Test anxiety is very common among high school and college students and a topic I often discuss with clients as they face exams throughout the school year. If you are one of the many people who feels anxious right before an exam even when you have studied, here are a two things you can try immediately before an exam.
Breathing Techniques
There are many different techniques out there and if you google "calming breathing techniques" you'll find a plethora of articles put out on the web by the Mindfulness and Meditation community. The important thing is simply to bring attention to your breath in a nonjudgmental way. Simply notice what your breath feels like in this moment. As your mind wanders back to the upcoming test (or perhaps even the test sitting on the desk in front of you), gently let go of those thoughts and return to an awareness of your breath. Notice where the sensations are the strongest. The tip of your nose? Your belly rising and falling? Next simply try to slowly inhale a little deeper, pause at the top of the breath and make your exhale even slower than the inhale. By mindfully focusing on your breathing, your mind will start to relax. When you slow the breath and bring air deeper into your lungs, your body too will calm and you'll be able to better access the information you have learned.
One thing I'd add now, because I've watched this go wrong. The breathing is there to help you stay at the desk and start the test. It is not there to make the anxiety disappear first. If you find yourself breathing and breathing and waiting to feel calm before you'll pick up the pencil, the breathing has quietly become a way to avoid the test, and anxiety wins that round.
So here's the version I teach now. Two or three slow breaths, then start reading question one while your heart is still going. The anxiety will settle on its own in the first few minutes, the way it does when you jump into a cold pool. You don't have to be calm to begin. You have to begin, and let calm catch up.
Positive Self Talk
My dad, a great public speaker, used to get nervous before he'd speak to a crowd. Nobody ever knew about his nerves though, because he appeared so confident! What was his secret? He was his own best cheerleader! Before a big speech, my dad would go into the men's room, look himself in the mirror and confidently say, "It's going to be ok! It's going to be alright!" This positive self talk helped him overcome his anxiety. When experiencing test anxiety, you're likely thinking, "I'm going to fail this test," "I didn't study hard enough," or "I'm not very good at taking tests." These thoughts are only going to make your test anxiety worse making it difficult to focus. By noticing that negative self talk and changing those statements to, "I've studied hard and know the material," "I will do my best," or "I've got this," your anxiety can begin to decrease, you'll stop catastrophizing and you can focus on acing your exam!
I still love that story about my dad. And I've learned that positive self talk works best when you actually believe it. If you studied hard, "I've studied hard and know the material" is true, and saying it reminds your brain of the facts. That's the CBT move: catch the catastrophe, check it against reality.
But some people, especially the perfectionists I work with, hear "I've got this" and their brain answers "no you don't." If that's you, don't argue with it. Try a different kind of statement, one that doesn't need anxiety's permission:
"Maybe I'll do great, maybe I won't. I'm taking the test either way."
"I can feel this nervous and still read question one."
"One question at a time. That's the whole job right now."
Those aren't cheerleading. They're willingness. You're not promising yourself it'll go well. You're telling anxiety it doesn't get to decide whether you show up. For a lot of students, that's the sentence that finally lets them breathe.
Two More Things That Help in the Week Before a Test
The two techniques above are for the five minutes before the exam. If test anxiety is a pattern for you, the bigger wins happen earlier. Here's what I'd add to the original post.
Practice the test, not just the material
Most anxious students study the content and never practice the situation. Then test day is the first time they've sat in a quiet room, with a clock running, with no notes, feeling their heart pound. Of course it's overwhelming. It's brand new.
So rehearse the situation on purpose. Take a practice test with a timer, phone in another room, no peeking. Do it in the actual classroom if you can get in, or the library if you can't. Let yourself feel the nerves and keep going. This is exposure, and it's the single most effective thing I know for test anxiety. Every practice run teaches your brain the same lesson: this feeling shows up, and I can still think.
Drop the safety behaviors
Safety behaviors are the things you do to feel less anxious that quietly keep the anxiety going. With tests, they look like:
Rereading your notes until 2am the night before, long past the point of learning anything
Checking and rechecking answers until the clock runs out
Asking three friends how they thought it went, the second you walk out
Studying straight through the night because stopping feels dangerous
Each one buys a little relief and costs you something bigger. The all-nighter costs you the sleep your brain needs to pull up what you studied. The rechecking costs you the last five questions. The post-test poll costs you a weekend of replaying it. If you want to understand why this happens, I explain the whole anxiety cycle in 5 Things You Need to Know About Teen Anxiety. The short version: anxiety feeds on the things we do to escape it.
Pick one safety behavior and drop it for the next test. Just one. See what happens.
When Test Anxiety Is Really About Something Bigger
Sometimes a student comes in for "test anxiety" and within two sessions it's clear the test is just where the anxiety shows up loudest. A few patterns I see a lot:
It's perfectionism. The fear isn't failing. It's getting a B. If a grade that most people would be happy with feels like proof you're not good enough, the test isn't the problem. The rule you're living by is. We wrote about this for parents in how to support a high-achieving teenager, and the same rule follows a lot of students to college.
It's panic. If your body does something scary during tests (racing heart, can't breathe, feel like you're going to pass out or lose it), and you've started avoiding tests or leaving early because of it, breathing tips won't be enough. Panic responds really well to treatment, but the treatment is practicing the sensations on purpose, not avoiding them.
It's checking. If you can't turn in a test without rereading every answer four times, or you redo problems you know are right because "what if," that's worth looking at. Sometimes it's anxiety. Sometimes it's OCD, and the treatment is different. ERP is the approach that works for OCD, and more than half of our clinical team is trained in it.
It's the move to college. A lot of students had test anxiety under control in high school and then it comes roaring back freshman year. That's usually because the old coping strategies depended on things that are gone now: a parent nearby, a familiar teacher, a predictable schedule. We wrote about why high school coping strategies stop working in college if that's you.
Does Anxiety Treatment Actually Work?
Yes, and we don't just say that. We measure it. Every client at Aspire fills out a short anxiety questionnaire when they start and again as therapy goes on, so we can see whether things are moving and change course if they aren't.
Here's what that looks like for the age group reading this post. Among our clients ages 18 to 25 who started therapy with at least moderate anxiety, 122 of them so far, the average GAD-7 score at intake was about 15. On that scale, 15 and up is severe, 10 to 14 is moderate, and under 10 is mild. By eight weeks the average had dropped to about 10. By the end of treatment it was about 7, which is solidly in the mild range. In research terms, that's a large change, and it starts showing up within the first two months.
For kids and teens under 18, we use a questionnaire built for them called the SCARED. The pattern there is worth knowing if you're a student or a parent planning around a semester: scores barely move in the first few months, while trust and skills are building, and then drop meaningfully by the four-to-five-month mark. The full numbers are in our guide to knowing if your teen needs therapy.
Two things worth noticing. Young adults tend to move faster than teens do. This makes sense. With a child, we’re often working with both the parents and teen and some may even be resistent to therapy so we have to spend some time getting buy in for a teen who’s parents bring them in. For young adults, they often make the decision to come to therapy themselves and are able to make most of the changes we suggest themselves.
These are real-world results from real clients at Aspire Counseling, not a controlled study, and an average can't predict how any one person will do. But they're why I can tell a stressed-out sophomore with a straight face that this gets better.
Begin Anxiety Counseling in Columbia or Lee’s Summit
If you are struggling with anxiety, the good news is that anxiety is usually very responsive to treatment! An important part of anxiety treatment is often counseling. The good news is that at Aspire Counseling, we have several therapists with a ton of experience working with anxiety. You don’t have to live in a state of fear and tension dreading the future or criticizing yourself.
We’d love to help you learn to manage your text anxiety. Your worry, fear, uneasy stomach or second guessing shouldn’t keep you from showing what you know when it comes to class tests. Our therapists primarily work with children ages 10 through retired adults and use proven techniques to help you overcome your fears, get “unstuck” and present your best self to the world.
We see teens in person at our Columbia and Lee's Summit offices and online anywhere in the state. To begin counseling start with these steps:
If your family lives on the Kansas side of the Kansas City metro, Ashley Elder at our Lee's Summit office is licensed in both Missouri and Kansas, so she can see your teen online from either state, not just in person at the office.
Contact our counseling clinic to speak to our care coordinator. Call Columbia at 573-328-2288 or Lee's Summit at 816-287-1116, or reach out online.
Schedule a free consultation with one of our teen therapists
Begin learning new ways to cope with and conquer your anxiety
Whenever you're ready for effective care and lasting change, we're here.
About the Author
Jessica Oliver, MSW, LCSW (formerly Jessica Tappana) is the founder and Clinical Director of Aspire Counseling, with offices in Columbia and Lee's Summit and online therapy across Missouri. She has more than fifteen years of clinical experience treating trauma and anxiety, with advanced training in EMDR, Cognitive Processing Therapy, Prolonged Exposure, ACT, and Exposure and Response Prevention. A lot of her current caseload is college students and high-performing professionals, which means she still talks about exams, deadlines, and the fear of not measuring up almost every week. She primarily works out of our Lee's Summit office serving the KC metro area.
This post was originally published on February 2, 2018 and updated on October 14, 2026 to add exposure-based practice for test anxiety, the safety behaviors that keep it going, when test anxiety is a sign of something bigger, and Aspire's outcome data.
