Public speaking anxiety

Public speaking anxiety is intense fear of speaking in front of others, marked by a racing heart, sweating, shaking, dry mouth and worry about being judged.

It is the most common form of social anxiety and ranges from ordinary nerves that fade once a talk begins to a phobia that leads people to avoid presentations, classes or promotions. Physically it reflects activation of the fight-or-flight response; cognitively it involves anticipating embarrassment and overestimating how visible the symptoms are. When fear extends to many social situations, clinicians consider social anxiety disorder; when it is confined to performance settings, it is classified under the performance-only specifier.

Assessment uses interview and questionnaires such as the Liebowitz Social Anxiety Scale, and care typically combines cognitive behavioral therapy with graded exposure, sometimes with medication before high-stakes events. Public speaking has a special place in cannabinoid research because the simulated public speaking test, in which participants prepare and deliver a speech under observation, is a standard laboratory model of acute anxiety. Several small trials have used it to test cannabidiol against placebo, with results that vary by amount and study. The research remains early, and no cannabinoid has an approved use for anxiety.