Test anxiety in adults

It is July, rain is coming down on the tin roof of the mess near Katabon, and Mahin’s friends have set up a mock viva board around his bed. Topu is wearing his father’s blazer two sizes too big. On the stove, a pot of khichuri is bubbling for after. “Mr. Mahin,” says Topu, in a deep voice, “tell the board the length of the Padma Bridge.” Mahin, 27, answers instantly, and the board applauds with spoons.

Last year it was different. He passed the BCS written exam, walked into the real viva at the commission, sat down, and his mind went white. He could feel his heart in his throat and his shirt sticking to his back. He could not recall the name of his own district’s river. “I know the answers,” he tells his friends. “In the viva board, they vanish.” The next viva is in six weeks, and he has started waking at night with his heart racing.

An illustration drawn from common experience. The person is invented; the pattern is not.

Understanding test anxiety

Test anxiety is intense fear before or during an assessment, with worry (“I will fail, they will see”) and physical symptoms such as a racing heart, sweating and a dry mouth. One explanation is that, at high levels, the worry crowds out working memory, which may be why known answers seem to vanish. Test anxiety is not a separate diagnosis in ICD-11 or DSM-5-TR. When the fear is mainly of being judged by others, as in a viva or interview, it may be part of social anxiety disorder; it can also come with panic attacks or generalised anxiety disorder.

How common it is

A meta-analysis of 238 studies, which included school and university students, found that test anxiety was linked with lower performance on standardised tests, university entrance exams and grade point average, with effects in the small to moderate range. Higher-stakes tests, and tests seen as harder, were associated with more anxiety, and low self-esteem was a strong predictor. Most of this evidence comes from students rather than working adults. We did not find a peer-reviewed prevalence figure for test anxiety among adults in Bangladesh.

Signs worth noticing

• Going blank on material you know well, only under assessment
• A racing heart, shaking, sweating or nausea before or during exams
• Sleeping badly in the days before
• Avoiding mock interviews, or postponing the exam
• Thinking of one bad viva again and again

How care helps

A psychiatrist checks whether this is test anxiety alone or part of social anxiety disorder, panic disorder or depression, and looks at sleep, caffeine and any physical causes of a racing heart. A meta-analysis of 44 randomised trials with 2,209 university students found that psychological interventions reduced test anxiety and modestly improved academic performance, with the most support for behaviour therapy; CBT, study skills training and combined approaches showed promise but had fewer studies. In practice this means graded rehearsal in conditions closer and closer to the real board, slow breathing to steady the body, and learning to pause and say, “May I take a moment?” instead of fighting the blank. Questions about tablets before an interview should go to a doctor who knows your health, not to a pharmacy counter.

What getting better can look like

Mahin’s preparation might be three mock vivas with strangers instead of friends, a pause and a breath when his mind goes white, and then the river’s name coming back, with a second to spare.

Common questions about test anxiety

How do I stop my mind going blank in an exam or interview?

The blank is thought to come from anxiety crowding working memory rather than from true forgetting. Rehearsing under realistic conditions, slowing your breathing and allowing yourself a short pause can help the answer return. If it keeps happening, therapy for test anxiety helps, and behaviour therapy has the most support in studies of university students.

Is test anxiety a mental disorder?

Test anxiety is not a separate diagnosis in ICD-11 or DSM-5-TR. It can be part of an anxiety disorder, such as social anxiety disorder when the fear is of being judged. Whatever the label, a meta-analysis of 44 trials found psychological treatment reduces test anxiety.

When to see a psychiatrist

If fear of exams or interviews is holding back your career, or anxiety now spills into other parts of life, an assessment can help. If you are having thoughts of ending your life, call 999.

Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.

Sources

• von der Embse et al., Journal of Affective Disorders, 2018 (PMID 29156362)
• Huntley et al., Journal of Anxiety Disorders, 2019 (PMID 30826687)