Is There a Connection Between Anxiety Disorders and Fear of Speaking?

We are all familiar with the concept of public speaking, but all speaking is public speaking. When ordering dinner in a restaurant, people do not consider this “public speaking” and may complete this task with minimal anxiety or self-awareness. Yet, a presentation in front of seven people may cause extreme distress.

Public speaking in a business setting can cause substantial stress, fear, nervousness, and anxiety for many professionals. The fear of speaking is considered one of the most common struggles in effective presentations and communication at work.

In this article, I will reference our research, coaching, and training experience with executive-level professionals over the years. I will focus on helping speakers understand where their fear of speaking comes from and how to best address it, particularly if they have a current diagnosis of anxiety disorder

Of course, there are many components to fear of speaking, such as family upbringing, company culture, personality, nationality, and learned behaviors. This article will help identify the connection between anxiety disorders and fear of speaking and how to manage this challenging and common condition.

We should start here: There is a significant difference between diagnosed anxiety disorders and the fear of speaking. However, people who struggle with anxiety are more likely to experience higher stress levels in specific public speaking settings. In this way, there is a connection between a diagnosed anxiety disorder and increased stress with public speaking.

Why does having a Generalized Anxiety Disorder (GAD) make it more probable that I will experience increased worry around public speaking compared to my coworkers?

Based on data from NOBA, a global psychology resource, they explain it this way:

“Research shows that individuals with GAD are more sensitive and vigilant toward possible threats than people who are not anxious (Aikins & Craske, 2001; Barlow, 2002; Bradley, Mogg, White, Groom, & de Bono, 1999). This may be related to early stressful experiences, which can lead to a view of the world as unpredictable, irrational, uncontrollable, and even dangerous. Retrospectively, some have suggested that people with GAD worry as a way to gain some control over these otherwise uncontrollable or unpredictable experiences and against uncertain outcomes” (Dugas, Gagnon, Ladouceur, & Freeston, 1998).

By repeatedly going through all of the possible “What if?” scenarios in their mind, the person might feel less vulnerable to an unexpected outcome, giving them some sense of security or control over the situation (Wells, 2002). Others have suggested people with GAD worry as a way to avoid feeling distressed (Borkovec, Alcaine, & Behar, 2004). For example, Borkovec and Hu (1990) found that those who worried when confronted with a stressful situation had less physiological arousal than those who didn’t worry, maybe because the worry “distracted them in some way.”

A distinction must be made between Generalized Anxiety Disorder (GAD) and fear of speaking. The fear of speaking is technically referred to as Glossophobia. Glossophobia differs from Generalized Anxiety Disorder, but they share some characteristics. described this type of condition as “a fear of public speaking, a prevalent phobia believed to affect up to 75% of the population. Some individuals may feel slightly nervous at the very thought of public speaking, while others experience full-on panic and fear. As a result, they may try to avoid public speaking situations at all cost, or if they must speak in public, they endure shaking hands and a weak, quavering voice.”

It is vital to distinguish between these two challenges, GAD and Glossophobia, so a person can understand, better manage, control, and resolve the core reason for the distress they feel when speaking publicly.

If I experience anxiety regularly, how can I minimize its impact on the quality of my public speaking?

There are many approaches to reducing GAD’s stressful and often debilitating impact on the quality of work presentations, pitches, internal updates, investor meetings, presentations to the Board, and other communication scenarios.

To minimize the impact of anxiety on public speaking, it is important to identify “catastrophic thinking.” Catastrophizing can be a result of or cause of anxiety.

Why is catastrophic thinking so detrimental?

As identified by NOBA, “The problem is, all of this “what if?” -ing doesn’t get the person closer to a solution or an answer; in fact, it might take them away from important things they should be paying attention to in the moment, such as finishing an important project. Moreover, many of the catastrophic outcomes people with GAD worry about are very unlikely to happen, so when the catastrophic event doesn’t materialize, the act of worrying gets reinforced (Borkovec, Hazlett-Stevens, & Diaz, 1999).”

People with GAD often miss out on many otherwise enjoyable life events. For example, suppose someone with GAD is planning to attend a conference they are speaking at on a Wednesday morning. In that case, they may spend all of Sunday, Monday, and Tuesday in panic, unable to eat, socialize or enjoy the other speakers at the conference. In many cases, after the presentation is finally over, they still need a few days to “decompress” and recover from the experience, therefore increasing the toll on them both physically and mentally before and after the event.

The fight or flight response that accompanies anxiety disorders can last for days or weeks at a time, as opposed to a temporary jolt of nerves that someone with fear of speaking might experience as they approach the stage or front of the room.

How will I know if I have catastrophic thinking due to GAD?

Here are some examples of catastrophizing:

  • “If I don’t do a good job in this presentation, I will expose myself as a fraud and be a total failure in life.”
  • “If I do not prove myself and my competency, I will get fired.”
  • “Everyone can tell I am nervous; they think less of me every time I speak in a group setting.”


Doctors often call catastrophizing “magnifying” because a person makes a situation seem much worse, dire, or more severe than it is. Unfortunately, Catastrophizing does not usually have any benefits. Interestingly, speakers are rarely judged as harshly as they think they will be. This disconnect is called cognitive distortion.

Cognitive distortion is a critical component of our lizard brain. Human beings might have developed cognitive distortions as an evolutionary survival method, but these thoughts are not rational or healthy in modern life and society. Instead, catastrophic thoughts can fill a person’s mind with unnecessary emotions that take time and thought away from the reality of a situation.

I do not want to deal with this; I have been this way for so long. Can’t I just ignore it and avoid public speaking?

A past or current diagnosis of an anxiety disorder such as Generalized Anxiety Disorder (GAD), Obsessive Compulsive Disorder (OCD), Panic Disorder, Post-traumatic stress disorder (PTSD), or Social Phobia (Social Anxiety Disorder) can cause fear of speaking to be more debilitating, with a level of anxiety that is not appropriate to the situation. Therefore, avoidance is not a sustainable way to live.

Intense speaking anxiety levels can lead to lower quality of work and performance, with extreme worry and fear that can diminish immune function. In addition, this anxiety could lead to drug or alcohol use, dependency on “stage fright” drugs such as beta-blockers, cause physical health problems, and, sadly, even suicidal thoughts and behaviors.

The National Alliance on Mental Illness states that over 40 million adults are in the US. (19.1%) have an anxiety disorder. Anxiety disorders are a group of related conditions, each having its unique symptoms. However, all anxiety disorders have one thing in common: persistent, excessive fear or worry in situations that are not threatening.

People tend to have anxiety about their anxiety; “Why am I like this? This is so stupid! Why am I this way? What is wrong with me? Why can’t I be normal?

Remember, an irrationally pessimistic forecast of your competency or future events will cause anxiety to spike and may diminish your quality of life. Most people experience cognitive distortions from time to time. However, if reinforced often enough, they can have increased anxiety, deepen depression, cause relationship difficulties, and lead to other complications.

How can I manage my catastrophic thinking?

When business professionals are ready to address their fear of speaking and strengthen their communication skills, they take on a crucial task. Whether it is an occasional private reflection, learning to increase comfort slowly over time with a specific plan, working with a speech coach, or asking a trusted advisor for help, they need to identify approaches that will work best for their personality, budget, time, and comfort level.

Fortunately, several methods address “all or nothing” thinking and catastrophizing. Here are a few:

  1. Recognize when thoughts are irrational, such as “Everyone thinks I am an awful presenter.” Replace these thoughts with a more rational mindset, such as “Some people may or may not resonate with my presentation, but chances are most people will find it helpful.”
  2. Think about an alternative outcome. Instead of thinking, “Everyone is going to find me boring,” think, “This information will be useful to some people, and they will appreciate me sharing it with them.”
  3. Acknowledge that you cannot control everything. Yes, people will sometimes judge a speaker but not unreasonably. For example, did the speaker arrive prepared? Did they get to the meeting on time? Did they have an outline of key points?

Final Thoughts

It makes sense that someone who struggles with anxiety is more likely to experience higher stress levels in specific public speaking settings. Understanding the connection between a diagnosed anxiety disorder and increased stress with public speaking can remove some of the burden or shame of nervousness and instead think of anxiety-prone brains as fancy sports cars, highly sensitive and in need of purposeful handling.

When a person is ready to tackle a cognitive distortion caused by an anxiety disorder, consider cognitive behavioral therapy or meeting with a communication coach who has experience with fear of speaking issues and challenges. Luckily, just as events may build up to the extent that they feel catastrophic, they can also be broken down and reconstructed so that they are no longer viewed as disastrous.

Increasing self-awareness and addressing the fear of speaking is a unique and personal experience. Choosing the right coach, therapist or advisor can provide critical life-long skills, improve quality of life, and open up endless possibilities for growth and career satisfaction.

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