How do I build confidence in public speaking when I physically panic before every presentation?

Physical panic responds better to physical preparation than to pep talks. A few things that actually move the needle, in rough order of what to try first: Practice out loud, standing up, in front of at least one real person before the actual talk — not just reading it silently or rehearsing in your head. The gap between "I know this material" and "I can say this material while a body is watching me" is the whole problem, and only practice closes it. Reframe the physical sensations instead of fighting them. Racing heart and adrenaline before a talk and before something exciting feel almost identical in the body — telling yourself "I'm excited" rather than trying to force yourself calm is a small trick that measurably helps, because you're not fighting a losing battle against your own nervous system. Cut every unknown you can control in advance. Know the room, know your first two sentences cold, know how the slides advance, get there early. Panic feeds on uncertainty, so remove as much of it as you can before you're standing up there. Do more low-stakes reps. The fastest way to get less scared of public speaking is more public speaking, in low-pressure settings — a team meeting, a toast, a small group — not waiting until the big presentation to face it for the first time in months. None of this makes the fear disappear entirely, and it doesn't need to. Most people who look calm up there aren't fearless — they've just done it enough times that the fear stopped being the main event.