Performance Anxiety Care for Athletes and Performers in NYC
The nerves spike right when the stakes peak, and the prep that works everywhere else won't train it away. Integrative Psych in Manhattan provides performance anxiety treatment with clinical rigor: one clinician handling therapy, medication when it's indicated, and the sleep and recovery that shape how you perform.
- In-person · Manhattan
- Telehealth · New York
Start with an assessment
Short, private check-ins that help you put words to what you're noticing before your first conversation.
Child ADHD
A check on a child's focus, follow-through, and emotional reactions.
Adult ADHD
A check on focus, organization, and follow-through in adults.
Anxiety
A check on worry, tension, and how much they shape your days.
Depression
A check on mood, energy, and interest in everyday life.
Our clinicians are affiliated with
What Athletes and Performers Experience
Performance struggles show up as patterns, and it helps to name them. These are clinical signals, not weakness or a missing edge. You might recognize some of these:
These point to real, treatable conditions, several of which show up differently under competitive and creative pressure than the textbook describes.
The short version
- Performance anxiety is task-specific and audience-dependent: it peaks under competitive or creative pressure and quiets when the pressure is off.
- Care pairs CBT for the catastrophic-thinking loop with clinician-guided medication, coordinated on one plan, and medication decisions account for your sport or art.
- One clinician handles your therapy, medication, and the sleep, recovery, and substance-use factors that shape performance, with no prescriber-and-therapist split.
- Care is in-person at our Manhattan office, or by telehealth anywhere in New York State.
- Every patient's care is informed by the Sigmund Assessment, so your clinician understands your training and performance demands before your first appointment.
It tends to show up like this
You might recognize some of these.
- Dread that starts days before a competition or show, not just in the moment.
- A body that turns on you when it counts: tremor, racing heart, shallow breathing, or a sudden blank-out.
- The yips: involuntary freezing or misfiring on a motor task you've executed ten thousand times.
- Identity tied so tightly to results that a slump or a loss feels like a verdict on who you are.
- Perfectionism that drove your rise and now drives sleepless, self-critical spirals.
- Sleep and recovery that won't reset against travel, late events, and adrenaline.
- An injury, a transition, or a looming retirement that's quietly reshaping your mood and sense of self.
- Drinking or substances creeping in as a way to take the edge off.
Common Conditions We See in Athletes and Performers
These frequently co-occur. The Sigmund Assessment maps the full picture first, so the plan targets what's actually driving it, not the loudest symptom.
Performance Anxiety and Stage Fright
Performance anxiety is task-specific and audience-dependent: it peaks at auditions, competitions, and live shows, then quiets when the pressure lifts. It runs on a catastrophic-thinking loop, the "what if I blank out" dread and the post-performance rumination, paired with physical symptoms like tremor and a racing heart. It responds well to treatment that targets both the thinking and the body. See our anxiety page.
Depression, Injury, and Transition
A serious injury, a forced position change, or the approach of retirement can trigger real depression, especially when identity is fused to the sport or the stage. It shows up as a flat mood, loss of motivation, and withdrawal, and it gets dismissed as "just a rough patch." Accurate diagnosis and early treatment change that trajectory. See our depression page.
ADHD and Focus Under Pressure
ADHD frequently co-occurs with performance anxiety. It can drive inconsistent focus, impulse-regulation trouble during competition, and executive dysfunction. Accurate evaluation separates the two, so the plan fits what's actually happening rather than the loudest symptom.
Sleep, Recovery, and Substance Use
Travel, late events, and adrenaline disrupt sleep and recovery, and substance use sometimes creeps in to manage them. These rarely exist apart from performance anxiety, so we assess and treat them together rather than one at a time.
How We Care for Athletes and Performers
Every patient's care is informed by the Sigmund Assessment, a structured evaluation your clinician reviews before your first appointment. It maps your symptom history, what's worked and what hasn't, your biology, your environment, and your goals, including the performance demands, travel schedule, sleep patterns, and injury history that shape how you function. Session one starts with a plan instead of paperwork.
From there, one clinician handles all of it from the same chair: CBT for the catastrophic thinking behind performance anxiety, plus medication management when the body needs it, such as beta-blockers for tremor and racing heart without sedation or cognitive dulling. Medication decisions are clinician-guided and take your sport or art into account; we do not rule on banned-substance status or competition eligibility, and we'll coordinate with the people who do. There's no prescriber-and-therapist split. Progress is tracked with validated measures, so when your schedule, sleep, or performance shifts, the data shows it and your clinician adjusts.
We can schedule around training blocks, rehearsal, competition, and touring. The practice houses clinicians affiliated with the National Institutes of Health, Columbia University, and New York-Presbyterian Hospital, and you can explore the research behind how we assess and treat. Care is available in person at our Manhattan office and by telehealth anywhere in New York State.
Assess
The Sigmund Assessment captures your symptoms, history, and goals before your first appointment, so your clinician already understands your case.
Match
We match you on clinical fit, which for many athletes and performers means a clinician who gives clear, structured feedback and understands the pressure you work under.
Treat
One clinician coordinates medication, therapy, and lifestyle care, including sleep, exercise, and daily structure, from the start.
Track
Progress is tracked with validated measures, so you can see what's changing rather than wonder.
Clinicians who work with athletes and performers
Board-certified psychiatrists and psychiatric nurse practitioners. The practice houses clinicians affiliated with NIH, Columbia, and New York-Presbyterian.
Insurance and Billing
Integrative Psych is an out-of-network practice. You pay at the time of service and receive a monthly superbill to submit to your insurer for potential out-of-network reimbursement. Many PPO plans reimburse a portion, and your insurer is the best source for what your plan covers. To check yours, call the number on your card and ask about out-of-network reimbursement for outpatient psychiatric evaluations, follow-up visits, and therapy.
Billing, simply
- Out-of-network; you pay at the time of service.
- Monthly superbill provided for reimbursement.
- Many PPO plans reimburse a portion of out-of-network care.
- Call the number on your card to confirm your benefits.
Frequently Asked Questions
What's the difference between performance anxiety and general anxiety?
Performance anxiety is task-specific and audience-dependent: it peaks under high-stakes conditions like auditions and competitions and quiets when the pressure is off. General anxiety is more pervasive and not tied to specific events. The distinction matters because CBT for performance anxiety targets the catastrophic-thinking loops unique to those moments.
Can medication help with stage fright?
It can. Beta-blockers can ease the physical symptoms, including tremor, racing heart, and shallow breathing, without sedation or cognitive dulling. Your clinician evaluates whether medication fits you and manages it alongside therapy on one plan, so the medication and the skill-building work together.
Will medication affect my competition eligibility?
Medication decisions are made by your clinician with your sport or art in mind. We do not determine banned-substance status or competition clearance; eligibility rules come from your governing body, and we coordinate with the people who manage them. Bring those rules to your first appointment so your clinician can plan around them.
Do you treat the yips?
Yes. The yips involve involuntary freezing or misfiring on a practiced motor task under pressure. We treat the underlying anxiety, stress response, and cognitive interference with CBT and, when appropriate, medication. The Sigmund Assessment maps the full picture first so the plan addresses the root.
How do I know if this is right for me?
If performance anxiety has become a pattern, or if sleep disruption, focus problems, injury, or substance use are shaping your preparation, an evaluation is a reasonable next step. The Sigmund Assessment maps the full picture before any treatment decision, so you get a clear read rather than a label.
Is treatment confidential?
Yes. All psychiatric care is protected by provider-patient confidentiality, which matters for public-facing performers and competitive athletes. Your treatment is not disclosed to teams, agents, management, or coaches without your explicit written consent. Telehealth runs on a secure, HIPAA-compliant platform.
Where can I find performance anxiety treatment near me in NYC?
Our office is at 80 8th Ave in Manhattan, where athletes and performers are seen in person. We also offer telehealth anywhere in New York State, with the same clinical standards as in-person visits.
Take the First Step
You optimize training, coaching, nutrition, and recovery. This is the piece that makes the rest of it hold up under pressure. Book a consultation: no referral, no long waitlist. You'll learn what a realistic plan looks like for your situation and decide from there. Appointments are in person at our Manhattan office or by telehealth anywhere in New York State.