nature.
- You do not need to be in a state of high anxiety when you do this technique. In fact, it is better to first give this a go when you are calm. That way, it will be easier to do when feeling anxious.
During this exercise, you’ll want to go through each large muscle group and tense and relax them. For example, you would go through these muscle groups in this order:
- Feet (curl your toes)
- Lower legs (contract your calf muscle by bringing your toes upwards)
- Entire legs (contract your thigh muscles while doing above)
- Hand (clench your fist)
- Entire right arm (flex like a bodybuilder while clenching your fist)
- Bum muscles (Pull your buttocks together)
- Stomach (clench your abs like a sit-up)
- Chest (take a deep breath)
- Neck and shoulders (raise your shoulders up to touch your ears)
- Mouth (open your mouth wide enough to stretch the hinges of your jaw)
- Forehead (raise your eyebrows as far as you can)
In the end, after a load of practice, you’ll be able to skip the tensing part and know how to just relax each muscle group.
However, tensing and then relaxing comes highly recommended as a way of you getting to know your body.
4. Ask yourself questions
Asking yourself questions to ground your thoughts and feelings can really help. Often we let our thoughts and feeling overwhelm us.
When I go up to speak I often am worried about “looking stupid”, tripping over what I have to say and, in high-stress pitching competitions, I am worried that I will not finish my story and will go drastically overtime.
These are some questions that I find help me:
- What am I so afraid of?
- Why am I feeling this way?
- What have I done in the past that proves that I can get through this?
- What is in my control or not?
Quite often the answers to these questions are so boring and benign that they calm me down almost instantly.
For example, what am I afraid of? Looking silly – don’t worry Donald Trump is president.
What is in my control or not? I can control how I deliver my speech or presentation but I cannot control what people think of me- therefore it is not worth worrying about.
5. Plan time to overcome anxiety
You would have noticed that all of the above advice can become time intensive.
Planning a little bit of worry time into your public speaking timetable can go a long way and give you the opportunity to implement some of the techniques that are discussed above.
Taking the time to devote some energy in training yourself is how to overcome public speaking anxiety will help before you need to turn to medications.
Tell the organizer you’d like some time (maybe just 5 minutes) before presenting – like out of the room or in a quiet space so do some breathing exercises. I know that I get nervous and twitchy just before presenting.
Therefore a little bit of time not sat down before I present goes a long way!
What medication for anxiety?
If none of the above methods are useful for you, perhaps you can consider if medication is suitable for your situation.
Taking medication is a decision that you shouldn’t take lightly. Any decision to take medication for anxiety should be made in consultation with your doctor or medical professional.
1. Medications that you take over a long period of time
1.1 Selective serotonin reuptake inhibitors (SSRIs)
The most common form of antidepressant is called selective serotonin reuptake inhibitors (SSRIs). They’re considered relatively safe and cause fewer side effects than other kinds of medications used to treat depression.
Because this type of medication needs to be taken over a long period of time, it can take several months to feel the full effect of the medication. But if you’re not feeling any improvements after about 6 to 8 weeks, talk to your doctor about trying another treatment or adjusting your dosage.
Medical paper/ case: https://www.ncbi.nlm.nih.gov/pubmed/31030620
Potential side effects of SSRIs:
Most people who use SSRI antidepressants don’t have major problems, but every kind of medical treatment carries some risk. The possible side effects of these antidepressants include:
- Insomnia
- Headaches
- Rash
- Blurred vision
- Drowsiness
- Dry mouth
- Agitation or nervousness
- Feeling dizzy
- Pain in the joints or muscles
- Upset stomach, nausea, or diarrhea
- Reduced sexual desire
- Problems with erection or ejaculation
1.2 Monoamine oxidase inhibitors (MAOIs)
Monoamine oxidase inhibitors (MAOIs) are a class of medication used to treat depression. They were introduced in the 1950s as the first drugs for depression. Today, they’re less popular than other depression medications, but some people benefit from their use.
Potential side effects:
MAOIs carry more side effects than other antidepressants, which is why they’re often the last drug prescribed to treat depression. Some side effects of MAOIs include:
- fatigue
- muscle aches
- nervousness
- insomnia
- reduced libido
- erectile dysfunction (ED)
- dizziness
- lightheadedness
- diarrhea
- dry mouth
- high blood pressure
- tingling of the skin
- difficulty urinating
- weight gain
The FDA requires a warning on antidepressants that they may increase the risk of suicide in children and young adults. While MAOIs are rarely prescribed for children, all people beginning any kind of antidepressant therapy should be watched for changes in mood, mindset, or attitude. Successful antidepressant treatments should lower suicide risk by increasing mood.
However, you should consult your doctor before you stop taking MAOIs or any other prescribed medication.
Medical paper/case: https://www.sciencedirect.com/science/article/pii/S0890856709658597
Source: https://www.healthline.com/health/depression/what-are-mao-inhibitors#suicide-risk
2. Medications that you take when required
2.1 Beta Blockers
Beta-blockers are medicines that work by temporarily stopping or reducing the body’s natural ‘fight-or-flight’ responses. In turn, they reduce stress on certain parts of the body, such as the heart and the blood vessels in the brain.
Potential side effects
The most common side effects of beta-blockers are:
• cold feet and hands
• fatigue
• nausea, weakness, and dizziness
• dry mouth, skin, and eyes
• slow heartbeat
• swelling of the hands and feet
• weight gain
The following less common side effects are also possible:
• sleeping difficulties and disturbances
• erectile dysfunction
• abdominal cramps
• constipation
• diarrhea
• depression, memory loss, or confusion
• back or joint pain
Medical paper/ case: https://www.pharmacytimes.com/publications/issue/2011/october2011/case-studies-test-your-skills
Source: https://www.medicalnewstoday.com/articles/173068.php#Interactions
2.2 Benzodiazepines (“benzos”)
Benzodiazepines are man-made medications that cause mild to severe depression of the nerves within the brain (central nervous system) and sedation (drowsiness).
What are the uses for benzodiazepines?
Adult men and women use benzodiazepines to treat:
- Anxiety
- Nervousness
- Panic disorders
- Muscle spasms
- Seizures
- Sleeplessness
- Alcohol withdrawal
- Status epilepticus (A life-threatening disorder of the brain.)
- Premenstrual syndrome
Common side effects include:
- Lightheadedness
- Drowsiness
- Confusion
- Sedation
- Memory impairment
- Improper body balance
- Increase or decrease in appetite
- Nausea
- Vomiting
- Constipation
- Weight gain
- Dry mouth
- Reduced libido
- Fatigue
Can you get addicted to benzodiazepines?
Yes, benzodiazepines or benzos are habit-forming and you can become addicted to them – even if you take them as your doctor or health care professional has prescribed. If you use these drugs over a long period of time you can develop a tolerance for them. This means that you will need higher doses of the drug to treat your health condition or disease because you’ve become tolerant of the weaker formulations of the drug.
Medical paper/case: https://www.ncbi.nlm.nih.gov/pubmed/30834865
The final word!
If you are looking for fear of public speaking medication – you need to know that this is quite a serious step and medication should be used as a last resort for your public speaking anxiety.
Check out my other article – Overcoming public speaking anxiety fast for more tips.
