Two simple techniques can help reduce stress-induced tremors.

Two Ways to Reduce Essential Tremor by Lowering Stress

Imagine that you are doing a solo hike on a lovely trail in the north woods. It’s late spring, and the forest is quiet except for birds chirping. You pause for a drink from your water bottle – when from behind you comes the sound of rustling in the undergrowth and a snapping twig. You look around, and coming toward you is a bear cub…and its mother. Without your voluntary control, your body goes into the fight-or-flight response as the nervous system immediately responds, causing faster blood and breathing rate (to get more blood to muscles and oxygenate you), suppressed digestion so your body doesn’t divert energy there (ever get “butterflies” in your stomach?), a flood of adrenalin (to mobilize strength and speed) and anti-inflammatory steroids (so you can still move if injured) and more! This is called hyperadapting, or simply stress. The bears were the external stressors that caused the stress.

In addition to scary external events, stress can also be triggered by internal beliefs and ideas: imagine that you wake up a little groggy hoping for a little more shut-eye. The clock says it’s 7:45 am. Then you realize your alarm didn’t go off and you have an important meeting at 9:00 am! Guess what? The same thing that happened with the bears goes into high gear – you are out of bed in a flash, heart pounding, stomach lurching, and headed to the shower faster than you ever thought possible.

The hyperadapted state is very powerful. It can be a life saver (or in the second case, a job saver) in a crisis. The problem is that daily life is filled with small stressors that also trigger hyperadapting, though greatly reduced. For those who live with essential tremor (ET), even a little bit of stress can aggravate the severity of tremors, making them more pronounced and limiting mobility. The good news is that calming the stress mechanisms can help reduce ET.

Here are two methods for calming stress, and with a little bit of daily practice they can easily become efficient ways to relieve stress.

1. Deep, slow breathing – The sympathetic nervous system is responsible for the fight-or- flight response to stressors, including the rapid breathing that comes with it. Although we are not in control of the sympathetic nervous system, we do have conscious control of the parasympathetic nervous system that engages what is called the relaxation response, during which the body is restored to its normal resting state. You can train yourself to have slow, deep breathing at your command, which counteracts the physical and emotional impact of stress. The American Institute of Stress calls deep breathing a “Super Stress Buster” and offers this advice: Abdominal breathing [also called belly breathing] for 20 to 30 minutes each day will reduceanxiety and reduce stress. Deep breathing increases the supply of oxygen to your brain and stimulates the parasympathetic nervous system, which promotes a state of calmness. Breathing techniques help you feel connected to your body—it brings your awareness away from the worries in your head and quiets your mind.

2. Visualization – Did you know that when you picture yourself doing something, like catching a ball, the same neurons fire in your brain as if you were actually catching a ball? In fact, when you read the first two paragraphs in this blog, chances are that images actually popped into your mind as you read about the forest, the bears, the cozy bed, the clock. Did you picture an analog clock or a digital clock? That’s visualization. Once you have started your practice of abdominal breathing, after taking 10 or so deep breaths, try picturing yourself in a peaceful place: lying in a mountain meadow on a warm day, floating serenely on a large air raft in a turquoise pool, meditating in a beautiful temple – anything that you choose. When you create an image of your own personal place of peace and serenity, it is there for you to call upon in times of frustration, tension, anxiety, etc. Just close your eyes for a few moments, put yourself in that special place, and take a couple of deep breaths.

Remember that practice makes peaceful. The best way to start training your parasympathetic nervous system to become “on demand” is to set aside a neutral time every day, if possible, and repeat the breathing and visualization exercise. Don’t wait for a stress-filled moment to be the first time you try it – you are likely to be disappointed, because it takes a few weeks to develop the skill.

As a reward, you may notice that after even several days, your tremors begin to diminish after you’ve taken your first few breaths. This will encourage you to stay on the path of overcoming how stress agitates ET, and bring new confidence in your body’s ability to help with tremors.

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.