Whenever a problem develops where no problem existed before, my first question is always: what is different now? You mention that you previously gave lectures to 150 people as a teacher’s assistant without the anxiety (or, perhaps more to the point, performance anxiety) you are currently dealing with in your professional life. What feels different to you about the two experiences? I wonder if the stakes seem higher now, the content more complex, or the audience more inquisitive or demanding. It seems reasonable that any of these possibilities, or something else along these lines, could create and/or intensify anxiety around public speaking.
If you can figure out what has developed to cause the problem, perhaps you can figure out some strategies for addressing it. For example, if upon reflecting on the differences between your experience as a TA and as a professional you discover that the content is more complex and the audience more inquisitive, it might be helpful to take some trainings or courses to deepen your knowledge of the content area. This might increase your confidence in your ability to answer questions as they come up. Maybe reflection will lead you to discover that your anxiety is less about content and more about style. Perhaps you have realized that the level of polish expected of professionals, as opposed to student TAs, is quite different and you don’t feel like you measure up. If this is the case, participating in a group like Toastmasters might be helpful in mastering and developing confidence in your public speaking skills.
Sometimes, unexplained anxiety that seems to come up out of the blue can be a way of getting your attention and forcing you to address dissatisfaction with an area of your life that you are not fully aware of.
You also raise the possibility that there is a medical problem that has developed and is to blame for this. The only way to rule that out for sure is to schedule an appointment with your doctor for an exam and discussion about this, and I recommend that you do that sooner rather than later. I am not a doctor, so as much as I hear your desire for explanations, it would not be appropriate for me to speculate as to potential medical issues you might be experiencing.
It is also possible that the problem is neither medical nor a reflection of simple insecurities about speaking in public. How do you feel about your career and where you are professionally? Sometimes, unexplained anxiety that seems to come up out of the blue can be a way of getting your attention and forcing you to address dissatisfaction with an area of your life that you are not fully aware of. If the above recommendations don’t yield any solutions and you land on a vague dissatisfaction with your career, what might be helpful is partnering with a career counselor to explore where you are, where you want to be, and developing a realistic plan for how to get there.
Best wishes,
Sarah
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