Q. I’m 46 years old, and I become extremely nervous whenever I’m expected to give a brief report or speech before a group of people. I thought I would overcome this with maturity, but instead it’s getting worse. Could you recommend any tactics or medication that could help?
A. Millions of people will sympathize with your dilemma. Public speaking or performing can be intimidating. Some doctors prescribe low doses of beta blockers for patients with severe stage fright. Drugs like Inderal (propranolol), Corgard (nadolol) and Tenormin (atenolol) can relieve the pounding heart and shakes, but people susceptible to asthma cannot tolerate such medicine.
Because there are other side effects you will need to discuss such medicines very carefully with your doctor to determine if any is appropriate. A safer approach is behavioral therapy. A psychologist who specializes in performance anxiety may be able to help.
Not everyone liked our answer:
Q. I don’t like your advice to the 46 year old who becomes nervous when speaking to a group. You suggested a medication, but it would have been far better to recommend joining Toastmasters. This organization offers training and practice so a person can learn to talk to a group–and enjoy it–without any drug side effects.
A. Thanks for the tip. A number of readers wrote us about Toastmasters. To find a local chapter, check with Toastmasters International. We’re in favor of nondrug solutions whenever they work.
Another story:
Q. Over the last six months I have developed a phobia about public speaking. Whenever I have to talk in front of a group my heart starts to pound, my voice gets very tight, my hands shake and I feel as though I am going to die. These panic attacks are affecting my ability to function at work.
My doctor gave me prescriptions for Paxil and Xanax but I hate taking pills for something like this and I worry about having to take them for years. What can you tell me about these drugs?
A. Xanax (alprazolam) can relieve anxiety and Paxil (paroxetine) is prescribed for panic. They offer short-term relief, but people can become dependent on them. Cognitive behavioral therapy, “Toastmasters” public speaking training and other non-drug approaches may provide more lasting benefit.
Here is another approach:
Q. I am petrified by the prospect of public speaking. I have no trouble interacting with my friends or family, but if I have to stand up in front of a group my knees shake, my hands sweat and my throat goes dry and raspy.
I have to give a report to my church organization. It is no big deal, but I am still scared. Is there a home remedy that you can recommend instead of a tranquilizer? I am very susceptible to side effects and such drugs put me to sleep.
A. If you have a dog, perhaps you could bring it along. A study at the University of Buffalo showed that most people feel more relaxed when their dog is near. As long as the church group doesn’t mind having Fido underfoot, that might help you get through the ordeal.
