Anxiety in Teens

Performance Anxiety & Exam Stress

What is it?

Adolescents are often faced with series of tests and exams, and opportunities to perform in front of teachers and peers (e.g., presentations, athletic events, musical performances). These situations can lead to a great deal of pressure for youth, which in the long term can result in stress and anxiety. Experiencing some pressure prior to an examination, presentation, or performance (e.g., athletic or musical) is a common experience. This pressure can be helpful, as it lets us know that the upcoming event is important to us and motivates us to work hard in hopes of a positive outcome. However, when the pressure becomes overwhelming, excessive, and begins to take over and inhibit our concentration and performance, this becomes a problem.

Stress is defined as the adverse reaction experienced due to excessive pressure or other demands placed on a person. When someone experiences stress, their body will react accordingly and go into a “fight or flight” response, which releases increased levels of adrenaline through the body leading to symptoms which can include: muscle tension, chest pains, difficulties sleeping, pounding heart, stomach upsets, and mind blanks. Although stress is a normal physical response to threatening situations, prolonged stress can result in serious mental and physical illness.

Concerns around failure, perfectionism, wanting to achieve a certain result/outcome, pressure to compete with siblings/peers, or pressure to achieve good results are examples of some of the concerns that adolescents can experience. These concerns if not addressed properly, can lead to long term problems like feelings of inadequacy, substance misuse, and mental health difficulties later in life.

Symptom Checklist

Signs of performance anxiety and exam stress include:

  • Social withdrawal
  • Indecisiveness
  • Feeling overwhelmed
  • Loss of motivation
  • Difficulties sleeping or getting out of bed
  • Muscle tension
  • Headaches
  • Stomach upsets
  • Loss of appetite
  • Fidgeting, nail biting, or teeth grinding
  • Sudden reluctance to play or participate in sports or activities they previously enjoyed
  • Mood swings
  • Grumpiness or being more irritable
  • Sudden reluctance to go to school prior to a test or exam

Treatment for Performance Anxiety and Exam Stress

Cognitive Behavioural Therapy (CBT) for exam stress and performance anxiety helps adolescents identify and understand the link their thoughts and worries have on their feelings and behaviours. A psychologist trained in CBT will work with your teen to explore their maladaptive thought patterns and help them develop new and more realistic patterns of thinking to help reduce their levels of anxiety. Additionally, a psychologist will also explore other factors that may be contributing to your adolescent’s experience of stress and work collaboratively with your teen to develop coping strategies to manage these effectively.


Author: Dr Daphne Bryant