Public Speaking Anxiety in College Students
If your palms start to sweat at the thought of giving a class presentation, you’re not alone- public speaking anxiety is extremely common. Dr. Holly Betterly MD, Board-Certified Psychiatrist in Weston, FL, explains public speaking anxiety- what it looks like, how it can impact your college performance, and when to consider seeking professional support.
This post is provided for educational purposes only, and is not intended as a substitute for professional medical advice. If you have questions, always reach out to your doctor for more information.
Struggling with your mental health? Reach out for professional support. Dr. Betterly is a board-certified psychiatrist in Weston, FL dedicated to helping you overcome depression, anxiety, and OCD. She offers appointments at her office in Weston, FL, conveniently located in Weston Town Center, as well as via telehealth for patients across Florida. Request an appointment today to start your journey to better mental health.
Jump to Section:
Public speaking anxiety in college students
How common is public speaking anxiety in college students?
If you find yourself experiencing feelings of dread every time you’re asked to speak in front of a group, you’re in good company. A 2017 study from the Journal of Voice found that almost 64% of college students reported a fear of public speaking.
The study authors found that public speaking anxiety is more common among:
Female students
Students with lower participation in activities involving public speaking
Students who perceive their voice to be too soft or high pitched
A 2021 study from Behavioral Modification examined public speaking anxiety in university students. The students were asked to rate their anxiety before being asked to give an impromptu speech. The results:
57% of students reported a high level of anxiety
20% of students reported moderate anxiety
22% of students reported a low level of anxiety
How can public speaking anxiety impact college students?
For students who experience public speaking anxiety, college campuses can feel like a minefield. Many classes require class participation, which could include contributing to a group discussion, or giving a speech or powerpoint presentation. For courses without any formal participation requirements, it’s still very common for students to be called on at some point to share their thoughts, read a passage from the textbook, or solve a problem on the board. Some colleges may even require their students to complete a public speaking course prior to graduation.
While some students may be able to work through their public speaking anxiety without much of a problem, others may find public speaking to be debilitating, representing a significant barrier to their college experience. When public speaking anxiety leads to avoidance behaviors, such as skipping class, academic performance can suffer.
What does public speaking anxiety look like?
When faced with a public speaking scenario, those who experience public speaking anxiety may struggle with worries and “what-ifs”, running through hypothetical scenarios and anticipating the worst possible outcomes.
A study from Archives of General Psychiatry found that the most common fears related to public speaking among survey respondents included:
Trembling, shaking, or showing signs of anxiety - 80%
Mind going blank - 74%
Doing or saying something embarrassing - 64%
Being unable to keep talking - 63%
Saying foolish/nonsensical things - 50%
In addition to fears and worries, public speaking anxiety may also involve physical symptoms of anxiety. We may notice changes in bodily sensations, such as:
Rapid and pounding heartbeat
Nausea
Loss of appetite
Sweaty palms
Shaking or trembling
Lump in the throat
Difficulty breathing
Dizziness
Muscle tension
Urgent need to urinate
General sense of uneasiness or dread
Other terms for public speaking anxiety
You may hear public speaking anxiety referred to as performance anxiety, which you can think of as a larger parent category that also encompasses a number of other conditions. While public speaking anxiety is a type of performance anxiety, they aren’t synonymous. Other types of performance anxiety can include sexual performance anxiety and sports performance anxiety.
If you’re feeling fancy, glossophobia is the formal term for a fear of public speaking, derived from the greek words “glossos”, meaning “tongue”, and “phobos”, meaning “fear or dread”.
Is public speaking anxiety a psychiatric disorder?
In short- it can be! For a mental health concern to rise to the level of a psychiatric disorder, it generally needs to be severe enough in nature that it interferes with your ability to function or causes significant distress.
Can public speaking anxiety meet this threshold? Absolutely, and for those people, it may be representative of an underlying psychiatric disorder (which we’ll get into in the next section).
For many people, however, public speaking anxiety may be no more than an occasional fleeting nuisance. You can think of this distinction as similar to how not everyone who experiences sadness is experiencing clinical depression.
Public Speaking Anxiety & Performance-Only Social Anxiety Disorder
Social Anxiety Disorder, or Social Phobia, is a type of anxiety disorder. This condition is characterized by fear or anxiety surrounding social situations in which one is exposed to the scrutiny of others. People with this condition fear that they will be judged negatively, which may lead them to avoid the social situation entirely, or endure it with intense anxiety.
For some people with social anxiety disorder, any social interaction may be anxiety-inducing: from ordering lunch at a restaurant, to meeting up with a friend, to attending a party. For others, the anxiety may be limited in nature, coming up only in response to speaking or performing in public. This type of social anxiety disorder is called Performance-Only Social Anxiety Disorder.
In the Diagnostic and Statistical Manual of Mental Disorders (DSM), this condition falls under Social Anxiety Disorder with the Performance-Only specifier.
How can we tell the difference between public speaking anxiety and Performance-Only Social Anxiety Disorder?
In Performance-Only Social Anxiety Disorder, symptoms must:
Be out of proportion/ excessive
Be persistent, typically lasting for 6+ months
Cause significant distress or impairment in functioning (such as at work, school, or social relationships)
Here’s two fictional case examples for illustrative purposes:
Case 1:
After asking a question and getting crickets, the professor announces that he’s going to start calling on people at random. Joe groans internally, averting eye contact. If he calls on me, it’s going to be so embarrassing, he’s going to think I’m an idiot. The professor notices Joe slumping in his chair and asks him for his thoughts. Joe gives a short but appropriate response. The professor thanks him for his input and moves on to the next student. Joe breathes a sigh of relief, and within a minute or so, he’s forgotten all about it, turning his focus to what’s on the menu for lunch.
Case 2:
Jane receives a copy of the course syllabus on the first day of class, and as she glances at the grading rubric, her heart begins to pound. Class participation is 5% of the final grade?! Her palms begin to sweat, and nausea begins to creep up in her throat. She envisions herself reading her essay out loud only to be met by roars of laughter and ridiculing looks from her classmates. I can’t do it, there’s no way, it’s just not possible. She remembers how distressing it was when she had to give a powerpoint presentation in a class last semester, and the feelings of dread that come up whenever she is asked to share a fun fact during introductions. She had been really looking forward to taking this creative writing class, but this completely throws a wrench in things- she decides to drop the course, disappointed.
In Case 1, Joe briefly feels nervous about speaking in front of the class, but he’s able to get through it without much effort or significant distress. His anxiety is short lived, and he’s able to quickly move on with his day. This is an example of public speaking anxiety that, taken in isolation, probably wouldn’t meet criteria for a formal psychiatric disorder.
In Case 2, Jane experiences intense anxiety at just the thought of public speaking. Her public speaking anxiety is longstanding, and interferes with her functioning in that she feels unable to continue with a course that she had been excited about. This is an example of performance-only social anxiety disorder.
It’s important to remember that each person’s experience with public speaking anxiety and Performance-Only Social Anxiety Disorder is different, and the above examples are not representative of all experiences. Symptoms can vary significantly in terms of severity.
Treatments for Performance-Only Social Anxiety Disorder
There are multiple effective treatment options available for those living with Social Anxiety Disorders. These may include therapy, prescription medications, or a combination of both. Only a mental health professional, such as a psychologist or a psychiatrist, can determine which options may be appropriate for you.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) is a specialized form of evidence-based therapy which involves examining and changing the negative thoughts, feelings, and behaviors associated with social situations. It may involve gradual exposure to anxiety-inducing situations in a controlled environment, as well as developing skills and strategies for coping with anxiety.
Prescription Medications
Selective Serotonin Reuptake Inhibitors (SSRIs), such as paroxetine and sertraline, and Serotonin Norepinephrine Reuptake Inhibitors (SNRIs), such as venlafaxine, are medications that are frequently prescribed to treat Social Anxiety Disorder. These medications are typically taken on a consistent daily basis, and lead to a gradual reduction in anxiety symptoms over time.
Other medications are prescribed on an “as needed” basis, to be taken shortly before a known public speaking engagement, such as a class presentation. These medications can provide short-term relief from in-the-moment symptoms.
Beta blockers, such as propranolol, are often prescribed for this purpose. Originally developed as medication for high blood pressure, beta blockers can help to alleviate physical symptoms of anxiety, such as a racing heart and sweaty palms. It’s important to note that beta blockers have not been approved by the FDA for the treatment of anxiety, so while they are often prescribed for this purpose, their use is “off label”.
Antihistamines, such as hydroxyzine, are another type of prescription medication that may be prescribed for short-term symptom relief. Hydroxyzine can have a calming effect, however some people may find that it makes them feel too drowsy.
If you’re interested in learning more about whether prescription medications may be appropriate for you and your unique health circumstances, reach out to a psychiatrist for further evaluation.
Finding treatment at college
If public speaking anxiety is interfering with your life and you’re concerned that you may be experiencing an anxiety disorder, reach out to a mental health professional for further evaluation of your concerns.
For more in-depth info, check out Dr. Betterly’s guide to finding mental health treatment as a college student. We’ll provide the highlights below!
On-Campus Resources
Many colleges and universities provide easy access to mental health treatment through a Student Counseling Center or Student Health Services. These services are often covered by the school’s tuition and fees, which means that students may be able to access these services at no additional cost.
More information about these services can often be found on the schools’ website, or through a quick Google search.
Off-Campus Resources
For some students, on-campus mental health treatment may not be an option. Perhaps their school doesn’t provide on-campus services, or are only able to provide services for a short period of time. Some students may simply prefer not to receive their mental health care through their school.
Another great option for accessing mental health treatment is by finding a local psychiatrist or psychologist out in the community. Many mental health professionals offer telehealth appointments, allowing students to receive care from the comfort of their dorm.
If you are considering prescription medications for your mental health, a psychiatrist is your best bet. Psychiatrists are medical doctors (MD or DO) who specialize in the diagnosis and treatment of mental health conditions. They are experts in prescribing psychiatric medications.
To locate a psychiatrist near you, check out the American Psychiatric Association’s (APA) free online directory.
If you’re interested in talk therapy, psychologists are a great option. Psychologists are mental health professionals who have typically earned a doctoral degree, such as a PsyD or PhD, and specialize in the evaluation and treatment of mental health conditions.
To locate a psychologist near you, check out the American Psychological Association’s (APA) free online directory.
Located in Florida? Dr. Holly Betterly is a Board-Certified Psychiatrist with experience working with college students at the undergraduate, graduate, and professional degree levels. She specializes in treating depression, anxiety, and OCD. She offers telehealth appointments for patients across Florida, helping her patients to access high-quality care from the comfort of their couch. Request an appointment to start your journey to better mental health.
