Hello Doctor,
My main issue is communication anxiety affecting fluent speaking and verbal expression.
I struggle with dialect/language switching confusion, accent insecurity, and difficulty forming and expressing thoughts smoothly. After moving from my town to a city environment, I became more self-conscious about the way I speak.
Whenever I need to speak around people — even in normal conversations — I become highly self-aware and mentally freeze, causing speech blocks and difficulty expressing myself. This anxiety usually does not happen when I am alone.
I read that this may relate to performance anxiety around language identity, involving self-monitoring, anxiety, and working memory overload affecting speech flow.
I also have a history of chronic bullying during school years, which may have contributed to this issue.
I would like your opinion regarding this condition and a suitable medication/treatment plan. If possible, please also share your contact no. Thank you
Answers (8)
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1. Breathe Slowly
If you are feeling anxious, you are more likely to breathe faster and shallower. Sometimes, the easiest and most important thing we can do to soothe ourselves is to focus on our breathing.
Inhale slowly. Count to three as you do it. Focus on each breath. Exhale slowly. Count to three as you do it.
2. Stay In the Present
Try the 5-4-3-2-1 technique
Focus on five things around you that you can see. A pen, a bottle of water, a spot on the wall - anything.
Focus on four things around you that you can touch. Your watch, the coffee mug, the chair you are sitting on - anything.
Focus on three things you can hear. Someone speaking on their phone, the TV in the background - any external sound.
Focus on two things you can smell - Maybe itâs a charcoal pencil, a hand cream, or leftover coffee in your mug.
Focus on one thing you can taste - What does the inside of your mouth taste like? Gum, coffee?
3. Muscle Relaxation
When you are anxious, you may feel your body tense up.
Find a quiet place. Slowly tense a muscle group. Letâs say you start with your shoulders.
Breathe in while you tense your shoulders. Hold the tension for a few seconds.
Slowly release the tension and breathe out as you do it.
Do this a couple of times before moving on to the next muscle group. What this practice essentially does is it builds awareness of tension in the body and also recognises when the body is completely relaxed.
4. Get Moving
Move your body. There is simply no way around it. When you do activities that get your heart rate up, like running, cycling, getting some exercise, or even dancing, it can literally change your brain chemistry..
5. Small Acts of Bravery
If thereâs something that makes you anxious, try tackling it in baby steps. For example, if public speaking freaks you out, start by giving a short presentation to a few friends. This can help you build confidence and manage your anxiety when it comes to bigger challenges.
6. Be Kind to Yourself
Practicing self-compassion can really help ease your anxiety. Remember, we all deserve to be cared for, and that includes taking care of ourselves.
Much love!
"Hi there, I understand that seeking help can feel overwhelming, but you’ve already taken the first brave step. I can guide you with a clear treatment plan tailored just for you, so you can feel better and regain control over your life. You can reach me directly on WhatsApp for quick support on seven zero eight two zero two two zero six two."
Hi, how are you? Thanks for reaching out.
What you’re describing sounds strongly related to social/performance anxiety with excessive self-monitoring during speaking. When someone becomes hyperaware of how they sound, their accent, wording, or how others may judge them, the brain starts overchecking every sentence in real time. This overloads working memory and can cause freezing, speech blocks, difficulty forming thoughts, and loss of fluency — especially around people, while speaking alone feels normal.
Your history of bullying may also have trained your mind to stay alert for judgment or embarrassment during conversations. So the issue is usually not lack of intelligence or language ability, but anxiety interfering with natural expression. Treatment often includes CBT, confidence rebuilding, reducing self-monitoring, exposure work, and sometimes medication if anxiety is severe. With proper therapy, many people improve significantly. Take therapy. You can connect with me on nine two six six seven two six zero six five.
Your symptoms point to **social performance anxiety** + **linguistic insecurity**, worsened by past bullying and city/town language shift. This is treatable.
**Next steps:**
1. **Therapy first-line**: CBT + speech therapy/fluency shaping. Exposure practice for social speaking.
2. **Medication options**: SSRIs like sertraline/escitalopram or propranolol for situational anxiety are commonly used, but require proper evaluation first.
3. **Immediate tools**: Slow breathing, 3-second pauses before speaking, practice alone → with 1 person → groups.
This needs a formal assessment before any prescription. Please book an in-person/tele consult with a psychiatrist or clinical psychologist. For safety, I can't share meds/dosage or contact details here.
You're not alone, and this does improve with the right help.
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
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