What Are The Best Beta Blockers For Social & Performance Anxiety?

Tablets and pills with the title "What Are The Best Beta Blockers For Social & Performance Anxiety?"

Performance anxiety or ‘stage fright’ has been a recognized social phobia for a number of years. It affects millions of people under different circumstances with everything from music to athletics.

If you’re one of those affected, don’t worry, all is not lost. Performance anxiety can be treated with beta-adrenergic blocking agents also known as beta blockers. But what are the best beta blockers for social and performance anxiety? Read on to find out.

What is Performance Anxiety?

Performance anxiety or ‘stage fright’ is a phenomenon which has been acknowledged for many years as a form of social phobia. Symptoms happen either immediately prior to, or during a public performance. It is often commonly associated with public speaking and is caused by stress to the sympathetic nervous system.

Symptoms of performance anxiety include:

  • Nausea
  • Tremors
  • Palpitations
  • Sweating

The criteria of performance anxiety is defined as:

“a persistent fear of situations in which the person is exposed to scrutiny by others, and fears that he/she may act in a humiliating or embarrassing manner; exposure to the stimulus provokes a n anxiety response; the phobic situation is avoided or endured with great anxiety; and the avoidant behavior interferes with occupational functioning.” (source)

Performance anxiety is classed as a ‘discrete’ social phobia, meaning it is only present during performance situations. Unlike ‘generalized’ social phobia, which affects around one in 25 adults and can present itself in any form of social situation.

However, if not successfully controlled, a discrete social phobia like performance anxiety can turn into a generalized social phobia. This is a downward spiral as that initial experience of anxiety can in turn, make you more anxious about other similar situations.

Extreme social anxiety can also become so intense it then leads to panic or anxiety attacks. These attacks are caused by a surplus of adrenaline to the body when the brain feels like it’s under threat. For many people, panic attacks resemble symptoms of a heart attack and although not particularly dangerous, they can be terrifying.

In the past decade, the amount of sufferers of social anxieties like performance anxiety have risen significantly due to constant pressure and scrutiny of social media.

Performance anxiety as well as generalized social anxiety can be controlled with what is classed as a psychiatric stress management program and with the use of beta-adrenergic blocking agents or beta blockers.

Theater curtain with dramatic lighting and lens flare

What Are Beta-adrenergic Blocking Agents (Beta Blockers)?

Beta blockers, which include Inderal (propranolol), Toprol (metoprolol) and Tenormin (atenolol) among others, have been used in general medicine since the late 1960s.

These drugs block beta receptors in the heart, thus, cardiac output, blood pressure and heart rate are reduced. This led to beta-blocker use in the treatment of a number of cardiovascular problems such as hypertension, angina and cardiac arrhythmias.

More recently, beta blockers have been used in psychiatry in order to treat anxiety specific disorders. They work as a treatment for anxiety because they can block the effects of the stress hormones adrenalin and noradrenaline. These hormones are what cause the physical symptoms of anxiety. These medications may be taken as needed approximately one to two hours prior to a stressful event.

Although beta blockers can be helpful in reducing the physical symptoms of performance anxiety, it is important to note that they are typically ineffective when it comes to reducing internal symptoms of anxiety caused by the fight-or-flight response.

Are There Any Precautions When Using Beta Blockers?

In most cases, the use of beta blockers is considered safe. In healthy people who have no form of pre-existing illness, they come with only mild side effects (occasionally) and are not habit-forming.

Mild, short term side effects may include:

  • Weakness
  • Tiredness
  • Short term memory loss
  • Numbness in extremities
  • DiarrheaInsomnia
  • Bradycardia (slowed heart rate)

Beta blockers are not advised for use by those who have any form or respiratory disease such as asthma or emphysema, as well as those with diabetes or any form of heart disease.


Dosage Recommendations

The following recommended doses are considered the most effective according to research. (source)

Tenormin (Atenolol)

One 50 mg tablet a day for the first week. If there is no response, increase to two 50 mg tablets, taken together or divided. After two weeks of 100 mg the patient should notice a marked decrease in the racing heart, trembling, blushing, and/or sweating in social situations.

Inderal (Propranolol)

You can take a 20 to 40 mg dose of propranolol as needed about one hour before a stressful situation. If necessary, you can also combine it with imipramine or alprazolam without adverse effects.

What Are The Best Beta Blockers For Social And Performance Anxiety?

If you are experiencing strong symptoms of generalized social anxiety, it may be worth visiting your doctor as beta blockers are only available as prescription medications.

Moreover, it is definitely worth discussing with a professional as they may be able to work with you in order to find the route cause of your anxiety.

As mentioned, beta blockers only help reduce physical symptoms of anxiety, however, these will not lessen the physical feelings of worry leading up to an event. Also, they should only be considered as a short term solution.

Establishing the route cause of your anxiety and working towards resolving the issue is a far better way to treat your anxiety entirely and prevent long term problems.

Anxiety written on a surface next to some tablets.

Natural Remedies To Beat Performance Anxiety

If you are experiencing mild performance anxiety and don’t want to move straight onto a prescription medicine, there are a number of natural and herbal solutions to beat anxiety.

You may find that actually, natural remedies may work better for you than beta blockers due to the fact that most herbal alternatives promote a feeling of calm and relaxation. Reducing the feeling of anxiety and worry will, in turn, reduce the physical symptoms. Unlike beta blockers which may physically prevent you showing any signs of anxiety, but still leave you with a feeling of dread.

Calming Techniques

In some cases performance anxiety can be controlled through calming techniques – we have all heard of picturing the audience naked!

For some people, using correct breathing or shifting focus can be enough to give them enough relaxation to be able to power through their anxiety.

Essential Oils

Essential oils have been around for thousands of years and have been used by many cultures including Chinese and Egyptian for medicinal purposes. One of the most effective uses is in the treatment of anxiety.

The best part about essential oils is that they are sourced from nature. Oils are extracted from the leaves, roots, bark, and flowers of different plants.

In clinical trials, a number of essential oils have been shown to lift mood and are effective at treating anxiety. (source) The smell of the oil is carried directly to the brain which acts as an emotional trigger and stimulates the sensory system creating a direct emotional response.

Moreover, as essential oils can simply be diffused into the air to promote relaxation, you turn the diffuser on and don’t have to think any more about it. Taking a pill every day can be a bother, especially if you are already taking a plethora of multivitamins and supplements like I am!

There are many essential oils out there, but the best essential oils for reducing the symptoms of anxiety and promoting a more calm feeling include:

Various Bottles of essential oils and essences

Herbal Tea

Of course, another popular natural remedy to promote a feeling of calm and reduce worries is to drink herbal tea.

Herbal teas are similar to essential oils in the fact they also come from natural, botanical sources. A sweet cup of herbal tea can literally allow you to drink your way to relaxation.

The best herbal teas for reducing feelings of anxiety include:

Herbal tea

Herbal Anxiety Supplements

There are many herbal supplements available which are designed to work in a similar way to beta blockers. Taking a herbal anxiety supplement before a stressful event can help reduce your symptoms of anxiety.

Herbal anxiety supplements contain a mixture of vitamins, plants and herbs known to promote relaxation.

Many well known supplement brands are offering natural beta blocker alternatives such as Calm Now by Zhou Nutrition. With a blend of hawthorn berry, passion flower and lemon balm, this supplement is designed to ease social stress and help you remain calm and focused and is one of the best of its kind currently on the market.

Many can be purchased easily at your local health food store or online.

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