Beta Blockers for Anxiety: The Ultimate Guide

Many performers (from musicians, to public speakers, to athletes) use beta blockers off-script to help with their stage fright & performance anxiety symptoms. In this article we look at what performance anxiety is and what causes it, how beta blockers actually work to help with anxiety symptoms, what the positives & negatives of beta-blockers are and finally, we investigate alternatives to beta blockers for those trying to overcome performance anxiety without any negative side effects.

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If you’ve been experiencing the “butterflies” every time you’re about to get on stage to perform in front of an audience, you might be considering beta-blockers to fight your performance anxiety (the official name for the “butterflies”).

Maybe you’re a musician, a public speaker, or a stand-up comedian, and your hands start sweating, your heart starts racing, and your voice gets shaky as the time approaches for you to take the stage.

And performance anxiety doesn’t only affect musicians and speakers. It can have an impact on anyone who has to perform at a high level under pressure.

So, whether you’re a ballplayer going for the 3-pointer to win the game, an actor auditioning for a role, or a student taking a critical exam, you’d benefit from avoiding the jitters, and remaining as calm and focused as possible.

Beta-blockers for performance anxiety

You may have heard about how some of your colleagues, who also used to experience similar pre-performance jitters, have benefited from using beta-blockers.

Beta-blockers are a type of pharmaceutical that doctors typically prescribe for cardiovascular conditions. But because of the way they work within the body, many performers use them to block the symptoms of performance anxiety (as we’ll discuss below).

Beta-blockers are especially popular among musicians. A 1987 survey by the International Conference of Symphony Orchestra Musicians, representing some of the largest orchestras in the U.S., found that 27 percent of their musicians were using beta-blockers for performance anxiety [1]. Experts estimate that number is much higher today.

And there are countless anecdotal stories all over the internet about speakers, actors, salespeople, and even people in social situations like date and parties, who use beta-blockers to shake off anxiety.

But do beta-blockers really help against performance anxiety in the long run? And are there any potential downsides to them?

Here, we’ll look at both performance anxiety and beta-blockers.

We’ll discuss what performance anxiety is, what causes it, and why performers take beta-blockers.

We’ll also discuss some of the potential downsides and risks to using beta-blockers, and look at some natural alternatives that promote calmness and focus for optimal performance.

What is performance anxiety?

Performance anxiety, also known as stage fright, is a set of symptoms some people experience when they have to perform at a high level in front of an audience, or under pressure [2].

As discussed earlier, it is prevalent among musicians, public speakers, stand-up comedians, and others who regularly get up on stage in front of audiences. But it is also common amongst athletes, students, and regular people in social situations.

Performance anxiety is a complex issue. It can be a combination of physical, mental, and emotional responses to a stressful situation, like performing under pressure. It is often experienced by people that suffer from a social anxiety disorder (SAD) [3].

People with a social anxiety disorder might have a fear of rejection or of being judged negatively by an audience, or by others at a social situation like a party. Unfortunately, it can cause some people to avoid situations that they find stressful, like pursuing a career as a performer.

What are the symptoms of performance anxiety?

Performance anxiety affects each individual differently. For some, it’s an annoying case of the jitters that they learn to push through. For others, it severe and debilitating to the point where it becomes impossible to perform.

But here are some of the most common symptoms that people with performance anxiety tend to experience [2]:

  • Racing heartbeat
  • Drynessin the mouth
  • Excessive sweating
  • Cold hands
  • Trembling voice, hands, knees

In severe cases, once might also experience the following:

  • Blurred vision
  • Nausea
  • Queasiness in the stomach

What causes performance anxiety?

Having to perform under pressure is a stressful situation for most people. Your natural stress response might cause you to experience a higher heart rate and slightly increased sweating. That little bit of anxiety can even be a good thing. It’s almost like a heightened state of awareness that can elevate the intensity of your performance.

But if you have performance anxiety, your stress response is more severe, and your body responds as if it were in real danger.

The adrenaline spike triggers your fight-or-flight mechanism [4], which results in anxiety symptoms like palpitations and trembling hands.

Who is at a higher risk of a social anxiety disorder (SAD)?

When it comes to social anxiety and performance anxiety, there can be various factors at play. It’s a complex issue that may combine both environmental and biological aspects.

Anxiety issues often run in the family, but it isn’t clear whether that is due to genetics or because of learned behavior from parents. Evidence also suggests that being bullied as a child, or having overprotective parents, can make someone more susceptible to social anxiety as an adult [5].

But one of the factors that can contribute to anxiety in a social or performance situation is an imbalance in your brain chemicals.

Neurotransmitter GABA and social anxiety

Neurotransmitters are like your body’s own chemical messengers. They carry messages between different parts of your nervous system. If there’s an imbalance in your neurotransmitter levels, then various functions, both mental and physical, can be affected.

You may have heard about serotonin and dopamine, both of which are neurotransmitters, and how they affect your mood. But there is another one called GABA, which plays a vital role when it comes to anxiety, calmness, and mental focus.

Gamma-aminobutyric acid (GABA) is a neurotransmitter that limits and reduces nervous activity in the brain [6].

According to an article published in the Journal of Neuropsychiatric Disease and Treatment [7], when GABA levels are out of balance in your body, you might be more susceptible to more severe symptoms of depression, PTSD, and also social anxiety disorders (SAD).

On the other hand, optimal GABA levels promote calmness in stressful situations, like during a performance.

What do beta-blockers have to do with performance anxiety?

Beta-blockers are typically prescribed by doctors for conditions such as high blood pressure, chest pains, irregular heartbeat, and in some cases, even migraines.

So, it begs the question of why do so many performers use beta-blockers to fight performance anxiety and to help them get through a gig.

To understand why beta-blockers may help someone get through a performance, a client meeting, or a date, we need to take a look at how beta-blockers work within the body.

How do beta-blockers work?

Beta-blockers relax the load on your cardiovascular system by blocking the effects of the adrenaline hormone.

Adrenaline is a stress-related hormone. It binds itself to adrenergic receptors in the heart, also known as beta receptors [8]. As a result, the heart has to pump blood with greater force, which causes your blood pressure and heart rate to go up.

Beta-blockers are also known as beta-adrenergic blocking agents. They block the effects of adrenaline and prevent it from binding to the beta receptors in the heart. Consequently, the heart can return to its regular workload, and your blood pressure can remain steady.

This is why beta-blockers are prescribed for people with high blood pressure and hypertension.

Why do performers take beta-blockers?

Performers take beta-blockers because it is too much adrenaline that is responsible for their anxiety symptoms.

When you’re about to go on stage, or you’re about to walk in for an interview or an audition, it is to be expected that you’ll feel some level of stress. Naturally, you’ll feel somewhat of an adrenaline rush as a part of that stress response.

For most people, it’s not a big deal, and as we explained before, they might even use it to their advantage to up the intensity of their performance.

But if you experience performance anxiety, the stress response goes too far. You experience a much greater effect of the adrenaline hormone, which causes your heart rate to skyrocket, along with other symptoms of stage fright.

Since beta-blockers block the effects of adrenaline, it also prevents you from experiencing the physical symptoms of performance anxiety. Remaining physically calm has an overall calming effect, which then allows you to get through your engagement.

And this is why a lot of performers use beta-blockers. But is it really helping them in their fight against performance anxiety in the long run?

Are there downsides or risks to using beta-blockers for performance anxiety?

There a few different types of beta-blockers available in the market that are popular with performers.

There’s Propranolol, which is the most popular, and it is typically used for short-term relief from the physical symptoms of social anxiety.

Then there’s Atenolol, whos effects are longer lasting than Propranolol, but it carries some added risks, as we’ll discuss below.

And finally, there’s Metoprolol, which is also popular, but it may have more side effects than the others.

Beta-blocker side effects

Beta-blockers are generally considered to be safe for performers. Especially if you only take them occasionally. But they do come with potential side effects, although not too common among performers who only use beta-blockers every now and then.

Here are some of the potential side effects of beta-blockers [9]:

  • Fatigue
  • Mood disorders
  • Digestive issues like gas, bloating, and constipation
  • Nausea, and in some cases, vomiting
  • Heartburn
  • Dry mouth

In some rare, but severe cases, one might also experience the following side effects:

  • Wheezing and/or shortness of breath
  • Swelling of extremities like hands, feet, or ankles
  • Fainting
  • Pounding heartbeat

If you experience any of the side effects mentioned above, you should immediately notify your doctor.

Potential dependency on beta-blockers in the long run

With prolonged usage, there’s a risk that you may become dependent on beta-blockers. In such cases, suddenly stopping beta-blockers could cause your blood pressure to spike to dangerous levels.

If you’ve been using beta-blockers for a long time, and you’re considering stopping them, be sure to speak to your doctor if you want to stop the medication and pursue alternative treatments.

If you only take beta-blockers for the occasional performance, speech, or exam, then dependency will most likely not be an issue for you.

But if you suffer from performance anxiety, and you start performing more frequently, you might also find that you’re taking beta-blockers more regularly. And in that case, the risk of dependency is something that you should keep in mind.

Beta-blockers may require a prescription

Some beta-blockers require a prescription from your doctor if you’re in the United States. So, it’s an added inconvenience of having to run to your doctor every time you run out.

Beta-blockers can only act as a temporary solution

Although beta-blockers can be useful in blocking the anxiety symptoms at the moment, none of them can help you overcome stage fright in the long run.

As we discussed above, performance anxiety is caused by different factors in one’s biology and/or environment. There are also the emotional and mental aspects of it.

Beta-blockers can’t address any of those root causes of performance anxiety. They can only prevent symptoms.

That’s not to say that beta-blockers don’t help performers. If stopping the symptoms allows you to pursue your passion as a performer or a speaker, then that’s a significant benefit.

But you should be aware that beta-blockers are only a temporary solution, and to really combat performance anxiety, you should consider more long term solutions like cognitive behavior therapy (CBT), meditation, and optimizing brain performance with proper nutrition.

Are there natural alternatives to beta-blockers?

When it comes to natural alternatives for beta-blockers, you’re looking for something that will have a similar end result. So, you want natural substances that allow you to remain calm in an otherwise stressful situation, like during a performance or an exam.

Instead of a pharmaceutical that blocks your body’s natural reaction (like beta-blockers), you’re looking for natural ingredients that support your brain to make it more resilient in stressful situations, so that you can remain calm and focused during your performance.

With that in mind, let’s look at some of the ingredients that you should look for in a natural alternative to beta-blockers.

What should I look for in a natural beta-blocker?

As we explained before, Gamma-aminobutyric acid (GABA) is a neurotransmitter that plays a vital role in promoting calmness and preventing anxiety [7].

So, boosting GABA is one of the best natural ways to prevent social anxiety, whether that’s at the dinner party or during a public speaking engagement.

Here are some natural ingredients that promote optimal levels of GABA in your brain.

GABA
The first thing to look for when trying to boost GABA levels is, well….GABA.

Supplementation has been shown to be an effective way to optimize GABA levels in your brain.

Beyond promoting calmness by reducing the activity of levels of neurons in your nervous system, GABA also increases alpha brain wave levels [10].

Alpha waves are a brain frequency associated with a state of wakeful alertness and creativity. This is often referred to as the “flow” state where performing at a high level feels natural and effortless.

L-theanine
L-theanine is an amino acid found primarily in green, black, and oolong teas. Regular consumption of L-theanine can support you in your fight against social anxiety[11], by reducing the levels of brain chemicals that contribute to stress and anxiety [12].

Just like GABA, L-theanine triggers the release of alpha waves to enhance relaxation, focus, and creativity [13].

L-theanine also boosts GABA levels in your brain, which further contributes to its effects against performance anxiety.

Magnesium
Magnesium is an incredibly important mineral that is responsible for hundreds of biochemical functions within your body, like energy creation, protein formation, muscle movements, and more.

But when it comes to performance anxiety, magnesium can help in a couple of different ways.

For one, it helps with the absorption of GABA in your body [14]. GABA and L-theanine elevate GABA levels in your body, and then magnesium facilitates better absorption of GABA by stimulating receptors in your body to absorb GABA better.

As a result, you feel a more potent effect of GABA, which means a greater sense of calmness and mental focus as you get through your performance.

Also, when combined with vitamin B6, magnesium has also been shown to improve the brain’s ability to focus on the task at hand, instead of getting distracted by negative, anxious thoughts.

Vitamin B6
Vitamin B6 combines with magnesium to improve focus and attention. One study showed that magnesium, when combined with vitamin B6, improved behavioral disorder in children with ADHD syndrome (attention deficit hyperactivity disorder) [15].

Although the study was focused on kids with ADHD, the findings suggest that the combination of magnesium and B6 would benefit those with performance anxiety. When you’re focused on the task at hand (performing, writing, playing a sport), your attention will shift away from the negative thought patterns responsible for your anxiety.

Additionally, vitamin B6 helps naturally synthesize GABA within your body [16], and low levels of B6 has been linked with increased stress levels.

PerformZen Calm Performance Formula

PerformZen is a supplement designed to help you remain calm and focused during a performance.

It combines GABA, L-theanine, magnesium, and vitamin B6, so they work synergistically to support your brain. They promote calmness (GABA, L-theanine, magnesium), as well as a state of energized focus (magnesium, vitamin B6).

Together, they will help you achieve that state of “flow” where you can perform at your highest level.

But that’s not all. PerformZen also contains two additional powerful ingredients to fight off stage fright.

Theacrine and Ginkgo Biloba.

Theacrine
Theacrine is a naturally occurring substance found in a Chinese tea known as Kucha.

It has a similar energy-boosting effect as coffee but without the jitters or the ups and downs [17]. It also promotes mental clarity, which, along with the energy boost, could be beneficial before and during a performance.

Ginkgo Biloba
Ginkgo Biloba has been traditionally used for healing purposes in Chinese medicine. It is an herb rich in antioxidants that has various benefits for brain health.

Evidence shows that Ginkgo Biloba can help you manage your stress hormone levels, which keeps your fight-or-flight response under control and prevents the symptoms of performance anxiety [18].

All combined, PerformZen is a potent formula when it comes to fighting performance anxiety. As a natural supplement, it promotes calmness, focus, and optimal cognitive performance.

Perform Better Under Pressure. Every Time.

Performance Anxiety is common before a big event or performance. For some of us, the stakes are extremely high and we have to perform at our absolute best! PerformZen was created for you; the high level performer who wants to stay focused & creative while delivering the best performance of your life, without the crippling anxiety & nerves. 100% natural and with none of the side-effects of beta blockers. Try PerformZen today:

Final thoughts on Beta Blockers for performance anxiety

Performance anxiety is no joke. If it’s more than a minor case of the jitters, it can have a significant impact on your life.

It can hold you back from pursuing your passion as a musician, actor, or a comedian. It can impact your career as an athlete if you repeatedly let anxiety get the better of you during “clutch” moments. And if you’re always feeling anxious at parties, that could be detrimental to your social life.

But the good news is that you don’t have to let social anxiety control your life.

If you’ve been considering beta-blockers, you should know that although it can provide temporary relief, it is not a long term solution. Not to mention, there could be side effects, and you may need a prescription.

Natural supplements like PerformZen promote calmness and better mental function with ingredients that support your brain so it becomes more resilient to handle stressful situations.

Check out PerformZen Calm Performance Formula today


Agnit is a performance expert and the lead writer for PerformZen. As an avid health and fitness enthusiast, he is passionate about helping people take control of their health to live happier, more productive lives. Someday, he plans to listen to his own advice and drink less coffee.

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