The first time I had a panic attack on stage, it was actually pretty minor and short-lived.
It was about 15 years ago and I was playing Principal Second violin for a summer outdoors concert at a place called the Redlands Bowl. It was sort of a pops-classical mix, and one of the pops tunes had a very brief, technically very easy solo -- only maybe six measures long -- for the Principal Second.
In the rehearsals leading up to the concert, though, my mind started playing tricks on me. It was as if a crafty little demon came to sit on my shoulder and whispered, "You know, that's very exposed for you. You might panic, right there." I dismissed this ridiculous idea; this was a very easy solo. Not a big deal. Even if I was really nervous and had a little stage fright or performance anxiety, I could play it. I could keep this bothersome demon away.
Then came the performance. About a page before the solo, the demon came back to sit on my shoulder, count off the time until the solo and tell me that it was going to be a big, horrible panicky moment.
It was absolutely ridiculous, and yet I could not get it to go away. By the time those six measures came, I was in a ringing tunnel of anxiety and could barely play. I eeked out a weak little solo that was nothing like I'd been playing or wanted to play. But I got through it. I actually went on that same night to lead the troops through the entire 1812 Overture and didn't feel the slightest pang of anxiety - nailed it, as a matter of fact, and felt great.
Well that was over, thank goodness.
But it wasn't over. Because over the years, every now and then, that crafty little demon would reappear. Not for every concert, but sometimes he'd show up at a rehearsal and pick some choice place in the music and announce to me, "You're going to have a little panic attack here."
He showed up at an audition. I was never more prepared for an audition than I was for that one, and then when I went to play, I was suddenly thrown into a tunnel of panic and physically unable to do a fraction of what I can do. I was so ashamed after that audition. I'd taken lessons from the concertmaster. I'd prepared as much as I knew how to prepare. I even did yoga right before the audition to calm my nerves! None of it mattered. I utterly failed.
Of course, I'd been nervous before, but this was different. I wasn't nervous about the music. I was actually confident in my playing. Instead, I was becoming deeply terrified of that demon - it was turning into a monster. It was fear of fear. If I felt that there were any stakes in the performance, the monster would come back and sabotage my efforts, make a fool of me.
This was too hard. I began to avoid performing, at least solos and exposed things. I tried to just perform for things that didn't feel like they mattered, or at least mattered in a different way. Like a benefit for my kids' school. Or church.
In fact, at my Unitarian Church, my husband was the guest speaker for one Sunday, and he wanted me to play. So for him, I played the Heifetz arrangement of Gershwin's "Ain't Necessarily So" - a bit of a joke that related to his sermon. I was excited to get into this juicy piece - I'd never played it. I learned it, worked it up, and played well for the service. In fact I played well enough that a few months later the music director at church asked me to be in a little orchestra, play concertmaster and do a solo. Sure, I'm probably over this anxiety thing by now!
But I wasn't. The monster arrived at the rehearsal, and announced to me I'd have a panic attack for the solo. I did. I shook like a leaf and could barely play. I felt awful, like I'd ruined the concert.
Thank goodness this did not happen when playing in the second violin section in orchestra. At least I could still do that.
Then a few years ago, I was called on to play first violin, rather than second. It was a little bit unexpected, a little bit last-minute; I'd already learned the second part. It was a smaller, chamber concert, with a very challenging piece. But this was okay. I practiced very hard, learned it well and felt good about it. That's when the monster showed up to let me know that I'd be fine with the challenging piece, but during the very easy Mendelssohn piece that was also on the program, particularly during the rather exposed slow movement, I'd probably have a panic attack. No way. So I over-practiced that piece, even though it was practically sight-readable. I made sure I could play it very well.
This just could not happen in orchestra, in the back of the section. No, it was not going to happen in orchestra.
Of course, I was wrong. It happened, and this panic attack was the most spectacular of all. When the designated movement came, I actually could not raise my violin to my chin. My heart was pounding faster than it has ever pounded in my life, as if I were in the middle of running an all-uphill marathon. No amount of yoga-breathing and meditative assurance could pull me from this state. I wanted to leave the stage but could not even do that - I didn't think my legs would hold me. The orchestra actually had to play, while I just sat frozen, utterly sick, trying to breathe, with my violin sitting on my knee.
Afterwards, someone I knew in the audience, a medical doctor whose daughter I'd taught for many years, was so alarmed that she told me she just knew I'd had a "mini stroke" and I should go to the hospital. I mean it was bad - but I actually had come back and played the rest of the concert - playing the difficult piece was actually a relief because I knew the monster didn't care about that.
But my friend was convincing, and based on how I felt, it was not hard to convince me that something must be terribly wrong. After the concert I did go to the hospital. It caused me to miss the second performance of the concert that evening. Everyone in the entire orchestra knew that I was at the hospital - they were so kind and supportive and empathetic. I was....mortified. The verdict: No, I had not had a mini-stroke. I'd had a nice, full-on panic attack.
"A panic attack can be really bad. You can think you are having a heart attack," the doctor said. And also, "I'm writing you a prescription for propranolol."
Wait what? Propranolol? Isn't that the generic name for Inderal, the beta-blocker that musicians sometimes take before performances in order to reduce fight-or-flight symptoms like shaking and heart-pounding?
I don't need that!
Or is it pretty obvious that I do?
That opened a whole new can of worms. Using a drug to perform? In my zeal to be encouraging, I'd actually told other colleagues things like "You can do it! You don't need a drug, just practice, make yourself feel prepared...You'll be okay!" Nice advice. But perhaps I had some evidence now that it doesn't always work.
On Violinist.com, there have been some pretty harsh conversations about the use of beta-blockers - and how they are some kind of "cheat" and that are "performance-enhancing" and "you don't need to use drugs if you are really prepared."
I felt very conflicted, failed, pretty hopeless.
That's when an angel appeared. Actually it was just a very kind email from a friend and colleague, but wow, it meant so much to me. She saw what was happening to me, and she understood. She wanted to let me know that something similar had happened to her as well. She'd gone through a period of crippling performance anxiety that made it so she could barely get on stage. Without knowing about what my doctor had just prescribed, she went on to say that I should be aware of a drug called Inderal, and that while not many people talk about it, "You would be shocked at how many people take it on a regular basis." Taking a small dose before a performance is actually less harmful than taking an Ibuprofen pill, she said. (Those who take it daily for heart problems take 40 mg a day - the dose for performance anxiety is 10 mg). It just stops the shaking, stops the runaway heart-pounding, stops the physical symptoms of high anxiety. "It won't keep you from getting nervous, and it won't make you play better than you can play in a normal low-anxiety situation."
She said that she had used this for a period of time, until she felt better about performing. Other things in her life helped as well, but she got to a point where she simply did not need it any more. It's not like she got "addicted" to it or reached a point where she could not do without it.
That was reassuring. Maybe I could try this. I filled the prescription. The bottle sat on my desk.
The next concert was not as exposed, and the music was not as difficult. But considering what I'd just experienced, I faced it with some real trepidation. Is it actually possible that something as simple as a medication would keep the monster away? Could anything keep that monster away? It was hard to believe anything could. But at this point, I was ready to try it. I also felt like I needed to try it. I could not have this happen at another concert.
My friend helped me figure out all the details about timing for the medication. I prepared as I always prepare - I got the music early and practiced it well - even the "easy" stuff. The fingers need to know what's happening, whatever my brain decided to do this time.
So I tried it. Yes, I was anxious about taking the medication meant to help me with being anxious. Driving to the gig, I didn't feel a lot different. But my experience on stage was different. She was right, I did still feel the same bit of "nervousness" about a performance. But this time the monster was just gone. Even if I tried to summon the monster, it wasn't around. I didn't shake; my heart did not race. My fingers were steady, my bow was steady, and I could play everything just as I'd practiced. In fact, I had not realized how badly that fear of fear was affecting me at every moment on stage, not just the difficult moments. To banish it - this was like a small miracle. I was so incredibly happy to enjoy myself on stage again, just to play like I can play.
I came home and my husband asked, "How did it go?"
"I think I have a new favorite pharmaceutical," I said, joking but not joking.
That was nearly three years ago. There's been a pandemic since, of course, and not much performing during the pandemic. But before that pandemic, I had a good year, after discovering that it's okay to take the Inderal/propranolol when needed. The tremendous relief of knowing that now I have a weapon against the anxiety monster has been a tremendous boon to my mental health. I used it for a number of concerts after my breakdown panic-attack concert. But after several months, I actually found that I did not always need it. I played pops concerts, church concerts, quite a number of concerts without it. That is because I began to trust again. I began to stop waiting for the monster, to stop fearing the fear. If I needed to, I knew could banish the monster. In the year before the pandemic, I played more concerts than I had played in many years. I began to take joy in it again and to say "yes" more often.
So let me tell you this: It is very easy for someone who has never felt crippling physical anxiety to say that you "don't need a drug" to help with it. At a younger age, I was guilty of that. I'm older and wiser now. You need what you need.
If you try to take a beta-blocker for all the wrong reasons (as some kind of shortcut or "performance-enhancing" drug), then it will be very obvious when it does not help you at all. But based on my own experience, it can be incredibly helpful, if physical anxiety is blocking your ability to perform.
It took me more than two years to be able to share this story - it's very personal, upsetting, emotional and close to the heart. (I was actually prompted by Bo Burnham's show, Inside - in which he pretty vividly portrays his own struggles with stage fright - it made me cry.) I'm sharing my experience because I think that most people who have a gift to share would rather share that gift than to give in to crippling anxiety. When practicing, over-preparing, yoga, meditation, bananas, therapy, and telling oneself to "get over it" do not solve the problem, here is one more tool that might help. There should be no stigma in using it.
Thank you to my friends, colleagues and family who helped and supported me through this.
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