Musicians' Health Collective

Musicians' Health Collective: Supporting the health of musicians (and normal people)

Filtering by Tag: fight or flight

What does a Beta-Blocker Do?

So in the last few weeks, I've been busy (and stressed, too!), but I've been thinking about stage fright, sympathetic response of the nervous system, and why things happen to us when we're nervous.  Most musicians will at some point run into beta blockers as an antidote to stage fright- whether a colleague uses them or even a teacher, by adulthood, we have encountered someone who uses them for something not related to its initial prescriptive purpose.  (Musicians are certainly not the only folks who use these-actors, presenters, etc., have been known to use them as well).

Whether or not you take them, it's useful to know what the heck is going on if one does take them. 

First of all, a beta blocker is typically prescribed for folks with heart issues, arrythmia, and who need to lower their standing heart rate.  It tackles the beta-receptors of the smooth muscles of the heart, kidneys, and sympathetic nervous system to prevent norepinephrine and epinephrine (adrenaline) from attaching to beta receptors, which ultimately encourages blood flow (as opposed to restricting vessels) and reduces overall heart rate.  If that language didn't make things clear, let me simplify.  Beta Blockers reduce overall heart rate and prevent adrenaline from playing its role in sympathetic response, AKA fight or flight.  That means it reduces the physiological symptoms of sympathetic system, which affects breathing, fine muscle control, tremors, etc. 

While this may sound like a wonder-drug, there are a few things to consider. 

This is one of the most common BB's: propranolol.

This is one of the most common BB's: propranolol.

-There are side affects, like all mysterious chemical concoctions, and they're fairly standard: nausea, vomiting, headaches, as well as more complex effects if one already has heart problems.  (And of course, there's a warning about sexual dysfunction, so don't forget about that.)

-Beta blockers are banned in the Olympics, but not in auditions.  What would it be like if they were banned in auditions?  It's a question I've pondered, because I think performance under pressure differs so widely person to person.  It would even the playing field, whether that's a good thing or bad thing.

-Beta Blockers only target the symptoms of panic, but don't address any of the psychological/somatic issues.  If your anxiety is based in a constant fear of being good enough, or prepared, or talented, then BB's will only help so much. 

-Some people (audition committees/teachers/etc.) feel that BB's limit expressivity, spontaneity, and in the moment performing creativity, which is something to consider.  If you regularly take them for performances and auditions, it might be worth wondering if you always need them. 

-The sympathetic response does have some benefits when you are in a stressful situation.  Your response time is quickened, your brain is particularly focused, heart rate/blood sugars increase to fuel the body, and muscles tense up to provide speed and power.  The whole point of sympathetic response is to support the body under dangerous conditions, so the changes that occur are meant to support.  I realize that performance is not life or death, but it is an interesting physiological response to notice.

I leave the decisions with you, but notice if beta blockers become a crutch.  Do you need them for every performance opportunity?  Do you find yourself using them for rehearsals as opposed to concerts or auditions?  (And if you're not a BB user, that's great too.)

Read more:

Musicians use Beta Blockers as Performance Enabling Drugs

3 Reasons Why Beta Blockers Could Be Holding You Back

Addiction in the Orchestra

Better Playing Through Chemistry

Stage Fright, Your Sneaky Hypothalamus...And Breathing

As part of my previous post, I talked a little about the nervous system, and how our body creates this "fight or flight" response in reaction to external stresses.  The next question then, is how to keep homeostasis between our stress response and our relaxed cellular repair parasympathetic system?  Last time, I talked a bit about conscious breathing, but let's go back to stage fright first.  I love this Ted Ed video about stage fright, because it tells us things we already know (from performing) but goes in a bit more detail about the hypothalamus, which is a regulator in your autonomic nervous system and a player in "fight or flight."

We've all seen the posters and images that say "just breathe" and whatnot, but there is a touch of truth to that.  Connecting to the quality of your breath is a great way to get control of your autonomic nervous system, which ultimately works independently. 

We've all seen the posters and images that say "just breathe" and whatnot, but there is a touch of truth to that.  Connecting to the quality of your breath is a great way to get control of your autonomic nervous system, which ultimately works independently. 

So this video pointed out some obvious things: preparation is essential, everyone's experience is unique, and your mental state affects your reaction.  Notice how the video ended?  By focusing on the breath.

Bringing mindfulness (of the breath and body) into the music space is an amazing way to start to

a) Become more aware of your breath quality/duration/depth

b) Become more aware of when your body freaks out

c) Start to gain a bit more control of the stress response.

While yoga and meditation practices can be a great way of gaining this experience, the simplest thing to do though is to start noticing how you breathe (short, shallow breaths?  Deep diaphragmatic breaths?  Belly Breaths?)  in day to day life.  Many traditions (Buddhist and non-sectarian) use the breath as a beginning point of awareness, and as a musician who is often under stress daily, this can be helpful. 

If you're in an orchestra and you're a soloist (wind player, section leader, conductor), take the few seconds before rehearsal or during tuning to check into your breath and your contact with the chair.  See if you can settle your energy downwards into your ischial tuberosities (sit bones)  while feeling into your ribs and belly as you inhale.   If you're preparing to speak (either to a class or committee) and you're nervous, do the same thing: begin with your quality of breath as a way of focusing your scattered mind and feel your feet rooted into the earth solidly.  Shallow breath means that less oxygen is in your body, and therefore less oxygen to your brain (and a less focused brain too!).  Another thing- to upregulate and energize, we lengthen our inhalation, if we want to calm the body, we lengthen the exhalation.  Want to learn more about breathing works?  This is also a great Ted Ed video to get started with!  In the upcoming weeks, we'll learn a bit more about meditation and how that practice can help musicians.

Nervous System 101

Most of us musicians understand "fight or flight," or at least we've felt it, but we often lack the understanding of what the rest of the nervous system is doing.  Our nervous system consists of the Central Nervous System (brain and spinal cord) and the Peripheral Nervous Stem (cranial and spinal nerves), which basically work in a feedback loop of information with the motor and sensory aspects. 


Within the peripheral nervous system are the somatic, enteric, and autonomic systems.  Somatic can be conscious or unconscious, and results in movement of skeletal muscles as a response to sensory input.  Simply put, the somatic system moves your body.  The enteric system consists of the 100 million neurons of your GI system, and the various actions needed for homeostasis. 

The autonomic system is unconscious and regulates internal organs.  Within the autonomic system are two more divisions: the sympathetic and the parasympathetic systems (now we're in more familiar ground!).  The sympathetic system is what's responsible for our "fight or flight" response, which causes our breath to shorten, eyes to dilate, heart rate to increase, and a few other things.  Most of us know this well from performing and public speaking!  Our parasympathetic system is the compliment, in charge of day to day functions of organs, cellular repair, etc.   


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