Musicians and Mental Health: A Toxic Culture Takes Its Toll on Players’ Well-Being

Poor mental health is shockingly common among professional musicians

By Miranda Wilson | From the January-February 2024 issue of Strings Magazine

Poor mental health is the last taboo of the classical music industry. Though most musicians will seek treatment for work-related physical injuries, mental health problems remain shrouded in silence. A 2016 study by researchers Sally Gross and George Musgrave found that poor mental health is shockingly common among professional musicians. From their initial survey of more than 2,200 self-described professional musicians in Britain, they discovered that 68 percent experience depression, while no fewer than 71 percent suffer anxiety and panic attacks. (By comparison, the National Alliance on Mental Illness reports that only 22.5 percent of the general population experiences mental illness.) In their follow-up book, Can Music Make You Sick? (2020), Gross and Musgrave reached the deeply pessimistic conclusion that pursuing a career in music is not worth the mental health risks.

Such a statement is unacceptable to those of us who have no intention of leaving the profession. But the statistics are alarming enough to provoke the question: if so many musicians are not okay, why aren’t we talking about it? “Simple,” says Kate, a 30-year-old cellist. “If I told anyone about my depression, I wouldn’t get gigs.” It’s telling that of all the string professionals I interviewed for this article, not one was willing to be quoted under their real name. 

The classical music profession has a problem, and it’s been going on for a long time. In a 2009 study for Clinical Medicine, authors Marco Mula and Michael R. Trimble list psychopathologies of 22 famous composers that include major depressive disorders, bipolar disorder, psychosis, panic disorder, and alcoholism. It makes for discomfiting reading and made me wonder: is there something wrong with music itself? While it might provide emotional catharsis and solace to nonmusicians, is it actually harming those of us who create it? 

“It isn’t the music,” says Jacob, a 22-year-old violinist. “Growing up, I loved how music made me feel. Playing violin gave me self-esteem because I got a lot of praise for it. After high school, music school was where I found a meaningful community of friends. Everyone there liked the same things I did. I felt safe in a way that I didn’t in high school.” 

But the pressure of conservatory studies took a toll. “My teacher got angry when I did anything wrong. He spent whole lessons shouting while I flinched away. Sometimes I could hardly play a note because he would scream ‘No!’ before I even got started. I felt like he was sucking my love of music out of me. Then I’d go to orchestra and my stand partner would point out every tiny mistake I made. I was terrified the conductor would single me out and make me play in front of everyone.” 

While still an undergraduate, Jacob was diagnosed with an anxiety disorder, for which he sought therapy. He is far from the only young musician to need it. In a 2021 study for Frontiers in Psychology, Jonas Vaag, Ottar Bjerkeset, and Børge Sivertsen demonstrated that Norwegian music students were far more likely to seek psychotherapeutic help than students in other disciplines, though they could not determine whether their mental ill health was due to individual issues or to the pressures of the field.


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Hearing this resonates with the students I spoke to. “Being a music student is stressful,” says Madison, 26, a violist in a graduate quartet program. “You spend four to six hours a day alone in a practice room, and you get lonely. A lot of talented people quit because they can’t stand the loneliness. You have to be unsociable and miss out on parties. I can’t help wondering if I’m missing out on major life milestones.” Her violinist colleague Emma, 27, nods vigorously. “There’s this culture of competing to see who can practice the most,” she says. “It’s an unspoken assumption that if you don’t, you’re lazy and don’t have what it takes. You wear yourself to a thread practicing, and then you go to rehearsal and have a fight about the bowings. It sounds so petty, but arguments about that stuff can get toxic. And then you have to deal with stage fright and being broke… it’s crazy.” 

Both Madison and Emma take anti-depressant medication, as do many other musicians I spoke to. Some reported regularly taking beta blockers for performance anxiety. This, too, is another of classical music’s open secrets. Stage fright is one of the great levelers; it strikes musicians of all ages and levels of experience. The fight-or-flight response dials cortisol and cortisone, the stress hormones, up to 11. Suddenly, your bow’s shaking uncontrollably and your left hand goes into a tight claw that can’t perform shifts and extensions. Psychotherapy helps some musicians, but many experience such severe trembling, sweating, palpitations, and nausea during performance that only medical interventions can help. 

mental heath violin illustration
Illustration: Bill Evans

Off the record, many musicians admit to the off-label use of propranolol, a heart medication. “Beta blockers don’t take away your fear,” explains Caden, a 26-year-old cellist, “but they take away the symptoms, so you don’t think you’re having a heart attack. You’re still afraid, but you can get through an audition without passing out or vomiting.” Such is the culture of shame and silence, however, that musicians are afraid to recommend propranolol openly. At least one music professor has been fired just for mentioning its existence to a student. With pressure like this, it’s no wonder that many musicians obtain the medication illegally without a prescription, further endangering their health.

As bad as performance anxiety gets, the musicians I spoke to described financial instability as a far greater source of anxiety. Younger interviewees speak bitterly about the “pay to play” aspects of building careers. “Forget summer festivals if your family isn’t bankrolling you,” says Emma. Then there are the unpaid performances “for exposure,” and orchestra pay-per-service so low that accepting a gig means losing money. More established musicians express resentment that music is becoming a “portfolio career” of precarious performing and teaching jobs. News reports of orchestras folding and universities shuttering music departments appear almost daily. 

“I’m barely making ends meet,” observes Isobel, a 38-year-old violist, “and every time I open social media, I have to see someone I went to music school with posting an Insta-perfect selfie of themselves in some famous concert hall with a caption like ‘My office for the day!’ Admittedly, I do it too. You put on a brave face and a big smile and act like you’re super successful so other people won’t think you’re a loser.”


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Is the takeaway from this that classical music is an unrealistic career? 

“No one’s naïve enough to think it’s easy,” says Kate, the cellist. “You take classes on careers and entrepreneurship in school. Everyone knows full-time orchestra jobs don’t really happen anymore. What they don’t tell you is how oversupplied the profession is. You can’t turn down work because if you do, you won’t be asked again.”

“You feel undervalued,” says Kyle, a violinist in his thirties. “You drive three hours to a gig that pays barely enough to break even. You sit in a hotel room feeling lonely and missing your family. And don’t bother complaining. Nonmusicians think that because you’re supposedly doing what you love, you’ll do it for peanuts. There’s a perception that being in the arts is self-indulgent and frivolous, when in reality it’s very hard work. You can’t admit to being depressed, because someone will tell you it’s your fault for making poor career choices. Not that you can do anything about it. Most of us don’t exactly have transferable skills that could lead to any other career.”

Maybe it’s time to stop romanticizing the stereotype of the emotionally disturbed creative genius and actually figure out some steps to address the epidemic of mental ill health sweeping our profession. The first step could be to start talking about it more. Musicians I interviewed agree that this is a good start, but that the solution should be institutional, not just personal. “Motivational speeches about ‘self-care’ are not helpful,” says Simon, 52, a double bassist. “There’s a whole ‘wellness’ industry, sometimes perpetrated by musicians themselves, that says you won’t have a problem if you do enough yoga and eat enough broccoli. They’re implying that the problem is on you, not on the conductor yelling at you or the orchestra CEO who thinks $40 per service for a section player is acceptable.”


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Lynda Warwick, PhD, a psychologist and amateur cellist, agrees. “Like other working situations, musicians require collective and organized solutions,” she says. “Holding abusive conductors and teachers to account may help with the trauma and anxiety caused by being humiliated, frightened, and made to feel hopeless about one’s ability to play well enough.” She is not at all surprised by Gross and Musgrave’s statistics: “An anxiety disorder is a perfectly reasonable response to abusive treatment.” Improving mental health “requires improving working conditions as well as dealing with ingrained trauma and abusive self-talk.”

The toxic comments of others often show up as negative inner monologues during practice. “We might not even be aware we’re thinking things like ‘That was terrible! You missed it again, you’re so stupid, you can’t get anything right,’” says Warwick. “We may be saying things to ourselves that we would never say to a friend.” In her own cello practice, she uses techniques from therapy to observe and problem-solve what she needs to correct without using “destructive emotional reactions.” 

What about musicians who don’t have health insurance and can’t afford a therapist? “There are workbooks and resources available for people who want to work on more productive ways of managing their emotions,” says Warwick. “Cognitive behavioral therapy workbooks can help people learn to shift thinking away from toxic self-management.”

Additionally, mental health resources are becoming increasingly accessible to musicians. In the United States, Sweet Relief Musicians Fund, Music Health Alliance, MusiCares, and Backline provide much-needed practical assistance for struggling musicians. For individuals, this help is a godsend, but systemic problems remain. It’s now up to music organizations to start a serious conversation about workplace dynamics, fair pay, and what it would look like to create a more supportive culture in this troubled, challenging, but ultimately still worthwhile profession.