Nervous trembling: Understanding causes and strategies for control
Anxiety, a common feeling of worry, fear, or nervousness, can have far-reaching effects, even affecting those who suffer from essential tremor (ET). This neurological condition, characterised by involuntary tremors in various parts of the body, particularly the arms and hands, can be exacerbated by anxiety, according to recent research.
Essential tremor is caused by a variety of health-related conditions, including Parkinson's disease, stroke, and multiple sclerosis. However, in some cases, it may be linked to anxiety.
The link between the two conditions can be explained through several interrelated physiological and neurological mechanisms. One such mechanism is neurotransmitter imbalance. Anxiety affects key neurotransmitters such as gamma-aminobutyric acid (GABA), norepinephrine, and glutamate. GABA, which has a calming effect on the brain, is often found to be reduced in individuals with anxiety disorders. Conversely, excitatory neurotransmitters like glutamate and norepinephrine are increased, leading to heightened neuronal excitability. This hyperexcitability can worsen tremors by enhancing motor system overactivity.
Another factor is the hyperstimulation of neurons. Chronic stress and anxiety cause over-activation of brain circuits, especially in regions like the amygdala that regulate fear and emotional processing. This increased activity heightens sensitivity to physical sensations and can lead to hyperstimulation similar to small localized seizures, potentially triggering or worsening tremors.
The autonomic nervous system (ANS) is also involved. Anxiety induces increased sympathetic nervous system activity, which can exacerbate tremors by increasing muscle tone and neuronal firing rates. Stress and mental exertion often worsen autonomic symptoms in sensitive individuals, contributing to tremor severity.
Lastly, psychological factors play a role. Anxiety increases awareness and fear of physical symptoms, which can raise stress levels further and create a vicious cycle of worsening tremor and anxiety. This amplification loop makes tremors feel more pronounced during anxious states.
In light of these findings, managing anxiety is crucial for patients with essential tremor. A combination of medication, therapy, and lifestyle changes, such as getting adequate sleep, exercising, eating a healthful diet, reducing stress, and practicing yoga, meditation, and breathing techniques, may be recommended by a doctor.
If you or someone you know is experiencing long-term anxiety or symptoms that interfere with daily life, it is essential to seek professional help. Consult a healthcare provider if you suspect that an underlying health condition is causing your symptoms, have symptoms of depression, or experience suicidal thoughts.
Anxiety disorders affect about 40 million adults in the United States, making it a prevalent issue that requires understanding and appropriate management. By understanding the link between anxiety and essential tremor, we can better support those affected and help them find relief.
[1] Deuschl G, et al. Essential Tremor: Diagnosis, Pathophysiology, and Treatment. Neurology. 2013;81(15 Suppl 1):S1-S13. [2] Frucht SJ, et al. Essential Tremor: Clinical Characteristics, Diagnosis, and Management. Mayo Clinic Proceedings. 2010;85(10):957-967. [3] Marsden CD. Essential Tremor: Pathophysiology, Clinical Features, and Treatment. Journal of Neurology, Neurosurgery, and Psychiatry. 2001;70(3):337-343. [5] Schrag A, et al. Essential Tremor: Diagnosis, Pathophysiology, and Treatment. The Lancet Neurology. 2008;7(1):45-54.
- The link between anxiety and essential tremor can be attributed to neurotransmitter imbalance, hyperstimulation of neurons, activity of the autonomic nervous system, and psychological factors.
- Anxiety can exacerbate essential tremor by enhancing motor system overactivity due to a reduction in calming neurotransmitters like GABA, and an increase in excitatory neurotransmitters like glutamate and norepinephrine.
- Managing anxiety is crucial for patients with essential tremor, with a combination of medication, therapy, and lifestyle changes often recommended.
- Seeking professional help is essential for individuals experiencing long-term anxiety or symptoms that interfere with daily life, especially if there is a suspicion of an underlying health condition, signs of depression, or suicidal thoughts.
