Exam Anxiety: What Helps and What Makes It Worse

The goal is not to feel nothing before an examination. The problem is high test anxiety, which research links to lower exam performance (see the evidence section below).

The goal is to keep the anxiety at the level where it helps rather than the level where it takes over. That is a smaller and much more achievable target than being calm, and aiming for calm is itself one of the things that makes it worse.

What follows is practical rather than clinical. If your anxiety is severe, persistent, or affecting your eating and sleeping for weeks, that is worth speaking to someone about, and the last section covers who.

Normal, and not normal

Ordinary exam nerves	Worth attending to
Nervous the night before, sleeping less	Barely sleeping for weeks
Racing heart at the start of the paper	Panic that stops you working entirely
Worrying about a weak subject	Constant dread you cannot put down
Appetite off on the day	Not eating properly for a long stretch
Relief and second guessing afterwards	Withdrawing from everyone for weeks

The left column is uncomfortable and unremarkable. It is what almost every candidate experiences and it does not need fixing, only managing.

The right column is not weakness and it is not something to push through silently. It is a signal to tell someone.

Preparation is the main treatment

Unglamorous and true. Most exam anxiety is a reasonable response to genuine uncertainty about whether you are ready, and the most effective thing you can do about it is reduce that uncertainty.

Two things in particular convert vague dread into something manageable.

Timed past papers. The specific fear of the unknown room, the clock and the unfamiliar question drops sharply once you have simulated it several times. The first time you sustain concentration for three hours should not be the real paper.

Knowing what you have covered. A syllabus checklist with topics marked as secure gives you something concrete to look at when your mind says you know nothing. It is usually not true, and evidence beats reassurance.

This is also why disorganised revision breeds anxiety. If you cannot tell what you have covered, every subject feels equally unfinished. Our guide to a revision timetable that survives real life covers building that visibility.

The night before

Three things help and one thing does damage.

Stop early. Working late produces very little and costs the sleep during which memory is consolidated. The NHS advises against cramming all night, since sleep helps more than last-minute study.

Prepare the practical things. Pens, identification, your slip, what you may bring, how you are getting there, how long it takes. Removing every logistical unknown removes a whole layer of worry, and this is the one thing fully within your control the night before.

Do something ordinary. Eat properly. Talk to someone about anything else. The evening is not going to change your preparation.

Do not learn new material. A topic met the night before displaces things you already half know, and the arithmetic almost never favours the newcomer. It also produces the specific feeling of discovering, hours before the paper, how much you do not know.

Avoid the crowd at the gate

The half hour before a paper, standing among other candidates, is often the most tense part of the day.

Someone will be loudly certain a topic is coming up. Someone will describe how much they revised. Someone will ask whether you covered a thing you have never heard of. None of it is information and all of it is contagious.

Arrive on time, stand somewhere quieter, and do not join the last minute comparison. If you must hold something, hold your own summary sheet rather than joining a conversation.

When your mind goes blank

This frightens people badly, partly because it feels like the knowledge has gone. It has not. Retrieval is temporarily blocked, which is a different and much more recoverable problem.

1. Stop and put the pen down for thirty seconds. Continuing to stare while panicking makes it worse.
2. Slow your breathing deliberately. The NHS exercise suggests counting to five in and five out if that helps, for at least five minutes, so learn it beforehand; in the room, a few breaths in the same rhythm is what is practical.
3. Move to another question. Almost always the right move. Retrieval usually returns once the pressure is off that specific question.
4. Write anything related when you come back. A definition, a diagram, one fact. Starting anywhere often unlocks the rest, and a partly correct answer scores more than a blank.

Practise the breathing before the day, during timed papers, so it is a familiar habit rather than something you are attempting for the first time while frightened.

The thought that does the most damage

It is this one: my entire future depends on this paper.

It is widely believed, frequently repeated by well meaning adults, and not true. There are resits. There are other institutions, adjacent courses, further selection rounds, and other years.

This is not a reason to care less. It is a reason to stop carrying a weight that is heavier than the actual situation, because that weight measurably damages performance on the day. Our guide to what to do if you miss the cut off exists partly so this is concrete rather than reassurance: there are more routes than most candidates know about.

Things that make it worse

• Comparing revision with other people. Everyone exaggerates in both directions and none of it is measurable.
• Trying to feel calm. Fighting the feeling adds a second problem on top of the first. Let the nerves exist and work anyway.
• Checking answers immediately afterwards. Between two papers nothing can be changed, and the NHS suggests talking about what went well rather than dwelling on difficult questions.
• Sleeping badly on purpose. Late nights are a false economy at every stage of the process.
• Total isolation. Some withdrawal is normal, weeks of it is not, and it removes the people who would notice you struggling.

Between papers

If you have several papers over days, how you spend the gaps matters more than people expect.

Do not review the paper you have finished. It is done, nothing can change it, and the NHS suggests talking about what went well rather than going over the hard questions, which gives you little to use in the next paper. If you are certain you made an error, that is still true tomorrow and there is nothing to be gained from confirming it tonight.

What the published evidence and guidance say

Test anxiety is measurable. A 30-year meta-analysis of 238 studies (von der Embse and colleagues, Journal of Affective Disorders, 2018) found that test anxiety was significantly and negatively related to a wide range of performance outcomes, including university entrance exams, with effects in the small to moderate range. So the aim of managing it is justified, and so is the modest wording: it is one influence on results, not the only one.

The table collects what the health guidance checked for this post actually recommends, with the date each page was last reviewed (checked on 18 October 2026).

Practice	What the source says	Source and review date
Slow breathing	Breathe in gently counting 1 to 5, out counting 1 to 5, in through the nose and out through the mouth. Repeat for at least 5 minutes; counting is optional and you may not reach 5 at first. Most benefit comes from doing it regularly.	NHS breathing exercises, reviewed 12 June 2026
Sleep	Most teenagers need 8 to 10 hours. Allow about half an hour to wind down between studying or screens and bed. Avoid cramming all night, since sleep helps more than last-minute study.	NHS exam stress, reviewed 8 March 2023
Practising the room	If anxiety is unhelpful, practise exam-day activities such as doing papers under exam conditions or visiting the exam hall.	NHS exam stress, reviewed 8 March 2023
After a paper	Talk through what went well rather than dwelling on difficult questions, then focus on the next one.	NHS exam stress, reviewed 8 March 2023
Exercise	Running, walking, swimming and yoga can reduce anxiety and stress.	NHS anxiety self-help, reviewed 22 October 2024
Caffeine	Avoid lots of coffee, tea, cola and energy drinks: caffeine can disrupt sleep and make anxiety harder to control.	NHS anxiety self-help, reviewed 22 October 2024
When to get help	See a GP if anxiety or low mood is severe, lasts, and affects daily life.	NHS exam stress, reviewed 8 March 2023

Two cautions about that table. These are UK public health pages, written for UK families, and the NHS exam-stress page was due for review in March 2026, so treat the details as guidance rather than law. And none of it is a Cameroonian or Ugandan source.

Where help is thin

The WHO adolescent mental health fact sheet (1 September 2025) estimates that 14.3% of 10 to 19 year olds live with a mental health condition, and that anxiety disorders affect 5.3% of 15 to 19 year olds. Those are clinical figures, far narrower than ordinary exam nerves, but they show why a small share of any exam class will need more than breathing.

Access to specialists is the harder problem. In the WHO Mental Health Atlas data republished by Our World in Data (retrieved 18 October 2026), Cameroon, Uganda, Kenya and Ghana each show 0 psychiatrists per 100,000 people (2019-2020 data; the published values are whole numbers, so the true figure is low but not necessarily zero), against 14 for the United Kingdom. The practical reading is that for most candidates the first person to tell will be a teacher, relative or health worker, not a specialist. That is a reason to tell someone early, while a conversation can still be enough.

Telling someone

If this has moved past ordinary nerves, speak to someone. A teacher, a school counsellor where one exists, a parent, a relative, a doctor, or any adult you trust.

Two practical points. Schools sometimes have arrangements for candidates in genuine difficulty, and you cannot access them if nobody knows. And saying it out loud to one person reliably makes it smaller, which is not a solution but is a real effect.

If you are having thoughts of harming yourself, tell someone today rather than waiting for the examinations to finish. That is more urgent than anything else on this page.

Look after the body, because it is half of this

Anxiety is physical as much as mental, and the physical side responds to ordinary things that are easy to abandon during exam season.

Eat something before the paper, even when you do not want to. Sitting a three hour examination without having eaten produces shakiness and poor concentration that feel exactly like panic.

Move every day. A walk is enough. The NHS lists walking, running, swimming and yoga as activities that can reduce anxiety and stress. It costs nothing, and it is the first thing candidates cut when they feel behind.

Keep sleep regular rather than merely sufficient. Going to bed and waking at roughly the same times matters as much as the total, and irregular sleep is its own source of the jittery feeling.

Questions students ask

I revise well and then blank in the room. Why?

Often because your revision and the examination are different activities. Rereading notes builds recognition, and the paper demands recall under time. Practising by testing yourself, timed, closes that gap. The method is in our twelve week revision plan.

Should I take something to calm my nerves?

Not without medical advice, and never something you have not taken before, on the day. Speak to a doctor if you are considering it. The NHS also advises avoiding lots of coffee, tea, cola and energy drinks, since caffeine can disrupt sleep and make anxiety harder to control.

Everyone else seems relaxed.

They are not. Composure in a corridor tells you nothing about what someone felt at four in the morning. Anxiety is close to universal and mostly invisible.

Does it help to accept I might fail?

Working out honestly what you would do if it went badly often reduces the fear substantially, because the unknown consequence is usually worse in imagination than the actual set of options. Spend twenty minutes on it once, write it down, then return to preparing.

The three that matter

Sit timed past papers so the room holds no surprises. Keep a checklist so you can see what you have actually covered. Protect your sleep.

Those three address the cause rather than the symptom, and they work better than anything you can do in the final week.

More in Study Skills, and for families, how to support a candidate through exam season.