From Autumn V
Posted May 18, 2005 at 09:18 PM
Autumn, beta blockers are a last resort. They should not be used as a crutch but to deal with debilatating problems. They do not get rid of nerves, they only help your body control and deal with excess adrenaline rushes. Ask your doctor, do a search in the archives here, look it up on the net, and ultimately decide for yourself, but try everything else first.
There...that's a contructive answer.
P.S. Nate, the impotence is not lasting. Only while the drug is in the system. With a name like Autumn I doubt she has much to worry about.
It is good to get nervous and the only way to deal with nerves is to get up there and face them. Going out on stage and playing the Brahms concerto is not like performing surgery. There is nothing on the line, no one's life at risk. The best way to deal with insomnia is to sleep much as the best way to deal with tension and nervousness is to relax. None of the teachers I have studied with used these beta blockers drugs or for that matter supported them in any way cause they knew what they were doing.
I know some professionals that have taken them but I don't think they really have a technical understanding of what they are doing so they take these drugs to sweep the dust under the carpet so to speak. Having a problem performing is all mental and I think it is even a good idea to talk to specialists much like athletes talk about their problems with sports psychologists if there is an issue about performing. I think a great teacher or coach can sometimes be that solution, someone who has not just taught in the classroom but someone who has had the performance experience.
"This might sound rather absurd but I even think for athletes a controlled cycle of anabolic steroids monitored by a doctor is more legit and makes an actual positive difference in performance more so than using these beta blockers for a musician."
You're right, that is absurd.
Perhaps you didn't fully read my post. Beta blockers DO NOT take the nerves away. If you are nervous about a performance, you are still going to be nervous on beta blockers. It does not remove nerves. At least not in my experience.
The only thing that beta blockers do is help level out too much adrenaline which can be very detrimental to one's playing. A complete lack of adrenaline is just as bad. Beta blockers, when taken in proper dose, level out that burst of adrenaline that causes debilitating shakes or muscle locks. There are certain performances where I will be nervous because there is someone in the audience that I care about, or it is a competition (I always get butterflies for those) etc. Beta Blockers DO NOT rid one of nerves if they are going to have them about the performance. They DO rid one of nerves if the only thing they are worried about in the performance are the muscle spasms.
Anyway, I know this is a pointless discussion because we've had it before yet you continue to argue that those of us who use beta blockers don't know what we are doing with a violin.
Nathan, I use beta blockers and I can assure you it has NOTHING to do with lack of preparation or lack of technique. I can post a sound clip if you like...
I just did a Google search on "beta blocker performance anxiety," and I found a very good discussion of the subject here
Here are a few excerpts:
"Beta blockers can significantly worsen some medical conditions. As a general rule, beta blockers should not be used in asthmatic people. Beta blockers can worsen congestive heart failure, Raynaud's syndrome, and diabetes."
"Musicians who take beta blockers often do so in small doses and only on special occasions, so they may experience no side effects at all from their use. However, many side effects have been reported."
"Beta blockers don't make you play better by themselves; they just relieve physical problems resulting from the fight or flight response. On the other hand, some musicians feel that adrenalin helps their performing, giving them an edge that adds intensity to the performance."
"Beta blockers have not been shown to directly improve a musician's emotional state, except to the extent that some musicians feel better when their physical problems are relieved. If your performance anxiety shows itself mainly in psychological ways (e.g. negative inner voices), beta blockers will not help you."
There are a lot more references to discussions on this topic.
It also sounds to me like Nate is using the impotence side effect more to scare people away from the drugs than to give them helpful information. As Preston pointed out, this side effect (which is probably generally less of a problem for women) lasts only while one is under the influence of the drug. Some anti-depressants also have similar sexual side effects.
I agree that it is important to work on one's mental strength, and it would be wonderful if every musician in the world could perform without shakes or spasms. Unfortunately, that is not the case. Performance anxiety is a complex psychological issue, and everyone experiences it in a different way. As Preston pointed out, the drug does not affect your nerves or your mental state in any way; it merely reduces the physical side effects of the body's fight or flight response. It is still up to every musician, with or without drugs, to learn to foster a positive mental state, to silence the inner critic, to become more in touch with the zone, or whatever you want to call it. Beta-blockers merely serve as an aid, not a cure.
Also, kudos to Pauline for her above post. That sounds like quite accurate information.
My offer of a sound clip post would be to demonstrate technical proficiency. Not that my playing is really needed as a demonstratin of technically proficient performers out there that use beta blockers. I think we would all be VERY surprised to find how many of our modern "idols" use them.
Anway, I don't believe I have a recent recording of my playing that shows muscle spasms...either using or not using beta blockers (as I don't use them for every single performance by any means).
If I were younger, perhaps I would work on trying to figure out an alternative. But I have the luxury of being senile now, so I can cheat, take the easy way, or cop out, which are a few phrases we will see enter the discussion soon.
Jessica I'm not insulting anyone but I certainly do believe the people that resort to these drugs don't have a real understanding of the physical effects the body takes under performance pressures. I have never studied with anyone that uses these drugs and find it rather amateurish and wimpy to have to use these drugs in order to perform well. I don't think getting shakes is a complicated pscychological issue. If one has prepared properly in the practice room before the concert the performance will go well and vice versa. Heifetz used to say to students that they had to be prepared 150 percent before going out on stage because according to him there would be an approximate 40 percent decrease and reversion when out on stage. Auer even suggested in his book if one could not face the pressures of performing that that person should think of something else to do. In the long run it takes nerves of steel to be a performer and getting nervous and using that adrenaline the right way can add to the whole excitement of a performance. I've heard stories of people also saying their worst performances were after they took Inderol.
I'm not trying to say that it's wrong to believe that they are wrong. I think we can all agree to disagree on that. However, I don't think we need to be resentful towards those who decide to take them. I decided to never take them again. I didn't want to become dependent on them to make me feel safe. I didn't have a bad experience with them but I feel that it was better, for me, to learn how to do without them.
The last item on this page talks about dealing with nerves and the anxiety of performing. It even touches on the exact issue of clammy and cold hands.
I don't have a position on drugs. But I'm somewhere between Puritan and junkie.
I have frequently eaten 8 bananas in one day. (I have also eaten 1/2 pound of Macadamia nuts in one sitting, a whole loaf of challa in one afternoon, a dozen oranges, 8 cups of tea, 5 apples in one afternoon, an entire 2 lb bag of pretzels after lunch, 6 yogurts for lunch, a wheel of camembaert in one sitting, 1/2 pound of raisins........and no I am not fat.)
Please be cautious with any pharmaceuticals, especially if you're self-medicating for undiagnosed issues.
Um...so you are saying that if you have a psychological problem, go to the psychiatrist, get a prescription for the legit problem, take them regularly, but for some reason, don't take them to perform? Or go to your medical doctor, find out you have a problem such as tachachardia or arithmia or an adrenal gland problem...and take prescription medication for it, which is fine, but to take it to control your health on stage is wrong? I just don't get it. Popping pills. I don't know anyone who has abused a beta blocker for recreational high. It doesn't affect you like that. I think that it is very offensive and quite closed minded to make statements about whether or not someone should take a medication or not. I show up at my doctor's office and say "I quit taking my medicine" and he says why, that is dangerous, and I say "because people thought it made my playing a lie. That it was performance inhancing..." Picture? Besides. Life is full of performing. Every day we have to perform every minute. Quality of life depends on how well we can perform tasks to emotions to thought. Playing violin in front of people is a portion of that. Would you tell a diabetic not to take his insulin because it makes him healthy enough to play well? If an anemic takes iron pills, is that "popping pills" in order to get an edge on the competition? No. It enables them to function where they would, if they didn't have a problem. Remember. Beta blockers are PRESCRIBED BY A DOCTOR. I think that they should be the ones to decide if you need them, to weigh the pros and cons, and to consider possible side effects. Just because none of your teachers had to take them, doesn't mean that the whole world is the same way. I hate these discussions because, really, there are so many cheap shots in them. The stigma that one should be able to control their body and mind and emotions without medication and if you can't then you are a flawed human being...the idea that it is a weakness of will or character to need antidepressants and not just snap out of it by changing your lifestyle...it is all part of the same societal misunderstanding of illness. Anyone who has been sick or who has had to deal with the very real and very HARD issues associated with being sick, might not appreciate being told by someone who has not had that struggle, that they aren't competant, are weak, or should dig deeper into the "real" issues underlying the problem. Sometimes a medical/mental illness IS what is the underlying factor. And to deny treatment for it because the medication is MISTAKENLY viewed as a drug which gives an unfair advantage or which plays the violin itself...he he....
anyway. If you've ever taken the drug, you'd know that it is not like that at all. And there are side effect sometimes, yes. And you can react badly from it, yes. But...so? THat is everything you put in your body. You have to be smart and do what your body needs. As for bananas, if you don't have a deficiency in potassium to start out with, I don't see how putting more than the needed amount in would help. I haven't heard people discuss much about the many violinists who drink alcohol before they perform. Why is a medication more of a hot topic than something that really IS what some people think beta blockers are? I'll stop now, because I'm just riled up. I'll be honest and say that I have been very offended from a few posts on this thread and greatful for some of the ones which try to inform. I just wish that if people can't answer the question that pops up over and over with decency and respect and honesty, then they shouldn't say anything. By the way....anxiety IS considered a REAL psychological problem for which treatment is sought. It isn't just the biproduct of negative thinking.
If you wanted to try the blockers, you'd ask him for them. You wouldn't just sit there and hope he'd prescribe them.
The people who are opposing them might be doing it for puritanical reasons, or they might be considering personal development and character. What happens to those concepts when you short circuit them, and what growth has occured? Everyone has their problems and all of them probably have a physical basis, ultimately.
I don't support or oppose them. The only important thing to me is thoughtful informed choice.
There is often a burden of guilt attached to taking meds that affect the mind/brain. I would not preach for or against taking any meds that affect the mind. I would encourage people to learn about meds and give careful thought to taking them.
It comes with the territory. Those who came before you did it, so there's no reason you can't either. It's a fear that should be conquered, not something that should have its physical manifestations slightly pacified.
I had a friend and co-worker and as I passed through the lab sometimes I'd see him soldering something, I'd pay attention because it's interesting to see how people work, a bit like guys and a car with the hood up, and he would be shaking, but of course not nervous at all. If he hadn't been able to do the work, no one would tell him to get over it and say he shouldn't take medication to stop it. Some people just shake for some reason. Nothing wrong with taking something to stop it if need be. You shake when you aren't nervous, so I think it's the same as your situation. I would just be keeping my fingers crossed about the long term side effects, if any.
My understanding is that many performers keep a small supply that they don't take every day, but will use to overcome the specific symptoms of performance. Whether to do this is a personal decision, which has to be based on each person's experience.
I've never taken beta-blockers, and if I can help it, I never will. That isn't because I'm puritanical (okay, I sort-of am -- I prefer not to take an aspirin if I can help it, though I do), but because I've had close personal experience with people who have taken beta-blockers for things like tachycardia, migraines and high blood pressure.
They were legitimately prescribed, of course, and medication is absolutely necessary in their cases. The side effects, however, were in one case absolutely unmanageable. I'm certainly overreacting; he was on the medication for more than five years before it got really bad. But to say that side effects aren't an issue when prescribed by a doctor is misleading -- you just accept the side effects and deal with them.
Yes, you can request just about any non-dangerous medication from your doctor; s/he might or might not give it to you, but many will. I've self-diagnosed, gone to the doctor and said "this is what I have, give me the cure", and it worked. (I was right. :)) Beta-blockers, though prescription drugs, are hardly controlled substances and, as was stated above, aren't recreationally abused... (I'm trying to imagine that...)
So my point is:
1) if it ain't broke, don't fix it. Yeah, I could probably fix my bow shakes with drugs, but they're really not bad enough to worry about.
2) if is *is* broke, go to a doctor and find out what it is.
3) if the above doesn't work for you, do as you please. But please be careful. :)
For those considering beta-blockers for performance, please please please be careful with the stuff (Inderol has been nicknamed "end-it-all") and only consider it after you have explored all other options - there are many.
To be brutally honest, I don't see how one could be a good performer with such a dihabilitating trait. If the beta blockers help you and don't have any negative side effects, then I'm sure it's the best option for you.
Beta blockers, like all drugs, have side effects. Most musicians who use beta blockers take relatively small doses and only take them before performances or auditions, so they are less likely to have adverse reactions than people who take them chronically. However, if you have asthma or take potassium supplements, it would be prudent to avoid taking beta blockers.
Beta blockers reduce the physical symptoms of performance anxiety. There are other medications and nondrug treatments for anxiety itself.
I would say that if you really need beta blockers or any other drugs, you should take them. Don't make yourself miserable. Just be aware of what you're doing and how it may affect you.
Yes, I concur completely. I take 10 mg.(which is a very small does) only for events which I know are big enough or important enough that I will be nervous for. As I stated in another response, the more you perform, the more de-sensitized you are apt to become. There is no danger of getting hooked on this type of drug. Gregg
Sorry Jim, but that's just an out and out generalisation with only minimal basis in fact. Most doctors I know take all aspects of patient care seriously. Certainly very few would ever prescribe anything simply because the patient asked them to.
That doesn't preclude a patient discussing a set of symptoms or condition with a doctor and asking to be prescribed something to treat that condition. However, if the doctor believed the requested drug inappropriate or didn't believe that the symptoms or condition warranted treatment of that nature then they are very unlikely to accede to the patient's request.
As to those pushing (and it is the right word) to use beta-blockers for some minor performance anxiety, I wonder how many of them get up in arms when an athlete is busted for steroids. Exactly the same concept; different methods, different actions, different side-effects, but exactly the same concept. In fact, beta-blockers are, I believe, on the banned list for sports; specifically target shooting. (I think)
Personally, I would prefer to avoid any drug for which I don't have a specific MEDICAL need.
If you have such an irresponsible doctor, run out the door now.
I'm quite an introvert. Shyness has been like a disease for me. Strangely ehough, at my job I can stand up and give a presentation in front of a bunch of suits without breaking a sweat, but put me in a social situation and I'm in real pain and misery.
It took all the will I could muster to attend my first lesson 2 years ago. A month into it, I was still sweating bullets and shaking. I went to see my doctor and discussed it with him and asked if there was a drug that would help me. I had thought of Paxil, since it is prescribed for anxiety. He already knew about beta-blockers being used by performers (not only musicians). After a lot of dicussion he left the room and then returned and gave me some websites to take home and do some research. I was to come back in a month to discuss it.
I returned and told him that the nervousness was debilitating and was threatening my continuing the violin. I have been on blood pressure medication for 5 years. A lot of beta-blockers are just the meds that were used for lowering blood pressure before more effective meds came along. Together, we decided to try it. He prescribed a low mg bb (not Inderal).
I took one 2 hours before my lesson 2 weeks in a row. I called and told him that it appeared to have no effect at all. I was still struggling. He told me to try 2. That did it. I was calm for my lessons and the horrible shaking went away. Some shaking was still there but it was manageable. I also used them when I knew I was playing for a group of family and friends. I'd say I was taking 10 of them a month.
As I've gotten to know my teacher and gained some confidence I have begun to relax. I don't really use them that often, but for 6 months they were a Godsend. I could never have continued with the violin as I was.
BTW, I will soon be 54 and I have no intentions of "performing" as a soloist (nor do I have any dellusions that I ever could) but I would like to play in a community orchestra someday. I wouldn't hesitate to return to them at that time until I could relax.
Personally, I would not still be playing were it not for them. Of course, if i were 21 and had my life before me, I may have sought alternatives, but this was the route for me.
Make no mistake, my doctor was very careful about my mindset and dug deep before prescribing them. It was never an "open" prescription.
I think the effect bananas have physically as a beta blocker is quite minimal. I think the effect bananas have psychologically as a beta blocker is greater.
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