In an exploration into the effects of mental health on musicians, clarinettist and Words About Music participant, Helena Maher, along with horn tutor Francesco Lo Surdo, aim to shed some light on the steps involved with identifying and treating performance anxiety.
Please note that neither Francesco nor Helena are trained in psychology. If you are at all concerned about your mental health, please speak to a medical professional.
As musicians, we often feel nervous before a performance. What is the difference between being nervous and suffering from anxiety? Francesco Lo Surdo, horn tutor at National Music Camp 2020, has suffered from performance anxiety, and wants young musicians to be more aware of the symptoms, effects and the ways to combat anxiety.
When nervous, we experience what is determined to be a sensible reaction to a scary situation. If we have anxiety, the situation isn’t always scary and the reactions are not always deemed sensible. These reactions are physical, and can have a negative impact on our personal, professional and academic lives.
“Anxiety is the most common mental health condition in Australia. On average, one in four people – one in three women and one in ﬁve men – will experience anxiety at some stage in their life. In a 12-month period, over two million Australians experience anxiety.”
Anxiety can sometimes be linked with other mental health disorders. However, as with Francesco’s experience, someone can suffer solely from anxiety. His first experience with anxiety was sudden. He was on tour with the Australian Chamber Orchestra. While standing on stage one day, he experienced what he can only presume to be his first panic attack. The sensation was vivid; he didn’t feel as if he was on the stage. There was a pressure in his head, and he felt as if he was going to pass out.
He sought help and a better understanding on what was going on, only to be faced with other health-related explanations and a range of misdiagnoses. It wasn’t until years later that Francesco finally saw a psychologist, who diagnosed him with anxiety.
Francesco’s anxiety is not directly linked with playing horn itself, but rather seems to be caused by the location in which he is performing. He never experienced anxiety while playing in the orchestra pit for operas. This first experience was when he was standing on a stage where he could see the audience.
Work stress is one of the largest causes of anxiety in the music industry. A recent study shows that over 80% of people who work in the music industry suffer from anxiety, depression or both. This has been determined to be caused by the long work days and the pressure placed on performers. Often, musicians will feel an intense lack of support, or the lack of stable income. 
Physical symptoms of anxiety can include: 
- A racing heart
- Faster breathing
- Feeling tense or having aches (especially neck, shoulders and back)
- Sweating or feeling dizzy
- ‘Butterflies’ or feeling sick in the stomach
- Constant worrying about things outside of your control
- Having trouble concentrating and paying attention
- Concerns that seem out of proportion
Many musicians who suffer anxiety do so because of the ‘perfectionist’ culture that surrounds classical music; every note must be without fault, each phrase must be played beautifully. There is no room for mistakes.
One common thought from people who suffer from mental health issues is “I haven’t been through a hard life, so I shouldn’t be suffering from [depression, anxiety, etc.]”. Mental health problems can appear in our lives at any point for any reason.
If you are finding that you are experiencing symptoms of poor mental health, it is always worth talking to someone about it.
Another symptom that Francesco has experienced is dissociation: a mental process of disconnecting from one’s thoughts, feelings, memories or sense of identity.
Dissociation can stem from a traumatic experience, where the brain disconnects from reality. The person suffering from it may feel as if they are in a world that is not real, or even that they, themselves, are not real.
As Francesco’s anxiety stemmed from standing on the stage, his dissociative episodes caused him to almost be transported away from those moments during a performance. If someone is in a situation that reminds them of a particular traumatic event, the person may disconnect from reality as a coping mechanism.
COPING WITH ANXIETY
It is common for those suffering from mental health problems to be hesitant to seek help. Often, what stops us from looking for help is fear: fear of being judged, fear of what the truth may be, or fear of the unknown. Remember that this is normal, but just as you would seek a health professional’s opinion on your physical health or something external, it is always beneficial to speak to someone about any concerns you have with your mental health.
The first step is to go to your local G.P. to get their opinion. If you want to do a personal self-test, checklist as a resource for a rough guide. It is worth noting that it does not give you a diagnosis, but rather gives you an indicator as to whether seeing a professional would be useful.
Seek personal support
It can be difficult to seek support from our work colleagues, professors or peers. It is common to feel isolated or alone in our struggles with mental health. Remember that more people will understand the way you are feeling than you think. Francesco found personal support through a member of his orchestra.
For some people, talking to family members is found to be the most comfortable option. Others will talk to their friends, or even their professors. Talk to someone you feel comfortable with; it is an imperative part of recovery to have support in your personal life. If you feel that you have nobody to talk to, then you can talk through this with your G.P., counsellor, psychologist, or psychiatrist. It is a natural feeling, but remember that you are not alone. You can also call one of the hotlines at the end of this article, or enter an online chat with a counsellor from Beyond Blue, which is also linked below.
TREATMENT METHODS EXPLAINED
Cognitive Behaviour Therapy
This type of treatment, also known as C.B.T., is used to help patients to identify the roots of their mental health issues. Through these sessions, patients will slowly begin to learn and apply different ways to combat these thoughts. C.B.T. can take a number of sessions to be fully effective, but it has been proven to be successful in combating issues such as anxiety and depression.
After consultation, a medical professional may decide that medication would prove useful in order to jump-start a patient’s recovery. There are a number of options, and a psychiatrist will help individuals to find one that proves effective for them.
Mental health can be a sensitive topic. Taking the above steps to begin the healing process can be confronting, but they will lead to positive results. If you have any concerns and would like to seek immediate help, contact the following organisations:
Lifeline provides crisis counselling, support groups and suicide prevention services.
Call 13 11 14, 24 hours a day, 7 days a week.
Headspace provides mental health and wellbeing support, information and services to young people aged 12 to 25 years and their families.
Call 1800 650 890, 9am-1am AEST, 7 days a week.
Beyond Blue aims to increase awareness of depression and anxiety, and reduce stigma. Call 1300 22 4636, 24 hours a day, 7 days a week.
Online chat service available 3pm–12am AEST, 7 days a week.
Blue Knot Foundation Helpline (formerly ASCA Professional Support Line) provides help, information, support or referral for adult survivors of childhood trauma and abuse, their partners, family and friends, health professionals and anyone in the workplace working with people who have experienced childhood trauma and abuse. Call 1300 657 380, 9am–5pm AEST, 7 days a week.