Test anxiety: why your mind goes blank and what helps

Test anxiety is the anxiety that arises when a situation in which your performance will be evaluated, such as a test, is seen as threatening. It brings bodily tension such as dizziness, a racing heart, shaking and stomach discomfort, along with persistent worry about failure and its consequences and a mind busy planning for the worst. Trouble concentrating, problems recalling and a sense of going blank during a test are also common (Putwain et al., 2023). Research splits it into two parts, worry and bodily reactions, and it is the worry part that tends to be more directly tied to lower marks (Cassady et al., 2025).

Test anxiety is not a diagnosis. Neither the American Psychiatric Association nor the World Health Organization has a clinical definition of “test anxiety” (Cassady et al., 2025), and it does not appear among the category names of the International Classification of Diseases, ICD-11 (WHO, 2026). Very strong test anxiety can come with an anxiety disorder, though, and in different studies it met the criteria for social anxiety disorder, specific phobia or generalised anxiety disorder (Putwain et al., 2023). WHO diagnostic guidance notes that people with generalised anxiety disorder may worry about doing badly in or failing an exam (WHO, 2024), and the US diagnostic manual, DSM-5, added a way to mark social anxiety disorder in which only performance situations, such as speaking or performing in front of an audience, are feared (American Psychiatric Association, 2013).

Fear of being judged while speaking or performing in front of others is covered in social anxiety disorder. Social anxiety tied to performance situations does not arise when the same activity is done alone (Barnhill, 2026a). Test anxiety also differs a little from exam stress: stress can mean seeing a situation as a challenge or as a threat, while anxiety comes from seeing it as a threat (Putwain et al., 2023). In a study that followed 527 Canadian high-school students over a school year, test anxiety stayed broadly the same for 71.3% to 81.4% of them, so it tends to persist rather than pass after a single exam (Yale-Soulière et al., 2026).

Test anxiety is mostly measured with self-report questionnaires, and the cut-offs used to call it high or low vary between studies and are often set arbitrarily (Cassady et al., 2025). So it is best not to judge yourself by an online “test anxiety test” score. mind.io does not offer a test-anxiety test, and this guide is not a diagnosis. It sets out, from research and official sources, how common test anxiety is, how it relates to marks, why it happens, what helps and what has weak evidence, medicines and herbal remedies, and where to get help.

In the 2015 Programme for International Student Assessment (PISA), 69.1% of Korean 15-year-olds agreed that “I often worry that it will be difficult for me taking a test” and 74.6% that “I worry that I will get poor grades at school”, above the OECD averages of 59.3% and 65.7%. On “Even if I am well prepared for a test I feel very anxious”, Korea was at 55.3%, close to the OECD average of 55.5%, with Japan at 62.1% and France at 47.2%. These are shares of students who agreed or strongly agreed with a single self-report item, not diagnosis rates (OECD, 2017).

Girls agreed more often. On average across OECD countries, 63.9% of girls and 47.1% of boys agreed that they feel very anxious even when well prepared; in Korea the gap was smaller, at 58.8% and 52.0% (OECD, 2017). In a survey of 2,435 secondary school students in 11 schools in England, 16.4% reported high test anxiety, 22.5% of girls and 10.3% of boys (Putwain & Daly, 2014). In a meta-analysis of studies with primary-school children, though, girls’ slightly higher scores (d = 0.21) shrank to 0.08 after correcting for publication bias (Robson et al., 2023).

How common it is depends heavily on the questionnaire and the cut-off. When 2,449 Dutch university students were asked a single question, 10% said they had test anxiety “all the time” (Cuijpers et al., 2021), but pooling 35 studies of medical students (13,489 people) and counting everyone at a moderate level or above gave 49.8%, ranging from 24.4% to 88.9% depending on the questionnaire used (Omar et al., 2026).

Stress is also high among young people in Korea. In the 2025 Korea Youth Risk Behavior Survey (54,170 students analysed, weighted), 41.3% of middle and high school students, and 43.0% of final-year high school students, said they usually feel “very much” or “a lot” of stress; this asked about stress in general, not test anxiety (Korea Disease Control and Prevention Agency, 2025). In the 2024 Social Survey, the worry most often named by 13- to 18-year-olds was studying (48.8%) (Statistics Korea, 2024).

Test anxiety and marks are linked, but the link is small to moderate. In a meta-analysis of 562 studies from 1950 to 1986, the correlation between test anxiety and test scores from Grade 3 upwards was −0.24, and in a meta-analysis of 238 studies from 1988 onwards it was −0.29 for worry and −0.18 for bodily tension (Putwain et al., 2023). Among 4,000 US undergraduates, students with low test anxiety averaged a B+ and those with high test anxiety a B (Chapell et al., 2005).

Students with good marks have plenty of test anxiety too. In PISA, across the OECD on average, students in the bottom quarter in science (62.5%) agreed more often than those in the top quarter (46.0%) that they feel very anxious even when well prepared, but in Korea the top (53.0%) and bottom (52.3%) quarters were similar (OECD, 2017).

Nor is it clear which causes which. In a study that followed 3,425 German students for 5 years, negative emotions including anxiety predicted lower maths marks later, and lower marks in turn predicted more of these emotions (Pekrun et al., 2017). In a study of 309 medical students preparing for a high-stakes exam, test anxiety no longer predicted exam scores once their knowledge during preparation was taken into account; instead, highly anxious students gained less knowledge during the preparation period. The effect may come during preparation rather than from going blank in the exam room (Theobald et al., 2022).

There are a few explanations for going blank. One theory holds that anxiety pulls attention towards worry and threat, leaving less for the task, though extra effort can keep results up (Eysenck et al., 2007). In a meta-analysis of laboratory studies, stress just before or during recall impaired memory retrieval slightly (Shields et al., 2017). But laboratory stress is not a real exam, and the medical-student study above found no sign of retrieval being disrupted during the exam (Theobald et al., 2022).

The saying that a little nervousness boosts marks is often explained by the Yerkes-Dodson law, and the MSD Manual also describes a curve in which anxiety improves performance up to a point (Barnhill, 2026b). But the law began in 1908 with an experiment in which a few mice per stimulus strength learned to avoid electric shocks (Yerkes & Dodson, 1908), and turning it into a law about anxiety and performance was a later reinterpretation (Teigen, 1994). Among students who enjoyed maths, moderate maths anxiety went with the best scores, but among those who did not, more anxiety went with slightly lower scores (Wang et al., 2015). Anxiety can help by prompting preparation and practice (Barnhill, 2026b), but deliberately raising tension to boost performance has weak support (Corbett, 2015).

Several factors add up rather than one cause. In a meta-analysis of 238 studies since 1988, test anxiety was higher with lower self-esteem and when a test was seen as difficult or high-stakes (von der Embse et al., 2018). In one study, 335 US primary-school children reported more test anxiety after the state tests used to rate schools than after ordinary classroom tests, though the difference was small (Segool et al., 2013). PISA found that how threatening students found tests mattered more for their anxiety than how often they were tested (OECD, 2017).

Perfectionism that worries about mistakes and other people’s judgement (perfectionistic concerns) was fairly strongly linked with test anxiety (r = 0.42), while setting high goals in itself was hardly linked (r = 0.04) (Burcaş & Creţu, 2021). But in a study that followed 478 German students for about 5 years, perfectionism did not predict later test anxiety once earlier test anxiety was taken into account, so it is hard to call it a cause (Stricker et al., 2023). Perfectionism has its own guide: perfectionism.

Pressure and scare tactics from others also play a part. In a survey of 474 Korean high school students, the more pressure to achieve they felt from their parents, the higher their test anxiety, a link partly explained by academic stress and burnout (Kim & Cho, 2023). In an experiment comparing two weeks with 40 primary pupils, in the week when teachers stressed what would happen if they failed, worry and bodily tension rose and test scores fell, though the lower scores were not explained by the rise in worry and tension (Putwain & Best, 2011). The NHS reports that many children who contact the support line Childline feel that most of the pressure at exam time comes from their family (NHS, 2023a).

Preparation matters too. University students with a lot of exam worry reported poorer study skills, saw tests as more threatening and made less effective revision notes (Cassady, 2004). Turning attention elsewhere and putting off revision to avoid anxious feelings can make failure more likely over time (Putwain et al., 2023). For putting things off, see how to stop procrastinating. Sleep and test anxiety two days before an exam affected each other (Hamilton et al., 2021).

If test anxiety lasts and gets in the way of life, psychological help and treatment have the most evidence. In a meta-analysis of 44 randomised controlled trials with university students (2,209 people), interventions reduced test anxiety (g = −0.76) and raised marks a little (g = 0.37). Behaviour therapy had the most support, and cognitive behavioural therapy and study-skills training looked promising but rested on few studies. There were signs of publication bias and reporting was poor, so the results call for caution (Huntley et al., 2019). Most of the interventions in that analysis were behaviour-based methods such as relaxation training (Huntley et al., 2023). There are few studies with school pupils, but behaviour therapy and cognitive behavioural therapy have shown promising results (von der Embse et al., 2013), and mindfulness programmes also reduced test anxiety, though with wide uncertainty and possible publication bias (Yılmazer et al., 2024).

In the weeks before an exam, practising under real exam conditions is recommended. The NHS suggests doing past papers within the time limit, seeing the exam room beforehand if possible, and facing these activities rather than avoiding them (NHS, 2023a; NHS, 2023b). In classes that used retrieval practice, 72% of students said it made them less nervous for tests, though this was a survey without a control group (Agarwal et al., 2014). Study methods themselves are covered in MBTI study tips. Regular aerobic exercise over several weeks may help reduce test anxiety, though results varied widely between studies, while a single 10- to 15-minute session right before an exam had no effect (Zhang et al., 2022).

All-nighters backfire. College students kept awake for 24 hours did worse on a thinking task yet rated their own performance higher (Pilcher & Walters, 1997), and in a meta-analysis of experiments, sleep loss meant that both material learned afterwards and material learned before were remembered less well (Newbury et al., 2021). The NHS also says sleep will help far more than cramming all night before an exam (NHS, 2023a). Still, do not panic about one bad night: in an observational study of 88 college students, sleep on the single night before a test was not related to marks, while sleep over the previous month and week was (Okano et al., 2019). If sleep is an ongoing problem, see insomnia: what helps.

Right before and during an exam, slow breathing may help. The NHS suggests breathing in through the nose for 4 counts, holding for 2 and breathing out for 7 (NHS, 2023b), and in an experiment with 122 Primary 5 pupils in Singapore, those who took deep breaths before a timed maths test felt less anxious and scored higher, though this is a single study (Khng, 2017). Planning how much time to spend on each question and moving on when stuck, then coming back, is also recommended (NHS, 2023b). Brief interventions that teach people to see a racing heart as the body getting ready improved performance a little across 35 studies (5,638 people) (d = 0.23), shrinking to 0.14 after correcting for publication bias, and none of the studies involved people with an anxiety disorder (Bosshard & Gomez, 2024).

A 2011 study in Science found that writing about your worries just before an exam raised scores and became widely known (Ramirez & Beilock, 2011), but a large replication project that repeated its laboratory experiment under a plan reviewed by the original authors found no effect (Camerer et al., 2018). A meta-analysis of 21 studies (1,457 people) found that a single session of writing before an exam barely reduced anxiety, and its effect on scores was unclear once one extreme result was removed (O’Meara & Lovett, 2026). Saying “I am excited” out loud helped change how people felt, but in a direct replication observers’ ratings of their speeches did not differ (Brooks, 2014; Poynter & Smith Pasqualini, 2025).

Use caffeine with care. Korea’s Ministry of Food and Drug Safety sets the recommended maximum daily caffeine intake for children and teenagers at 2.5mg per kilogram of body weight, says to cut down or stop if palpitations, headaches, anxiety or sleep problems appear even within that limit, and advises avoiding it in the late afternoon and evening (Ministry of Food and Drug Safety, 2026a). Even in healthy people, more caffeine went with a higher risk of anxiety (Liu et al., 2024), and in experiments with 237 people with panic disorder, 51.1% had a panic attack after a large dose of caffeine (Klevebrant & Frick, 2022). For panic attacks, see panic attacks: what to do.

Parents and teachers do better to say that failing is not the end of the world and that there may be another chance, rather than scaring students (NHS, 2023a). The more often teachers used scare tactics before exams, and the more threatening students found them, the lower their exam scores tended to be (Putwain & Remedios, 2014).

Korea’s Ministry of Food and Drug Safety stresses that “there is no pill that makes you do well in exams”. Beta-blocker medicines, wrongly known as “anti-shaking pills”, are prescription-only medicines for heart and blood-vessel conditions such as abnormal heart rhythm, angina and high blood pressure, and they can cause side effects such as drowsiness and tiredness, dizziness, a drop in blood pressure on standing up and a slow pulse (Ministry of Food and Drug Safety, 2026b). They may not suit people with breathing problems such as asthma or with low blood pressure (NHS, 2026), and two meta-analyses of studies in anxiety disorders both concluded that the evidence does not support their use (Steenen et al., 2016; Archer et al., 2025). Using them for exam anxiety is not an approved use, and evidence on their effect and safety for it is sparse (Vinther et al., 2018). Do not take someone else’s pills.

There is no “study pill” either. The Ministry says that buying ADHD medicines online without a prescription, or taking pills prescribed to a family member or friend, breaks Korea’s narcotics control law, and that using them outside their approved purpose can cause side effects such as sleeplessness, loss of appetite, headaches and a faster heart rate (Ministry of Food and Drug Safety, 2026c). Taken without the condition, they can cause headaches, anxiety and, in severe cases, hallucinations (Ministry of Food and Drug Safety, 2026d). In an analysis of 47 experiments in healthy adults, improvements in thinking were small (Roberts et al., 2020), and in a study that followed 898 US college students without ADHD, those who took stimulants without a prescription did not improve their grades (Arria et al., 2017). There is more in drug addiction.

Many Koreans take woohwangcheongsimwon (cheongsimhwan), a traditional herbal remedy, before exams. Over-the-counter woohwangcheongsimwon products list palpitations and mental restlessness among their approved uses (Ministry of Food and Drug Safety, n.d.), but we could not find any clinical trial of it for test anxiety or exam marks. A 2010 review of 43 Korean studies found that 32 were animal experiments and concluded that they did not strongly support its effects (Lee et al., 2010). In a survey of 608 nursing students, 36% had taken it, and those who had reported problems such as drowsiness (30%) (Lee et al., 2005); Korean adverse-event reports also flagged drowsiness and dizziness (Choi & Shin, 2026). The product leaflet says to consult a doctor or pharmacist first if you have high blood pressure, heart or kidney disease, or take other medicines (Ministry of Food and Drug Safety, n.d.). It is best not to take any medicine for the first time on the day of an exam.

Online ads for foods and supplements marketed as “supplements for exam takers”, or for “concentration” or “relieving tension”, were among the 45 posts caught as unlawful advertising in the 2025 checks before Korea’s university entrance exam, the CSAT (Ministry of Food and Drug Safety, 2025).

Nerves before exams are common, but get help if anxiety or low mood is severe, lasts and gets in the way of everyday life (NHS, 2023a). If panic attacks come, with a sudden racing heart, breathlessness, dizziness and a fear of dying, talk early to family and a mental-health professional (Ministry of Health, Labour and Welfare, n.d.). Do not brush it off either when anxiety makes a young person refuse to go to school or complain often of stomach-aches or headaches (Elia, 2025). If low mood carries on after exams are over, the PHQ-9 check-in looks back over the past 2 weeks.

In Korea, middle and high school students can get counselling in their school’s Wee class (school counselling room), and local Wee centres offer psychological assessment and counselling in one place and refer students to specialist care when needed (Wee Project, n.d.). Young people aged 9 to 24 and their parents can use Youth Counselling 1388 (call 1388), with online counselling open 24 hours a day (Korea Youth Counseling & Welfare Institute, n.d.). University students can turn to their student counselling centre, and if anxiety is severe, consider seeing a psychiatrist. For a first visit, read seeing a psychiatrist for the first time.

In Japan, students can talk to a school counsellor, an outside mental-health professional working in schools, and if their school has none they can see the counsellor at a nearby school (MEXT, n.d.a). The education ministry’s 24-hour children’s SOS dial (0120-0-78310) is also available (MEXT, n.d.b). In France, Education Ministry psychologists support secondary school and university students (Choisir le service public, n.d.), university students can use student health services and free psychologist sessions (Étudiant.gouv, 2019), and Fil Santé Jeunes offers an anonymous, free helpline (0800 235 236, daily 9am to 11pm) (Fil Santé Jeunes, 2022). In the UK, seeing a GP is a good place to start (NHS, 2023a).

If exams or results bring thoughts of ending your life, do not carry them alone. Please reach out to a crisis line right away: call or text 988 in the US and Canada, call Samaritans on 116 123 in the UK and Ireland, or find a line at findahelpline.com elsewhere. If you are in immediate danger, contact your local emergency services. A report on 285 young people under 20 who died by suicide in England and Wales in 2014 and 2015 found that, of the 145 in education, 46 (32%) were under exam-related pressure, from current or upcoming exams or results, but it stresses that suicide is rarely caused by one thing and that its design cannot establish cause and effect (NCISH, 2017). In Korea’s 2024 Social Survey, the reason most often given by 13- to 19-year-olds who had had suicidal urges in the past year (4.5%) was grades and university entrance (32.9%) (Statistics Korea, 2024).

Q. Are nerves always bad? A. No. Anxiety can help by prompting preparation and practice (Barnhill, 2026b). But there is little support for the idea that a little nervousness raises marks, and on average higher test anxiety goes with slightly lower marks (Putwain et al., 2023).

Q. Does test anxiety come from not studying? A. Not only that. In Korea’s PISA data, students in the top and bottom quarters in science agreed about equally often that they feel very anxious even when well prepared (OECD, 2017), and a study of 1,569 Canadian students also suggested that low achievers may not be the only ones at risk (Plante et al., 2022). Still, preparation and study skills go with lower test anxiety (Cassady, 2004), so preparing early may help.

Q. Isn’t it better to study all night before the exam? A. No. Sleep loss means remembering less of what you studied (Newbury et al., 2021), and people kept awake did worse even though they felt they did well (Pilcher & Walters, 1997).

Q. Can I take cheongsimhwan before an exam? A. We found no study testing whether it helps test anxiety, and drowsiness and dizziness have been reported (Choi & Shin, 2026). If you take it, check the leaflet’s warnings, and if you have high blood pressure or heart disease or take other medicines, consult a doctor or pharmacist first (Ministry of Food and Drug Safety, n.d.).

Q. Is it the same as fear of public speaking? A. They overlap but are not the same. When the core fear is being judged negatively by others, it is closer to social anxiety (WHO, 2024). See social anxiety disorder.

Q. Is there a test-anxiety score? A. The questionnaires used in research have no agreed cut-offs (Cassady et al., 2025). mind.io has no test-anxiety test either. The GAD-7 check-in is not a test-anxiety scale, but it looks back over the past 2 weeks at whether anxiety stays with you beyond exams.

Q. I heard writing down your worries before an exam helps. A. The original study said so, but a replication and a meta-analysis found almost no effect (Camerer et al., 2018; O’Meara & Lovett, 2026).

Q. How can I help as a parent? A. Rather than scaring them, tell them failing is not the end, and help them sleep enough and practise under exam conditions (NHS, 2023a).

Q. I messed up my exam and I want to die. A. Please do not carry this alone. Reach out to a crisis line right away: call or text 988 in the US and Canada, call Samaritans on 116 123 in the UK and Ireland, or find a line at findahelpline.com elsewhere. If you are in immediate danger, contact your local emergency services.

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