Tyrannical conductors, stage-fright and awkward playing partners can all take their toll on performers. And the British Performing Arts Medical Trust says that the everyday stresses of life in an orchestra can be just as acute as those of working in an office but often go unrecognised.
A survey carried out last year for the BPAMT found that depression among musicians is running at "unbelievably high levels", with 70 per cent suffering performance anxiety.
The research said that RSI (Repetitive Strain Injury) suffered by musicians is linked far more to mental stress provoked by incompetent and overbearing conductors, inadequate or dis- organised rehearsals and incompatible desk partners thanthe physical demands of playing.
The BPAMT now assigns doctors to 40 orchestras around Britain including the London Symphony Orchestra, the City of Birmingham Symphony Orchestra and the Royal Liverpool Philharmonic Orchestra as well as the Welsh National Opera and the Royal Opera House. Doctors are on hand as stress counsellors or to combat hearing problems, voice problems or dystonia - loss of muscle control.
Dr Ann Fingret, chairman of the doctors' group AMABO (Association for Medical Advisors to British Orchestras), says: "Musicians get ordinary conditions which can have different effects because they are musicians. Suppose you have high blood pressure - the treatment is usually one tablet in the morning. But if you're performing in an orchestra the time you're under most pressure in the evening. And, of course, RSI can be a real problem if you're practising six hours a day."
The trust was set up in 1993, and says in the past four years it has seen RSI halve among musicians. It is not just classical musicians they help. "We are here to help singers, dancers, actors, trapeze artists - you name it," says Jilly Black of the BPAMT.
Kate Jones, a flautist and singer, is training as a counsellor in order to help musicians: "If you are in the string section of an orchestra you have to share a music stand, which can be an enormous problem if you do not get on; it's like sitting next to someone in the office who is difficult. In the orchestra how you sit means you can develop physical problems. Most musicians are freelance, and are reluctant to admit physical problems or they won't be hired again."
Ms Black says the BPAMT helpline receives 1,000 calls a year. "In a normal job if problems are affecting your ability to work, you might not want your manager to know, if he's a real bastard. So we treat people quickly and quietly."Reuse content