Exam Anxiety

Very few people go into exams calmly, because exam situations can involve a risk of failure. That’s why stage fright and nervousness before exams are normal. However, if those affected flee from this situation because of this, there is talk of serious exam anxiety.

Exam Anxiety

What is exam anxiety?

Exam anxiety is a special type of anxiety that is linked to situations in which people have to prove their ability and their specialist knowledge. The fear is all the higher, the more depends on passing the exam. The fear of a possible failure can paralyze examinees in an exam situation to such an extent that the knowledge they have learned can no longer be retrieved. See whicheverhealth for Hyposalivation Meanings.

A blackout can occur in which tasks can no longer be mastered and mistakes are made out of sheer excitement, although the examination material has actually been mastered. It can be the exam itself that makes you afraid, the preparation for the exam, the exam situation itself, fear of failure, of the examiners or of being overwhelmed.


Exam anxiety is widespread and can have different causes. In most cases, it is an acquired fear due to previous bad experiences with exams or the examinee himself or those around him have increased expectations. Anyone who has had the experience in the course of their life of not being able to please others and has been punished if the desired performance has not been provided can, based on this experience, assess situations in which performance is required as threatening situations.

The same can happen to people whose parents were worried about what neighbors and relatives might think of them. In this way they learn to be guided by the expectations of others and not to develop their own standards. Self-confidence is weakened by previous negative experiences and exam situations trigger fears from now on. A general negative expectation can also play a role (self-fulfilling prophecy).

Symptoms, Ailments & Signs

Exam anxiety is a mixture of physical and mental problems. Some people react to the announcement of an exam with inner restlessness and feelings of anxiety, sometimes several weeks before the exam up to the day of the exam.

A distinction must be made here between normal test anxiety and test anxiety that may require therapy. Normal exam anxiety leads to adequate preparation for the exam. If the test anxiety is very strong, it can lead to a depressive mood and a high level of insecurity.

Difficulty concentrating, a blocked memory and negative thought loops can mean that what has been learned cannot be retrieved. In addition, there are often physical symptoms such as heavy sweating, shivering or trembling, headaches, increased blood pressure and sleep disorders. Some even have to take sedative medication.

Diagnosis & course of disease

Careful diagnostics are required to distinguish normal nervousness from severe test anxiety. Those affected usually have a longer period of suffering before they seek professional help. The symptoms of insomnia, concentration problems and physical problems such as heavy sweating and tremors are not sufficient evidence of exam anxiety because these symptoms also occur with other anxiety disorders such as social phobia.

Because test anxiety is usually a combination of several factors, it is not easy to diagnose and requires extensive discussion and narrowing down of what exactly is causing the anxiety on the exam. The most important diagnostic means are therefore questions to those affected, possibly also special diagnostic questionnaires. The fear can only be treated in a meaningful way if the actual trigger for fear can be narrowed down.


While mild test anxiety usually does not necessarily have a negative effect, but can even help candidates to prepare themselves thoroughly for an exam, severe test anxiety has exactly the opposite effect. In severe cases, those affected are already suffering from symptoms such as general malaise, loss of appetite, diffuse anxiety and insomnia months before the exam date.

Those affected feel discouraged and are convinced that they will not be able to cope with the examination material. In extreme cases, there are also physical symptoms such as high blood pressure, hot flashes and chronic headaches. Difficulty concentrating in connection with a blocked memory and negative thought loops then ensure that what has been learned cannot be retrieved and the negative expectations are fulfilled.

Those affected are then no longer able to free themselves from this negative cycle and absolutely need professional help. Preferably by a psychotherapist who specializes in the disorder. A typical complication of exam anxiety is depression, which usually requires both medication and therapy to be treated.

Some of those affected develop a burn-out syndrome, which is accompanied by complete physical and mental exhaustion. In these cases, the recovery process usually takes several months. Patients are almost always forced to interrupt their education.

When should you go to the doctor?

If symptoms such as tachycardia, dry mouth, nausea, dizziness or tightness in the throat occur before an exam or a public appearance, it is often test anxiety. A visit to the doctor is indicated if the symptoms appear again and again in similar situations. If the test anxiety has a negative effect on the performance, medical advice is also required. People who suffer from an anxiety disorder or have physical conditions that make the condition worse should speak to a professional about the symptoms.

The right place to go is a psychologist or psychotherapist. A yoga class or physiotherapy can help to reduce the internal pressure. Chronic test anxiety may be due to a mental illness that needs to be treated. If the test anxiety leads to a circulatory collapse, the emergency doctor must be called in. The person concerned should receive comprehensive medical treatment and be examined to rule out physical causes. A panic attack also requires therapeutic work-up together with a psychologist or another person you trust.

Treatment & Therapy

People with high test anxiety can do a lot to relieve themselves of the greatest pressure. An important prerequisite for reducing anxiety is intensive study and practice before the exam. That gives inner security. Instead of constantly thinking about possible failure and maneuvering themselves into hopelessness, they could encourage themselves that they can pass the test.

As it is well known that a healthy mind lives in a healthy body, it is important to also take care of the body, to eat well and, if necessary, to practice long-term relaxation methods. Learning at the last minute is counterproductive and increases anxiety, it is more helpful to take the exam day calmly. In the exam itself, it helps to do the easier tasks first and then solve the more difficult ones.

Very nervous people should be aware that an exam is not a matter of life and death, but in the worst case a bad grade or a retake of the exam. Those who are in extreme distress can have herbal tranquilizers prescribed or seek therapeutic help. However, a certain nervousness is part of it, otherwise nobody would probably take on the learning.


The most important prevention is adequate preparation for the exam. Anyone who has mastered the subject matter gains inner security and is more confident about the exam. Another way to reduce anxiety is to learn relaxation techniques. With regular practice, they can effectively reduce anxiety. It is also helpful to be quizzed by other people. In this way, it becomes clear what has already been mastered and what still needs to be learned.


Even if the test anxiety has been successfully treated, it can relapse at a later point in time. It therefore makes sense to keep practicing the strategies you have learned after the therapy has been completed. During therapy, the patient has usually also learned to recognize what is causing his fear to increase. These unfavorable fear enhancers can often be specifically avoided.

If avoidance is not possible or does not seem sensible, the patient can face the fear in a targeted manner. The exercises and ways of thinking learned during the therapy help. If the anxiety worsens again over time, further therapy may be useful. It may be necessary to refresh the content of the therapy, especially when exam situations arise again after a long period without exams.

Even after successful therapy, some patients tend to avoid exams, for example by not advancing as far in their careers as they actually could. The fact that this is an avoidance tactic is often denied. Here it is important that those affected are honest with themselves and actively question again and again whether exam anxiety really no longer has a decisive influence on their lives.

You can do that yourself

Slight test anxiety can often be overcome by self-help. It is important not to avoid the anxiety-causing situations, as avoidance increases the anxiety disorder. First, sufferers can analyze their fear hierarchy. The question is: Which situations trigger the fear? Typical points are:

  • waiting before the exam
  • the evening before or the morning before the exam
  • the exam itself
  • studying before the exam
  • registering for the exam
  • think about the exam

Other situations related to the exam may arise. In the personal fear hierarchy, the fear triggers are sorted according to how much they cause fear. This order does not have to follow any logical criteria.

There are two basic approaches to self-help for exam anxiety. One is based on enduring fear unaided. The other approach uses techniques that can reduce anxiety. For example, a kneading ball or smelling oil can be useful here. If possible, first expose those affected to the situation that causes the least anxiety. You can only imagine the situation at first. The confrontation is not over until the fear has completely subsided.

This exercise should not be stopped prematurely, as stopping can worsen the anxiety disorder. In the case of severe test anxiety, it makes sense not to carry out this confrontation yourself, but to seek therapeutic help. Behavior therapists often work with the method described here, but can support the patient in a targeted manner and prepare them for the confrontation. Regular relaxation exercises can also reduce anxiety.