Do You Have Musical Performance Anxiety?

Violinists performing
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Musical performance anxiety is a type of anxiety experienced by some people with social anxiety disorder (SAD). Musicians who experience this type of anxiety are critical and self-evaluative before, during, and after performances. This negative self-evaluation causes disrupted concentration and a host of physical symptoms that result in performance below the ability of the musician.

Why do some musicians experience such debilitating performance anxiety? When musical performance anxiety is experienced as part of SAD, it is likely due to a combination of factors such as innate temperament and negative early performance experiences. In general, researchers have found that females are more likely than males to experience this type of anxiety.

Musical Performance Anxiety Statements

What does musical performance anxiety feel like? If you experience this fear, the following statements probably sound familiar. Questionnaires with statements similar to these have been used by researchers to examine the thoughts and feelings experienced by people with musical performance anxiety.

  • The harder I work to prepare for a concert, the more likely it seems that I will make a mistake.
  • I worry about a negative reaction from the audience.
  • I have a sense of dread before performances.
  • I worry about performing weeks or months in advance.
  • I never know the night of performance whether or not I will do well.
  • There are times during performances when I wonder if I will make it through.

Problematic thinking is often at the root of musical performance anxiety. Thoughts such as "My performance needs to be perfect or I am a complete failure" or "I had a good performance tonight but I must have just been lucky," create and maintain anxiety. Below are some common thought distortions that may be contributing to your anxiety about performing.

  1. Black or white thinking: "If my performance isn't perfect, I am a failure."
  2. Overgeneralization:
    1. "I had a bad performance tonight; I have always been a bad performer and always will be."
  3. Mental filter:
    1. "Everyone must have noticed how I messed up in the middle; it doesn't matter that the rest was OK, my mistake ruined the performance."
  4. Disqualifying the positive: "I had a good performance tonight but I must have just been lucky."
  5. Jumping to conclusions: "The audience was really quiet tonight, they must not have liked my performance."


When musical performance anxiety is part of SAD, cognitive-behavioral therapy (CBT) with a trained therapist can be helpful to identify cognitive distortions and work towards more positive thought patterns. In addition, behavioral therapy interventions such as cue-controlled relaxation, systematic desensitization, progressive muscle relaxation, and breathing techniques may help to reduce anxiety when performing.

Although cognitive and behavioral interventions can be successful on their own, pairing these treatments with medication may reduce anxiety more quickly and effectively.

Medications such as beta blockers can be helpful to manage anxiety symptoms during performances.

Beta-blockers such as Inderal (propranolol) taken before a performance reduce symptoms of anxiety such as increased heart rate, shaking and sweating. In addition to beta blockers, benzodiazepines and selective serotonin reuptake inhibitors (SSRIs) may be helpful in managing musical performance anxiety.

If you are a musician dealing with severe performance anxiety, it is important to get help. Although some anxiety about performing is normal and may even enhance your performance, excessive anxiety is neither helpful nor inevitable. There are options to overcome your fears and reach your full potential as a musician, but you need to make it a priority to get your anxiety under control.

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By Arlin Cuncic
Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety."