Sweating During Presentations

Reader’s Question

I suffer from situational shyness and I’m also bipolar. My bipolar is currently stabilized with carbamazepine and Paxil. I have always been shy to a certain degree but have worked very hard to overcome this stumbling block. When I was in high school I would actually become almost mute due to my anxiety. However, when I get to know people they sometimes wish I would become mute again.

I have worked very hard to overcome my shyness. I have read several self-help books, talked about it with counselors and have challenged myself by joining clubs such as Toastmasters and other groups. I also take Paxil which seems to relieve some the flushing symptoms that I used to suffer when in a stressing situation. This year I even took on the responsibilities of teaching classes for my work. I would definitely say that people describe me as an outgoing and confident person.

The problem I am having is that when I speak before large groups of people or even get into stressful situations I begin to sweat. I am not overweight and do not suffer from any abnormal condition that would cause me to sweat but it continues to be the last major problem that I seem to have been unable to overcome. I have attempted to isolate the triggers that cause my sweating and it seems the major stressor is when I am speaking to a group of people for the first time. However, it also happens sometimes when I am in my managers’ meetings with people I have known for years and I have to talk. Another thing I noticed is that when I become more comfortable with people the sweating does not occur at all.

Is there some kind of medication or treatment for this? Can you give me some tips or suggest some books that might help?

Thanks-a-million!

Our Consulting Clinical Psychologist’s Reply

The same physical mechanism that creates the flushing probably creates the sweating. Also, mental health medications such as Paxil often have sweating and flushing as a side effect due to the action on the neurotransmitter Serotonin. As you might expect, anxiety of any kind increases these reactions. By trial and error you may discover some strategies to deal with the sweating. Some are:

1. Don’t eat a full meal before your presentations. This prevents the aftermeal changes in blood sugar that often prompt symptoms.
2. If allowed, drink a sports drink such as Gatorade prior and during the presentation. If it worked for Elvis it can work for you.
3. Develop a pre-presentation ritual. We often find that famous entertainers use the same ritual each time they go on stage as the ritual is relaxing and preparatory — rather than anxious and anticipatory.
4. Anxiety can prompt the flushing and sweating response. Once you become comfortable with the people, it disappears. The trick is to be comfortable with your material in the presentation, making the audience irrelevant. I can talk psychology to 300 people any day of the week…but my most anxious community talk was a motivational talk to high school students upon their graduation. I wasn’t comfortable with the topic as it was separate from psychology.

You can also consult your psychiatrist/physician. We often use medications for “stage fright” such as Inderal. I’d also recommend researching and reading some tips for speaking in public, stage fright, anxiety attacks, etc. Sounds like you’re on the right track…just improving your techniques at this time.