Beta-blockers for kids?

February 19, 2012 at 04:02 AM · A student's mom gave her a beta-blocker before an audition she was nervous about. The student is 11. I am really not sure how to feel about this...What do you all think? Okay, not okay? What are some techniques you suggest to your students/use yourselves for nerve-wracking situations?

Replies (67)

February 19, 2012 at 01:21 AM · Just FYI, I had told my student to drink lots of coconut water (which contains tons of potassium, a natural nerve-calmer), and to practice the heck out of the pieces she was going to play.

February 19, 2012 at 04:12 AM · I think learning how to deal with nerves is part and parcel of being a young kid who performs. I'm not a parent but if I was I would not give my kid beta blockers, I'd give them a banana and say "do your best!"

February 19, 2012 at 04:13 AM · I suppose there could be extenuating circumstances - a major other stress (death in the family perhaps) or perhaps a medical need but assuming these are not the case then a VERY BIG NO!!! What the heck. Seems to me the results of the competition were more important to the 'mother' than the child. Surely no caring parent would subject their child to unnecessary drug treatment. Even if there is no medical danger at all (which I doubt) think about the message the child is getting - that if life gets tough the solution is in a pill bottle.

February 19, 2012 at 04:17 AM · Before a big test, I use half a sleeping pill, 0.5gr. is enough to calm my nerve and doesn't make me super sleepy. I tend to finish a test early with half an hour after double checking my work so I use that time to snooze. She's eleven, big deal. I've seen plenty of those over in Asia taking beta-blocker before. It only matter about how well you play in front of the judges anyway.

February 19, 2012 at 04:48 AM · I'm curious as to whether a doctor was involved.

Beta blockers block the effects of adrenaline, the "fight-or-flight" hormone. If the student suffers from tremors, hyperventilation, tachycardia, or palpitations, they could be helpful IF she has had a full medical evaluation to diagnose underlying causes of these conditions.

Eleven is awfully young to be so self-conscious and nervous about an audition. It's also too young for an audition to determine whether or not she gets into conservatory, gets scholarship $$$, gets a job so she can live somewhere other than under a bridge, eats this week. How big a deal was it?

Full disclosure: I take a beta blocker three times a day, every day, in a higher dose than what is recommended for performance anxiety. They do nothing to eliminate the mental aspects of performance anxiety. They are not tranquilizers, sedatives, or anti-anxiety drugs. They can mitigate the some of the effects of adrenaline in some people. They won't help if you haven't prepared well, and they won't make you less nervous.

If the mother did this on her own, it's up there with giving a 6 year old Botox before a beauty pageant. If the child's doctor was involved, there may be more to the story.

February 19, 2012 at 07:48 AM · I think Skylar answered the question perfectly. Where's Whitney when you need her.

February 19, 2012 at 10:15 AM · Lyndon - I agree entirely. And frankly I'm horrified that anyone could condone self-medication of children - and there isn't even a medical problem to treat. Why not also put them on steroids so that they can make the tennis team, or how about some implants to give them a leg up on securing that acting job...

This is truly depressing...

February 19, 2012 at 01:07 PM · "...think about the message the child is getting - that if life gets tough the solution is in a pill bottle."

That is it Elise, we now believe there is a pill for everything. Nervousness is not only part of life but part of being a musician.

However I have worked with a world class string player who took beta blockers before a first night to avoid bow shake. Having seen the work she has done since, I would guess there was something about the situation that made her nervous. She could have sight read the part it was so easy for someone of her standard.

February 19, 2012 at 01:27 PM · Charles wrote: "I think Skylar answered the question perfectly. Where's Whitney when you need her."

When first I scanned your comment I thought you were agreeing with Skylar! Silly me, that was brilliant...

February 19, 2012 at 04:28 PM · Wow, betablockers to 11 year olds.

Sounds like the Olympics. Propranolol - the most effective betablocker for these situations - is a banned substance in competitive sports.It has been used in shooting events. It is no good for any active sport as it slows down the heart rate and cardiac output.

Lisa you are mostly correct: betablockers do counter the effect of adrenaline and do not have much effect on the psychological part of nervousness itself. They diminish the shakiness and tremors however in higher doses they can have some calming effect. This also depends on what type of beta blocker it is. Most people on beta blockers need them for heart conditions like hypertension. These are selective beta 1 antagonists that mostly work on the heart and do not have as much effect on tremors and nervousness and also less side effects related to the lungs. (All betablockers, even the selective beta 1 ones, can trigger asthma attacks. Beta 1 and 2 antagonists like propranolol even more so)

Propranolol is used in kids mostly for the prevention of severe migraines. Interestingly kids do not have as much trouble with the slower heart rate and lower blood pressure as adults, in particularly the elderly who often cannot handle beta blockers in normal doses.

The issue of performance enhancing drugs and psychotropic drugs is a real can of worms. In surveys a third of University students in the USA acknowledged using stimulants like ritalin at the time of exams. It works. I believe it is similar in some East Asian countries.

About 8% of school age children in the US are on psychotropic drugs.Mostly stimulants and anti depressants, but now also increasingly atypical anti psychotics which have a calming effect on behavior. In some school districts it is way higher. In Britain the number was 0.8%, in France 0.4%.

February 19, 2012 at 05:08 PM · This audition was to be allowed, as a 6th grade student, to participate in the high school orchestra. Not a real big deal. I thought it was pretty strange when my student told me. I elected to tell her that I knew of people, when I went to Peabody, who could not perform without them, and that I didn't think that was a good thing, and hoped she understood. She said she probably wouldn't use them again that often, and that the experience was weird because she felt as though she should be nervous but her heart rate was normal.

I had told my student to eat a few bananas, but she intensely dislikes bananas, so I suggested coconut water, which can be calming as well. I guess that wasn't strong enough?

In defense of her mother, she's pregnant at 45 and on bedrest until the birth, so she may have felt that since she couldn't be there she'd provide some sort of chemical comfort...wait, wait, that doesn't send a good message AT ALL!

There's a fine line we walk with parents of students - many of my students parents have similar values to mine but occasionally I run into situations where I'd really like to say something but feel it's not my place. Though I think if it happens the next time said student has an audition or performance, I'll have to speak up.

February 19, 2012 at 07:47 PM · oh my god, that is so stupid. Where are we that we have to medicate our children to be successful? What about the musical message? Is music "success"? Beta blockers are to my eyes similar to some illegal drugs. Would you recommend a child to sniff a nose of heroine to calm its nerves before concert? I don't think so! I know its a hard comparison but often the pharma industry sells us ship wich will be illegal in 5 years because it is harmful and addictive. I would never give a children a medicament or drug as long as he or she is healthy without it. Drugs and psychological-Medications should only be used conscious and with free will. Apart from that is the anxiety one encounteres before or while performing something wich is a part of the performance and makes you question yourself and your possible message.

Also i would consider the fact that a medication with beta-blockers could possibly have a permanent effect on the neuronal system or brain of the child. I think children should be threatened with the least possible dosis of whatever they need in terms of medications. They all have bad side effects and are often overdosed. I would recommend the use of herbals, teas or something like that in case if it is necessary, but be careful with that too.

And nothing is better than reasonable parents and a good athmosphere.

February 19, 2012 at 08:19 PM · "Before a big test, I use half a sleeping pill, 0.5gr. is enough to calm my nerve and doesn't make me super sleepy."

Skylar, where are you getting sleeping pills? If they are not over-the-counter sleep aids like Tylenol PM, then there are a couple of options:

1. You are given them by an adult. That's a felony.

2. You are taking them from an adult. That's probably some kind of crime. Or maybe a friend is stealing them from his/her parent.

3. You've been prescribed sleeping pills by a physician for sleep problems and are taking them for a different purpose.

But of course, you've said your name and age might not what you say it is, so it's difficult to believe anything now.

February 19, 2012 at 09:09 PM · The cavalier attitude towards medication for young people has taken a particularly nasty turn in England. It has been reported that a 14 year girl wants breast implants, apparently her mother is supporting her.

February 19, 2012 at 10:17 PM · I'm appalled and agree with most of the criticisms above. When I have more time, if this thread is still open, I'll make a few suggestions to help cope with nerves, w.o. drugs - no magic bullet, mind you, but a few helpful tips.

I've never used beta blockers but am aware of them as my mother has had to use them for a heart condition - of course prescribed and supervised by a doctor. I'm generally opposed to them. I can sympathize with someone who wants to take them - and it should ALWAYS be under a physician's care - for an extremely important event, like a major orchestra audition or solo competition. But the problem is that while beta blockers may not be intrinsically addictive, one can get psychologically dependent - e.g. "I'll just take them for this event...well, also for this event...and this one is really important, too." And here is a child starting to do this at 11!

February 20, 2012 at 02:30 AM · Skylar,

Not stupid enough to take sleeping pills before performing. As far as my reputation is concerned: I call it how I see it.

I hope this isn't you (it is some Skylar Nguyen who looks to be on something and whining about her parents):

http://www.youtube.com/watch?v=1o2JiukLwhQ&context=C3f0e04aADOEgsToPDskKf-itDI3Xjfwad2bq6wanP

So sure, just keep popping those pills. Let us know how that all works out.

February 20, 2012 at 05:29 AM · My aunt who's a licensed psychologist in California mentioned to me how she sees this growing trend of over medicating patients - especially in her field with adolescents. I find it ridiculous beta blockers are being given to an 11 year old. This stuff is used on people with high blood pressure.

Taking drugs or drinking a martini won't win you an audition, athletic event, or make you test well and get you into a top school. Working hard the right way will with proper guidance.

February 20, 2012 at 05:50 AM · You claim to be a 13-year-old Asian girl with the name of Skylar Nguyen who has problems with her mother. Or at least you've assumed that identity. So I find a video of a 13-year-old Asian girl of the same name complaining about her her parents. How many Skylar Nguyens are there exactly? So this makes me a racist how?

I've sparred with just about everyone on this site, but the one thing I've never done is simply resort to name-calling.

February 20, 2012 at 06:36 AM · Thanks frieda! The second half of my question was about alternative techniques you use or suggest to your students. I certainly know of a few, but would be interested to hear what (non-pharmaceutical) methods people use.

February 20, 2012 at 10:01 AM · interesting to this topic maybe the autobiography of midori!

February 20, 2012 at 11:45 AM · How so Simon?

February 20, 2012 at 11:53 AM · Skylar: perhaps from your young perspective you can't see this very clearly yet but there is far more to life than winning competitions and 'getting into Juliard'. You then have to survive both experiences and their aftermath - and you will inevitably reach a point where there is no pill that can serve as the crutch or power supply to carry you through. That point you can only master by personal strength and inner resourse.

You also fail to realize that passage through life is not just about you - its about the people you interact with. Sooner or later (from your attitude, its going to be very soon and its nothing about race - I have no idea what race you are by the way, and you me neither) they are going to read you and your ethics and then you will hit a brick wall. The reference to Whitney above was particularly pertinent - I wonder how young she was when a pill helped her achieve stage nirvana. Take a look at that - was her outcome worth her success? If you answer yes - then sure, follow that route but realize that to those of us who have had more life experiences the famous story of selling your soul to the devil for a life of prosperity is very close to mind.

February 20, 2012 at 01:36 PM · @elise: because Midori writes there about times in her life where she was addicted to tranquilizers and as far as I remember she took them in concerts very early... a very honest book!

February 20, 2012 at 04:44 PM · Skylar, I'm seeing some parallels here with this contentious behavior. If we examine the two following hypothetical scenarios:

"It's OK not to learn how to deal with stress, just pop a pill".

"You have to agree with me or I'll call you names and accuse you of being racist".

These scenarios aren't exactly the same but they have one thing in common. They both show an impatience with common processes in life that everyone needs to learn to deal with. An inability to have civil discussions with people and an inability to deal with stressful situations might not seem like a big deal now, but they catch up to people later on. The end might seem to justify the means, but often it is the means that are actually the whole point in the long run.

February 20, 2012 at 06:31 PM · Simon. Wow, I like her a lot more already. being honest about ones own personal failings must surely be one of the most difficult (and also cathartic) thing we can do. Its a major step towards overcoming...

February 20, 2012 at 11:23 PM · Has Midori then, come out with a memoir?

February 21, 2012 at 12:04 AM · I've seen plenty of those over in Asia taking beta-blocker before.

Asia is a big continent with many different countries, ethnic groups and cultures. It's one thing that you speak about your own experience in your native country (I don't know whether drug use is as widespread as you make it out to be there), but it's another to make it sound like a prevailing practice in 'Asia'. Perhaps I am too naive or ignorant, but growing up in Taiwan, with family, relatives and friends living in multiple Asian countries, this is news to me. In fact, I had never heard of anyone taking beta-blockers for non-medical reasons until it was brought up in discussions at v.com.

Raphael, Midori's autobiography "Einfach Midori" was published in Germany in 2004, and republished this year. It's in German only, unfortunately for those of us who can't read German.

February 21, 2012 at 12:35 AM · I can't think of a name for that other than child abuse. Beta-blockers can have some serious side effects, and I have to imagine that they could be far more harmful to an 11 year old than an adult.

And Skylar, I don't know what to say. If your behavior on this site is your idea of playing grown-up, you got it all wrong. Maybe you should keep your eclectic medical advice to yourself.

He who self-medicates has a fool for a patient (and I guess a fool for a doctor). Szeryng may have pulled it off (to some extent), but every shortcut eventually catches up.

And Scott, I retracted my comment in the other thread. You seem to have been very prescient, because this one is a doozy.

February 21, 2012 at 04:44 AM · Greetings,

Scott, I don`t recall sparring with you. Perhaps I was on drugs at the time and missed it...

Cheers,

Buri

February 21, 2012 at 05:09 AM · Note to self: nicer to Christian, tougher with Stephen

February 21, 2012 at 02:58 PM · Giving a child any medicine that is not prescribed by a physician is child endangerment. Such behavior is punishable by fines and/or jail time in most countries.

February 21, 2012 at 04:29 PM · I want to say two things. The first is, that I agree with many people that 11 is a far too young age to start with betablockers, no doubt.

Further, one of the (many) reasons why I did not aim to become professional, was that when I were 14-15 I got very bad stage anxiety. I did not know about the existence of betablockers, so every time I performed it was a total disaster. The bow could not stay still on the strings, and out of nervosity I had milk acid in the left hand that forbid me to even move the fingers. Having discovered the betablockers then (and not now) probably would have encouraged me to continue on the professional track. But then: my normal rest pulse at this age was always around 90. Imagine what happened to my heart when I got nervous!

Another thing I would say to the parents: if your kid must use beta blockers at age 11 to perform, maybe she is not mentally built for a career as a performer, despite her or his talents. Talent is only a small part of what you need to become a good. If I use betablockers now, yes, maybe I do good performances.

But do you know what the bad part is? During this period, I have developed chronic stress-related stomach issues, globus feelings on throat, nightmares, etc. The stress before, under and after a concert ALWAYS will leave traces unless you actually can deal with the stress in a medication-free way.

If I would have a student with these problems, I would encourage her to take music theory and composition classes, so that she can learn to express herself musically in a way that might be more fitting for her personality. I would also put her to play more chamber music, especially quartets.

But lets also be realistic: all of us here agree on that betablockers are bad in such a young age.

But when there will come up a new thread with an adolescent wondering "Can I become a soloist despite being late starter?" most will write "No, you must already handle Brahms violin concerto at age [insert one integer between 0-10] with [insert appropriate adjectives], now its too late, you will never make it." THIS IS the place where we should start with relieving the pressure, instead of forcing children to become machines at a young age!! The more we push on kids to be perfect at a young age, the uglier and less ethical will hte methods to achieve it be.

Do YOU want to support a world where children start taking betablockers at age 11? If not, then be consistent and support people of all ages to reach their dreams without setting "realistic" deadlines.

(Its a little bit similar to if a 11 years old girl would like some beauty operation; no matter how sick it sounds, its a direct response to the demands the world puts on girls to constantly improve their appearance. eHow "how to make an anorectic.")

February 21, 2012 at 05:32 PM · Well considered discussion by all.

In a nutshell, I would say that medical treatment should be prescribed by medical professionals only for medical problems. I don't think it's ever a good idea to prescribe medical treatment for non-medical problems. Likewise, non-medical treatment is not appropriate for medical problems.

And, indeed, what kind of lessons are we giving our children that happiness and success can be had for the asking simply by taking a pill or getting the right surgery?

It used to be that human happiness, success, and relationships were in the realm of ideas and emotions, choice, spirituality, art, philosophy, and meaningfulness in general. Now we seem to be living in an era when all human problems are becoming more and more medicalized.

I don't know about you, but I'm not so sure I want to think that the meaning of my life is no more than a chemical reaction in my brain.

February 21, 2012 at 06:08 PM · Just a few random thoughts about nerves and beta blockers:

•I'm not sure that kids displaying gross stage fright really ever get over it. It may improve incrementally, or they just get filtered out of the career. People seem to have innate responses to performance stress which may or may not be elastic. Some can have very bad stress, like Horowitz, and manage somehow, and some can't. I think there has to be some very large excess of some compensating talent, like a photographic memory or very deep concentration once the performance starts.

•Stage fright is, for many people, a whimsical phenomena. One could play without it for their entire youth, and then for some reason--perhaps the stress of having to get a job and pay the mortgage--they suddenly get it. You can play without it on Friday and Saturday only to panic on Sunday. Or one MAY gradually grow out of it during a career.

•Beta blockers do NOT prevent stage fright per se, although they can help manage SOME physical manifestations. If you aren't meticulous in your preparation, don't have a great sound, or don't make convincing phrases, they won't make your career.

I wouldn't be surprised if there is a large placebo effect. They shouldn't be considered a magic bullet.

February 21, 2012 at 07:06 PM · I stated the implications on the parents of children who are given drugs that are not prescribed to them above (fines and/or jail time). Notice I am not laying any blame on the child.

I grew up in an area where a few of my friends had parents that epitomized the stereotypical pushy parents that forced some sort of performance out of their kids. It's the exact same unhealthy type of parent that forces perfection whether it's an instrument, toddler beauty pageants, or the kind that scream at coaches during sports events.

It's all unhealthy once any sort of medication, performance enhancer or abuse is involved. What's next? Drug testing before recitals?

February 21, 2012 at 10:11 PM · Ok, I just have the feeling to stop beeing so over conscious about this topic:

Yes, I think that any sort of drugs are bad for children, but what about adults? My most loved musc was created from drug using people. In the Autobiography of Keith Richards one can read how he worked a long periode of his life on drugs. Cocaine keeping him up heroine for calming him down. I am not a Rolling stones fan, but they achieved a lot...

Ok my point is: Why is it in classical music scene that everyone tries to pretend living like an ascetic? If Menuhin did, why should it work for everybody.

What about coffeine, tranquilizers, alcohol, anti depressants.. etc.

also great classical musicians lived their life to its fullest: Like Mozart and probably all russian composers...

Could it be possible, that a glass of wine or some beers could be good after work or a pill or two would help us getting ourself together on stage better and perform with success and pleasure?

I dont want you to trie it all out and I didn't try it either, but does everyone know what exactly he/she condemns in drugs?

I think they are so popular, because they have two sides and one can be good. Talking just about the bad side just makes the mystery even bigger, followed by more misuse!?

February 21, 2012 at 11:36 PM · Simon,

Keep in mind that for every Keith Richards there's a Whitney Houston, Amy Winehouse, Michael Rabin, or Eugene Fodor, Marilyn Monroe, etc. Your logic is that because the artist was successful, the drugs are therefore good and helped create it.

However one could also argue that drugs are, for the most part, addictive and dangerous and make people less creative and less productive. In looking at places like the mid-South with its current epidemic of prescription pain pills, my area of southern Oregon with its meth problems, or much of Russia with endemic alcohol abuse without thinking otherwise. As a teacher from k-12 to college, my experience with kids that smoke marijuana is that, while they may feel smart, it actually makes them appear to the outside world as lethargic and less capable of remembering what you tell them.

In other words, Keith Richards was successful not BECAUSE he did drugs, but in spite of it. He got lucky.

Scott

February 22, 2012 at 01:39 AM · Ok, calm down. First Keith Richards is not my role model. Second I want to provoke.

I know from experience, that drugs have bad effects on your body and mind. Even the so called "soft-drugs" like marihuana and alcohol. It affects not only your brain but also your personality, especially when used regularly.

I just wanted to point out, that there can be a reason for drug abuse especially in the hard music business. I told you about Keith Richards because he is an example for someone who kept his work up with drugs. Later he did drugs because he was addicted to it of course (and he doesnt fear to tell, wich is quite something). But he started with drugs to work harder and sleep less than he could without. Thats exactly what tranquilizers or uplifters can do with you. Even Coffeine is a drug and can cause many problems too.

I don't say that it is good to take drugs and maybe I am getting too far away from our overlapping music taste, the classical music, when I go to Nirvana and Alice in Chains and many other bands? They are great in a poetical/lyrical and a musical way and many songs coming from a drug background... not to mention Amy Winehouse and Michael Jackson probably too.

Those people had a hard business: exhausting tours, always producing new, exiting music. The pressure of being on stage and to perform well. No private life.

I think many of those musicians start with drugs not because they are looking for fun. Most of them were quite strong personalities and hard working people. They know where drugs can lead you, but the think they could work for them... bad choice of course. Many other people stick with medications like they did with drugs because they first work quite well. But later they cause more pain than pleasure.

And: I don't want to be like Keith Richards or any other of those (mostly dead) guys. But I see, that they had a goal in mind and they tried to use drugs for their success (in case of Keith Richards he started with at his times legal Pharmazeutics). But of course with most drugs they make you pay later and they make you their slave... not the other way around anymore.

Also Layne Staley, the singer of "alice in chains", one of the best rock singers to me with the deepest lyrics I have ever heard, admitted, that he never created something when he was high. (he died in 2002 on an overdose) So my conclusion is anyways that drugs are not working on the long run. But really, what would music be without the influence of drugs today? 70 % of rock songs deal with love and 30 % are about some kind of drug problems.

I know its not the bright side of music, but to ignore it, it is just too big. And I see that in classical music business there is the same pressure too youngstars especially... and the problem of drug abuse is mostly a tabu discussion.

So actually before we start to say that betablockers are "not helping" you with the real problem. I want to point out, that they maybe help you very well, maybe more than you could expect, but what else do they do with you? And are you able to seperate from being on drugs and being clean when you start enjoying a substance. To me drugs give you an illusion of life. It may be helpful sometimes but generally I think the most complex, interesting and challenging state of mind is being clean. On stage, off stage, at work, at party... everywhere. Not that this is my kind of life, but I know that my senses are only how they should be when I am clean, everything else is an illusion. But sometimes events in life are also an illusion: Like getting a Diploma could be for somebody the illusion of a successful career. But does not necessarily have to be. Also to be accepted at a music school is the illusion of sucess or that you made good music, in fact you maybe just got lucky. For those illusional moments you may try to push yourself into that illusion with drugs because otherwise you could feel out of place... wich is probably an quite realistic feeling from an humanistic point of view.

February 22, 2012 at 04:56 AM · I can see it now: In the future when you're auditioning at Julliard they'll make you submit to a drug test. Ufda.

February 22, 2012 at 05:44 AM · I've heard that eating a banana 20-30 minutes before an audition has a calming effect. Anyone confirm this? I'm trying this next week before lessons as I always get nervous playing in front of my instructor.

February 22, 2012 at 06:01 AM · Yes Dominic, it is because bananas contain potassium and vitamin B, both of which have a calming effect on the nervous system. Also potassium can help to lower blood pressure.

February 22, 2012 at 08:39 AM · Bananas and coconut water (I think already mentioned in this post) contain potassium and slow release energy, also bananas are quite filling so they stop tummy rumbles

February 22, 2012 at 02:27 PM · Can anyone cite some evidence or is all of this just anecdotal hogwash?

February 22, 2012 at 04:20 PM · OK...if you want to get technical: This is because potassium controls the activity of muscles and also the transmission of electrical impulses through the nervous system. Since this mineral helps in the conversion of glucose into glycogen, its deficiency would also result in experiencing complete loss of energy. A deficiency of potassium (K on the periodic table) is a condition known as hypokalemia. By that same token having too much potassium is called hyperkalemia, and isn't desirable either. In the proper amounts it is an important mineral for the efficient function of all cells, tissues, and organs in the human body. It is an electrolyte, a substance that conducts electricity in the body and particularly throughout the central nervous system, along with sodium, chloride, calcium, and magnesium. Potassium is crucial to heart function and plays a key role in muscle contraction.

As for B vitamins (bananas contain cobalamin aka B12), they aid cell metabolism. This is important for the central nervous system because it affects how each neuron functions. The neuron can be divided into three main functional parts, the cell body, the axon, and the dendrites. The cell body is the center of the cell. This is where cellular metabolism occurs, as well as the production of proteins.

This isn't "evidence" in the sense that it would hold up in court, but it's what I remember from high school level biology. As for evidence, I am a violinist and from personal experience it does seem to help.

February 22, 2012 at 04:27 PM · Also bananas etc. are also not magic cure, and I doubt anyone would have a hissy fit if they couldn't have their banana. But its good to think about nutrition. You have to eat something before you play so why not make an informed choice. Limiting caffeine is also an obvious idea

February 22, 2012 at 06:01 PM · Bananas are a good source of potassium and this is a good thing to take if you are going to do any severe energetic excersise for the reason given that you need this electrolyte for any excitable cell.

Excitable cells include your neurons and muscles. Potassium is accumulated in these and its slow leakage out of the cell is what sets up the 'resting membrane potential' (potassium is positively cha6rged so its leakage makes the inside of the cell negative, by about -65 mV. Thus, potassium serves to make cell into 'a charged battery'. Electrical impulses travel in nerve and muscle cells - but they are not like electicity in a wire, they are much slower and formed by a very transient influx of the other key cation, sodium (which is pumped OUT of the cell at rest).

So far so good and you can see that if you do a LOT of excercise (since you have an enormous store of cations and can pump them back) it is possible to deplete electrolytes - which is why you should not drink pure water when exhausted but something with electrolytes in it - like gatorade. Or eat a banana.

Other than that bananas are good, low cal food and tummy filling!! However, if your violin playing has exausted you to the point of needing potassium I suggest you learn to moderate this with tai chi or something. [And if you have potassium retention/uptake (periodic paralysis) issues see a doctor, a banana may be the worst thing to take.]

And thats all from this scientists perspective - the mind calming aspects may well have a biological origin but its not something I am familiar with.

[Disclaimer: Neurophysiologist with 40 yrs experience in muscle and nerve cellular electrophysiology.]

February 22, 2012 at 06:22 PM · If there is a widespread belief amongst musicians that eating bananas will calm the nerves, then it is very likely to work, even if it does little on a cellular level. I'd give the 11-year-old a banana and tell them they won't be nervous.

People may give all sorts of reasons on a cellular level why a banana may work, but I suspect that since individuals can be so open to suggestion (especially if they are younger) that the placebo effect will far outweigh the actual chemical ones.

If you haven't seen this fascinating article in the New Yorker, it is very timely and relevant to the discussion:

http://www.newyorker.com/reporting/2011/12/12/111212fa_fact_specter

February 22, 2012 at 06:45 PM · Scott - I agree wholeheartedly - but that is outside my expertise and more in yours. Not that I'm don't indulge in psychosomatic treatments myself and if I could convince myself that quince jelly was the antitode to performance anxiety I would eat quince jelly. Sure better than beta-blockers and maybe more effective!

February 22, 2012 at 07:52 PM · what's gotorade?

February 22, 2012 at 08:11 PM · Lyndon,

the well known documentary `Idiocracy` offered conclusive proof that using Gatorade rather water enhanced the quality of life. This may be the next step for Greece.

Cheers,

Buri

February 22, 2012 at 08:29 PM · I'm with Scott Cole on this. While it was wonderful for Michael and Elise to have reviewed the relevant biochemistry of potassium, it's still not clear whether eating a banana really has the desired effect (or any demonstrable effect) on one's nervous system in the short term aside from the placebo effect. The body is curiously adept at keeping the its chemistry constant despite the junk we feed ourselves.

For a while people were popping mints in the middle of the SAT exam because there was some kind of "study" that suggested it would help keep you alert. Maybe that is what I need between movements of the Franck Sonata to keep from falling asleep while bowing.

February 22, 2012 at 08:43 PM · Lyndon: gotorade healthier than water????? a lot of doctors would like to disagree with that!

Including my qualification "after strenuous exercise". If there are lots then please find me one (mainstream doc) that would.

February 22, 2012 at 08:48 PM · One interesting experience: I was out the other day with my obviously-teething infant. A woman noticed and suggested a homeopathic remedy in sugar pill. "Why not just give him a sugar pill" I asked. She said "then it won't have the vibrational energy." She then pointed to her son. He had an amber necklace that she told me had cured his teething because "the heat from the teeth went into the amber and got trapped in the bubbles." I just nodded. Many otherwise-ration people take and believe in homeopathic remedies, but there's absolutely no mechanism by which they should be able to do anything. The whole industry makes it clear that there is nothing in the solution except "vibrations" left over from what used to be in it but is so dilute that there is, essentially, nothing, nada, zip, zilch. I have no doubt that homeopathic remedies do their work through the placebo effect, just like they did in the late 18th century when that guy thought it up.

The issue here is interesting because the placebo effect is not being experienced by the child but by the parent, and probably du to what we call the "fallacy of positive instances." Babies don't teethe continuously, so one could give him any kind of substance and he may stop for a few hours or even days for no reason at all.

It's like taking Airborne or vitamin C: you may not get sick after taking it, but that doesn't mean it does anything at all.

February 22, 2012 at 11:11 PM · Wow, Scott. That's pretty out there. Perhaps I could sell her an amulet or two. ;)

From what I understand, (husband is a family physician) beta blockers are prescribed for adults in these situations but not for kids.

February 23, 2012 at 03:09 AM · Great examples Scott - but lets not forget that much of (current) medicine was developed originally by trial and error by witch doctors, mothers and soothsayers. Before they were recognized as 'real' they were probably all dismissed as the proverbial magic elixir by the medical establishemt, as it was at the time. Even washing the hands between examining patients was vigorously resisted by the clinicians who were first informed of its value.

The point is that we can not be entirely sure that something does work (at all) until we test it rigorously by an impartial method. Perhaps amber IS useful for something that goes beyond its psychosomatic effect - it would be a shame to miss that if we make the assumption 'a priori' that it is without medical value.

I do realize, however, that there are not the resources to test every idea - all I am suggesting is that its wise to keep the mind open. But perhaps thats the difference between the clinician who has hard choices to make every day, and the researcher who is not responsible (at least directly) for people's well being. We have that luxury...

February 23, 2012 at 05:26 AM · I'm a believer in chocolate. One Godiva Dark Chocolate Truffle can cure most anything! ;)

February 23, 2012 at 08:00 AM · Well, I have another strategy. When I'm getting ready for an audition I sometimes set the violin down, go outside and run around a few blocks until I'm out of breath. Then I come back in and have a run-through of my audition material. Being out of breath is not the same thing as being nervous, but I find that it provides a similarly taxing situation that prepares me mentally and physically to perform under conditions that might not feel ideal.

February 23, 2012 at 09:26 AM · Michael a teacher once reccomended a similar thing, running up and down the stairs. Its a tried and tested approach

February 23, 2012 at 10:00 AM · I run regularly to reduce stress, period. Works for all kinds of stress. I haven't yet tried it for performance anxiety because, well, I'm not good enough to perform, yet, but it works for everything else, so why not?

February 23, 2012 at 10:59 AM · Michael - I'm going to do exactly that, but I didn't plan it. In late march I am performing my first concerto, playing for my birthday party (its a real vanity affair!). Before playing I'm also doing a ballroom dance showcase so maybe that will get rid of the Queezies...

Its a great idea - I think the exhaustion thing would work for me....

February 23, 2012 at 05:05 PM · This one makes some sense. Running will use up some of the excess adrenaline, calming you.

February 23, 2012 at 05:49 PM · Elise,

We don't have to test everything. Testing amber necklaces to see if they help with teething pain would be a waste of time, as would healing crystals and magnetic bracelets and concoctions touted to "supercharge your immune system" or "blowtorch belly fat away in days!"

My point is that placebos are very useful. That's why I'd never dissuade a student from eating bananas before a concert. And I'd give the 11-year old a "magic concert smoothie" instead of a drug.

As the NYer article concludes, though, placebos present us with a dilemma: there's a large body of evidence that they work. However, you obviously can't give someone a placebo and tell them it's a placebo. So how can placebos be used on a large scale without telling people? Is it ethical?

The passage of time doesn't always resolve the issue of whether something actually works or doesn't. In an age of information, there's no reason people should be buying homeopathic remedies or cleansing their colons. But they do.

February 23, 2012 at 07:23 PM · Scott wrote:

"As the NYer article concludes, though, placebos present us with a dilemma: there's a large body of evidence that they work. However, you obviously can't give someone a placebo and tell them it's a placebo. So how can placebos be used on a large scale without telling people? Is it ethical?"

And then I think he answered it too:

"The passage of time doesn't always resolve the issue of whether something actually works or doesn't. In an age of information, there's no reason people should be buying homeopathic remedies or cleansing their colons. But they do."

:) It a self regulating system. The fact is that by using such things as amber beads people are creating their own placebo treatments - an icon if you will that they can attribute magical healing powers to and actually induce their own improvment. Pehaps its the best kind of placebo because there is no need for a health professional to administer it.

[And on testing everything - of course you are right that would be silly. However, we have right to keep an open mind - and observe carefully so that when there is a pattern of success it will gain attention. That is what is lacking, and getting worse as medicine thinks it has all the answers. Accupuncture was regarded as hack medicine but now it can be supported by health insurers and even though I am still not convinced that is also a placebo-like effect it seems to have a place in treatment for those for whom it works.]

February 23, 2012 at 07:34 PM · One can only test what one can see and understand how to measure. When we understand everything, then we can say what is/not a placebo, a medicine, magic, or whatever. Always wise to keep mind/eyes open for new possibilities, ones that lie outside the frame of reference. (after all, it wasn't THAT long ago that the majority of 'good' physicians poo-poohed the need to wash hands before or after medical procedures.)

February 25, 2012 at 02:12 AM · Interesting topic. I can tell you that my daughter had been on beta blockers for supraventricular tachicardia ( rapid heart beat) between the ages of 8-13. She performed all those years while on treatment, and we never thought it was making any kind of difference. She had an ablative procedure which cured her tachycardia when she was 13 and hasn't needed any treatment afterwards. I remember that after that, when she was performing, she noticed her heart beating out of control, palms sweating, being nervous in a physical way...things she hasn't experienced before. And had to get used to. As a physician i can say that beta blockers are pretty harmless, but i would be more concerned with the child developing a need for an emotional crutch, something artificial to rely on. Beta blockers are used for stage fright all the time, at that age i would just suggest consulting a doctor for the appropriate dose per kg of body mass.

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