Is Essential Tremor Turning You Into a Hermit?

Whether you’re an introvert or an extravert, relationships with family, friends, acquaintances, co-workers and even momentary encounters are not just a fact of life. Social interaction is essential for your wellbeing on every level. Here are just a few benefits of socializing:

  • Physical wellness – boosts the immune system
  • Mental wellness – reinforces a positive outlook
  • Emotional wellness – makes you feel valued and increases self esteem
  • Spiritual wellness – puts life in perspective and gives it meaning

Embarrassment leads to isolation

At least 60% of people with essential tremor (ET) report they are embarrassed by the involuntary shaking of their hands, head, voice, etc. Embarrassment is particularly acute when eating and drinking in public is out of your control. We feel embarrassed when we are obviously so “different” from the norm that we attract stares or other unwanted attention. Embarrassment also brings up shame and guilt.

Social life for those with ET is not for the fainthearted. It is a constant set-up for involuntarily behaviors that are humiliating. If ET progresses, reluctance to socialize eventually turns into avoiding interaction as much as possible. Ordinary situations like meeting a friend for lunch, belonging to a club, doing volunteer work, attending a birthday party, etc. start disappearing from one’s social calendar.

For those with ET, feelings of embarrassment are closely linked with depression. The more intense the embarrassment, the greater likelihood of depression symptoms like persistent sadness, loss of interest in normal activities, feelings of worthlessness, fatigue and anxiety. In turn, such feelings make it harder to resist the emotional impact of embarrassment. Thus, psychological suffering is a vicious circle.

Suffering is contagious

It’s not just the person with ET who experiences emotional hardship. Those who care about him or her also become distressed as they perceive increased withdrawal and psychological suffering of the one they love. Even if their empathic perceptions overestimate the inner pain of the loved one with ET, they too often begin to experience depression.

Overcoming isolation

The irony is, if you have ET and are finding yourself becoming a hermit, you are not alone. You and countless other people with ET face the same instinct to withdraw from your social circles. It’s as if the pain of loneliness is preferable to the compounded suffering of embarrassment and depression. The tendency to find shelter in isolation is powerful and not easy to overcome when medications and other measures to minimize tremors fail to bring relief from the situation.

However, retreating from relationships comes with a price. Humans are hardwired to interact with each other. Short-circuiting that need is likely to make the situation even worse. While it takes effort to overcome the instinct to crawl into your private burrow, don’t give up. Here are some suggestions for actions you can take, and as you reflect on them, you may come up with your own ideas:

  1. Connect with those who understand you best, those who also have ET. The International Essential Tremor Foundation offers a list of national support groups and a calendar of events. If there’s not a group near you, their website encourages you to consider starting one. “Chances are, with the millions of people around the globe affected by essential tremor, it is likely there will be others in your community who are also seeking support. Being a Support Group Leader volunteer can be a wonderful and rewarding experience.”
  2. Turn to your existing relationships with loved ones. Invite close family members and friends to come over, and if eating or drinking is too embarrassing for you, choose a time that’s not about food. Forget about Emily Post’s rules for entertaining, and don’t apologize for not serving refreshments—or, if such courtesy was drummed into you from childhood onward, have simple ready-made finger foods on hand, and let your guest do the pouring of liquid. No one is judging.
  3. Consider joining an online ET group such as our Facebook ET Awareness and Support Group. If keyboarding is too difficult and voice recognition software is not your thing, please join so you can simply read what others post. You will be able to relate to their experiences (which helps overcome feeling “different”) and know that others share what you’re going through.
  4. Stay physically active, which helps counter the tendency toward depression. If intense physical exercise worsens your tremors (which is not unusual due to the release of adrenalin), be assured that such an effect is temporary and gradually subsides when your workout is over. However, if you find it too disruptive or disturbing, try an easy, long walk in nature.
  5. Talk honestly about your feelings with those you trust the most. Any problem can easily become the “elephant in the living room”—everyone knows it’s there, but no one wants to bring it up. Those who care about you may be holding back out of mistaken sensitivity to your feelings, and you may be doing the same thing with regard to them. This mutual silence reinforces the belief that ET should not be talked about openly, which in turn magnifies isolation. You may be surprised at the relief all around when the “secret” is finally aired.

MRgFUS to control medication-resistant tremors

At Sperling Neurosurgery Associates, we offer Neuravive, an FDA-approved noninvasive ET treatment to stop tremors in the dominant hand. Visit our website for more information on the treatment, and how to contact us.

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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