Performance Anxiety in Athletes: What It Feels Like and What Helps

What performance anxiety feels like

A research review of performing artists and athletes describes performance anxiety as having two sides. The physical side can include a racing heart, shaking, difficulty breathing and heavy sweating. The thinking side involves worry about the result and overthinking, which often disrupts attention.

For an athlete, that might mean a pounding heart on the start line, shaky hands before a serve, or attention that drifts to the scoreboard when it needs to be on the next play.

Feeling anxious is a normal part of life, and some nerves before a big event are expected. The concern is when the anxiety is strong enough to get in the way of playing, or of enjoying a sport you used to love.

When nerves become something more

The National Institute of Mental Health (NIMH) notes that for some people with social anxiety disorder, the anxiety arises only in performance situations, such as giving a speech or competing in a sports game. People may blush, sweat or tremble, have a rapid heart rate, feel their mind going blank or feel sick to their stomach.

That does not mean every nervous athlete has a disorder. These can be signs to pay attention to when the fear is intense, keeps returning, or leads to avoiding competition or practice. A therapist can help sort out what is going on. You do not need a label to ask for support.

How counseling approaches it

Counseling for performance anxiety is practical and skill-based. The approaches below are ones that research has studied in athletes and performers, or that NIMH describes for anxiety in performance situations.

• Cognitive behavioral therapy (CBT): NIMH describes CBT as teaching different ways of thinking, behaving and reacting to situations, to help a person feel less anxious and fearful.
• Gradual exposure: a CBT method of facing a feared situation step by step, so a person can return to activities they have been avoiding. It may be paired with relaxation exercises.
• Relaxation techniques: slow, deep breathing and progressive muscle relaxation, which involves tensing and then releasing different muscles.
• Imagery: picturing objects, scenes or events that are associated with relaxation.
• Motivational self-talk: practicing encouraging phrases to use under pressure.
• Mindfulness: one of the stress management techniques that NIMH says can reduce anxiety symptoms.

What the research says

A systematic review with meta-analysis looked at psychological interventions for performance anxiety in performing artists and athletes. The studies tested relaxation, imagery, motivational self-talk, mindfulness, biofeedback, psychological skills training and combined programs. The authors concluded that these interventions can potentially help ease performance anxiety in the moment.

They were also careful about the limits. The studies varied widely, some were small or of lower quality, and the authors said this made it hard to determine how effective the individual interventions are. A fair reading is that these skills are promising and worth trying, with no single method proven for every athlete.

The National Center for Complementary and Integrative Health says relaxation techniques are generally considered safe for healthy people, though a few people report increased anxiety when they try them. A therapist can adjust the approach if a technique does not suit you.

Young athletes and their parents

Children and teens worry about many of the same things adults do. NIMH notes that their concerns often center on school, extracurricular activities, friendships and the future. Sport can become one more place where a young person fears letting someone down.

The American Academy of Child and Adolescent Psychiatry (AACAP) points out that sports help children get exercise, make friends, have fun, learn teamwork and improve self-esteem. It also raises concern about a highly stressful, win-at-all-costs attitude in sports culture.

1. 1Lead with supportAACAP encourages parents to provide emotional support and positive feedback. After a game, ask what was fun or what they learned before you talk about the score.
2. 2Keep expectations realisticHold expectations that fit your child's age and ability. As AACAP puts it, success is not the same thing as winning, and failure is not the same thing as losing.
3. 3Model calm on the sidelinesChildren watch how adults behave at games. Respectful spectator behavior shows them how to handle pressure and disappointment.
4. 4Listen for more than nervesIf worry about sport keeps returning and your child starts avoiding practice or competition, ask gently what is going on and consider talking with a professional.

How we can help

Therapists on our team work with athletes on the mental side of performing, using approaches such as CBT and mindfulness-based approaches. Our sports performance counseling page explains what sessions involve. If worry reaches well beyond sport, our anxiety therapy page may be a better starting point, and parents of young athletes can read about teen therapy.

All sessions are by secure video, and clients must be physically in Pennsylvania, West Virginia or Arizona during a session. You can meet our team and book a free 15-minute consultation. Counseling is talk therapy. We do not prescribe medication, and questions about it belong with a prescriber.

If you are in crisis or thinking about harming yourself, call or text 988, or call 911. Locascio Wellness does not provide emergency services. Our crisis resources page lists more options.