Last year, I started to lie awake at night thinking about the fact that I might die one day. Then I became obsessed with reading about air pollution. This quickly progressed to me breaking down in tears at work on alternate days for tiny, seemingly insignificant reasons, and flying off the handle whenever my boyfriend basically did anything other than give me a hug. Sure, I had a lot on, but don’t we all? Eventually, after a particularly embarrassing breakdown, I went to the doctor and, within three minutes, had some beta blockers.
I’d heard of them already, see, because I sometimes perform comedy on the side and it’s bandied about as a solution for pre-gig nerves. When I did a Radio 4 recording, one of the other acts said she gets serious pre-show nerves ‘but it’s fine after a gin and tonic and a beta blocker.’ A week later, a friend of mine asked how I deal with performing and I joked ‘a gin and tonic and a beta blocker’ because I am deeply unoriginal. He responded with: ‘Oh, my wife is always badgering me for propranolol, she pops them all the time’. He’s a doctor, by the way. And sure, he was pissed, so this was probably an exaggeration, but it meant that when my own doctor asked me if I’d like to try beta blockers, I was more than up for it. They felt like the new ‘thing’.
‘Beta blockers are used for the somatic symptoms of anxiety, such as increased heart rate, tremors, and that kind of thing,’ explains Professor David Taylor, a professor of Psychopharmacology at King’s College. ‘When you have anxiety, you tend to release adrenalin and this increases you heart rate, giving you a fight or flight reaction. Beta blockers react with that.’
Basically, they make you feel like you’re not nervous. Your body doesn’t sweat, shake, and your mouth doesn’t stutter. Your heart rate remains normal. There’s some debate as to whether it also acts as a bit of a placebo but, whatever the reason, it totally sorted me out.
It’s difficult to tell whether they’re being prescribed more because, while stats from the Health and Social Care Information Centre show a steady increase for Propranolol - nearly doubling in the past 10 years – they’re also used to treat cardiovascular issues. When I ask if more 20somethings girls are using beta blockers for anxiety, Professor Taylor is adamant that they’re not. ‘They’re not a first line treatment for anxiety,’ he says. ’Beta blockers are used for anxiety much less than they ever were.'
This is, however, contrary to the droves of responses I got when asking people to talk to me about beta blocker use. ‘I think they are almost more popular than anti depressants in cases of anxiety,’ says Emma, a teacher who took beta blockers earlier this year for a period of time when she was feeling anxious. ‘The school doctor where I work recommends them very highly for a lot of the stressed pupils taking exams, the 17 and 18 year olds. From conversations with him, it seems they are becoming more common among a lot of the girls at the school.’
‘I think more people are using them now,' says Hannah, who has taken beta blockers. 'Plenty of my friends have been open about doctors prescribing Beta Blockers which does lead me to think that they might be over prescribed’. Lauren, a student, has also noticed a rise in beta blockers at her uni: ‘It is pretty common knowledge here that you can go to your GP and get beta blockers pretty easily. I have heard about people getting medicated before job interviews,’ she tells me.
It’s not surprising, considering the fact that beta blockers seem like the ultimate wonder pill if you’re at all anxious – and while they have side effects, let's be honest, Calpol has side effects. People I spoke to tended to not experience any issues with them, and personally I found them way easier than antidepressants – Sertraline rendered me completely high as a kite for seven days, complete with dilated pupils and not being able to feel my arms.
Beta blockers are, however, supposed to treat only localised anxiety – so public speaking, for example – rather than generalised anxiety disorder, but surely it's difficult to tell these two apart? Harriet, for example, went to the doctor due to anxiety specifically at work. 'Everytime I had a meeting with them I found myself getting flustered and nervous and didn't feel like I was able to assert myself,' she says. 'I think the stress and anxiety I felt about work kind of spilled over – I found myself getting really nervous about seeing people (parties, one on one, the whole lot) and getting mild panic attacks. So beta blockers stop all that.'
Doesn't this sound like generalised anxiety disorder? Professor Taylor's answer is simple, and a bit curt: 'There’s a test to determine a generalised anxiety diagnosis, so there is no misdiagnosis. Beta blockers are just for localised anxiety.' Well, maybe that's the recommended practise – but Harriet wasn't given a test. 'I just got them straight away' she says.
Hannah also wasn't tested for generalised anxiety disorder before being prescribed propranolol. ’I didn’t have to take a test. They took my blood pressure and asked about my contraceptive pill but that was it,’ she says. ‘I think that I would have benefited more from counselling or CBT rather than handed a pill, but sadly resources in my area were tight and talking to a counsellor would have involved travelling to another town.’
Out of the 15 women I spoke to who had been prescribed beta blockers, only half of them had taken the aforementioned test, so how can we say with 100% conviction that they are being prescribed correctly? And, if it's easy to get them, this breeds another concern: that it's quite difficult to stop wanting them. While propranolol isn’t a physically addictive substance, it’s certainly psychologically addictive; the Guardian reported on its widespread usage in the classical music industry, and the few comedians I've heard talking about beta blockers before gigs can't be the only ones. Plus, it's handy if you get a bit nervous at parties – and who'd want to go back to being a gibbering wreck if you'd found a way to feel a bit invincible?
‘I could definitely see myself just getting into the habit of taking them,’ says Harriet, from Scotland, who started taking one a day for anxiety she felt in work and social situations. ‘I don't take them as often just now as I quit my terrible job and don't feel the need to – but there will be days where I get a wee bit nervous and think "oh god I wish I could take one right now". I don't think they're addictive as such, but I think you can get used to their effects and it can almost become a bit of a crutch.’
Lauren agrees, saying: ‘I think it would be easy to fall into a habit of relying on them. I had a job interview recently and I think if there was something that would have taken the edge off my nerves I would have considered it, although I do feel a little guilty saying that.’ And this is coming from someone who experienced side effects (‘they were making me slower’) to the extent that she asked to be taken off them.
In terms of myself (yes, guys, let’s bring it back to me please), I’m performing in a high-pressure show again and while I tried to resist the temptation to go to the doctor, I’d started bursting into terrified tears a few too many times (and in front of too many people) to ignore the mounting anxiety. And when I went back, I barely had to tell him what was going on for him to have prescribed me a month’s worth.
I carried them around for a few days and then, eventually, chucked them away because I, ironically, felt anxious about taking them. I started a course of CBT instead.
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Photograph: Molly Cranna
This article originally appeared on The Debrief.