Involuntary hand tremors can rob a person’s quality of life. Some tremors stem from an underlying neurological condition such as Parkinson’s disease (PD). More commonly, the source is a movement disorder called essential tremor (ET), a progressive but non-life-threatening condition. Many persons with ET or PD find that stress worsens tremors, but there’s a difference between stress and stressors.
- STRESS is an almost instant change in body functions and reactions triggered by a stressful situation. It is called the fight or flight response. The normal resting state of our bodies is a calm balance in which our heartbeat is regular, our blood pressure is low, our breathing is relaxed, etc. However, when triggered by a stressor, the body automatically goes into high gear, flooded with hormones that act like a heavy foot on a gas pedal. We have no control over it—or do we?
- STRESSORS are external or internal stimuli that activate the stress response. External stimuli are things like physical danger, losing car keys, a job interview, an embarrassing event, etc. Internal stressors occur within our minds and are based on beliefs, emotions and memories. Internal stressors such as anger, resentment, worry and fear can happen even when the events that triggered them are long past—but the body still goes into fight-or-flight mode when they pop into our mind. We have no control over the stressors that occur in life—or do we?
- Managing stressors – You have more control over stressors than you may think. Make a list of the stressors in your life (personal, professional, relationship, economic, etc.), rank them in order from the least to the greatest, then determine where to start in terms of the easiest to get rid of. Many “how to” resources are available online or at your local bookstore/library.
- Managing stress – You also have more control over the stress response than you realize, but some practice is needed in order to “train” what is called your parasympathetic nervous system. In contrast to the flight-or-flight response, the parasympathetic nervous system is the rest-and-digest response. The simplest place to start is with something you already do without thinking: breathing. There are many approaches to learning and practicing calm breathing—and the time to start is when you’re NOT stressed. Think of learning new breath techniques as sort of a peace-filled boot camp. You wouldn’t send an untrained soldier into combat, nor should you expect that the next time you’re frantic, a few slow, deep breaths will calm you down. It won’t work unless you devote a few minutes every day in a quiet, private place practicing controlled breath—but in the end, you will be amazed at how unruffled by stressors you are.
Stress and tremors: a vicious cycle
Since the stress response affects the entire system, it likewise makes tremors more severe. This has two outcomes: a) it becomes even harder to perform manual tasks and b) the tremors become even more obvious. Difficulty with tasks and embarrassment are additional stressors, adding to and prolonging the automatic stress response. This can become a nightmarish vicious cycle.
The stress response is as ancient as life itself. Life has survived by instantly reacting to danger. The brain, nervous system, and hormonal chemicals charge us up and command our metabolism assign energy resources where they are most needed. As soon as the stressor is gone, the body returns quickly to a calm state. However, calling upon the stress response for too long and too often ultimately does more harm than good. A chronic state of overstimulation eventually damages the immune system and sets up precancerous conditions like chronic inflammation. One study of data from the Veterans Administration even suggests that chronic stress can directly cause ET through nervous system injury.i
We don’t have control—or do we?
Perhaps we simply accept personal and professional stressors as a fact of life, and thus expect fight-or-flight to be an inevitable part of existence. However, the ancient Greek philosopher Epictetus said, “It’s not what happens to you, but how you react to it that matters.” There is a third alternative to fight-or-flight called stress management:
How can this affect tremors?
In an April 2019 podcast, neurologist Sarah Mulukutla, MD, MPH discussed how PD patients reduce tremors by calming the nervous system through techniques like meditation, yoga, relaxation, etc. She states, “This has been studied and is a valuable skill for people with PD. Many of my patients have learned to control their tremor with relaxation exercises.” If you are interested in how stress management can help your tremors, talk to your medical team about resources available in your area.
iHandforth A, Parker GA. Conditions Associated with Essential Tremor in Veterans: A Potential Role for Chronic Stress. Tremor Other Hyperkinet Mov (N Y). 2018 May 17;8:517.