If the thought of delivering a speech makes your heart race, your palms sweat, and your stomach turn, you are not alone. Fear of public speaking ranks ahead of illness and dying. Why? Many women dread the public embarrassment and humiliation that might come from making a mistake, being perceived as incompetent, or being judged.

For some women, however, this fear becomes overwhelming to the point that it interferes with their daily lives. They might retreat into a "safe" job with little public contact or turn down a job that requires making presentations. When that happens, the fear has escalated into a more intense state - anxiety. From a biological standpoint, anxiety is grounded in the "fight or flight" response that protects human beings from real physical threats.

"Anxiety isn't bad. It motivates us to get out of harm's way and is an important part of living," according to Jerilyn Ross, M.A., L.I.S.W., and author of Triumph Over Fear: A Book of Help and Hope for People with Anxiety, Panic Attacks and Phobia. "But when anxiety becomes disproportionate to the situation and leads to avoidance of the fear-inducing situation and other undesirable consequences, it should be assessed", says Ross.

Anxiety is a general term for a variety of disorders that include panic disorder, generalized anxiety disorder, post-traumatic stress disorder, obsessive-compulsive disorder, and phobia. The extreme fear of public speaking described above is typical of a type of anxiety called social anxiety or social phobia - and women are twice as likely as men to suffer from it. In fact, women are twice as likely as men to suffer from all anxiety disorders with the exception of obsessive-compulsive disorder.