British Association for PERFORMING Arts Medicine

Managing Performance Anxiety

In this Resource:

  • What is Performance Anxiety?
  • Causes of Performance Anxiety
  • Physical and Mental Symptoms of Performance Anxiety
  • Some Strategies for Managing Performance Anxiety

New: Our performance anxiety poster is designed to help manage anxiety in the moment, such as just before going on stage. If you’d like to order copies of the poster, please email


What is Performance Anxiety?

Performance anxiety or ‘stage fright’ is a feeling of fear accompanied by increased bodily arousal, and is experienced by most performers at some point. The physical symptoms can be debilitating and, once experienced, the fear that it will happen again can create a pattern.

Performance anxiety is not an indicator of age, status, experience or reputation. It might only emerge around certain situations in specific locations and ‘important’ people, or be broader and occur during every performance, rehearsing with others, or in the build-up to a performance – on any occasion where your perception of the resources you have available to you do not seem to align with the demands of the situation.

Fortunately, there are tried and tested strategies for managing performance anxiety and, like all of your essential performance skills, they will improve with practice.

A certain level of arousal is needed for optimal performance. The Yerkes-Dodson law describes this relationship between arousal and performance. Essentially, if arousal is too low or too high, performance will suffer. In order to achieve optimal performance a moderate level of arousal is needed.

The Yerkes-Dodson law illustration: Bell curve

Causes of Performance Anxiety

You are more likely to experience performance anxiety if:

  • You are by nature a ‘worrier’ and tend to get anxious or upset in everyday situations
  • You have an unhappy memory of a previous performance
  • The performance is labelled as ‘high profile’ or ‘important’
  • There hasn’t been much time to prepare, practise and rehearse
  • You are working with new people, especially people you perceive as ‘difficult’ or people you feel in awe of
  • There are major current life stressors affecting you or someone close e.g. bereavement, illness, relationship breakdown or financial precarity
  • You have perfectionist traits and/or hold yourself to rigid and unrealistically high standards which you (or anyone else) would rarely be able to achieve

Physiological and Mental Symptoms of Performance Anxiety

One or several of the below symptoms may occur:

  • Sweating – especially hands
  • Dry mouth
  • Heart pounding
  • Breathing gets faster and shallower
  • Shaking or trembling
  • Dizziness
  • ‘Butterflies’ in the stomach
  • A sick feeling (actual vomiting is less common)
  • The urge to keep rushing to the loo
  • Feelings of apprehension, fear, dread, or panic
  • Feelings of failure, inadequacy, lack of skill

Negative and self-critical thoughts may also occur, such as:

  • I am not good enough
  • The performance will go badly
  • I’ll mess up the tricky bit
  • People will think I’m terrible
  • Panic is going to get the better of me and I’m not going to be able to cope
  • I can do it on my own at home but will I be able to do it on the day?

Strategies for Managing Performance Anxiety

Below are a variety of strategies for managing performance anxiety that span across the short term and long term.

For in-the-moment relief, this BAPAM performance anxiety poster is designed to help manage it in the moments before going on-stage, while some of the below strategies can provide longer-term background support. 

  • Refresh your techniques: If your fears are based on shaky or inadequate technique, book yourself some time with a trusted teacher or expert in your field.
  • Performance coaching: Working with an experienced performance coach or attending online training sessions can help you learn new skills and embed them into your day to day creative practice.
  • Adopt a consistent attitude towards each performance: A philosophy of ‘important’ performances not only increases the pressure, it also has a flipside of perceived ‘unimportant’ performances where you may not fully engage. It’s better to cultivate a ‘next’ performance mentality focusing on a consistent attitude and-day-by-day preparation.
  • Distraction techniques: Distraction techniques can be helpful when waiting backstage. Bring a book or something that can take the mind away from the task ahead. Distraction might not work for everybody, so it is essential to experiment to find out what works best for you prior to performance.
  • Physical warm-ups: Warming up the body by marching on the spot, for example, can help increase arousal if you are feeling lethargic.
  • Breathing techniques: Breathing techniques, such as the “Box Breathing” exercise in this BAPAM performance anxiety poster, can help manage stress in the moment. 
  • While preparing material, or while waiting to go on stage, try visualising your successful performance – how will you be standing, sitting or moving? This can enable you to mentally practise positive experiences of performing.
  • Avoid self-medication: Avoid self-medicating, for example with excessive alcohol or street drugs, as this is likely to have undesirable side effects and may be addictive. This also goes for excessive exercise, comfort eating, restrictive diets or cutting out meals altogether.
  • Talk things through: Sometimes it can help to talk things through with a suitable psychotherapist, for instance if your performance fears relate to long-standing difficult psychological events, panic attacks, social anxiety or phobias, or you have a wide-ranging tendency to perfectionism. You might ‘explain away’ anxious feelings or tell yourself that your anxiety ‘isn’t that bad’ because acknowledging problems fully is difficult. Talking things through with a trained professional can help uncover more rooted issues and bring about awareness. Additional support may be available through BAPAM mental health services and from occupation-specialist practitioners like those listed in the BAPAM Directory.
  • Medication from a trained health professional: Medication such as beta-blockers and tranquillizers help some people manage anxiety, but it is important to see your GP to discuss if they are appropriate for you, how they work, and the pros and cons including possible side-effects.

Getting Further Help

There’s no need to suffer with performance anxiety alone. Even if you have put up with it for a long time, BAPAM can help you find out about expert practitioners, accessible mental health support, and financial help that may be available, and make positive progress.

To support you in managing anxiety and other performance-related health problems, BAPAM provide free clinical advice, healthy practice training, and work with partners such as Help Musicians and Equity on mental health support schemes. We provide further information on a wide range of organisations, schemes and individuals providing practical help. Our performance anxiety poster is designed to help manage anxiety in the moment, such as just before going on stage.

For more information give us a call on 020 8167 4775 or email


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British Association for Performing Arts Medicine
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