Wednesday, May 15, 2013


Have you ever thought that when you sit for exams, tests or some task which requires you to perform so that you can be judged, your heart starts beating fast, you become nervous and invariably your performance declines. This happens to everybody but for some it is so disabling that it messes up your entire performance to a considerable degree. People wonder what their performance would have had been had this phenomenon not been a part of their experience.
First of all as a psychiatrist I would like to explain this phenomenon and then I would like to give certain tips which would be of immense help to you.
  This phenomenon in psychiatry is called performance anxiety. By performance anxiety I mean any nervousness, increase in heart rate, sweating, tremors, dryness of mouth, weakness which occurs just before giving any test etc.
This may be as impairing in children as in adults and could be the main reason behind your child's failure in examinations.
Tips to reduce performance anxiety can be divided into drugs based and non-drug based.
To start with i would like to list non drug based measures. Main non drug based measures include-
1) Deep breathing exercises-these are the easiest and cheapest way to overcome your anxiety.
2) JPMR-these are progressive muscle relaxation exercises which very effective way to control your disabling anxiety symptoms. But the drawback is that you need to learn them from a qualified psychiatrist or psychologist and they are time consuming.
3) Distraction techniques-the main principle which governs this type of therapy is that your thoughts lead to these symptoms. So distracting from your anxiety provoking thoughts will cause these anxiety symptoms to subside.

Main drawbacks of non-drug based measures include:-
-it is time consuming.
-exact technique needs to be mastered to have maximum effect.        
-it needs space.
-it is not useful in case of severe anxiety.
-it is difficult to teach to children.
-instant benefit is limited.
To people who have these limitations drug based methods are best which include
1) Beta blockers such Propranolol which can be taken before exam or test.
2) Benzodiazepines such as Alprazolam. It is for short term control of anxiety.
3) SSRI'S such as Escitalopram. It is for long term control of anxiety.
Main drawbacks of drug based measures include:-
-A consultation from a psychiatrist must before administration of drugs.
-It is costlier than non-drug based methods.
So it is advisable to get a proper health and psychiatric evaluation before instituting any treatment.

With best wishes for healthy and long life
Dr Hitesh Sharma 
MBBS, MD (Psychiatry)