Fear of public speaking: How can I overcome it?

Fear of public speaking is a common form of anxiety. It can range from feeling a little nervous to extreme fear and panic. You may try not to speak publicly, or you may do so with trembling hands and a shaky voice. But by preparing, practicing and getting help if needed, you can overcome your fear.

These steps may help:

• Know your topic. The better you understand what you're talking about — and the more you care about the topic — the less likely you'll make a mistake or get off track. And if you do get lost, you'll be able to get back on track quickly. Take some time to think about up to five questions the audience may ask and have your answers ready.
• Get organized. Ahead of time, carefully plan out the information you want to present. This includes any props and audio or visual aids. The more organized you are, the less nervous you'll be. Use an outline on a small card to stay on track. If possible, visit the place where you'll speak, review the equipment and practice the talk before your actual presentation.
• Practice, practice, practice. Practice your presentation several times. Do it for some people you're comfortable with and ask for feedback. It also may help to practice with a few people who you don't know well. You may want to make a video of your presentation so you can watch it and see ways to improve.
• Challenge specific worries. When you're afraid of something, the fear may be larger than the actual threat. List what you're worried about. Then list what else could happen and any evidence that supports whether or not what you fear will happen. Ask yourself how past presentations have gone.
• See yourself as a success. Imagine that your presentation will go well. Positive thoughts can ease concerns about how you perform socially and make you feel less anxious.
• Breathe deeply. This can be very calming. Take two or more deep, slow breaths before you get up to the podium and during your speech. Most of the time, anxiety peaks right at the start of the presentation and usually settles down within a few minutes.
• Focus on your material, not the audience. People mainly pay attention to new information — not how it's presented. In fact, when presenters are anxious, they tend to overestimate just how much others can tell they're stressed. The audience may not notice how nervous you are. If audience members do notice that you're nervous, they may root for you and want your speech to be a success.
• Don't fear a moment of silence. If you lose track of what you're saying or start to feel nervous and your mind goes blank, it may seem like you've been silent for an eternity. In reality, it's probably only a few seconds. Even if it's longer, it's likely your audience won't mind a pause to think about what you've been saying. Just take a few slow, deep breaths.
• Celebrate your success. After your speech or presentation, give yourself a pat on the back. It may not have been perfect, but chances are you're far harder on yourself than your audience is. See if any of your specific worries came true. Everyone makes mistakes. Look at any mistakes you made as ways to make your skills better.
• Get support. Join a group that offers support for people who have a hard time with public speaking. One effective resource is Toastmasters International, a nonprofit organization with local chapters that focuses on training people to speak and lead well.

If you can't overcome your fear with practice alone, think about getting professional help. Cognitive behavioral therapy is a skills-based approach that can ease the fear of public speaking.

As another option, your doctor or other healthcare professional may prescribe a calming medicine that you take before public speaking. If your healthcare professional prescribes a medicine, try it before the next time you'll be speaking publicly to see how it affects you.

Feeling nervous or anxious about public speaking is common, but it also can be motivating. Fear of public speaking is a form of performance anxiety, along with stage fright and test anxiety.

But people with severe performance anxiety that includes great anxiety in other social situations may have social anxiety disorder, also called social phobia. People with social anxiety disorder can be helped by cognitive behavioral therapy, medicines or both.