4 Good Reasons to Manage Essential Tremor Stress

There are two types of stress. The first, acute stress, usually happens in response to a sudden dramatic situation, such as a short notice demand from a boss, an accidental injury, discovering marijuana under your teen’s mattress, etc. In acute stress, your body immediately goes into the fight-or-flight state known as the stress response. However, once the situation is under control, your biochemical state returns to normal in 20-60 minutes.

The other type of stress, chronic stress, is exactly what its name describes. It means the fight-or-flight mechanism stays elevated due to a lasting anxiety-provoking situation over which you have little or no control. Chronic stress is bad news for the brain. Here’s why.

The fight-or-flight response is automatic when we perceive a threat to our physical, mental or emotional well-being. The body becomes super prepared to flee or stay and defend itself in what feels like the blink of an eye. Biochemical and electric signals flood the body, resulting in a superfast release of hormones into the bloodstream:

  • Adrenaline and noradrenaline (increases heartbeat and breathing rate for more energy, increases clotting factor in the blood in case of injury, enhances perception ability such as pupil dilation, strengthens muscle tension to prepare for action but can lead to trembling)
  • Release of cortisol (makes more glucose – a sugar – more available for energy, helps prevent inflammation, regulates digestion and blood pressure, helps with immune response)
  • Chronic stress and the brain

    The problem with chronic stress is the body doesn’t have a chance to return to normal. This means that cortisol levels in the blood remain high. In turn, this leads to long term higher blood sugar levels, metabolic changes that foster weight gain, and damage to the immune system. But that’s not all. A new study from Harvard specifically looked at the impact of sustained elevated cortisol on the brain.i What they found is sobering. For study participants (average 48.5 years old) with no dementia at baseline, those who had chronically elevated cortisol blood levels during the 8-year follow-up period had lower brain volumes (smaller brains) and impaired memory function—even before symptoms started to show.

    Essential tremor: a source of chronic stress

    For individuals with essential tremor (ET), stress becomes a fact of daily life. The problem-solving involved in preparing and consuming food and beverages, the frustration of fumbling to get dressed, the helplessness when trying to write or type, the embarrassment of being stared at in public, and many more different situations is a source of constant stress. It seems so unfair that a physical condition also compromises one’s physical and cognitive health due to chronic stress and elevated cortisol.

    4 reasons to manage chronic stress due to ET

    A review of the paragraph on chronic stress and the brain shows us four reasons why stress management is especially important for those with ET:

    1. High levels of cortisol eventually make the body resistant to insulin. Over time, the pancreas struggles to keep up with the high demand for insulin, glucose levels in the blood remain high, the cells cannot get the sugar they need, and the cycle continues.ii Theoretically, this increases the risk for diabetes.
    2. Cortisol affects several mechanisms that have to do with fat storage, appetite and cravings. Not only does chronic stress raise the chances of weight gain, but gaining unwanted weight often increases the emotional – not to mention the physical – stress in a person’s life.
    3. The ways in which cortisol reduces inflammation will eventually suppress the immune system if they linger. This means a person becomes more prone to colds and other illness, and possibly to autoimmune disorders that are difficult to treat and cure.
    4. Memory impairment (and possibly losing brain volume) influences quality of life for the worse. Coping with ET requires keeping track of many things, and good problem-solving skills.

    Managing stress

    There is broad consensus that stress management should include healthy eating, regular exercise, 7-8 hours of nightly sleep, rewarding family and social relationships, and having fun. There are also stress management “boosters” that may take 6+ weeks of daily practice to start seeing results, but they really work:

    • Calming breathing techniques
    • Daily deep relaxation of muscles (e.g. tense/release practice or other similar exercise)
    • Meditation
    • Activities in line with your values that give your life meaning or purpose

    With particular regard to ET, chronically higher levels of adrenaline and noradrenaline may also aggravate tremors due to increased muscle tension.

    Acquiring good stress management skills is well worth the time and effort. To paraphrase ancient words of wisdom, for those with ET stress management is its own reward.

    iEchouffo-Tcheugui JB, Conner SC, Himali JJ, Maillard P. Circulating cortisol and cognitive and structural brain measures: The Framingham Heart Study. Neurology. 2018 Oct 24. https://www.ncbi.nlm.nih.gov/pubmed/30355700

    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.

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