Breaking Stress cycle: Effective strategies for exam anxiety

Exams stress frequently trigger a fear of failure in students, resulting in mental,  physical, and behavioral reactions. They commonly face intense worry, cognitive confusion, uneasiness, and heightened bodily tension leading to low self-esteem, anticipating failure, and resorting to self-criticism as a coping strategy. These debilitating effects of anxiety ultimately impair their exam performance¹

Neuroscience of Stress: Biological & Neurological Mechanisms

During exam stress, cortisol is released from the adrenal cortex due to activation of the hypothalamic-pituitary-adrenal (HPA) axis. Release of cortisol leads to physiological changes such as elevated heart rate, increased blood pressure, and higher blood glucose levels². This hormone crosses the blood-brain barrier and binds to receptors in the hippocampus, affecting areas involved in memory and emotion, such as the hippocampus and amygdala. As a result, long-term memory retrieval is impaired, which explains why students may forget studied content during exams³

Mind Over Matter: The Power of Mindfulness in Managing Stress

To manage exam-related stress effectively, it is important to stay present and adopt a non-judgmental attitude toward thoughts and emotions. Practicing mindfulness can lower cortisol levels and improve focus.

1. Body Scan: Observe physical symptom such as tension or restlessness without judgment. Accept and acknowledge each feeling with calm awareness.
2. Mindful Gadget Use: During exam stress, consider a conscious pause before turning to gadgets; intentional use or a deep breath can help restore focus.
3. Focused Study Start: After a break, take a moment to refocus before resuming studies; begin with full attention to enhance retention and performance.^4,5

Breaking Free: Practical Tools to Disrupt the Stress Cycle

1) The Exam Prep Mindset: Turning Anxiety into Motivation

• Comprehend the syllabus and exam pattern
• establish a study schedule
• solve previous university question papers.
• take brief notes
• strategically plan your answers
• take regular breaks from studying.
• Managing time by priortising tasks by urgency and importance⁶

 
2) Exercise: Natural stress buffer
Exercise promotes hippocampal neurogenesis by increasing neurotransmitters such as β-endorphins, vascular endothelial growth factor, BDNF, and serotonin.

Following can be practices

• At least three times a week, spend 15 minutes each day walking or cycling.
• Avoid cross-legged sitting and junk food, engage in swimming or sports⁷

3) Nutrition: Fuel for the Brain

• Artificial Sweeteners – Elevate stress hormones and should be avoided.
• Omega-3 Fatty Acids (e.g., chia seeds, flaxseeds) – Enhance BDNF levels and support neurotransmitter balance.
• Salmon – Rich in astaxanthin, an antioxidant that protects omega-3s from oxidation and supports brain health.
• Curcumin – Modulates gut microbiota, reduces inflammation (via NFκB inhibition), and influences dopamine, serotonin, cortisol, microRNAs, and histone deacetylases, thus lowering anxiety.
• Vitamin D (e.g., from milk) – Regulates calcium balance, neurotransmitters, BDNF, ion channels, and supports gut health and immune modulation.
• Ketogenic Diet – High-fat, low-carb diet shown to significantly reduce anxiety levels.⁸

 
4) Sleep: The Mind’s reboot system
‘Sleep-wake’ cycle disruptions during exams lead to tiredness, headaches, body aches, poor digestion, inability to concentrate, irritability, short temperedness  and 8hours of sleep is necessary to give better performance during exams⁷
 
5) Support Systems: The Role of Family, Friends, and Mentors

• Mentors carefully listen to students, guide them in doubts, sharing their success stories, motivating them.
• Friends and family don’t judge them and provide emotional or moral support during exams⁹

 
6) 7 C’s to Build Resilience: How to Bounce Back from Exam Stress

• Competence: thinking that they can handle effectively.
• Confidence: believing own abilities.
• Connection: being close with family and friends can give sense of security
• Character: having strong moral values and have a caring attitude.
• Contribution: believing that they can contribute to others in need.
• Coping: ability to effectively cope with stress to be prepared to overcome life’s challenges.
• Control: believing that they can overcome outcomes of their decisions¹⁰

 
7) The Power of Positive Affirmations: Rewriting Your Exam Narrative
Self affirmations reduce the effect of negative emotions and  allows them to focus on sources of positive self-worth that transcends the threat which improves emotional wellbeing. ¹¹

References:

• Akshaya S, Ninan J, Thomas S. Test Anxiety Among College Students. Int J Creat Res Thoughts. 2021 Jan;9(1):3411–3412.​
• Hinds JA, Sanchez ER. The Role of the Hypothalamus–Pituitary–Adrenal (HPA) Axis in Test-Induced Anxiety: Assessments, Physiological Responses, and Molecular Details. Stresses. 2022; 2(1):146-155.
• Ahmed F, Dubey DK, Garg R, Srivastava R. Effects of examination-induced stress on memory and blood pressure. J Family Med Prim Care. 2023 Nov;12(11):2757-2762. doi: 10.4103/jfmpc.jfmpc_925_23. Epub 2023 Nov 21
• Zandi H, Amirinejhad A, Azizifar A, Aibod S, Veisani Y, Mohamadian F. The effectiveness of mindfulness training on coping with stress, exam anxiety, and happiness to promote health. J Educ Health Promot. 2021 May 31;10:177
• Saighal T. Mindfulness helps fight exam stress: A student’s guide to be mindful during exams [Internet]. India Today. 2017 Dec 20 [cited 2025 Apr 30]. Available from: https://www.indiatoday.in/education-today/gk-current-affairs/story/mindfulness-helps-exam-stress-new-study-1113979-2017-12-20
• Sharma A. Class 10 Board Exam 2025: Expert Shares Strategies To Turn Anxiety Into Motivation [Internet]. Zee News. 2025 Jan 2 [cited 2025 Apr 30]. Available from: https://zeenews.india.com/education/class-10-board-exam-2025-expert-shares-strategies-to-turn-anxiety-into-motivation-2830349.html&#8203
• Austin DS. Killing them softly: neuroscience reveals how brain cells die from law school stress and how neural self-hacking can optimize cognitive performance. Loyola Law Rev. 2013;59:791–867.​
• Norwitz NG, Naidoo U. Nutrition as metabolic treatment for anxiety. Front Psychiatry. 2021 Feb 12;12:598119.
• National Academy of Sciences, National Academy of Engineering, Institute of Medicine. Adviser, teacher, role model, friend: on being a mentor to students in science and engineering. Washington (DC): National Academies Press; 1997
• Peterson, C. & Seligman, M. E. P. (2004). Character strengths and virtues: A handbook and classification. Washington DC: American Psychological Association.
• Cascio CN, O’Donnell MB, Tinney FJ, Lieberman MD, Taylor SE, Strecher VJ, Falk EB. Self-affirmation activates brain systems associated with self-related processing and reward and is reinforced by future orientation. Soc Cogn Affect Neurosci. 2016 Apr;11(4):621–9. doi:10.1093/scan/nsv136