Beta Blockers for contests?

[_si]

Hi all,
I suffer really bad nerves on stage at contests.
I shake uncontrollably and my heart races.
I find it impossible to perform to band room level on stage ( strangely I'm fine in concerts).
I've read on here players combat this with the use of beta blockers.
My questions are
1) will beta blockers help me?
2) when do you take them ( how long before you play)
3) is it ok from a moral standpoint?
4) I read they are prescription only, so do I have to go to my Dr's and explain that I want them for contests? or is there a workaround? I feel it's likely a doctor wouldn't feel it a reasonable request for this reason.
Cheers!

 

[Mesmerist]

I've taken them in the past but since rejoining the banding world after a 5 year break I'm determined not to use them again. Yes they do take the edge of the nerves but it's tricky knowing how much you need and when to time it. I did the areas and Buxton which I found hideous and nauseating because of nerves and I thought about giving up. Then I watched the James Morrison series on You Tube posted on here at tmp and would you believe it, his "happy breaths" works for me. Did the Rochester contest a few weeks ago and in spite of the resonating echo in the hall actually found myself enjoying performing half way through the piece. Shook like a wet dog after a bath once we finished but that's a first for me, actually enjoying a contest.

 

[WhatSharp?]

I battled with stage shakes for years trying all sorts of techniques and herbal remedies, eventually after to talking to a few people I went to the doctors and got beta blockers perscribed, transformed my playing I can now play without the physical shaking which all but destroyed my playing. I take one about 1 1/2 - 2 hours prior to playing (and I only use them for contests and where I have solo passages or solos). It may well be a placebo affect but it works for me and I do notice the difference when I haven't taken one.

 

[euphoria]

You have to consider that a known side effect of beta blockers is erectile dysfunction.

For the other side effects: Beta Blockers: Types, Side Effects, Interactions

 

[GordonH]

The problem with contest is that you can't use the usual methods of controlling fear. If you look at any material on musicians nerves they are all about concert performance and full of statements like "there is nobody in the room judging you" (except there is) "everyone is on your side and wants you to play well because they have paid to hear you" (except the audience is made up entirely of people who want you to get less points than them and they mostly got in for free). This is why contests are more difficult to deal with and probably best avoided in my experience. I got so screwed up at one point I could not play sitting side on to an audience. I could stand up and play a solo with no wobbles at all, but I could not play a hymn tune or a march sitting in my seat. It took a couple of years to rehabilitate myself and using beta blockers was part of that - although not deliberately as I was prescribed them for other reasons.

 

[2nd tenor]

You have to consider that a known side effect of beta blockers is erectile dysfunction.

For the other side effects: Beta Blockers: Types, Side Effects, Interactions

That's the trouble with many drugs, they have side effects that you don't want and maybe didn't understand before you took the medication.

Though it's good to raise the topic again I'm sure that there have been other posts on Contest nerves - i.e. there's additional supportive stuff out there if you can find it. I don't Contest but have found that the better I practice and the better I play in rehearsals then the better I play in Concerts. Having developed '*uck it' and '*od them' attitudes over the years (I aim to shut out and be desensitised to any critical views of those listening) also helps me just get on with playing to the level that I've practiced to, and the support of an understanding Band (and MD) when you slip-up is a tremendous help too. In fact I think that any sensible Band would regard such a supportive attitude to slip-ups and distressed players as essential to both the Band's wellbeing and long term results too. Pet rant: IMHO any band that doesn't rally around and support its (hard working) players doesn't deserve to have them.

In short work at killing the need for Betta Blockers rather than resorting to them - I didn't say that it was easy or that there wouldn't be a few painful incidents along the way. Not a direct answer to the OP but one that I hope will help.

 

[Ianroberts]

You have to consider that a known side effect of beta blockers is erectile dysfunction.

And when it dysfuncs they usually come on here and start posting against "The Donald", that soon gets them up and ready again !

 

[JimboFB]

Hi all,
I suffer really bad nerves on stage at contests.
I shake uncontrollably and my heart races.
I find it impossible to perform to band room level on stage ( strangely I'm fine in concerts).
I've read on here players combat this with the use of beta blockers.
My questions are
1) will beta blockers help me?
2) when do you take them ( how long before you play)
3) is it ok from a moral standpoint?
4) I read they are prescription only, so do I have to go to my Dr's and explain that I want them for contests? or is there a workaround? I feel it's likely a doctor wouldn't feel it a reasonable request for this reason.
Cheers!

1. Might do, might not, probably tho.
2. Hour or so before
3. Yes, why wouldn't it be?
4. To be on the safe side I wouldn't go to your GP. Don't lie, just be straight up and explain. You should get them prescribed. There's no real difference to having a job where you have to do public speaking and get nervous.

I know loads of players at the very top level that take these to help,combat nerves. It's not illegal it's not cheating. It IS (in my opinion) dangerous to take pills prescribed to someone else as you literally have no idea what will happen if you've not taken me before. Amazing how bands have a 'chemist' in their ranks.

For me personally, ive been on stage bricking it before but that's part of it for me, taking something to get rid of that would take the edge away.

Also (apparently) you can get drunk really quick soon after so be careful as a previous band colleague of mine had a very scary experience driving home from a contest after one pint.

 

[GordonH]

Word of caution:

I have to see my doctor every eight weeks to get a prescription. I can't get them on a normal repeat prescription as the side effects need monitored. This might be to do with the condition I am taking them for and the fact I take them regularly rather than just before a performance.

On the timing of taking the tablets, I take a second tablet around 4pm, but if I am playing I put that off till later on. I find taking it 30 minutes before is about right as the effects have kicked in enough and will last long enough.

There are downsides though. I would not take them before playing jazz as something of the spark goes out of it. You need some adrenaline. In many ways I find them of more help in those initial rehearsals of a new piece where you need to have the confidence to get through a sight read. I definitely find them beneficial for that.

Another downside is weight gain. I put on a stone after taking beta blockers for a few months (continuous dosing) because it reduces adrenaline and slows your metabolism. I have lost the weight again by changing my diet a bit, but it has taken since Easter to lose it.

I suppose if you are only taking them occasionally you won't have the longer term issues.

 

[pedaller]

My partner works for the NHS as a low intensity CBT therapist. You should ask your GP to refer you to your local IAPT service (to a PWP) or you could do it yourself. Do the 4 W's. (What, Where, When and with Whom). Then do your 5 Areas (what's the situation, list your thoughts, emotions, physical symptoms and behaviour when it happens). Psycho-educate yourself on the fight/flight response, why we have it, why it's not helpful in a banding situation, then do some exercises. Work on your confidence and self esteem, don't catastrophise or negatively predict, and play in a band because you enjoy it/love it. There's loads of worksheets to work through on self-help.co.uk and or Centre for Clinical Interventions (CCI) - Psychotherapy, Research, Training Try mindfulness (grounding yourself), go to the gym, learn about 'sleep hygiene' and lay off caffeine-based drinks. Don't put yourself in a chair in the audience when you get on stage (you'll start to generate critical, negative thoughts like 'what are they thinking', 'they're gonna think I'm crap, the judge is gonna rip me to shreds and I'll be embarrassed and humiliated by band members, etc. etc.). Your job is to sit in your chair as a player on stage. You're not a member of the audience and what they're thinking is beyond your control. It's not your job to put yourself in another player's chair and imagine what they think of you either. Don't go inwards to your minds eye. Keep an external focus. Concentrate on the notes on your music sheet, not on your internal self. Training yourself through self-management to reduce your adrenalin and telling yourself 'what's the worse that can happen' (look up behavioural activation, worry tree, stress control (preventing grasshopper thinking) and looking up cognitive restructuring (CR) will all help solve your problem. You have the capability, opportunity and motivation to change your behaviour. Good luck. If you really hate your on-stage nerves, you have all the motivation you need to overcome it.

 

[Ianroberts]

My partner works for the NHS as a low intensity CBT therapist. You should ask your GP to refer you to your local IAPT service (to a PWP) or you could do it yourself. Do the 4 W's. (What, Where, When and with Whom). Then do your 5 Areas (what's the situation, list your thoughts, emotions, physical symptoms and behaviour when it happens). Psycho-educate yourself on the fight/flight response, why we have it, why it's not helpful in a banding situation, then do some exercises. Work on your confidence and self esteem, don't catastrophise or negatively predict, and play in a band because you enjoy it/love it. There's loads of worksheets to work through on self-help.co.uk and or Centre for Clinical Interventions (CCI) - Psychotherapy, Research, Training Try mindfulness (grounding yourself), go to the gym, learn about 'sleep hygiene' and lay off caffeine-based drinks. Don't put yourself in a chair in the audience when you get on stage (you'll start to generate critical, negative thoughts like 'what are they thinking', 'they're gonna think I'm crap, the judge is gonna rip me to shreds and I'll be embarrassed and humiliated by band members, etc. etc.). Your job is to sit in your chair as a player on stage. You're not a member of the audience and what they're thinking is beyond your control. It's not your job to put yourself in another player's chair and imagine what they think of you either. Don't go inwards to your minds eye. Keep an external focus. Concentrate on the notes on your music sheet, not on your internal self. Training yourself through self-management to reduce your adrenalin and telling yourself 'what's the worse that can happen' (look up behavioural activation, worry tree, stress control (preventing grasshopper thinking) and looking up cognitive restructuring (CR) will all help solve your problem. You have the capability, opportunity and motivation to change your behaviour. Good luck. If you really hate your on-stage nerves, you have all the motivation you need to overcome it.

eh ?

 

[pedaller]

Well to put it another way (from webmed):
Simply put, stress and anxiety about performing in front of people causes performance anxiety. Confronting your fears and vulnerabilities, accepting yourself for who you are, and not feeling like you have to prove yourself to others, is the first step toward overcoming performance anxiety. Keep in mind that nobody is perfect, nobody expects you to be perfect, and it is OK to make mistakes.

The second step is learning how to redirect your negative thoughts, beliefs, images, and predictions about performing in public. Doing this is not as difficult as you might think.

• 
  
  • Caffeine and sugar intake the day of the performance.
  • Eat a sensible meal a few hours before you are to perform so that you have energy and don't get hungry. A low-fat meal including complex carbohydrates -- whole-grain pasta, lentil soup, yogurt, or a bean and rice burrito -- is a good choice.
  • Shift the focus off of yourself and your fear to the enjoyment you are providing to the spectators. Close your eyes and imagine the audience laughing and cheering, and you feeling good.
  • Don't focus on what could go wrong. Instead focus on the positive. Visualize your success.
  • Avoid thoughts that produce self-doubt.
  • Practice controlled breathing, meditation, biofeedback, and other strategies to help you relax and redirect your thoughts when they turn negative. It is best to practice some type of relaxation technique every day, regardless of whether you have a performance, so that the skill is there for you when you need it.
  • Take a walk, jump up and down, shake out your muscles, or do whatever feels right to ease your anxious feelings before the performance.
  • Connect with your audience -- smile, make eye contact, and think of them as friends.
  • Act natural and be yourself.
  • Exercise, eat a healthy diet, get adequate sleep, and live a healthy lifestyle.
  • Keep in mind that stage fright is usually worse before the performance and often goes away once you get started.

Overcoming Performance Anxiety: Tricks of the Trade
There are also mental tricks you can play to help you perform with less anxiety. These include:

• Focus on the friendliest faces in the audience.
• Laugh when you can, it can help you relax.
• Make yourself look good. When you look good, you feel good.

These tips should help reduce performance anxiety. But if they don't, talk to a counselor or therapist trained in treating anxiety issues. You may benefit from more intensive therapy, such as cognitive behavioral therapy, to help overcome performance anxiety. In addition, beta-blockers such as propranolol that lower the heart rate and block the effects of adrenaline are sometimes used by people with performance anxiety.

 

[ari01]

and not feeling like you have to prove yourself to others

It's a competition, that's the whole point?!?!?

 

[2nd tenor]

It's a competition, that's the whole point?!?!?

True, it is a competition however a player's best performance (and result for his or her band) might well be delivered by ignoring that fact. In my experience of playing in Concerts (I don't contest) my playing improves when I forget about prooving how well I play to the audience and others and just get on with playing my best and for my pleasure. As the Yanks say: "your mileage may vary".

Pedaller. Thanks for a couple of very informative posts. By the looks of your profile you have been contesting for a few decades so I recon that you've more experience of them than most. Tuba parts aren't always considered challenging - particularly by people who don't understand how difficult it can be to 'drive' a Bass - but should you make a mistake then everyone hears it loud and clear i.e. the pressure is on Bass players just as much as anyone else.

 

[pedaller]

Pressure is inevitable, but I go back to 'what's the worst that can happen?'. The best bands in the UK have virtuosos who split a note. And of course it's a competition, which is one of my main points. Hussain Bolt isn't at the starting block thinking negatively, worrying about the audience, the runners lined up next to him, his heart beating, his head sweating or his legs shaking. He isn't reinforcing his fear, looking for a crutch (metaphorically as a real crutch would mean he's not competing at all), and he's not popping betablockers before the starting gun fires, or thinking about having to win for his team, his PA or his critics. I know he's a lone worker and banders are a team, but getting perspective is something of a challenge we all need to try and tame. The earth corkscrews around the sun and we're flying through space at thousands of miles an hour. If we live 'til we're a hundred, it's a spit in the ocean. We build up difficulties to catastrophic proportions and it's good to work on how we think (well I think so anyway).

 

[pbirch]

My view is this - beta blockers are not consequence free drugs and they do affect the whole nervous system. Team competition is a funny thing, an individual might not want to let the other 28 members of the band down and be tempted to use drugs (prescribed or otherwise). How can a band, in good conscience, allow one or two of its members to put themselves at such risk when there are other proven psychological measures to deal with performance anxiety

 

[pbirch]

Hi all,
I suffer really bad nerves on stage at contests.
I shake uncontrollably and my heart races.
I find it impossible to perform to band room level on stage ( strangely I'm fine in concerts).
I've read on here players combat this with the use of beta blockers.
My questions are
1) will beta blockers help me?
2) when do you take them ( how long before you play)
3) is it ok from a moral standpoint?
4) I read they are prescription only, so do I have to go to my Dr's and explain that I want them for contests? or is there a workaround? I feel it's likely a doctor wouldn't feel it a reasonable request for this reason.
Cheers!

I have given a view above, but to answer your questions -
1 no - this is a psychological issue to be dealt with in your mind
2 don't
3 no - you are putting yourself at an unacceptable risk.
4 yes they are prescription only, yes you have to see your doctor and you are quite correct, a decent GP will not feel it a reasonable or justifiable use of health service resources
your GP may be able to point you in the direction of help for your problem, along the lines suggested by pedaller above, but in a case like this you may well have to pay for it.
But take heart, because when it comes to performance anxiety there are 2 types of people - those who have it and those who lie about it

 

[Accidental]

and to offer an alternate view based on work/study and experience of a number of players who do use beta blockers....

1) will beta blockers help me?
2) when do you take them ( how long before you play)
3) is it ok from a moral standpoint?
4) I read they are prescription only, so do I have to go to my Dr's and explain that I want them for contests? or is there a workaround? I feel it's likely a doctor wouldn't feel it a reasonable request for this reason.

1) Yes - well maybe.
In the simplest terms, beta blockers act by blocking the physical effects of anxiety and your 'fight or flight' responses. I know several players who have used/do use them to help with performance anxiety by 'calming the nerves' and reducing physical symptoms such as raised heart rate/temperature and shaking.
2) Ask your prescribing doctor.
3)I think so, yes.
Morally I don't see it as any different from people who use psychological props or routines or 'need' certain food/drinks before playing
4) Yes, you need them prescribed by your GP - perhaps talk in terms of 'performance anxiety' rather than just contesting though!

Bottom line.... if YOU think they may help, then I think you should be guided by your gut instinct and a medical professional who knows you, not a bunch of strangers on t'interweb. I would go and have a chat with your GP and take it from there

 

[2nd tenor]

and to offer an alternate view based on work/study and experience of a number of players who do use beta blockers ..................

Bottom line.... if YOU think they may help, then I think you should be guided by your gut instinct and a medical professional who knows you, not a bunch of strangers on t'interweb. I would go and have a chat with your GP and take it from there

Well I see your several points and appreciate an alternative view but 'ouch'.

Interesting point about not telling your Doctor that you need medication for Contests but rather for Performance, and it makes me wonder whether such a consultation should be outside the NHS. If I were a SCUBA Diver or a Microlight Pilot then I would have to visit my GP for chargeable medical checks outside of their NHS duties, if I was a HGV driver I would also have to pay my Doctor for work related medical checks. (A quick Google search brought up this site which might be informative: Non NHS Charges ). If those people have to pay for leisure and work consultations then why not Bandsmen (and Bandswomen) who want recreational medication for Contesting?

How well does any GP know any patient? I understand that GP's have about ten minutes per appointment and long waiting times for them, and that patients often don't see the same Doctor for successive appointments. That's not to knock the NHS or GP's (we are fortunate to have both) but rather a statement of the situation as I understand it. Given those limitations of time and familiarity is it really reasonable to expect GP's to take all the responsibility and make a 100% accurate judgement on whether Beta Blockers are OK for your intermittent use? Patients, not their GP's, have the first have responsibility for their health and part of that responsibility is to make sensible judgements about what they do.

 

[Accidental]

Interesting point about not telling your Doctor that you need medication for Contests but rather for Performance
Patients, not their GP's, have the first have responsibility for their health and part of that responsibility is to make sensible judgements about what they do.

Actually I said "not just contesting", because contesting is just one type of performance; they're all important, and (in my experience) they all cause anxiety, the roots and symptoms of which people need to be talking to their GPs about if they're considering medication..... that's all.
Apologies I didn't make it clearer!