Good experience with natural beta blockers, anyone?
I’m researching my options for a beta blocker to make my hands stop shaking during performances. Has anyone had a good experience with a natural beta blocker, such as a herb, or vitamin? Thank you!
What's wrong with regular beta blockers? They're a very safe drug with minimal side effects, and I bet you her docotr would happily prescribe them for performance anxiety.
I don't know if 'natural beta blockers' exist, and there's a good chance they wouldn't be as effective.
Is this a joke? Why is everyone trying to stop doing vibrato for performances?
I found a single study from 1990 stating that Transcendental Meditation practitioners had a lower beta-adrenergic receptor sensitivity, but you may find that yogic flying practice cuts into your violin practice.
I don't know if beets qualify as a "natural beta blocker" but they are very effective at lowering blood pressure. Unfortunately, I found it difficult to tolerate them--in any form--on a daily basis.
Regular beta blockers - they have worked great for me, every time since 40 years ago! I only need 5 mg (1/4 of a standard 20 mg pill). After the first time I used BB I lost all fear of subsequent solo performing - after 30 years of well-justified terrors.
I’ve been on bbs for a heart condition for several years. I notice a huge difference (positive) in my nervousness since I’ve been on them, but I still get nervous when playing in front of people.
I found a different solution for overcoming stage fright:
Cotton Mather: My thoughts exactly.
Maybe a little empathy? Tony, I hope you and Cotton don't ever use antibiotics either. Just train your white blood cells to cope with pneumonia, gangrene, etc. And if you get diabetes, just train your pancreas ...
Well, yes, it is a good idea NOT to use antibiotics, because it strengthens your immune system to be exposed to such infections and repeated use of antibiotics breeds antibiotic-resistant superbugs. Obviously, there are extreme cases, but violin performance is not life or death, so it's a moot comparison.
I'm pretty sick of people treating modern medicine as a 'last resort', or worse yet, something to be avoided. Beta blockers are completely harmless in correct dosages with doctor's approval. There is literally no reason not to use them.
Good luck getting older, Cotton. There's nothing like age to make you appreciate better living through chemistry.
A reminder for everyone that the title of this discussion is "Good experience with natural beta blockers, anyone?" If you can not answer the question, please do not hi-jack the thread for your own agenda. Respect.
There's arguably no such thing as a "natural beta blocker", OP seems to have been misled. I think those of us who are encouraging OP to use beta blockers are doing the right thing.
Actually, cotton, you still feel everything the same as you would when not on beta blockers. The only difference is that the physical side effect of extreme shaking is mitigated. I find that people who say things like "just get over it" are those who never experienced an extreme problem in the first place.
Thanks for the helpful feedback, guys! I'm most certainly not against a regular beta blocker. I was just curious if anyone has had a good experience with a natural alternative.
For those of you who have used regular prescription beta blockers - have you noticed any side effects?
It's worth emphasizing that performance anxiety is not chronic general anxiety. It's not normally helped by anti-anxiety drugs. Prescription beta blockers are useful for blocking the physical effects of an acute flood of adrenaline, which is what happens in performance.
I would highly recommend looking at this thread on this exact subject, as clarinetist Gregory Smith of the Chicago Symphony Orchestra has a wealth of experience to share:
Cammi, when I take them (especially in a higher dose) I can feel drowsy for a few hours after. On the occasion I've taken too much, I have been a little 'out of it'. That's just my experience - there may be more potential side effects - best to talk to a doctor.
Studies have shown a long time ago that beta blockers prolong lifes which many other blood pressure mechanisms actually do not do in that extent at least. They are really harmless if used correctly. I would say that any natural herb medicine is more likely to be harmfull than beta blockers in exception fo some people with astma. I have asthma and use beta blockers for health reasons with no problems at all and so do many others.
One of the potential dangers of beta blockers is kidney damage.
Do you have any pre-existing health conditions, Andrew?
Why don't we find an even more public forum for me to tell you my medical history?
If a person has kidney damage all the medicine usage has to be evaluated again and many normally safe medicines cannot be used. However the likelihood of beta blockers causing kidney damage is quite unheard of. Some beta blockers are even used by people with kidney damage, but then great care has to be used. It may be that a person has kidney damage without knowing it and starts using a medicine that is not good for kidney damage and then alas blames that medicine for the kidney damage.
"However the likelihood of beta blockers causing kidney damage is quite unheard of."
Changing your mindset is the best natural beta blocker ever!
I am sorry Cami if sounded unemphatic. I am not.
All these calming strategies may be perfectly fine and helpful in the long run. They're not likely to get the OP through her next audition. I'm wondering, for example, how many trials the OP would need to conduct before she discovers how many grams (or pounds) each of honey, chocolate, and banana she needs to eat to achieve the same effect as 10 mg of propranalol. Not to mention what that will do to your bowels half-way through your cadenza.
My heart stops beating for 5 seconds or more at a time if I don't take my beta blockers. It's not deadly, but it feels like you can't breath and is very uncomfortable.
I have not done beta-blockers, but adrenaline, when uncontrolled, can do bad stuff. A lot of the PTSD that veterans see comes from stress hormones unleashed in combat, which literally fries your brain so it cannot behave normally. No idea if this is the same response that is being fought onstage, but it is worth thinking about.
Marty Dalton - a serious medical condition requires serious medication. No doubt there.
Hi Cammi - I'm a trained herbalist. Herbs have done for me what better living through chemistry has not been able to do (herbs have been a last resort for me on multiple occasions, and I keep going back to them because they work when used correctly!) Herbs have also not been able to do for me what better living through chemistry has only been able to do!
I believe that if you are going to take beta blockers, you should obtain a prescription from a doctor. You will need a beta blocker that comes in a dosage that you can divide, since the dose used to relieve performance adrenaline effects is far smaller than the dose used to control blood pressure. Most physicians will write prescriptions for musicians for this purpose.
Pamela, I think the answer to your question about performance anxiety is complicated.
I've probably said it before, but I fail to see why there should be any correlation between possessing musical talent and enjoying standing on a stage alone in front of an audience. If your kid has talent, it seems like sadism to me to make them play solo to an audience if the kid doesn't like it. But that's the nature of music, unfortunately, unless you remain anonymous in an orchestra.
When my oldest son was 11 years old, he suffered from performance jitters and one of my chamber buddies recommended Bach Rescue Remedy Pastilles. They may or may not have had a placebo effect, but he claims that they helped. They are touted as an homeopathic solution for stress and anxiety.
We went through all this here just over 14 months ago.
Homeopathic remedies do not, by definition, contain any active ingredient. The water molecules are supposed to "remember" the active ingredient, which is eventually diluted out to something on the order of a teaspoon in Lake Erie. A silly idea of 18th century German origin, no better than other quack cures of the time.
1. Those who advise to use willpower to "get over" an overactive adrenaline response -- I'm curious if you feel the same way about drugs to treat other medical issues (i.e. cancer, depression, anxiety, infection).
Lydia - I agree with you! I have the same surges, but mine also are accompanied by a hyper-critical mental state with the violin - which is not present when teaching other material, or giving speeches, but is present at other times in my day-to-day life. It seems the adrenaline rush of any kind of performance simply amplifies this tendency.
Scott - I know some folks who think they are wonderful and have seen amazing changes in people, and I know others who agree with you. I've taken them in the past and had nothing happen, and other times they seemed to work some kind of magic. I mentioned homeopathics because they are by all accounts safe for pretty much anyone to take. If they work (placebo effect or not), great.
Although I express cynicism, I played piano in three or four sessions of a music festival every year throughout my teens. It terrified me, but I never thought of refusing to do it, whereas I refused to go to Sunday school and I refused orthodonty. Apart from that, I can't really recall my feelings about anything.
The issue with herbs is that if the herb works, by definition it contains an active medicinal ingredient. And you are getting that ingredient mixed in with a bunch of other things, in all likelihood. And each plant will contain a different amount of that compound, which means that you cannot get a precisely measured and consistent dosage, and cannot really predict the effects.
Alcohol is said to be an effective (but controversial) remedy. And natural.
One thing I want to throw in to the conversation here: please take note that all of the people that are vocally pro-beta blocker here are those that actually routinely perform.
I don't perform very much actually Erik, and one of the reasons I don't is because I get really freaking nervous. I want to try beta blockers, but like so many people I've had it pounded through my thick skull that somehow that it's some kind of cop-out, and all I need is more experience. We'll I'm in my 50s. Just how much experience do I need?? And so, this very thread has me doing something about it! I'm calling my doctor tomorrow to get an appointment.
Lydia, if you gravitate towards getting something from a pill, then by all means. The thing with herbs is that when given correctly, **undesirable** side effects from said herbs are ideally zero. So it's a matter of how you approach your own life.
Cammi, I hope reading through all the nonsense of this thread has given you an important and boring lesson about taking medical advice from violin message boards.
I did make one important discovery: One of the things that was really making a big difference in my impression of nervousness was having an upset stomach pre-performance, sometimes starting several hours before, or even the night before.
Lydia, would you mind elaborating on the bit about mitigating the shakes technically? Are there specific physical processes that can be employed while playing that you've found useful towards that end? (I hope the question makes sense--can't quite think of another way to phrase it at the moment.)
Pamela, while I am somewhat an advocate of not using commercial medications, homeopathic medications and herbs, and even diet choices are not necessarily any more free from side-effects than commercial drugs.
Basically you want to try relaxing the muscles. So for right-hand shakes, split up the bowings -- use much more bow than you normally would. It's useful to practice the opening of your program with an alternative bowing -- or simply choose your default bowing to be for the bow-shakes if you figure they are inevitable. (But I can get bow-shakes mid-work, too; I'm generally comfortable changing my planned bowings if I need to.)
Cammi, I just remembered a more 'natural' alternative to beta blockers: there is this stuff that you spray in your mouth before a performance and it calms nerves, though not as much as beta blockers do. Sorry, I can't remember the name, but it definitely exists. If your nerves are not too extreme maybe you could give that a try?
Thanks. I figured it was something along those lines, though I see how these strategies might be questionable in an audition. Although intelligent bowing selection for shake-problem areas certainly seems like it could have a place in audition prep.
Pamela wrote, "The thing with herbs is that when given correctly, side effects from said herbs are ideally zero." If you have found success with herbs without side-effects, that's fine. But that's one data point. If science has taught us anything, it's that anecdotal evidence may be grounds for a hypothesis, but not a conclusion. The road to a conclusion in pharmacology is long, difficult, and expensive.
This all boils down to what we, as individuals, are willing to tolerate based on the information we have culled from professionals and research from multiple sources.
"The thing with herbs is that when given correctly, side effects from said herbs are ideally zero."
Juliana, a recommended performance preparation technique is to exercise briefly and vigorously (for instance, run quickly in place) in order to bump your heart rate up a lot, and then trying to play.
Erik Williams said: And all of the vocal anti-beta blocker people are those that *don't* routinely perform.
Just fyi, you sound like kind of an insensitive douche, Tony.
I apologize for sounding (and perhaps being) an insensitive douche.
Tony -- logical fallacy by conflation.
"1. By intorducing “special needs” to children we forgot, that some children are special because they are gifted and some are just dumb."
What a lot of misunderstandings. Its obvious that many posters did not read a significant portion of the posts above.
Performance anxiety is very real, and it sucks, and I'm sorry you're having to deal with it. I remember you saying (?) that you played other instruments? Do you have performance anxiety issues with those instruments as well?
I agree with Elise that you've got to be careful about drug interactions. In the US, Propranolol is only available by prescription, so presumably you're talking to your doctor about other drugs you're taking (and whether you've got liver cancer or whether you're actually allergic to Propranolol). If you get all your medications from the same pharmacist, they check for potential drug interactions also, but of course that will not include OTC meds.
Tom, I certainly understand not wanting to dispense medical advice over the internet, but surely you can share the mechanism underlying "courage"-mediated beta-antagonism?
Tom, performance anxiety isn't simply 'nerves.' Please stop telling people to get over it. If she could have done that, OP would have not needed to post here.
I'll preface this by saying that I've never taken beta blockers for a performance, or been on a beta blocker prescription during a period of time when I was playing the violin, so I do not have any personal experience of taking them for performance anxiety.
Tom I dare say you are not the only qualified professional here :) But there is a big difference to giving specific medical advice and giving general medical or pharmacological information. The former is fraught with conflicts, even danger but the latter is generous and helpful - and no more than one can glean from the internet.
Tom, I didn't guide anyone here to self medicate. Please quote me where exactly I did that. Further, as a medical professional, you ought to know better than to minimize psychological issues and you ought to know better than to tell someone to 'change their mindset.' Performance anxiety is very real, and it's not a mindset. It's an abnormal response to stress that interferes with normal activities. And it's manageable.
Nobody has suggested that the OP obtain beta-blockers from a back-alley drug dealer. The term "self-medication" is wholly inappropriate when these medications are readily prescribed for performance anxiety by physicians. Really, none of the posts here have gone beyond the scope of the sort of "ask your doctor if Propranolol is right for you" verbiage that is common in TV commercials.
In my own experience, facing a fear and overcoming it can be really empowering.
J I, I'm not laughing. I think there's a spectrum of performance anxiety between mental "mental nervousness" and crippling physical symptoms that people experience, and I am interested to learn from those who have successfully overcome any of the above. I must admit, however, that I'm *particularly* interested in developing the ability to play music in the presence of physically crippling/and or nauseating levels of adrenaline. Is this an experience you share?
Edited because I discovered I *can* be more concise. Cammi asked about experiences with beta blockers and side effects. In my experience, Propranolol significantly attenuates the shakes, and seems to help reverse the feedback loop that develops after a critical mass of shaky performances, where the fear of the shakes brings on the shakes. It doesn't seem to prevent mental jitters for me, though I should add that the mental component has not always been correlated with the onset of physical symptoms.
J I, your frost-bite analogy is interesting. A cellist friend once compared the sensation of shaking in performance to shivering from cold, and acknowledged that he had partially addressed it by wearing extra-warm clothing in stressful performace situations.
Cammi, chamomile tea is not a beta blocker ("Apigenin, a component of Matricaria recutita flowers, is a central benzodiazepine receptors-ligand with anxiolytic effects."--
Elise, in my experience beta blockers have reduced the mental parts of performance anxiety just as much as the physical symptoms. However, it is admittedly more of an indirect result. I believe a lot of the anxiety comes from anticipating the physical symptoms and how they will impact your performance. When this risk is removed, the anticipation/anxiety doesn't occur. Gradually your body learns not to associate performances with nervousness.
I can appreciate Tom's reluctance to get anywhere near a comment that might have any chance of being construed as a recommendation. The language of TV ads is carefully screened by lawyers.
Coming back to the issue of drug interactions, one of the dangers of herbal medicines is that when folks' doctors ask "what else are you taking," they forget to include the herbal medicines. Nowadays the forms you fill out at a doctor's office or hospital will explicitly say to include OTCs and herbals, so hopefully that will decrease the likelihood of negative interactions.
"Elise, in my experience beta blockers have reduced the mental parts of performance anxiety just as much as the physical symptoms."
The "mental effect" is not necessarily entirely a placebo effect. Human physiology is complicated and it's hard to isolate one system from another. So even though a drug might not work directly on the CNS, there can be CNS effects as a consequence of secondary chemistries within the body. That's all conjecture of course (which, depending on your perspective, may be indistinguishable from BS).
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