There is no cure for presentation stage fright, but you can reduce its symptoms with beta blockers. However, even with the help of medication, your nerves will still be on edge, and you'll still be up there with a cracking voice, runaway heart rate, and nauseating dread.
You've probably seen plenty of posts promising to "Level Up Your Presentation Skills" or read excellent books like "Resonate", "Presentation Zen", and "Confessions of a Public Speaker". You've worked on your 12-17 seconds of eye contact, posture, hand-gestures, and voice projection. You've watched a thousand hours of TED talks and practiced your opening with humour, narrative arc, and emotional hooks.
But because you're human, your stage fright now - after working on it so very hard - is worse. The problem is that focusing on the million ways you're doing it wrong only makes things worse. If you have severe stage fright, the worst way to improve your presentation is to focus on your presentation skills.
This might sound counterintuitive, but presentation skills are like a UI: they're just enough to create an experience for the people who matter - your audience. You don't need to be perfect; you just need to be presentable enough to get on with creating an experience for them.
So what's really important? Is it maintaining a consistent look and feel, using too many fonts and variations, or crafting a beautiful narrative arc? Not as much as you might think. What matters is that your presentation serves the user experience you're designing for.
A surprisingly simple trick is to open with a question they would very much like an answer for. Pose a question and start. Don't hesitate. And whatever you do, don't try to establish your credibility or sell them on why they should listen to you.
Another crucial rule I have when giving presentations - whether it's a mega-event keynote or a small intimate meeting - is that nobody is allowed to introduce me. If they insist, then it must be only my name (though I try to discourage that too). And I do not introduce myself. This sends the message that I'm not what matters; I'm just a UI.
This approach might seem radical, but it's been incredibly effective in reducing my stage fright. By keeping the focus off of me and onto the experience I'm creating for the audience, I can get on with delivering a presentation that truly serves them.