Performance anxiety can feel crippling.
Many of us can remember a time—whether before a big performance, a presentation at work, a pivotal meeting, or a pitch to investors—when our hands got clammy and our breathing became shallow as the pressure ignited our fight-or-flight response.
We often feel particularly alone during moments like this.
Performance anxiety is isolating; it separates us from the rest of the world as our hearts beat frantically and our voices tremble.
Worse, we often judge ourselves for these physical symptoms (even when they’re completely involuntary), as we assume that our experience is unique, that we alone struggle under pressure.
The truth, of course, is that nearly everyone suffers from performance anxiety at some point- even the most experienced of performers.
Music superstars like Katy Perry and Shawn Mendes have spoken openly about their struggles with performance anxiety. And Jim Safka, former CEO of Ask.com and Match.com, has described a paralyzing fear of public speaking that plagued his early career.
How do insiders treat performance anxiety?
There are many different tools top performers turn to when it comes to finding a way to overcome performance anxiety.
And insiders like Katy, Shawn, and Jim have all turned to beta-blockers to treat their performance anxiety.
In an interview a few years ago, Katy mentioned she uses beta-blockers to help her manage her pre-show nerves and fear of letting everyone down: “I have to take beta blockers [before each show], I get so nervous.”
Propranolol, a type of beta-blocker commonly prescribed for performance anxiety, works by blocking the effects of adrenaline on the body.
Treating performance anxiety with beta-blockers was first reported in 1976, and their popularity soon exploded among musicians, public speakers, and business professionals. And doctors have been prescribing them to top performers for decades.
Beta-blockers are prescription medication, and performance anxiety is considered “off-label” use. Still, after 40 years of off-label prescriptions for performance anxiety, beta-blockers are considered generally safe for most people and have seen use in high-pressure events across the world.
Grammy nominee and Mozart in the Jungle author Blair Tindall credits beta-blockers with helping her overcome her intense stage fright during important auditions and crucial live performances: “Beta-blockers had such a positive effect on my career”.
So, who uses beta-blockers?
The short answer is: “people in every field.” Just a few examples include:
- A 2015 study at the Royal College of Music in London found that three-quarters of the musicians surveyed had used beta-blockers for performances or auditions. 92% of those musicians had found them effective in reducing performance anxiety.
- Shawn Mendes has used beta-blockers to be “less stressed out and calm down and breathe” when he performs.
- According to a prominent physician, 15% of speakers at an American Cardiology Association Conference used beta-blockers before presenting.
- Both Jim Safka and Richard Nelson, the founder of a Y Combinator company, have spoken openly about the benefits of beta-blockers on their careers.
No one has complete control over their own biology.
Even speakers who have gone to the podium hundreds of times will occasionally feel their hearts pound and their breath come in shallow gasps. Sadly, it’s often when the stakes are highest that these symptoms manifest.
By addressing the physical symptoms of performance anxiety, beta-blockers have helped top performers, from violinists to CEOs, face their audiences feeling prepared, confident, and in control.
Beta-blockers are prescription medication and may not be right for anyone. Consult with one of our licensed doctors today to find out if they are the right option for you.
Reviewed by Dr. Alex Dimitriu
Dr. Alex Dimitriu is a Stanford-trained physician with dual board certification in psychiatry and sleep medicine. The included content is not intended to replace medical advice. Always be sure to discuss any prescription medications with your doctor.