Using Ativan/anti-anxiety drugs for tests

[QUOTE=Kyzteke;5504373]
Having grown up in the late 60’s & early 70’s (hell, I was even at Woodstock!), and having known many, many musicians, I can pretty much guarantee that they aren’t using beta blockers…[/QUOTE]

She’s talking about Classical musicians. Seriously - I lived on the performing arts floor in college at a very serious music school. The entire string section was on Ativan.

I would consider taking something for nerves. I don’t show very much, and I get anxious about showing inconsistently. Under normal circumstances, I can usually get over the pre-show jitters by having a glass of wine before bed the night before and doing relaxation exercises in the morning. I do recall one show though where I had a full blown panic attack schooling the day before the show and it was pretty much a waste of money the next day - I was too fried to ride well. In that situation, it would have been nice to have an option to take a pill.

[QUOTE=smm20;5504573]
She’s talking about Classical musicians. Seriously - I lived on the performing arts floor in college at a very serious music school. The entire string section was on Ativan. [/QUOTE]

not to pick on you or your post, but I think there needs to be some clarification here regarding the different medications and drug classes being thrown out here for those reading who are not familiar with them. Ativan is not a beta blocker (beta blockers are atenolol, metoprolol, propranolol, labetolol, etc, commonly used for blood pressure, cardiac arrhythmias, tremor, etc). There is a big difference in the way that beta blockers and benzos (ie Ativan) work, and for which conditions they are useful. Anti-anxiety drugs come in a few different forms, some which work very quickly (benzodiazepines- Ativan, Xanax, Klonopin, Valium), and some which are long-acting and generally not sedating, meant to be taken daily to improve the chemical balance in the brain (SSRI’s- Prozac, Paxil, Celexa, Zoloft).

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I have used both xanax and atenolol (beta blocker) for my nervousness.
If you do, be sure you know what doses to take so you don’t fall asleep in the test!!

I am pretty much past that now. I still get nervous but I don’t have melt downs.

It’s not my intention to minimize peoples’ situations, it’s just that …

In that situation, it would have been nice to have an option to take a pill.

… it makes me uncomfortable to think of ativan, for example, as a “nice option” …

If one’s panic attacks are so limited to a specific performance situation, it really does seem more healthy for both mind and body to attend to the situation and encompass the emotional with mental and physical demands of showing (or playing).

Maybe I’m just feeling envious of people for whom medication is an option rather than a necessity for getting through the day.

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AWG, remember, people have different reactions to drugs. Ativan may knock you on your keister, the people I have seen take it dont have that reaction at all. They just dont experience debilitating anxiety. Could be the dose prescribed is much lower, too, and catered to the intended activity.

[QUOTE=AllWeatherGal;5505471]
It’s not my intention to minimize peoples’ situations, it’s just that …

… it makes me uncomfortable to think of ativan, for example, as a “nice option” …

If one’s panic attacks are so limited to a specific performance situation, it really does seem more healthy for both mind and body to attend to the situation and encompass the emotional with mental and physical demands of showing (or playing).

Maybe I’m just feeling envious of people for whom medication is an option rather than a necessity for getting through the day.[/QUOTE]

I guess I shouldn’t have used the phrase “nice option.” I was trying to say that when you have occasional panic attacks, you learn to recognize the difference between a bit of nerves and a full blown attack that will not go away. For me, it is like the difference between upset stomach and food poisoning - both start out with some indigestion, but with food poisoning, even before it hits, you know something is very very wrong. For me, panic attacks come on in the same way - I know that there will not be a way out and if I try to work through it, it only becomes worse. I’ve had them in restaurants with friends and the only solution has been to leave - something that I hate to do and in retrospect feels so silly (I normally love restaurants! I’ve worked as a waitress!) and embarassing, but at the time is really the only choice. After that experience at the show, if the same thing happened again, I would scratch and go home. My horse doesn’t deserve to deal with me when I’m in that state of mind. So in that situation, I really do think that medication would be a viable “option” if the other option is to get off and leave.

I should also add that when they happen so rarely, it is very difficult to address the issue or understand exactly what causes it, let alone take action to prevent it in the future.

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EqTrainer …
“catered to the intended activity” is where I have the concern, when it’s something that requires physical motor coordination, I guess. Doses don’t come much lower (.5 mg) than what I take on occasion, but you’re absolutely right about differing chemistries. A responsible physician/psychiatrist will be aware of an individual’s likely response.

And it seems that I have a more conservative attitude towards medication :wink:

smm20 …

I just took a moment to read about anxiety disorders (not something I felt a need to actually research!) … and found this a number of times

“A specific phobia is an intense fear of a specific object or situation, such as snakes, heights, or flying. The level of fear usually is inappropriate to the situation and may cause the person to avoid common, everyday situations.”

My remarks were made with the idea that the ONLY situation that brought on the panic or worry was riding a test, which is not to my mind a common everyday situation, or a situation in which people can afford to be slightly “out of it”.

I just ask that everyone reading the thread and contemplating a little helper understand the seriousness of the idea and not borrow a pill from a friend, but seek the advice of a medical professional.

[QUOTE=AllWeatherGal;5506069]
EqTrainer …
“catered to the intended activity” is where I have the concern, when it’s something that requires physical motor coordination, I guess. Doses don’t come much lower (.5 mg) than what I take on occasion, but you’re absolutely right about differing chemistries. A responsible physician/psychiatrist will be aware of an individual’s likely response.

And it seems that I have a more conservative attitude towards medication :wink:

smm20 …

I just took a moment to read about anxiety disorders (not something I felt a need to actually research!) … and found this a number of times

“A specific phobia is an intense fear of a specific object or situation, such as snakes, heights, or flying. The level of fear usually is inappropriate to the situation and may cause the person to avoid common, everyday situations.”

My remarks were made with the idea that the ONLY situation that brought on the panic or worry was riding a test, which is not to my mind a common everyday situation, or a situation in which people can afford to be slightly “out of it”.

I just ask that everyone reading the thread and contemplating a little helper understand the seriousness of the idea and not borrow a pill from a friend, but seek the advice of a medical professional.[/QUOTE]

No doubt people need to see a doctor about this, I have said that here and say it in real life. “Conservative about meds”… Is nothing to be winking about tho. What you need them for is not necessarily the same as what someone else needs them for, and no ones need or requirement is more or less correct than anothers. It just is.

Pills can also be cut in half :). Doses can be experimented with before you get on the horse and at home.

The people who I have seen use it were literally crippled (and therefore rendered ineffective and dangerous) by the pull between their desire/need to ride and their anxiety/fear. I am sure that they would have experienced the same thing at a horse show until they worked through it a few times. If their reflexes were slowed minuetly it was not obvious and quite frankly was probably for the best because spastic and hyper doesnt really work well around horses either.

I think our message is mostly the same…Get medical advice/treatment. My concern is for people who have anxiety about riding NOT getting medical treatment, and meds if that is what it takes - and never riding again, or being dangerous/ineffective because of their fear levels - and the damage it does to them psychologically. The people I dealt with were adult, competent riders, good riders, who had fallen into a vicious cycle. The sad and noteable part to me is that they were told to “get over it” and “cowboy up” and blah blah blah… It didnt work. It made it worse.

Whoa, nellie!

Pharmaceutical help to slightly optimize performance in a dressage test taken for fun?

I can see this if you are taking a big test that will have a profound effect on your life, the LSAT or Bar Exam in the US, a college entrance exam in Japan or China. I don’t see the justification otherwise, especially if we aren’t talking full blown panic attacks.

[QUOTE=cu.at.x;5503861]
This just illustrates perfectly the bias against mental illness in society. Would you say that to someone on insulin? Anti-seizure medication? You probably think people taking antidepressants are poor riders too. I’d like you to experience anxiety for ONE day and then come back and tell us how you feel.[/QUOTE]

To me, these are apples and oranges. The OP was not talking about truly debilitation or life-threatening conditions. The OP said nothing about classifying nervous riders as “mentally ill.” I don’t think anyone would genuinely confuse medication require to control seizures (grand mal or otherwise) and the “mothers little helper” type use of meds we are talking about here in a hobby or even an intense competition.

[QUOTE=Quibbler;5503761]

I haven’t tried it, but studies back up the idea that humming or singing from performing can prevent you from overthinking a situation, so instead you rely on your muscle memory. I don’t know how it would translate to equestrian sports, but it might be worth a try (as long as you don’t forget your test!).[/QUOTE]

An exercise rider on the TB track told me that those guys sometimes sing to their horses. IMO, that has a great deal about getting the person to breathe. That changes the muscle tension of your own body, and that in turn lets you feel more in your horse and ride better. Since talking to this guy, I have tried it and I can tell you that it works. If you realize that breathing can change more subtle things, sooner or later you can produce this feeling in your body by breathing and without the tunes.

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I would suggest a sports psychologist, a good trainer, and some mileage. If needed drop down a few levels until the tests are almost too easy and build from there. You can also do smaller schooling shows or do some really small “open” shows where there are very few people and very entry level classes. For some (like horses) it just takes time to develop confidence so don’t try to rush things!

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EqTrainer … point taken (no winking involved). My understanding of the original question and most of the replies was that of mvp’s.

Seriously??:eek:

Wow…how depressing is that? They would probably be better off with weed, which is what most of my musician friends who went to Berklee used. However, I really don’t think they were using it for anxiety…I think they just used it for fun…

As for the OP’s question – if she has a chronic anxiety disorder and/or mental illness that is one thing. But if it’s just “show nerves” she needs to learn to handle it without the drugs. Drugs WILL help the symptoms, but they will NOT help you learn to deal with the anxiety.

That’s why the ‘quick fix’ isn’t always the best way.

However, I have heard good things about Rescue Remedy and it’s very, very safe. Incidently, Carol Lavel mentioned she and one of the other team members took it before the Olympics tests…

If you have a general anxiety disorder and Ativan is what your psychiatrist has recommended, by all means take it. But you should not be riding a horse or driving while “under the influence”. I don’t generally have any anxiety problems and my show nerves are fairly manageable (well, dressage show anyways. Jumping is another story). However, I do have a morbid fear of certain dental procedures (basically anything having to do with a dental dam or a block to hold open my mouth). After having a MAJOR panic attack once at my dentist’s office, he now prescribes Ativan for me prior to anything other than routine cleaning. He insists that I have someone drive me there and back home and I usually end up passed out for the rest of the day. I can’t imagine possibly trying to ride a horse while on that medication, and I would not feel safe in the ring with some else riding who is on Ativan. I would imagine that you may be leaving yourself open to a lawsuit if you were to lose control of your horse and cause and accident while on meds as well.

[QUOTE=Samigator;5503696]
I would not take a benzo, nor would I recommend or prescribe one for horse show nerves. Benzos are for temporary use in people who have severe debilitation by acute anxiety that interferes with their normal life functions

Not appropriate. Just my opinion.[/QUOTE]

Ditto! And I am a HUGE advocate for mental health awareness/acceptance, so it’s not that I’m being insensitive or dismissing the realities of anxiety. It is also possible that the benzos could hurt… drugs that depress your system can have a wicked rebound effect, so that they actually increase your baseline anxiety/agitation for a while. Not to mention the safety concerns of mixing sedatives and equines.

My suggestion - Cognitive Behavioural Therapy. A therapist will work with you specifically to reach a certain goal, and it has been proven to be quite effective. This isn’t pour-your-heart-out, I-hate-my-dad, two-boxes-of-tissues-per-visit therapy… it is focused on reaching behavioural/emotional goals and intended to last for a specific timeframe.

[QUOTE=CatPS;5507189]
My suggestion - Cognitive Behavioural Therapy. A therapist will work with you specifically to reach a certain goal, and it has been proven to be quite effective. This isn’t pour-your-heart-out, I-hate-my-dad, two-boxes-of-tissues-per-visit therapy… it is focused on reaching behavioural/emotional goals and intended to last for a specific timeframe.[/QUOTE]

This is exactly the type of therapy to look for - it’s basically about teaching you techniques you can use yourself to break out of the psychological/emotional cycle, or at least recognize you’re in one (depending on the severity of the condition - sometimes you can’t break out because your brain chemicals are Doing Their Thing) to take appropriate steps - take medication, alert a friend or loved one that you need assistance, whatever.

That said, depending on the severity of the problem, some type of medication MAY be indicated in the short-to-medium term to help you get to a place where you can use the CBT techniques and develop confidence in their effectiveness. But that’s for a doctor to assess and discuss with you.

(And really really do NOT just take someone else’s medication, even if they’re prescription and you know it is what it says on the bottle. There may be some reason why that particular drug is a bad idea for YOU that you aren’t aware of.) (Plus, it’s not legal. :slight_smile: ) (Particularly do not do this on show day, when it’s a drug you’ve never taken before and have no idea how it will hit you. That’s just a recipe for disaster.)

Beta blockers work for classical musicians because they help keep the kind of jittery nerves that impair the very fine motor control you need to play instruments well at the level they play.

That is far from what will help anyone that is working with the larger muscle groups and exerting more physically.
I would think beta blockers may tend to impair a rider’s reflexes needed to ride, not just keep jitters at bay.

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I sympathize with anyone who has terrible show nerves. No matter what I’m doing in a show, I end up petrified. I’ve literally sat on my horse ready to throw up and contemplated scratching, except I was too nervous to do even that. Once I’m in the ring and actually going, I’m okay, but man those pre-class jitters are bad. I always wonder why on earth I show when I get so nervous, but… I like it. It’s fun, when I get past the paralyzing fear.

Benzos affect people differently. Lots of people are on benzos PRN or daily… they still manage to work, drive, and function. There’s a difference between a low dose for anxiety and a high enough dose to knock you out and render you useless. Try it out at home to find the lowest dose that works for you without making you tired or loopy. I’d rather be in a ring full of people comfortably relaxed and able to focus on their riding instead of their nerves.

This is the most important point made on this thread, as it involves the safety of others, plus our horses.

It supercedes any need for drugs by a rider to quiet anxiety so they can get in the show ring.

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To everyone saying you should never ride when on benzos, have you ever taken them regularly? Or just very rarely for some kind of procedure where the goal was to all but knock you out?

Yes, benzos can be used to pretty much sedate someone. I was given IV Valium when I had my wisdom teeth pulled. BUT, they are not always prescribed in those doses!

Seriously, I was on a good bit of Klonipin for about 6 months. That’s what kept me functioning at all (that and the Neurontin, and a couple other things). I still rode, usually 3 horses a day. I drove. I was FINE to be on a horse, and my doctor agreed. If you adjust the dose before climbing into the car or onto the horse, it’s not something that’s forbidden! The vast majority of drugs have some kind of warning about not driving before you know how the drug will affect you. Would you sit at home on your couch because you took a Benadryl?

Some people do have very real anxiety issues. They might not be crippled by their anxiety, but to tell them to just not show because of some nerves, when maybe a physician-prescribed med, in a small and safe dose, would allow them to do something they enjoy, without the performance anxiety, seems kinda callous. Doctors prescribe these drugs for uses other than crippling anxiety, and used responsibly they are very effective.

[QUOTE=Hampton Bay;5507970]
Would you sit at home on your couch because you took a Benadryl?[/QUOTE]

I would. It makes me drowsy. One day I took Benadryl because I had a rash, I think I only took 25mg. But my mother in law called about an hour after I took it and I was completely incoherent and didn’t remember talking to her the next day. :confused: probably shouldn’t be driving in a state like that, I might forget what a red light means.

I don’t think anyone is saying NOT to show because of show nerves. I think more people are saying DO show, do what you can, and try to keep working through it. When you make it through the class, it builds confidence and gets easier the next time. If you rely on taking a drug to get you through it, what are you going to be thinking the next time you show? “Oh I need my - fill in the blank.” Then you will rely on that drug to help you get through your class, and I would bet it would be harder in the long run to ever overcome those show nerves without drugs.

To those saying that those of us against this are denying or minimizing other peoples’ anxiety is wrong. I experienced severe show nerves with my last horse. We showed a lot, and yes I was nervous, nauseated, and scared to go in the ring, but the more classes I rode in, the easier it got. I never turned to drugs or alcohol to help me cope- Tums? yes. I found the best way to help with those show nerves was to burn off some energy of my own (go for a run or ride a longer warm-up), change my routine a little (ie no big breakfast before showing) and keep showing. Now with my current horse, I have just a touch of the show nerves still, but I bet it would be a lot worse if I had relied on something to get me through that toughest time.

Here is a real life example of how severe anxiety can be managed- I work in the medical field, and used to be petrified of needles, blood, etc. I nearly fainted dozens of times as I went through school, especially in anatomy lab and surgery rotations. It was so bad I once had to leave to go lay down in the middle of a lecture on dermatology. I nearly dropped out of school on numerous occasions because I thought I would never make it through like this. I went to see a therapist and learned how to meditate and control what I was thinking about. My brain had been running amuck, going on and on about how much blood I was seeing and how much that must hurt, etc. Once I learned to control that and focus on what I was doing, ie, sterile technique, anatomy land marks, and thinking through the next steps of the procedure, I really controlled my thoughts myself, and it got MUCH better. Sure I still had a few times that I had to sit down, but I got over it and have not had any problems since. This anxiety was severe, affected my CAREER, I worried every day that I would have problems, and I often did. It nearly caused me to change careers, and has significantly impacted my life. But this example goes to show that there are ways (other than drugs) to cope with anxiety and work through it, and in the long run you CAN overcome it, even if it is severe, and that the more you experience it, the easier it gets.