Long winded response, but this is something that I can quite personally relate to.<p>My senior year of college I was tasked with giving a presentation on an entire semesters worth of work to the class, no problem - except the catch was that you weren&#x27;t allowed to have any notes with you. I&#x27;d never had an issues with presenting or speaking in front of audiences before, a little bit of nerves like most people, but nothing more than that. Well the day of the presentation comes and in my mind I knew ahead of time that it wasn&#x27;t going to go well - I&#x27;d never given a talk to a class with no notes and I had convinced myself that without something to reference I was going to screw up. Well 30 seconds or so before it&#x27;s my time to speak I begin to get the fight or flight response and start to have a panic attack - mind goes blank, heart literally pounding, I&#x27;m frozen. I don&#x27;t really remember what I said, but I remember spouting off a lot of &quot;umms&quot; and &quot;fucks&quot;. It sucked.<p>I eventually got over that embarrassing moment, but I&#x27;m convinced that I&#x27;ve now actually taught myself how to easily have a panic attack during moments that trigger even the slightest bouts of performance anxiety. Conference calls, medium-sized meetings, you name it, my body triggers an anxiety response - something that I never had a problem with before, it&#x27;s debilitating, and I fear that it&#x27;s holding me back in life.<p>The only thing that works for me (that i know of) is taking beta-blockers when I know ahead of time that I may be &quot;in the spotlight&quot; discussing or presenting something at work. They work wonders and really silence the physical responses that the body produces that are ultimately the catalyst of a panic attack, but the effects don&#x27;t last veery long. So unless I&#x27;m popping pills all day, I&#x27;m basically always on-guard and fearful of those impromptu situations that pop-up where I could be called upon to speak - an &quot;unmedicated&quot; me could easily freeze-up slip into panic mode.<p>I sympathize with Dr. Habib and  I&#x27;m wondering if anyone else on HN is in a situation similar to me and how they&#x27;re coping, treating or hopefully curing it.