Fear of public speaking is a common form of anxiety. It can range from slight nervousness to paralyzing fear and panic. Many people with this fear avoid public speaking situations altogether, or they suffer through them with shaking hands and a quavering voice. But with preparation and persistence, you can overcome your fear.

These steps may help:

• Know your topic. The better you understand what you're talking about — and the more you care about the topic — the less likely you'll make a mistake or get off track. And if you do get lost, you'll be able to recover quickly. Take some time to consider what questions the audience may ask and have your responses ready.
• Get organized. Ahead of time, carefully plan out the information you want to present, including any props, audio or visual aids. The more organized you are, the less nervous you'll be. Use an outline on a small card to stay on track. If possible, visit the place where you'll be speaking and review available equipment before your presentation.
• Practice, and then practice some more. Practice your complete presentation several times. Do it for some people you're comfortable with and ask for feedback. It may also be helpful to practice with a few people with whom you're less familiar. Consider making a video of your presentation so you can watch it and see opportunities for improvement.
• Challenge specific worries. When you're afraid of something, you may overestimate the likelihood of bad things happening. List your specific worries. Then directly challenge them by identifying probable and alternative outcomes and any objective evidence that supports each worry or the likelihood that your feared outcomes will happen.
• Visualize your success. Imagine that your presentation will go well. Positive thoughts can help decrease some of your negativity about your social performance and relieve some anxiety.
• Do some deep breathing. This can be very calming. Take two or more deep, slow breaths before you get up to the podium and during your speech.
• Focus on your material, not on your audience. People mainly pay attention to new information — not how it's presented. They may not notice your nervousness. If audience members do notice that you're nervous, they may root for you and want your presentation to be a success.
• Don't fear a moment of silence. If you lose track of what you're saying or start to feel nervous and your mind goes blank, it may seem like you've been silent for an eternity. In reality, it's probably only a few seconds. Even if it's longer, it's likely your audience won't mind a pause to consider what you've been saying. Just take a few slow, deep breaths.
• Recognize your success. After your speech or presentation, give yourself a pat on the back. It may not have been perfect, but chances are you're far more critical of yourself than your audience is. See if any of your specific worries actually occurred. Everyone makes mistakes. Look at any mistakes you made as an opportunity to improve your skills.
• Get support. Join a group that offers support for people who have difficulty with public speaking. One effective resource is Toastmasters, a nonprofit organization with local chapters that focuses on training people in speaking and leadership skills.

If you can't overcome your fear with practice alone, consider seeking professional help. Cognitive behavioral therapy is a skills-based approach that can be a successful treatment for reducing fear of public speaking.

As another option, your doctor may prescribe a calming medication that you take before public speaking. If your doctor prescribes a medication, try it before your speaking engagement to see how it affects you.

Nervousness or anxiety in certain situations is normal, and public speaking is no exception. Known as performance anxiety, other examples include stage fright, test anxiety and writer's block. But people with severe performance anxiety that includes significant anxiety in other social situations may have social anxiety disorder (also called social phobia). Social anxiety disorder may require cognitive behavioral therapy, medications or a combination of the two.