# Presentation Fear and Propranolol



## metoo

Wow - this site saved my life. I was convinced I would have to quit my job.

First off, I have never posted to anything in my life and because of the impact, I am sharing my brief story.

About 10 years ago, I had to read out loud and my body went into panic. I was always nervous for presentations or introducing myself but from then on, I was a wreck. I tried books and Toastmaster and got better but always struggled. My career responsibilities grew and so did my fear. In the beginning of the year, I had an exec presentation scheduled and lost three week of my life just thinking, practicing, etc. Then, I declined introducing some conference speakers because I could not see myself able to make it through the introductions reading out loud.

I just do not trust that my body will not betray me. With the use of the below drugs, my life is back and I know that my body can not betray me in these situations. I am also more confident in general now because I am not constantly thinking about the fear, trying to figure it out and change (will not stop working on the cognitive side, thought life, deep breathing, etc; however, I could just not break the fear of the fear cycle)

Well, I recently tried Propranolol. It worked miracles for me. It does not take away the nervous fear but all the physical symptoms. I also added Xanax for a really high stress exec meeting. Below is what works for me:

- 20mg Prop about 1 hour before (worked again in a sales meeting great yesterday)
- .25 Xanax only for major stress presentations (I try to avoid because it does make me less sharp thinking but does kill the nerves for me)

Hope this helps somebody like it really helped me!!!


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## EmptyRoom

I'm glad this site saved you, you're welcome here.


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## tomcoldaba

Thanks for sharing. I am a member of 3 toastmaster clubs for 3 years. I have overcome the fear of public speaking. If I have to give a major presentation before a room full of executives, I am very nervous. Your suggestion makes sense, just do the drugs only in high pressure situations. I thought you have to take Xanax regularly for it to have any effect. From your post, you can take Xanax as needed.


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## IllusionOfHappiness

Glad to hear this site helped you so much .


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## sasha northton

*did I write this?*

what you describe is identicle to my situation - my career is starting to take off but the added responsibility (especially presentations, de-briefings, reporting to the board etc...) sent me into a tail spin.

I take 80mg Propranolol (slow release) in the mornign before 'something scary' and if it is very scary/important I also take 2mg of Diazepam. The Diazepam deals with the mental anxiety and the beta blocker deals with the physical sympotms. I have done several presentations on this combo and everything was fine. I just havent learnt to trust myself and my body/mind to the point where I don't need to worry for weeks in advance.

I will worry for 2 weeks before an event to the point where I am physically ill and then on the day I will take my special mix and that calms me down. 30 seconds before the 'performance' I get really calm/relaxed and feel an urge to get up there and get it over and done with - the feeling you get when you are just about to skydive - weird. Once I am up there I am fine but afterwards I feel like I have been awake for a week straight - totally exhausted.

Anyway, well done - keep up the good work.

Sash


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## metoo

tomcoldaba said:


> Thanks for sharing. I am a member of 3 toastmaster clubs for 3 years. I have overcome the fear of public speaking. If I have to give a major presentation before a room full of executives, I am very nervous. Your suggestion makes sense, just do the drugs only in high pressure situations. I thought you have to take Xanax regularly for it to have any effect. From your post, you can take Xanax as needed.


I took toastmaster too - told repeatedly that I was a great speaker and much of my nerves were gone BUT the first 30 seconds to a minute were the biggest challenge in high stress/work situations. For whatever reason which I researched/thought about/stressed about etc, I could not figure out how to prevent this from happening and it only got worse (death spiral).

The propanol stops the physical symptoms (for me, fast heart rate, then trouble speaking). The Xanax handles the anxiety and can be taken 30 minutes before (highly addictive and will lose effect if you use repeatedly).

I have the biggest yet presentation this week. Just used the Prop for the practice run and may not use the Xanax for the real thing in a few days (definitely using the Prop). Just used the Prop for a sales call last week and amazing - introduced self, presented and I was like my heart is not racing so my mind was like this is no problem (I know my material, just do not trust my body).

My goal is to go only Prop since it is not addictive and allows me to focus more ... hope this helps because this site really, really, really save my life.


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## metoo

sasha northton said:


> what you describe is identicle to my situation - my career is starting to take off but the added responsibility (especially presentations, de-briefings, reporting to the board etc...) sent me into a tail spin.
> 
> I take 80mg Propranolol (slow release) in the mornign before 'something scary' and if it is very scary/important I also take 2mg of Diazepam. The Diazepam deals with the mental anxiety and the beta blocker deals with the physical sympotms. I have done several presentations on this combo and everything was fine. I just havent learnt to trust myself and my body/mind to the point where I don't need to worry for weeks in advance.
> 
> I will worry for 2 weeks before an event to the point where I am physically ill and then on the day I will take my special mix and that calms me down. 30 seconds before the 'performance' I get really calm/relaxed and feel an urge to get up there and get it over and done with - the feeling you get when you are just about to skydive - weird. Once I am up there I am fine but afterwards I feel like I have been awake for a week straight - totally exhausted.
> 
> Anyway, well done - keep up the good work.
> 
> Sash


Sash - keep working on it - found meditation and prayer was the next step for me to being more "calm" in general. Now I know the presentation event can be handled, I am really working on the cognitive/thought life side (still hate to take the drug, like I am an athlete cheating BUT it works).

Keep it up and please share with someone else.


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## curmudgeon8976

Hi all, 

I started suffering panic attacks toward the beginning of 2010 as a result of a long term build up of stress related to university teaching and finishing a PhD.

The anxiety was very intense (choking sensation; shortness of breath/difficulty breathing; rapid heart-rate; sweaty palms; sense of impending doom – all the good stuff) – and for sometime I feared that my chosen career as an academic/lecturer was over. While I now recognise this as catastrophic and unrealistic thinking, at the time, it felt like a reasonable assessment –*for sometime I was struggling to talk to people in the corridors, attend meetings, socialising become almost impossible and I couldn't play sport/exercise without panicking. Things came to a head when in the middle of a lecture I was having a panic attack, and despite trying to push through, had to stop the lecture saying I was feeling unwell. This was a crucial moment for me – perhaps the worst – where I felt I had no control over the anxiety beast. 

I went to my doctor and he put me on Lyrica (pregabalin), a new drug used for nerve-pain but also off-label for generalised anxiety disorder. Despite progressively upping the dose, it didn't seem to do anything for the anxiety. We then trialled a SSRI (Effexor extended release), which I seemed to have a pretty bad physical reaction to. I only had one tablet at night and woke up with the sweats, chattering teeth and high anxiety. At the time, I was highly sensitive (hyper vigilant) to changes in my body so part of this (over)reaction I believe was psychological.

After the terrible reaction to the SSRI I decided to not use medication to manage the problem and I began a series of CBT sessions with a local clinical psychologist who was excellent. This was the slow beginning of getting my life back on track. I did, however, have a container of 2mg diazepam (valium) up my sleeve to use if I really needed to. 

I learned some excellent skills in therapy around managing worry, using breathing to control anxiety and also confronting your fears – getting into those situations that you fear and learning that you can cope – and even enjoy them. The goal is keep confronting, be brave and courageous, and you eventually re-train your nervous system not to over-react to what you perceive as anxiety provoking events. 

Long-story not-so-short, I wrapped up the PhD, got through the teaching semester and took 3 months off, something my psychologist encouraged and endorsed. While I still have some minor residual problems with anxiety, I've got my life back in order. I barely have any social anxiety anymore but sometimes still get anxious about doing public presentations etc – though I do these a lot as an academic!

I've found the combination of propranolol and diazepam a god-send for dealing with public speaking/performance anxiety. For large/important presentations I use a combination of 40mg Propranolol and 2.5mg Diazepam. I take both about an hour or an hour and a half before the presentation. Diazepam takes about 20 minutes to 'kick-in' and propranolol about an hour. The diazepam, as other people are staying, calms the anxious thoughts, while the propranolol stops your heart racing and sweaty palms – I believe it also helps with making sure you don't breathe too rapidly. 

One of the things that my psych recommended was to use the diazepam/beta-blocker combo for lectures etc but to taper down each week. I did this last year, and it wasn't long until I was doing lectures without any meds which was a good feeling. 

Hope this helps. Feel free to ask any questions you might have.


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