Health Chart

Kiran Bhagat | Monday November 8, 2010 00:00

Is there any way to treat fear or anxiety associated with public speaking?

Answer

Many people, including professional actors and politicians, get nervous before speaking in public. This can be a lot worse when fear of public speaking is a manifestation of social anxiety disorder or social phobia, defined as a persistent and irrational fear of situations that may involve scrutiny or judgment by others.Fear of speaking in public is a very common type of social phobia. We don't know what causes these problems. They may be learned, inherited or, possibly, biochemical in nature.

Researchers are exploring the idea that heightened sensitivity to disapproval may be physiologically or hormonally based.A bit of anxiety can be a helpful way of focusing one's energy before a talk. And you wouldn't want to eliminate it completely, but here are some recommendations for managing anxiety when it is too overwhelming to be useful:

* Learn breathing exercises. Practice them regularly and do them before speaking to keep yourself calm.

* Take a small dose of a beta-blocker, such as atenolol or propanolol, 30 minutes before you have to speak. These are beta-blockers drugs, usually prescribed to control high blood pressure. Consult your physician, or a stress therapist/psychologist who treats anxiety disorders, particularly social phobias.

* Consider cognitive behavioural therapy, which is very useful in treating social phobia. The goal of this form of treatment involves helping patients gradually become more comfortable with situations they fear. It includes deep breathing to control anxiety.

I sometimes worry myself into a panic. I begin to think that something is terrible is going to happen. I try not to think of these things but this just creates more worry. What do I do?

Answer

Worrying is a common problem. It can make you miserable and can actually take a toll on your health. Some research has suggested that chronic elevation of stress hormones prompted by worry can damage areas of the brain and that worrying may reduce immunity, making you more susceptible to infection. I don't mean to give you more to worry about. Not all worrying is bad - it can motivate you to plan ahead or take action when you're up against a real problem.The kind of non-productive worrying you describe can become chronic and escalate into generalized anxiety disorder (GAD), which is characterized by physical symptoms including muscle tension, headaches, trembling, restlessness, sweating, abdominal upsets, dizziness and irritability.

My first recommendation to address your worrying habit is cognitive behavioral therapy (CBT), a form of psychotherapy that can help you recognise the distorted thinking patterns that can lead to worry and teach you to address them with healthy coping skills. CBT works quickly - a great advantage. You will need to find a good stress therapist or psychologist trained in CBT. There are several in Botswana.You can also try these approaches, all of which can help you break the worrying habit and relieve the tension that accompanies worrying:l Breathing exercises. Try my relaxing breath, using instructions on my Web site, www.drweil.com, to relieve tension.

* Avoid caffeine, nicotine and other stimulants, all of which can exacerbate tension.

* Exercise regularly: This can lower stress hormones and increase production of brain chemicals such as serotonin and endorphins that positively affect mood.

* Address your fears: When you worry about things you can do something about, take action.

* Put your worries on paper. This can show you that your fears are exaggerated or unrealistic.

* Try meditation. This can lead to long term reductions in anxiety among those with anxiety disorders.

* Take a good multivitamin with B-complex and an omega-3 (fish oil) supplement: the B vitamins in the supplement can help balance your mood; magnesium helps relax muscles, and a deficiency in omega-3 fatty acids has been associated with increased anxiety and depression. Take one to three grams of fish oil daily.