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Question:
I AM a second-year student studying in one of the top five junior colleges. I have just completed my examinations. I am utterly disappointed as I know I have messed it up once again.

I was well-prepared for the exams, but the same problem always haunts me, whether I take a class test, quiz or major exam. I would just freak out and be very nervous. I try to calm myself down and take deep breaths, but all to no avail.

Is there any medication that will solve my problem? What should I do?

-Nervous

Answer by Dr Brian:
 

What you have is very common, so don't freak out. Students, sportsmen, artists and doctors all have this Performance Anxiety. Seek treatment soon, or else it may develop into a major fear; in your case, a phobia of examinations.

First, let me congratulate you on your perseverance in continuing to take exams, and not missing them, as many have done, due to your fears.

The first lesson is that hiding or avoiding the problem will only increase the fear and make it more difficult to take the next test.

The second lesson is to correct your perception. You have developed, over time, a 'loss of control' mentality. Even before the exams, you are afraid. To correct this anticipation anxiety, you need to correct your faulty thinking. You do not always freak out and fumble. Remember, you are in a top junior college. Your thinking exhibits two faults. The first is called catastrophic thinking, in which you believe some symptoms of normal anxiety will inevitably lead to a total loss of control. The second is termed black-and-white thinking, in which you believe that you are either totally in control or that you are totally out of control. Life is usually not so clear-cut. Allow for some areas in which you may not be totally in control and, instead, focus on your strengths. These forms of faulty thinking are often seen in many students who progress to the top-ranked schools. Many of them were top students in primary schools but in the better secondary schools, they had difficulties achieving the same success due to more academically-inclined peers. They suffer a loss in self-esteem and confidence when they compare themselves with their new classmates. The situation is more pronounced in junior colleges, as the less academically-inclined would have taken other paths.

The third lesson is to empower yourself with techniques to reduce or conquer your fears. During counselling, you can learn to reduce the anticipation anxiety by:

Using visualising success techniques

- seeing yourself sailing through the exams (for example)
- Practising doing tests in exam-style settings;
- Having a comforting object on the exam table;
- Using images of a more calm environment or person to relax;
- Meditation or prayer;
- Deep breathing and progressive muscle relaxation;

Developing good exam techniques like

- adequate time allocation,

- doing the questions you know first,

- trying to do short and quick reviews of what you know for the questions that you find difficult, and reviewing it later.

 

There is also medication to help you if the above techniques are not able to correct the problem in time. Specific medications to reduce palpitations and tremors are available, as are medications that will work in a few minutes to shut out these panic symptoms. And there are also medications to reduce the recurrence of panic attacks, and to improve the mood. Please see your family physician for more advice.

Do not lose hope, many have been helped and there is no shame in admitting to the problem in order to seek help. Your teachers could certainly help you with some coaching, and seeing the familiar faces of sympathetic teachers at the exam hall always works wonders.

Note:
DR BRIAN Yeo is a consultant psychiatrist in private practice. He has postgraduate qualifications in child and adolescent psychiatry. He is also a Certified Master Substance Abuse Counsellor and is currently the Singapore Medical Association representative to the Singapore Anti-Narcotics Association's management board.

Extracted from Straits Times 25 July 2004