Adderall and Singing: Vocal Master Class #3

Terri is a 23-year old recent college graduate with a BFA Degree in Musical Theater from a well-respected academic program on the East Coast. Several years ago she studied singing with me during one of her summers at home. She had a great sense of humor and was an accomplished dancer as well as an experienced ingenue. She clearly had received some good vocal training from her college teacher at that point. We had a good summer together, working on repertoire for her audition book as well as vocal technique, and then I did not hear from her again….

….until right after she had graduated from her program. When she emailed, she said that there was something “terribly wrong” with her voice. Her teacher and others she had consulted were not able to help. She said that she had seen an otolaryngologist recommended by the voice program, and he had determined that her vocal cords and surrounding muscles were fine. We arranged for a consult and I asked her to bring a copy of the report.

When she arrived I couldn’t believe that it was the same young woman with whom I had worked. Her demeanor was drastically changed, her face sunken and anxious. When she sang, her breath response was completely locked up and her once-lively tone was either a thin wisp or a spread-yelled-throaty-strangle. She stood stiffly and was not engaged in any way. What, on earth, had happened in the two years since I had since her? She was with the same teacher all four years.

It would have been a complete waste of time to work on “breathing.” Since I had worked with her before, my first instinctive thoughts were 1) substance abuse or 2) medical side effects. It turned out to be both, through no fault of her own.

In our first lesson I asked her what had changed in her life since I saw her last. She told me she had broken up with her boyfriend and was diagnosed with ADD and severe anxiety disorder. DING! I asked her if she was taking medication for ADD and she said she was on Adderall. DA-DING! I asked how long she had been on it and she said over 2 years. My jaw dropped.  Here is why this is significant–

Any medication not prescribed or used properly can lead to trauma or death, but Adderall, a controlled substance, is one of the few drugs where “death” is sometimes listed as a side effect. Other side effects can include respiratory distress, dry mouth, irritability, anxiety, muscle stiffness and insomnia. It is very, very hard on the central nervous system. I told her that it was my understanding that Adderall is sometimes used at the beginning of treatment for ADD, and then a less toxic drug is prescribed for consistent use.

It turns out that her psychiatrist, in the town where she went to college, was regularly refilling her Adderall prescription WITHOUT monitoring her. This is absolutely beyond my realm of comprehension and morally criminal.

I told her I thought that the medication was causing massive dysfunction all through her system. At this point she said that she couldn’t dance for more than a few minutes without becoming winded and exhausted. She also told me that my theory was the first sane speculation she had heard as to why her voice had stopped working. After beginning to cry, she said that her relationship with her parents was strained because they were tired of seeing her so strung out and unhappy. They also had said they would not support her financially past the summer.

So I came up with a plan:

1. First, I helped her find a psychiatrist on her insurance plan who could wean her off the narcotic and help her transition to another ADD drug. I told her that she had to be in therapy during this transition.

2. Then I wrote a long email to her parents, explaining what I felt the problem was and telling them to speak with her doctor as to how long she would need to get off the drug and adjust to the new meds. I never heard back from either of them, although they were paying for her lessons. They were furious with her for needing lessons after they had paid for college to learn “this stuff.”

3. I suggested we wait two weeks from the time she started with her new doctor to when we had her first lesson.

Then I stayed in touch with her by phone until she returned for her first lesson. The sparkle was back in her eyes, she was able to laugh more easily, breath response was more active and she felt her voice coming back. She clearly liked her new doctor and trusted her.

Terri and I had about 4-5 lessons this past summer, and in addition to functional vocal work, I tried to stimulate more body involvement within songs that she knew with Chekov Psychological Gesture Work. (Thank you to Dr. Matt Edwards for introducing me to this kind of work!) Those of us who work with singers after their undergrad or graduate programs have observed that sometimes they sing like “talking heads.” They look great from the neck up, and the body seems to be an afterthought. But Terri was so elated to be out of her “prison,” as she called it, that understandably, she wanted to forget any kind of work and just start performing with joy again. And this is why I thought the Chekov work could help facilitate that.

The problem was, after two-years of poor vocal fold function, all sorts of compensatory muscle behaviors had snuck in and taken root. She was very loyal to her former voice teacher and kept going back to her for lessons at the same time we were working. When I asked her why she was doing this, she said that her former teacher worked repertoire and she “really needed to do that.”

I told her that I could work repertoire with her as soon as her voice was back, but she suddenly stopped coming. Her former teacher sent me a link to her senior recital from April, where I felt Terri was clearly just holding on for dear life to get through her recital requirement. The link was accompanied by a note from her teacher, boasting that the recital was proof that Terri had the full package and was fully marketable. The teacher didn’t seem to notice how much trouble that young woman was in, although she did thank me for “helping her figure out what was wrong with her throat muscles.”

To coin a popular phrase right now: I.can’t.even.

I think the college teacher could not admit she missed the boat with Terri and was bent on guarding her turf to justify the money spent for the degree. (In a future post, I’ll describe a time I completely missed the boat, and what I did about it.)

Making large mistakes happens–we are all human and in a field where a lifetime is not long enough to learn what we need to know. The key is, how do you learn from the experience, take responsibility, and repair the relationship with someone who trusted you so completely with their body, soul, time and money?

The last I heard, Terri had gone to New York City and was making the audition rounds while continuing to study with her college teacher. I would be very surprised if she got hired for anything, but I have to accept that my role in this singer’s life was just to help get her off a drug that was destroying her.

It’s never about us as teachers.  It is about how we serve the person in front of us.

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ADDENDUM: ADDED OCTOBER, 2017:

Terri actually DID come back in the fall of 2017 because she had decided to pursue a masters in music therapy and wanted some help preparing for her auditions. She told me that her experience with me had awoken her to this speciality and she wanted to work as a music and dance therapist.  She had a few lessons with me and then I sent her to a guitar teacher so she could learn basic fold guitar chords and get used to singing with guitar. This is a desired skill for music therapists going through the academic degree system.

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