Beta-Blockers

[Chuck(G)]

Maybe not like baseball, but professional music is about performance. When you're up on stage honking, no one cares how smart you are or that you're a wonderful wife or husband, or that you're a pillar of the community. It's all about performing (that's why they call it "performing arts"). No one's going to forgive a string of clams because you're a nice guy. Just like baseball.

There are those who think that we're being silly about drugs and sports and that "anything goes" should be the rule. After all, isn't a sprinter on anabolic steriods just availing himself of the latest technology, much like getting a new pair of high-tech shoes?

So, for the sake of argument, let's take the same approach in musical performance--anything goes. Inderal is a permissiable drug; no secret is made of its use and its freely employed.

So, candidates for a position are asked point-blank if they're using any performance enhancing drugs and are also required to fill a specimen cup as part of the application process.

Suppose you've got two candidates who play pretty much equally well, but one uses a beta blocker to calm his or her nerves and the other doesn't.

Which one will you hire? After all, the guy with the nerves may leave his Inderal at home on a performance night--and who wants a performer who is at risk of panic attacks?

[windshieldbug]

Which one will you hire? After all, the guy with the nerves may leave his Inderal at home on a performance night--and who wants a performer who is at risk of panic attacks?

No problem- I'm sure one of the numerous other people who remember their's will be happy to provide one as long as it's replaced!

[circusboy]

I can't disagree with Chuck(G) more.

Regarding the "where does it stop" argument, what if a player had a headache before a performance? Would a couple of aspirin be out of the question?

I don't know much about beta-blockers, but it sounds as though they are pretty safe (like marijuana; unlike alchohol or heroin or steroids). If they treat a disorder, why not employ them?

Regarding art vs. sport, these are vastly different fields. Outside of the audition situation, arts are non-competitive; you can't place bets on an outcome. Though they may share the word "performance," the connotations are hugely dissimilar. A musician's goal is not just to hit all the notes or get through a piece fastest or play the loudest, etc. A musician's goal is to create an appropriate emotional response in a listener or to create beauty or to self-express, etc. Both pursuits rely on a certain amount of physical prowess, yes, but in sport that prowess is paramount; in art it's just a step to a larger (IMO) goal.

Whatever gets you through the night . . .

[Chuck(G)]

Whatever gets you through the night . . .

If it's legitmate, then it'll withstand the light of day. Be completely open about it--at your audition, let the jury know that you're taking Inderal, or have taken a shot of Dickel with your Valium to smooth the jitters. Or have been smoking a little weed for inspiration. After all, it's the music right? The jury will certainly understand.

See how far you advance--or even if you get to play at all.

Myself, I've had my fill of substance-abusing "artists". The last one I had a run-in with is now doing 9 years for nearly beating his girlfriend to death with a baseball bat while intoxicated. Heckuva tuba player, though.

[windshieldbug]

If a competitive British brass bander uses Inderal, then it IS "performance enhancing" in both senses. Double negative?

[MaryAnn]

Myself, I've had my fill of substance-abusing "artists". The last one I had a run-in with is now doing 9 years for nearly beating his girlfriend to death with a baseball bat while intoxicated. Heckuva tuba player, though.

So you're saying that if someone takes 10 mg of Inderal, he will nearly beat his girlfriend to death with a bat? Was this guy all strung out on Inderal?

BTW, you're proving what I said about the arguments you see about beta blockers. For some reason some people seem to put beta blockers taken for performance anxiety, in the same category as illegal drugs, even if they are prescribed by an MD and are about 1/10 or 1/20th the dose that someone would take for high blood pressure. It's ok if someone takes beta blockers in huge doses for high blood pressure, as long as they're only "inadvertently" getting the adrenalin-shakes-removal result.

Fascinating. Let's see if we can come up with a rule set:

1. It's ok to take beta blockers for high blood pressure
2. It's ok if the beta blockers taken for high blood pressure, also work to relieve excessive adrenalin reaction in a performance situation
3. It's not ok to take even a minute dose of beta blockers to relieve the adrenalin reaction, if you don't already take them for high blood pressure.

So: If you want to be able to take beta blockers to relieve the adrenalin reaction, develop high blood pressure. Then it will be ok to take them.

Where I see the logic tree falling apart is when people mentally/emotionally equate a legal, prescribed drug to an illegal drug. If beta blockers would make you almost kill your girlfriend with a bat, I'm pretty sure they would be illegal. I have never been able to find the logic in the emotionally-charged reaction against beta blockers. It seems to be along the same lines as opinions about politics or religion; you believe what you believe, and ain't nobody gonna change your mind, no-way, no-how.

MA

[iiipopes]

OK, setting aside my personal bias against beta-blockers for a variety of reasons, here's the real issue:

1) Performance anxiety is a real issue for some people.
2) Professional help is sometimes necessary, as it is for any physical or mental issue.
3) Other studies for other types of similar issues seem to point towards a combined approach of medicine with counseling as being more efficacious than either alone.
4) As with any medicine, it should only be prescribed and administered by the appropriate licensed health care professionals, and only after a physical exam to get the whole picture, including screening for any other issues that might be related/alternative causes, for example depression, or for contraindications (things that would actually make you more ill).
5) If there is a combination or regimen of positive factors available to help relieve the need for the medicine, as for example losing weight to help with high blood pressure, or controlling diet for some mild forms of diabetes, which tend to lessen or end the need for the medicine, then these positive factors should be followed.
6) Did I say all with the ongoing consultation and monitoring of an appropriate licensed health care professional?

[circusboy]

Well said, MaryAnn.

I take further umbrage (that's right, I said "umbrage") with Chuck(G)'s use of quotation marks around "artist" to denigrate those with substance abuse problems. Though many such folks have had difficult, even tragic lives as a result of their behavior, their abuse does not mitigate the power of their artistic output.

There's a further problem with the all-too-common practice of lumping all psychoactive substances together. Keep in mind that the laws of the U.S. regarding these matters are arbitrary at best, at worst driven by the pharmaceutical, alcohol and tobacco industries. It would do the citizens of this country some good to read up on it a little:

http://www.drugpolicy.org

Yes, some drugs--legal or illegal--are bad: destructive to health, family, creativity, career, and more. Others cure disease, relieve pain, "cleanse the doors of perception," and (so I've recently learned) block adrenaline enough to allow a musician to get through an audition.

[Chuck(G)]

So you're saying that if someone takes 10 mg of Inderal, he will nearly beat his girlfriend to death with a bat? Was this guy all strung out on Inderal?

No, but I'm saying that the mindset is what will get you into trouble. Taking drug "A" is okay as long as it helps me with my performance. Perhaps taking other drugs will also help; after all, it's my livelihood on the line.

Fine. If you think that taking drugs to help with performance is okay, then be up front with it, instead of treating it as a dirty little seccret. Use your smiling face to endorse full-page color advertisements:

Hi, I'm Fred Blattweasel, Principal Horn of the Dogpatch Philharmonic and I'd be a blithering mess of goo without my Inderal(tm)".

Before I discovered Inderal(tm), when the time came for Siegfried's Horn Call, you couldn't tell me from a pack of coyotes in heat. My rendition of the Schumann Konzertstück sounded like a burlap sack of cats being kicked down a dusty road. Believe me, I was about ready to drop the music buisness and become a Flight Traffic Controller.

But a friend suggested that I talk to my doctor about Inderal(tm) and now everything's real cool, man!

I suspect that because this isn't done, it's not really okay with most folks. "Boy, Mabel, I bet that old Fred would have really blown that entrance without his drugs.".

Further, if it's okay, when does it start not becoming okay? How about a high school student with performance jitters? A 9 year old at her first piano recital?

I don't think that someone who's taking Inderal for hypertension who also happens to perform is guilty of using a drug as a crutch, anymore than a player using cannabis for glaucoma is.

FWIW, the fellow I'm speaking of got his habit while attending an establishment at 18th and Ortega--probably because he found it helped him to be more "artistic".

[funkcicle]

maybe we shouldn't allow people with high blood pressure to play in symphony orchestras.. they could forget to take their blood pressure medicine and have stroke before an important concert.

[jdsalas]

It's going a little far comparing using beta-blockers to the performance enhancing drugs that are creating issues in baseball. As far as I know taking a pill is not going to make you play all the right notes. You still have to practice!!

[Donn]

No, but I'm saying that the mindset is what will get you into trouble. Taking drug "A" is okay as long as it helps me with my performance. Perhaps taking other drugs will also help; after all, it's my livelihood on the line.

So don't touch drugs, because it will lead to the hard stuff before you know it, and 9 year old girls will be using it for their piano recitals, etc.

Except, if you're already taking the drug in question for a non-mental medical reason like blood pressure. Except, if the drug in question is one that you and your friends are accustomed to using, maybe alcohol or caffeine.

This kind of perspective (or lack of, really) essentially creates a great big blind spot that can make you vulnerable, and you can see it happening, people getting hooked on pain killers etc.

[Chuck(G)]

This kind of perspective (or lack of, really) essentially creates a great big blind spot that can make you vulnerable, and you can see it happening, people getting hooked on pain killers etc.

I'll confess a strong bias against medicating things that might otherwise be handled through other means.

Yes, at my age, I have hypertension, but was able to talk my physician out of throwing the whole pharmacopeia at me. For one thing, ithe massive drug dose was playing havoc with my hearing.

I got on a simple diuretic, lost weight and upped my exercise. My BP is under control without any fancy drugs and has stayed that way for several years now.

At one point in my life, I experienced severe tension headaches. The cure suggested was to give me a sublingual vasodialator--just slip the pill under your tongue and you'll feel positively lightheaded. Instead, I learned to deal with stress and was a much happier person for it. I imagine that now it's pretty easy to find a doctor to prescribe oxycontin for just about any little ache or pain.

I had problems sleeping through the night--my physician first prescribed trazadone, then Ambien. I found that if I wore a warmer set of pajamas, I slept like a baby.

Now we're giving a close cousin to cocaine--Ritalin--almost indiscriminately to kids who may or may not have ADHD. Some, it's been discovered, only need some parental guidance and discipline. But it's easier just to pop a pill. Well, that one's beginning to come home to roost:

http://gslc.genetics.utah.edu/units/add ... italin.cfm

The siren song of modern drugs is powerful--and it's pretty easy to get a prescription for just about anything--even cannabis in some states. But I think learning not to fall into the drug trap might be good for us all.

[Dean E]

Taking a pill is a western remedy. Both western and eastern remedies work to achieve personal goals such as sustained performance and serenity.

There is nothing wrong with being attuned to one's body. Methods of eastern traditions comprise paying attention to the senses of balance, digestion, blood pressure, and what Buddhists call "monkey chatter."

Get help when it is needed. However, nothing to excess. Tertiary consequences with personal growth and effectiveness, law enforcement, families, friends, and jobs may result from the overuse of, abuse of, and addiction to anxiety and pain relieving remedies.

Feel the energy of your excitement and adrenaline, and use the energy to your advantage.

[windshieldbug]

Speaking for those that are not here, the people I know in the symphony who were taking WERE under a doctor's supervision, and it was a last resort, not an easy fix. It did not make you play ANY BETTER, only prevented deterioration under foreseeable circumstances. And in conversations, they saw it AS THEIR DUTY, to the people who had shelled out good money to be in the seats.

I wouldn't have wanted anything that would dull my joy at playing such great music (even with violas present), but there it is. I don't feel that suggesting to a horn player that after 20 years of hard study she was in the wrong business (gee, they don't know it by then in their pocketbook, at least!?) and should be retrained is very productive.

Nor can I pass judgement if art is better or worse for possibly not having that voice.

I do know that it's hard enough to find decent, paying work in the classical field, and I've never heard of anyone besides legitimate, classical musicians taking BB's. In that respect, it IS like sports, tenure or not, you're only as good as your last performance, and if the skip decides they don't like you any more, you're GONE! (but no pressure or anything... )

[joebob]

Being close friends with a number of MD's, I can tell you that they prescribe inderol for performance anxiety in LOTS of people in different professions. Just for example: corporate executives who struggle with nerves at public speaking engagments; golfers; actors; dancers; politicians; job interviewees - the list could go on.......

Why do people keep it a secret? As is evident in this thread, there are people who think it is a really bad thing and would possibly deny employment to someone based solely on the fact that they take inderol. I've never seen any evidence that 10-30 mg of inderol prescribed by an MD for an appropriate patient is harmful or addictive or can lead one to addiction to other drugs. If someone presents such evidence, maybe my thinking will be different, but from my point of view, it's really nobody's business if someone takes inderol. I'm sure there are individual cases where inderol is harmful, but there are individual cases where tylenol, aspirin, and any other drug is harmful. If someone struggles with performance anxiety, I would suggest they ask their doctor about it.

[iiipopes]

The other reason they keep it secret is that taking most prescription drugs without a prescription is illegal.

[Chuck(G)]

I have heard of some institutions that offer desensitization classes that essentially put you in a more hostile environment--on stage, alone, with the temperature turned up, members of the audience talking, joking, heckeling staring, walking in and out, etc. Perhaps some of the education professionals on the BBS can point you in the right direction.

Another thought is to enroll in a couple of drama classes. It might take the edge off the tension and it couldn't hurt your playing.

[Mudman]

Having read this entire post, I wonder about the use of beta blockers for situations like auditions. The reason the music dept includes these "Juries" as part of my finals is to help prepare us for what is to come in auditions and and playing before panels in professional situations.

What are the dangers of taking BB's in doeses of 10-50 Mg? As a young healthy musician am i condemned to 1000's of practice hours without the so-called "assistance" of BB's to yield to me the fruits of my labors?

I put a great deal of work into my low register as perscribed by my teacher in order to extrapolate the sound from my playing. The result at the panel was pathetic.

Personally, I would advocate performing much more in public before considering beta blockers. If after a few years of frequent performing you still sound great in the practice room but crash and burn in public, then you might try beta blockers.

See if you can overcome your anxiety on your own first. It may make you a stronger player or more compassionate teacher in the long run, even if you eventually decide to use beta blockers.

Perform daily for somebody--drag a friend in to the practice room and see if you can improve that way. Pretend that you are performing when you practice. Play for your dog. Then go out in public and play on a street corner. Play in a public school. Put on an unaccompanied set of tunes and play it anywhere you you can. Blazhevich, Bordogni, B-flat scales anything that gets you in a performance situation. I made money playing Blazhevich in the Chicago Train Station during a 6-hour layover. People dig that stuff.

[iiipopes]

You want a cure for performance anxiety? As a freshman in high school, you march your first show of five completely different shows you are going to learn and march that season and each year thereafter with an instrument you had never even picked up, much less played until two weeks before, and definitely never performed with, then drop your mouthpiece and bits on the run in, try to mime your part anyway, and have to run around and through the football players after the show is over looking for it, and you're looking like you're doing the funky chicken trying to find it because you can't see it under the glare of the stadium lights because it fell exactly lengthwise in the middle of a yard line. After that, nothing is worse, no calamity can phase you because you've just finished making the worst fool of yourself you can, and all you can do is go up. At least you can brag about your straight marching because of the way the mouthpiece and bits landed! The effects of the incident pay off seven years later when, in grad school (a non-music degree program) at an NCAA I school marching band, you are the only souzy who can march and play the signature bass riff to "Big Noise from Winetka" cleanly, in the key of concert D major, even better than the so-called music majors and grad asses, and get a standing ovation from the entire band when the director, frustrated at the riff not being clean out of the section, has individual tryouts right then, right there, in front of everybody, and after the rest muck it you nail it to the wall because you've been there, and you know as far as you and your souzy are concerned, you fear nothing because you know you are the meanest sob in the valley, er, football field.

Yes, medicine for jitters is sometimes required, but just like the old saying, you gotta get back on that horse and ride, and in the long run, it's the best cure, and even if some sort of prescribed medicine is still needed, you still have to take the reins and go. Pick your saying: the English, "Get on with it," the Eagles, "Get over it," the mid-70's slang, "Get your $#!+ together," Nike, "Just do it," etc.