Everything You Might Want to Know About Beta Blockers for Anxiety, According to Doctors
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Not sure about you, but nervous energy comes at me like a bat out of hell. And, of course, it's always at the literal worst moments. Big job interview? My heart races like it's at the Olympics. Stressful meeting with a boss? My skin gets all flushed and hot. If you've been there, then you know that all these pesky physical symptoms only make you feel even more out of control. But what if I told you there could be a secret weapon found in the most unlikely of places? That place would be beta blockers.
Okay, okay, if you're thinking, Aren't beta blockers for, like, my dad? You're not wrong. Beta blockers are a type of medication used to treat heart conditions and cardiovascular diseases, like congestive heart failure, heart attacks, coronary artery disease (aka when a bunch of gunk builds up in an artery and blocks regular blood flow to the heart), to name a few. But in some instances, doctors can prescribe them for migraines, certain shakes and tremors, and off-label for situational anxiety.
For those of you with regulated nervous systems (how does it feel to be God's favorite?), situational anxiety is when you feel anxious before an event, like performing in a play or giving a speech, says Scott Breitinger, MD, a psychiatrist at the Mayo Clinic. Some people are able to work through these feelings and still do their thing without missing a step, while others feel like their body is betraying them *raises hand*. Celebrities like Khloé Kardashian and Robert Downey Jr. have said they take beta blockers before red carpets and other Hollywood moments, and reality star Paige DeSorbo has been open about how life-changing they've been for her on her podcast, Giggly Squad.
Situational anxiety shouldn't be confused with generalized anxiety, though, which is way more persistent, can become dysfunctional, and impairs day-to-day function, says Dr. Breitinger. So basically, if you're anxious all the time, even when everything's chill, it's probably not situational anxiety. But! If you feel nearly paralyzed from nerves before big moments, that could be situational anxiety, and a beta blocker could be a useful tool to help it out.
If you have been toying with the idea of starting a beta blocker or are now suddenly intrigued to learn more, keep on reading for everything you need to know about taking them for those moments when you're freaking the hell out.
In short, it's a medication that helps slow your heart rate. Without getting too deep into it, there are two different kinds: selective, which are focused on the heart only, and non-selective, which work on your whole body, heart included.
For context, selective beta blockers are typically used for things like when chest pains start after the heart doesn't get enough blood. On the other hand, non-selective beta blockers may be preferred by doctors for preventing things like migraines, and these are the ones prescribed for situational anxiety.
Remember all those pesky symptoms like sweating, shaking, and shortness of breath? Well, these bad boys are caused by a spike in adrenaline, the hormone known to make you feel amped up, says Sanjiv Shah, MD, a professor of cardiology at Northwestern University's Feinberg School of Medicine. Beta blockers work by blocking the effects of adrenaline, slowing your heart rate and reducing those physical signs and symptoms of nervousness and anxiety, he explains. Essentially, think of using beta blockers like turning down the volume on your fight or flight response.
Unlike antidepressants or other SSRIs, beta blockers don't directly aid in quieting worries or nervous thoughts—this is a heart medication, lest we forget. But for some people, they do help you to feel more in control of your body, especially since they can also help increase blood flow to the brain to allow it to function at its best, explains cardiologist Nishant Shah, MD, an associate professor at Duke University School of Medicine.
If you're taking beta blockers for situational anxiety, the dosage is typically one or two pills about an hour ahead of the specific event. Of course, your doctor who prescribed them should give you clear instructions too!
Your doctor will also tell you to take the beta blockers for a test-drive first—say, during a normal working day or when you don't have a high-pressure situation on the horizon—just to see how your body responds. Raw dogging a dose before a major moment (be it a date, family event, or stressful work presentation) and having a bad reaction is definitely not the vibe, so this part is pretty crucial.
It's important to note that beta blockers should be more of a tool in your kit for navigating situational anxiety, rather than a long-term solution. To really get in control of your situational anxiety, you likely need a full-blown arsenal, including a therapist or psychiatrist (ideally in your insurance network). They'll likely use a variety of techniques to help, like exposure therapy, which means continuing to put yourself in the situations that make you nervous.
Yes. Like most meds, beta blockers come with a list of potential side effects, such as low blood pressure, low heart rate, fatigue, reduced libido, and sleep disturbances, according to Dr. Breitinger. Dr. Nishant adds some people may experience hair loss, weight gain, and erectile dysfunction for patients with penises.
I know, I know, that sounds like a lot, but Dr. Nishant also says most people tolerate beta blockers just fine, and some never feel side effects at all. Just be sure to keep a super close eye on how you feel, and make sure you keep your doctor up to date on your medical history.
There are also certain people who shouldn't take beta blockers, including people who already have low blood pressure or anyone with diabetes, says Dr. Breitinger. That's because beta blockers can mask the symptoms in those patients, he explains.
Before you do anything, talk to your therapist, psychiatrist, or doctor—they'll help you determine if you have situational anxiety or generalized anxiety. Start by describing how you feel and what triggers your symptoms. If your physician agrees that what you're experiencing seems like situational anxiety, mention that you'd like to give beta blockers a try. After that, the next step would be to get a prescription and take it for a test drive.
Again, just make sure your physician knows your full medical history (no, seriously—tell them all the things) because beta blockers may affect people on certain medications and those with asthma or chronic lung diseases differently, Dr. Sanjiv explains.
And remember that while beta blockers may serve as a sort of Band-Aid for getting through stressful events, they're not a cure. 'When we work to confront the things we're fearful of, that fear gradually extinguishes itself,' Dr. Breitinger said. 'The role of the medication is just to get the patient to the point where they feel like they can confront the fear.'
Always consult your health care provider, dietitian, or other medical professional before taking a new medication or supplement.
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