Fear of public speaking is a common phobia. It can range in severity from slight nervousness to paralyzing fear and panic. Many people with a fear of public speaking avoid public speaking situations altogether, or suffer through them with shaking hands and a quavering voice — after a night of tossing and turning and worrying. But in most cases, a fear of public speaking can be overcome.

These steps can help:

Don't avoid it. This doesn't mean you have to jump right in and do a major speech or presentation. It does mean that to overcome your fear you'll have to face it and take gradual, deliberate steps to gain confidence and skills. If you avoid speaking situations and approach the ones you have to do with dread and without careful preparation, your fear of public speaking won't improve. It may even become more difficult.

Know your topic inside and out. The better you understand what you're talking about, the less likely you'll make a mistake or get off track. And if you do get lost, you'll be able to recover and quickly get back on track.

Get organized. Have the information you want to present carefully planned out ahead of time, including what you want to say, and any props, audio or visual aids you'll use. The more organized you are, the less nervous you'll be.

Use audio and visual aids — for yourself, and for the audience. There's nothing wrong with using an outline on a small card to keep yourself on track. Likewise, using audio and visual aids such as slides, flip charts and video segments can take the focus off you — and put it onto the material you're presenting.

Practice, and then practice some more. Practice your complete presentation several times, until you're completely comfortable with it. That way you won't forget something or suddenly wonder what's supposed to come next.

Practice in front of people you know. Do your presentation for a few people you're comfortable with. Ask them to provide you with constructive feedback. If possible practice in the same location you'll do your presentation.

Know your audience. Clearly identify what they expect to learn from you. If there are likely to be questions, take some time to consider what they may cover and have your responses ready.
Double-check the room setup. If you'll be presenting, make sure you're familiar with the lights, sound system, projector, computer and any other technology you'll be using. Make sure everything's working properly.

Relax. As simple as it may sound, learning some specific steps to help you relax can make a big difference. For example, before your presentation, take deep, slow breaths. Close your eyes and visualize a calm and successful presentation.

Focus on your material, not your audience. People are primarily paying attention to the information you're presenting — and not how you're getting your message across. Chances are they won't even notice your mistakes or nervousness.

Trust your audience. With few exceptions, your audience will be rooting for you and will want your presentation to go smoothly. If they do notice you're nervous or get a little off track, they won't judge you. Public speaking is challenging, and people realize that. It's likely every person in your audience has experienced the same nervousness at some point.

Don't be afraid of a moment of silence. If you lose track of what you're saying or you begin to feel nervous and your mind goes blank, it can seem like you've stopped talking for an eternity. But in reality, it's probably only been 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.

Recognize your success. Your presentation or interview may not have been perfect, but chances are you're far more critical of yourself than your audience is. Give yourself a pat on the back, and think about the fact that you've accomplished one more step on the road to becoming a confident speaker.

Get support. You aren't alone in your fear of public speaking. There are nonprofit and commercial groups out there to help you learn and practice the skills you need to overcome your fear and become the effective, confident speaker you want to be. 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 seem to overcome your fear of public speaking with practice alone, your doctor may prescribe a calming medication that you take prior to public speaking. For example, beta blockers (usually used to treat high blood pressure and certain heart conditions) have been shown to help. Ideally, you should try this medication before you use it for a speech so that you know how it affects you. Another approach that may help is to see a counselor who can help you come to terms with your fear of public speaking.

Nervousness or anxiety in certain situations is normal, and public speaking is no exception. Known as "performance anxiety," other examples include stage fright and writer's block. However, people with severe, debilitating performance anxiety may have a disorder known as social phobia (also called social anxiety disorder). People with social phobia often have more than one type of performance anxiety, and may even have depression or anxiety disorder. Social phobia may require treatment with medications, counseling or a combination of the two.