Most doctors who give musicians beta-blockers have no idea what it’s like to be a performer. Also, most musicians are not qualified to suggest beta-blockers to other musicians. With those statements, let’s cover everything you need to know about beta-blockers so you can decide whether you should or should not use them for your performances.
We will answer questions like what are beta blockers? What are the pros and cons of using beta blockers? Lastly, I will share some stories of performers who have used beta blockers because it may not always be a yes or no answer. By the end of the article, you will have enough information to make a confident decision and to also educate your fellow peers.
Disclaimer: if you are reading this article to understand the in-depth science of beta blockers, you’re better off reading another article because this is tailored towards what a performer needs to know.
What are beta-blockers?
Beta-blockers are pills created to help prevent cardiac problems such as heart attacks by blocking your adrenaline. But why does a performer take a pill for cardiac problems? Well, when we get nervous, we can trigger an overwhelming adrenaline from our Fight or flight response which may cause trembling, cold hands, sweating, tense muscles. Therefore, the pill blocks the adrenaline and gives us more physical control over our performance. Great, so now we naturally flowed into the pros of taking beta blockers.
a. Blocks your adrenaline and gives you more physical control over your performance
i. No more shaking!
b. Easy to use (reaches peak effect after 1.5 hours)
i. No matter how nervous you are, you can swallow a pill
i. Price depends on insurance/drug store, but it should be pretty cheap
d. Performance culture accepts the use of it
i. You do not usually get shamed if you use them
That sounds pretty good, right? More physical control, easy, cheap, and my peers won’t criticize me for using it. Well, there are some cons and I think they are important to understand as well.
a. Blocks your adrenaline
i. Ironic that this is a pro to using them. However, if we are to reach peak level, we need some adrenaline.
b. Creates a dependency on the pill to perform
i. The more you take them for performances, the more reliant you are to perform with them. We should aim for being able to perform relying more on our self-efficacy and self-esteem. Note that it is a dependency, not an addiction.
c. Need to increase dosage over time
i. To get the same effect, you must increase the amount of pills you take. This may not sound like a lot but if you’re going to the professional level, there could be an average of 4 concerts a week. That’s a lot of beta-blockers.
d. Does not address negative thoughts
i. It may give you physical control, but you can still mentally psych yourself out and the self-doubt remains. What it reveals is that it’s not a holistic solution.
e. May dampen your emotional response to music
i. Some musicians report that they cannot feel the characters of the music as much. If this happens to you, you’re robbing the audience for what they came for. You’re also robbing yourself of personal enjoyment while you perform.
f. Blocks you from addressing the core causes of performance anxiety
i. Is the core cause of your anxiety shaking and trembling or other physical manifestations? No, those are the effects. The core causes go deeper than that but beta-blockers only “cure” the physical effects (not the cognitive effects). It’s similar to the choice between losing weight with dieting pills or cultivating a healthy lifestyle. Most likely someone who develops a healthy lifestyle will be much happier than the person who is taking dieting pills but still living an unhealthy lifestyle. With beta-blockers, you can use them or you can develop the confidence, systems, and grit to fully express yourself on stage and communicate to the audience.
Now that we have a good overview of beta blockers, let’s learn from real performers and their experiences.
Bob had an audition for the concertmaster position in his symphony and reached out a week before his audition. He had been using beta-blockers for over 30 years and asked if he should use it. This was most likely his only shot at this position. I mentioned it may be a bit difficult to go in there with a lot of confidence, especially if he suddenly stopped taking beta blockers- so he decided to take them. We worked on other audition strategies and he played well but ultimately did not win the audition.
•We often battle the line between performance execution and how we feel.
•A week to overcome a strong dependency on beta blockers is a lot to ask for.
•You can get a highly respectable job and sustain that job using beta blockers your whole career.
Now I want to introduce Sam, who is similar to Bob in that he too had been taking beta blockers for every performance for over 30 years. He came to the program wanting to stop taking beta blockers because he wanted to perform without them. With a regular performance schedule, he had many opportunities to slowly reduce his dependency on beta-blockers. At first, performances without beta blockers made him freak out so he continued using them. However, he slowly reduced his dosage and over practiced to compensate for the self-doubt. This allowed him to build small successful performances with less and less beta blockers. Eventually, he performed without beta blockers, managed his anxiety, and felt a self-esteem boost for conquering this feat. Imagine taking beta blockers for 30 years and being afraid to perform without them. Having that experience of just walking out there to perform is one of the most liberating feelings a performer can have. But it doesn’t stop there. Not only did he stop feeling the need to take beta blockers for every show, he was able to tap into a higher level of performing. He felt more engaged, energized, and forced himself to deal with his demons. While his professional career is nearing retirement, he couldn’t be more enthusiastic about performances.
•It will be an up and down battle with beta blockers but ultimately you can be free from them if you used them for a long time.
•Performing at the highest level is simply not possible with beta blockers.
Now onto the final story of two performers who share the same outcome. Cindy, in high school applying for college, and Sarah who is applying for her doctoral degree both had the option of taking beta blockers for their auditions. I persuaded both to not take beta blockers because I had confidence they could perform well without them. We worked on anxiety management techniques, helped them face their fears, and created successful performance experiences. With this confidence, they were understandably shaky for the very first audition, but managed to play their best for the rest of the auditions. Not only did they get into their programs, but to this day, they still do not use beta blockers for performances as the pressure increases.
•If you have the option, don’t take beta blockers.
•What you think is a big performance now is often not a big performance over time.
•Beta blockers give you limited consistency, but limit your best performances.
I hope these stories shed some light on your perspective of beta blockers. Ultimately, you have the power to choose whether or not to take them because remember, you are always in charge and responsible for your decisions.
If you decide to take them…
•Visit a doctor
•Be aware of the cons
•Be aware of the side effects listed on the medication
•Short term use strategy
If you decide NOT to take them…
Know that overcoming anxiety is not easy. It took a lot pushing my comfort levels, facing my fears, growing a sustainable and supportive environment, and persistence. However, after all that hard work, it left me with the belief I could perform my best on stage which was not only a huge boost to my performance confidence, but life. The lessons we are taught in the performing arts world translate beyond life. It teaches us to be honest with ourselves, to be present in the moment, and expose our weakest attributes to improve them. Essentially, it is intense but presents the opportunity for us to become our best selves.