Coming Back from My Big On-Stage Panic Attack

June 7, 2021, 5:04 PM · 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.

demon on my shoulder

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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Replies

June 7, 2021 at 10:12 PM · Laurie, Your honesty and forthrightness reinforce why you are a wonderful writer as well as the perfect person to lead v.com. I'm guessing many of us are dealing with our own "monsters," and they certainly do loom larger when they are kept hidden. Fear truly does beget more fear. Thank you for sharing this intensely personal story. I know it wasn't easy to do. I'm quite certain it will help others who have a "gift to share" and may be struggling to do so.

June 7, 2021 at 11:08 PM · Thank you for this testimony, Laurie. I went through a similar experience when I was in my late teens and early twenties. It would have saved me years of anguish if I had had inderal available. The naysayers don't have a clue. Very glad it worked out for you, and sorry you had to go through that ordeal.

June 8, 2021 at 12:47 AM · An Omaha church music director and his doctor brother did some of the studies on the use of Inderal and performance anxiety when I was in college. Their findings changed my life in graduate school. It wasn’t always easy to find a doctor to prescribe for this reason, but I never go anywhere without it, however, I use it rarely. I feel so badly for my students who get so nervous but I don’t tell them about Inderal until they are of age.

June 8, 2021 at 01:28 AM · That is a really honest essay. I am sure many folks will appreciate it so much!

My own demons are elsewhere, but I know so many people who have exactly what you describe, and can learn so much from this post. Thanks for writing it!

June 8, 2021 at 03:07 AM · I didn't even know, till I'd finished school, that performers used beta-blockers to deal with nerves. Later I read that Itzhak Perlman used them.

As a kid, just starting out in recitals, I found my own way to out-bully the nerves – play some hard-hitting, aggressive material in the first few minutes to burn off some adrenaline. It worked.

So, no surprise, my attitude used to be: "Well, if I, as a kid, managed it without drugs, why can't the rest of you?" Now my position is: "Live and let live." If you can perform well without the drug, great. For a lot of us, like me, this comes from performing often. But if you just can't play up to your level without the drug, then do what works for you.

June 8, 2021 at 04:17 AM · Kim, I agree with you when it comes to kids - I don’t think it’s actually a treatment that is medically approved for children.

For kids, I believe in providing a lot of performance opportunities and building a supportive environment. If that isn’t working and there are possible mental health issues, then seek medical expertise - that would not be for me to advise!

June 8, 2021 at 04:30 AM · Thank you for sharing your story, Laurie. I’m not a performer, but I can relate to this in so many ways. I feel very lucky to currently have the opportunity to take a biofeedback course, and I’m just amazed to learn how profoundly my psychic states can influence physical states like heartbeat, blood pressure, body temperature, and muscle tension, and how profoundly those physical states can influence my psychic state. We’re amazing and complicated creatures!

June 8, 2021 at 05:46 AM · Interesting read! This is a topic I used to think lot about, because I have had so many different circumstances where such phenomenon happened. It truly feels dreadful: like you are stuck in a nightmare and your body just won't do what it is told, you can't think, nothing works.

With time, I grew very tired of this and worried it would inhibit my enjoyment of life forever. I then put it very bluntly to myself: how can I expect to provide for and guard others, if I have crippling anxiety in non-lifethreatening circumstances (ex. music and sports)? What becomes of me when facing actual danger? Steady progress started from this realization and the work continues everyday. It helps tremendously to tame even the slightest frustrations and uncertainty because I think it's the exact same mechanism at work. I started small, like with any other skill.

I do have nerves performing, I have to be nervous to give it all I can. But these days it's the good kind of nervousness, I'm looking forward to perform. It's already set beforehand how the performance will go, so I don't really worry about it - I have done all I can to affect it in the practice room. Heifetz had it figured out :) but I know that's not a solution applicaple to every circumstance. It's just what worked for me...

June 8, 2021 at 03:28 PM · Thank you for a really helpful article for me! I'm also not a big performer right now but anxiety is something I generally deal with. When/if I go back into performing, this will be a really great read for me to feel better about the situation - everybody gets nervous, and it will be ok.

June 8, 2021 at 04:23 PM · I've been there, especially in my elementary school through high school years, but also as an adult restarter ~9 years ago. I've gotten better in recent years, and have learned to perform through the nervousness (thinking of it as excitement instead). Good to know that medication can be an option if ever needed.

And, wow, a comment above from Lara St John!

June 8, 2021 at 06:21 PM · This really hit home for me. I used to be so good at auditioning that my chutzpah and bravado oversold my preparation. (I always seemed to get seated higher than kids who were more skilled and better prepared.) Performing wasn't *easy* but it wasn't terrifying, either. And then something changed. It might have been my nightmarish performance of the Beethoven F Major Romance with my high school youth orchestra during my senior year–it was a piece I'd performed multiple times. I had it in my fingers. And then my bow started to shake, on the very first note. It went downhill from there. Not long after, as you describe, the fear began to take hold, claiming greater and greater real estate. Once it was public performances, solos. Then community orchestra auditions, even ones where I knew the conductor. Then easy pieces in church. Eventually I benched myself–no more auditions, so no more orchestra. As a non-professional violinist, I can't really justify the solution you've discovered, but I sure wish I could. You've given me a lot to think about.

June 8, 2021 at 06:47 PM · Thanks for sharing your story, Laurie.

One small inaccuracy: A therapeutic dose of propranolol can be as little as 10 mg. That's what I take for purely medical reasons. 40 mg is actually quite a lot.

Unfortunately that 10 mg dose does nothing for my nervousness! (It does lower my heart rate, at least.)

June 8, 2021 at 11:45 PM · Thanks Laurie.

The stage-fright topic returns.

I would be surprised if my personal experience was unique, but, the social situation and music culture makes a difference. I only have that anxiety for our western classical music. For non-classical genres the fear is zero. That includes doing amplified solo violin in front of audiences in the thousands. I think that is because somewhere in my mind I know that the audience is not there to judge, but to be entertained.

My ranking of fear situations, from worst to zero is :

Audition in front of a committee of three. (if something can go wrong, it will)

Stand-up solo.

Sitting down solo as first violin in a quartet or in the concertmaster spot.

Second Violin or Viola in a quartet. (I assume the audience is listening to the first violin!)

Zero fear:

Orchestra section.

Non-classical genre.

Part of the problem is that so much of our repertoire is so ___ difficult. It seems like walking the high-wire act at the circus without a safety net.

I have discovered that solo singing is even worse. You feel naked. You don't have a physical object, the instrument, to hide behind. And the nerves directly affect the breathing and muscle control.

June 9, 2021 at 12:02 AM · Hi Lydia,

I'll stand behind what I said about Inderal dosage. While it sounds like you have a medical condition that requires a low dose, certain heart and hypertension patients very typically take 40 mg - actually twice a day or more, and actually the following link says that "In some instances a dosage of 640 mg a day may be required"! (Have a look here for a run-down of various dosages for various medical conditions.)

My point is that the dosage for use for performance anxiety is quite low; it starts at 10 mg, which is the lowest dose. That works for some people, not all; some take more.

June 9, 2021 at 03:04 AM · Laurie: I, too finally tried beta blockers (propranolol) about 1.5 years ago. At the age of 29, it was my first positive performance experience. I was actually able to enjoy myself. I believe I even smiled several times during the performance. Since then, I've looked forward to the idea of playing for others, which is a brand new feeling.

To be locked inside a broom closet of fear your whole life because you've been physically disabled every time you're on stage really sucks, and can 100% ruin a person's musical experience and their perception of music in general.

And it reduced my fear in general even when I didn't use it after that, because I knew what it was like to have at least ONE positive performing experience. And I knew that I had an option for the future.

Like you said, only those that haven't truly struggled with crippling stage fright are so opposed to the use of beta blockers. They probably think "well I've felt nervous, so I get it." No, it isn't feeling nervous. It is shutting down and becoming completely incapable of rational thought or action. And sometimes it hits you like a ton of bricks, without any warning. Everything is fine, then your body dumps a huge amount of adrenaline into your veins and you can't think, move, or speak normally, let alone play the violin well.

So I say to those anti-beta people: be thankful you haven't dealt with a stage fright problem that was serious enough to make you understand.

June 9, 2021 at 03:59 PM · continued,-

low-dose beta-blockers sounds safer than what happens at my Mariachi jobs; the cases stay in the car, we tune in the parking lot, and vocal warm-up is a shot of tequila.

June 9, 2021 at 05:20 PM · The alcohol idea has been mentioned a few times in a few places, so I'll chime in to say it's not something I've tried. I've been a teetotaler for most of my adult life so I have never actually had a drink before playing. As a depressant, alcohol certainly would not address the same physiological issues that a beta-blocker does. With alcohol being an addictive substance, I think it's a whole other can of worms.

Who knows, but I've never heard of anyone's life being wrecked by beta-blockers!

June 9, 2021 at 05:37 PM · agree-jq

June 9, 2021 at 07:51 PM · Life wrecking ability would depend to a large degree upon dosage. I know of accidents due to passing out from low blood pressure. Mainly falling but also a car wreck or two. Alcohol will adversely affect coordination and for a nondrinker who may not know if they have alcohol dehydrogenase insufficiency it would have dramatic unwanted effects.

Ultimately, panic symptoms are a result of an underlying problem and taking inderal is treating the symptoms and not the problem. What it does is allow a person to get along and buy them time to get at the root of the problem. Once the root of the problem is solved and eradicated then the drug becomes less needed.

What Joel has said about being judged vs entertained is the key for many people of getting rid of this terrible plague that is so limiting and painful.

June 9, 2021 at 09:48 PM · I understand what you are saying, Ann, but my point is that beta-blockers are not physically addicting in the way that alcohol is. I feel it's false to equate the widespread and devastating problem of alcoholism with rather rare cases of misuse of beta-blockers. And frankly, I'm hearing from a great many people who found beta blockers actually helped them resolve the actual root of their panic-attack problems: namely, the fear of the panic attack, and they were thereafter able to stop using them.

June 9, 2021 at 10:09 PM · I was merely pointing out that there are side effects to these and no one should assume they will not have them even at low doses so caution is in order initially. There are also long term effects of almost any drug, speaking as someone with training in biochemistry. I said absolutely nothing about the misuse of beta blockers which seems to be a nonproblem. I would never blame a thing for its misuse.

What you say about the root of the panic attack is also true. The first one is sometimes or often triggered by an unknown cause and subsequent ones are triggered by the first. I had these for 10 years and was disabled by them. Not stage fright, but another kind. Beta blockers were unknown back then. Fortunately I found help from a person who knew how to discover the root cause.

June 9, 2021 at 10:54 PM · I'm glad you were able to find help Ann! I agree that caution and attention is called for. Another article about beta blockers and musicians (this article by Blair Tindall) said that many people get beta blockers from colleagues, relatives or friends, rather than from doctors. A doctor's supervision seems like the best course, though there are countries and places where they won't prescribe for anxiety. Lots of complex issues!

June 10, 2021 at 02:34 AM · Great post on a needed topic! There should be absolutely zero shame for taking beta-blockers, they are there to prevent a physical tailspin. They can be very effective. They are not performance enhancing (I never played "better" than I would have, like let's say the way Lance Armstrong rode faster), but it did allow me to "hang on" to the many months of preparation I put into my professional orchestral auditions. In my own experience a little dosage goes along way for some of us who have naturally low blood pressure... Also, get a prescription from a doctor. For me BB worked wonders for the first round of auditions - I can't take them for recitals or anything that lasts longer than 10 minutes (like final rounds) because when my adrenaline goes down naturally after being on stage for a while, my blood pressure tanks on BB and I end up cold, confused, and with numbness. So for non-auditions I do simulation training (playing for people a lot). Each person has to find their own mix of remedies and the more honest we can be about all the options, the better. Bravo, Laurie for putting it out there.

June 10, 2021 at 05:50 AM · My doctor pretty much gave me propranolol (generic inderol) as soon as I mentioned what my problem was and what I thought the solution was. It was a very positive and easy experience. In fact, I did the consultation over the phone. The only thing was that she needed to look up the recommended dosage for that use, so she took about 1 minute to do that. She ended up giving me 40 mg tabs, and I started off by testing 20 mg, and finding that 30mg is my sweet spot for high pressure performances. If I'd had the chance, I would have subsequently done lower and lower doses until I was using almost none. In this way, I could have conditioned myself to believe that I could indeed have a good performance, and eventually I might not need it at all.

On a somewhat related note, if you have a doctor that is highly skeptical whenever you, the patient, suggest something, get a new one. Life is way too short to deal with gaslighting doctors.

June 10, 2021 at 01:09 PM · https://bulletproofmusician.com/3-reasons-why-beta-blockers-could-ultimately-be-holding-you-back

https://www.local802afm.org/allegro/articles/beta-blockers/

June 10, 2021 at 03:15 PM · This was really interesting, and thanks so much for sharing. How does one go about getting a prescription? Must you be diagnosed with anxiety?

June 10, 2021 at 03:16 PM · I struggled for many years with absolutely debilitating stage fright. When I was auditioning in Vienna in my late twenties, it completely destroyed many opportunities. I discovered propranolol and it made it possible for me to perform. I think that for some people it is that only way to be able so perform and there shouldn't be such a stigma about it.

June 10, 2021 at 04:39 PM · I've been using 2.5 mg of Inderal/Propranolol for performance stagefright symptoms since 1977. My first performance-anxiety experience happened in November 1951 when I performed a couple of old English songs on violin for my high school English class. I had been performing (real music) around our county for 3 years by then on violin and cello, sometimes for pay. I loved doing; it never a fear, never a shake!

But within a couple of measures of starting that classroom performance my bow hand started to shake. I had no idea what was happening because I was unaware of any fear or nervousness. But forever after, almost every time I performed a violin solo or in any exposed role, my bow arm would start to shake. It started with my cello playing about 10 years later. That did not stop me from continuing to play chamber music or to become concertmaster of my community orchestra around 1970 and to continue in that role for 20 years. The biggest problem was being forced to limit most of my solo playing to the upper half of the bow. After discovering Inderal I still recall aa couple of solo performances standing in front of our orchestra when I would make a special effort to get the bow all the way to the frog to prove to myself that "I could do it."

It was not until I learned about Inderal at the 1977 San Diego Chamber Music Workshop that I found the solution to my problem and I have used beta blockers for every "exposed" public performance since then. I weaned myself down from a full-size pill to 2.5 mg - and it still works. I have "met" people on line who found relief using beta blockers and were able to wean themselves off the need; I never could.

In my old age I have learned that beta blockers can also be effective temporary treatment for "essential" or "familial" tremor, which I have developed (as have two of my adult children). This has nothing to do with performance anxiety, but I have used it for some performances and even for some rehearsals, but I have also found a different way to hold my violin and viola bows to reduce the shakes and that is what I do if the music will allow it.

Beta blockers (BB) are pretty powerful medicine so the minimum amount that works for one is the amount one should experiment to find and take. I have found it is not a good idea to use BB on consecutive days if you discover any side effects. Physicians and pharmacists advise against using BB if you have asthma. And it greatly amplifies the effects of consuming alcoholic beverages.

June 10, 2021 at 09:15 PM · Laurie,

Thank you for sharing your story. I had a similar experience upon performing a brief solo at a friend’s wedding over 10 years ago. My physician actually suggested Inderal when I mentioned that all the practice I put in didn’t prepare me for the incredible shaking of my bow hand!!! I had experienced performance anxiety before and tried many approaches from breathing techniques, yoga, and eating bananas before a solo. They didn’t work and my performance at the wedding caused my husband to ask “what happened?”. I had been resistant to Inderal for decades and decided to try it. Over time I was able to reduce the dose to 2.5 mg. I am hoping that I won’t need it anymore, bout am glad to have it.

PS: I really didn’t have the emotional anxiety prior to performing a solo, but the incredible shaking I experienced along with my inability to stop it was quite upsetting!

June 11, 2021 at 04:49 AM · Wow, so much truth to this article. I’ve struggled with anxiety and many physical repercussions. I’m finally on a medication that helps deal with chronic muscle tension. I think my anxiety would cause my muscles to clench so much my body would shut down, even if my mind didn’t want it to. I relate to taking on easier, less demanding jobs because I could t handle the mental and physical repercussions of high-stress performances, even if my fingers felt well-prepared. I know I’m a good player. I know I’m a good performer. I love being on stage, but my body can only take the flood of cortisol for so long before it wears out. The medication helps me play again without as much fear, and my body can bounce back faster than it otherwise could.

June 11, 2021 at 12:24 PM · An honest and brave share, Laurie. Thanks for writing it!

I personally don’t use beta blockers as it has not “enhanced” my performances, however for people who are absolutely debilitated due to shaking, or any of the physiological symptoms of performance anxiety, then I don’t see why they shouldn’t use it as an aid.

Interesting and insightful comment thread!

June 11, 2021 at 01:07 PM · Laurie:

Allow me to add my kudos for your openness, willingness to share, and acceptance of such a serious problem. And to the many, many responses reflecting support (even with the differing opinions). If all human problems were dealt with as they are in this discussion thread, it would be a better world.

Dr. Milton Erickson (famous psychiatrist and clinical hypnosis expert) said this: "Life will bring you pain all by itself. Your responsibility is to create joy."

What could bring more joy than the wonderful art form of violin music and the sharing of one's inner soul.

Sandy

June 11, 2021 at 09:22 PM · Another thing I want to add: I think the actual amount of people that use beta blockers for performing is severely under-reported, because so many people are afraid that admitting its use would affect their reputations and subsequently their careers. Someone like Perlman can more easily admit he uses them, because his name is so big that nothing could stop him from selling out every concert. But it's a much riskier jump to admit you use them if you're anything less than a superstar already.

Anyways, good on you for being open about it. I think we need a lot more well-known people in the violin community to come out and say that they, too, benefit from the use of beta blockers.

June 11, 2021 at 10:58 PM · Laurie, thanks for sharing your story! I have to admit when I first read it I had a hard time believing it was you speaking. Maybe because you are such a good editor of this site, and are a professional violinist, I tended to picture you as bulletproof. Of course I know that's not true of many skilled professionals in many fields, but for some reason I'm still always surprised to find it out for people whose skills I admire and respect.

Performance anxiety was such a huge part of my violin learning in childhood and adolescence, and it was the biggest reason I didn't pursue music more seriously, and eventually quit for a while. I remember trying beta blockers soon after I restarted playing the first time, in my late 20s. (I was also working on overcoming my fear of public speaking at that point, and the two anxieties were related.) I must have not understood what they were supposed to do, because my perception was that they didn't help at all, so I gave up on them after a few tries. But what I was hoping for was that I would *feel* calmer, and then I would be able to manage the physical symptoms because I was calm.

Instead I discovered, with fingerless gloves, something similar to what you're reporting here for inderal: fingerless gloves helped me address the cold, stiff, shaky hands and fingers that anxiety brought me. And addressing those physical symptoms had a positive effect on my mental state, not the other way around. I still get performance anxiety these days, but it's manageable.

Again, I appreciate your openness about this. If inderal had helped me way back when I'd probably still be taking it!

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