Essential tremor gets worse in stressful situations.

How Stress Makes Essential Tremor Worse
Essential tremor (ET) is the most common form of uncontrollable rhythmic shaking, though it is sometimes misdiagnosed as Parkinson’s disease. The involuntary trembling results from abnormal communication between certain areas of the brain (cerebellum, thalamus, and brain stem). It is estimated that 10 million Americans suffer from ET, though many cases are so mild that people don’t see a neurologist unless it progresses to where it interferes with daily living.

ET is generally considered progressive, though for some patients decades can pass with very little change. However, even when the tremor doesn’t interfere much with life, it can become noticeably worse when the patients encounter challenging circumstances. Often, the tremor subsides after the problem is resolved. This occurs because the challenge or problem triggers an internal series of rapid physiological changes called the stress response, fight-or-flight response, or simply stress. What kicks stress into gear is called the stimulus or simply stressor.

STRESSOR OCCURS –> STRESS RESULTS!
A stressor can be situational and short-lived, such as running late for an appointment or becoming angry at a provocative teenager. Longer term pressures can also amplify tremors. For example, learning that one’s job will be phased out within six months, or getting an elderly parent to accept the need to sell her home and move into a retirement community, can cause months of increased anxiety.

What occurs in the body during stress is a heightened state that affects virtually every system. Starting in the brain, nerve signals and hormones course through the body, sending it into high gear. It happens so quickly that it’s impossible to be aware of the processes occurring but one can feel their effects. Changes in the heartbeat, blood pressure, breathing rate, muscle tension, perspiration, digestion occur, and sense become sharper. An important component of the stress response is adrenaline. This physical chemical, together with everything else, makes tremor worse.

Fortunately, most day-to-day stress is the result of short-lived problems. Once they are handled, the body returns to its normal state. However, life can also bring chronic stress; when stress continues, the body adapts by remaining in a heightened state but there is a price to pay. Fatigue, damage to the immune system, emotional tension, mental aggravation and increased tremor are signs that long term stress is taking a toll.

No one can avoid stress, but the good news is that we can develop stress management skills that utilize the body’s built-in calming apparatus, the parasympathetic nervous system. Stress management involves practice, in much the same way that regular weight lifting builds muscle. Breathing techniques that can be learned in classes like yoga, and centering exercises during meditation, are just two of the ways that patients with ET can reduce the impact of stress on their tremors – as well as their emotional serenity.

Take a little time to learn more about the stress response, the power of the parasympathetic nervous system, and how to harness that power by learning a few simple methods. Coping with ET often requires willingness to explore new, and often wonderful, ways to enjoy a better quality of life.

About Dr. Dan Sperling

Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Neurosurgery Associates.