The toast you have been dreading since March

TL;DR: A wedding toast is harder than a work presentation because you cannot decline it, the room is full of people whose opinion you care about, and everyone is watching your face. Write it short, three minutes at most. Memorize the first two sentences and the last two so you can start and land without reading. Rehearse it out loud, standing, at least three times. Do not drink to settle your nerves, because alcohol makes the delivery worse while making you feel better about it, and it hits harder on an empty stomach at a wedding. Eat something. Speak earlier in the evening if you can choose. If your body has wrecked speeches before, propranolol blocks the physical part, and it must not be combined with alcohol and needs a doctor's screen first. Tell Dr. Ash what happens to you.

Nobody trains for this one. A wedding toast is often the only public speaking a person does in a decade, in front of an audience made up of people whose opinion of them matters, on behalf of someone they love, with no option to say no.

That combination is why people who present at work without difficulty describe dreading a toast for months.

Why is a wedding toast harder than a work presentation?

Because almost every variable is worse.

The audience knows you. Anonymous evaluation is uncomfortable; evaluation by your family, your friends, and your partner's family is a different weight. There is no going home afterwards and forgetting it.

You cannot decline. Refusing a work presentation costs you something professionally. Refusing to speak at your sibling's wedding costs something else, so people accept and then carry it for months.

The stakes feel moral, not professional. A bad quarterly update is a bad quarterly update. A bad toast feels like a failure of love, which is why people over-prepare the sentiment and under-prepare the delivery.

Alcohol is in the room. It is offered, it is free, and it presents itself as the obvious solution. It is the single most reliable way to make the speech worse.

The anticipation runs for months. Long anticipation is its own physiological load. People report worse sleep for weeks before a wedding they are speaking at.

What helps?

Write it short and rehearse it out loud.

Three minutes, maximum. Nearly every bad wedding speech is a long one. A short toast is easier to deliver, easier to memorize, and better received. Write it out, read it aloud with a timer, and cut.

Memorize the opening and the closing. Two sentences at each end. The opening lets you start while your body is at its worst without composing anything, and the closing gives you an ending you can steer toward if the middle wanders. The middle can be read.

Rehearse standing up, out loud, three times. Reading it in your head is preparation for a different task. Speaking under observation is what you are being asked to do, so the practice has to be speaking, ideally in front of one person.

Hold the card low and still. A page held at arm's length turns a small tremor into something visible from the back. Rest your hand on the table or hold the card against your chest.

Pause after the first sentence. It reads as composure, and it refills your lungs. People speed up to escape the discomfort, which is what empties them.

Guidance from the Clinic

"Somebody once told me the two drinks were medicine. I asked what happened at the last wedding, and he said he could not remember the second half of his own speech. That is what the medicine did. It worked on the fear and charged him the memory."

Why is drinking to settle your nerves a bad plan?

Because it improves how you feel and worsens what you produce, and you are the one person in the room who cannot tell.

Alcohol reduces anxiety in the short term and impairs articulation, timing, judgment about length, and the formation of new memories. The result people describe afterwards is common enough to be predictable: they felt fine, the speech ran long, they said something they would not have said sober, and they cannot recall the second half.

Weddings make it worse than usual. Drinks arrive earlier than food, so a toast often happens on an empty or near-empty stomach with an unknown number of glasses behind it. Nerves also speed drinking, so the person who is most anxious about speaking is often the one who has had the most.

The practical plan is to eat before the drinks arrive, hold at one if you drink at all, and if you have any choice about timing, ask to speak earlier in the evening.

Where does propranolol fit, and what about mixing it with alcohol?

Propranolol blocks the adrenaline reaching your heart, lungs, and muscles, so the pounding heart, the shaking hands, and the wobble in the voice do not develop. It leaves your thinking, your memory, and your timing alone, which is why it is a better fit here than anything sedating. The usual approach is 10mg to 20mg about an hour before, and the first dose should be taken at home on an ordinary day, well before the wedding, so you learn how it affects you.

Do not combine it with alcohol. Both lower blood pressure, and together they can leave you lightheaded, particularly on standing, which is what a toast requires of you. If you take it, do not drink beforehand. Choosing between them is part of the plan and worth deciding in advance instead of at the table.

The safety list applies as it does everywhere. Asthma and any reactive airway disease rule it out, because propranolol is non-selective and can trigger bronchospasm. So do a resting heart rate under about 55, heart block, heart failure, low blood pressure, and any beta-blocker you already take. Insulin-treated diabetes needs a physician's review. The complete list is on who should not take propranolol, and dose, timing, and evidence are on propranolol for performance anxiety.

A benzodiazepine is a poor choice for a wedding for the same reason alcohol is, with the added hazard that combining the two depresses breathing. It also blurs the memory of an evening you will want to remember. The comparison covers both.

When is this worth a longer conversation?

When the dread outlasts the wedding.

If you have declined roles at weddings and funerals to avoid speaking, if the anticipation has cost you months of sleep, if you feel this way about most social occasions and not about speaking alone, or if alcohol has become part of how you attend events at all, then the toast is one visible instance of something wider. Social anxiety disorder responds well to cognitive behavioural therapy, and treating only the tremor would leave the rest.

That distinction is what an evaluation is for, and performance anxiety covers how the two present differently.

Related at Fishtown Medicine

• Performance anxiety: what your body is doing
• Propranolol for performance anxiety
• Who should not take propranolol
• Presentation anxiety
• Interview nerves

Scientific References

1. Brantigan CO, Brantigan TA, Joseph N. Effect of beta blockade and beta stimulation on stage fright. The American Journal of Medicine. 1982;72(1):88-94.
2. US Food and Drug Administration. Inderal (propranolol hydrochloride) prescribing information, alcohol interaction. FDA Access Data.
3. Söderpalm Gordh AHV, Söderpalm B. Healthy subjects with a family history of alcoholism show increased stimulative subjective effects of alcohol. Alcoholism: Clinical and Experimental Research. 2011;35(8):1426-1434.
4. Mayo-Wilson E, Dias S, Mavranezouli I, et al. Psychological and pharmacological interventions for social anxiety disorder in adults: a systematic review and network meta-analysis. The Lancet Psychiatry. 2014;1(5):368-376.
5. Söderlund H, Parker ES, Schwartz BL, Tulving E. Memory encoding and retrieval on the ascending and descending limbs of the blood alcohol concentration curve. Psychopharmacology. 2005;182(3):305-317.