Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 9/16/2021
How bad is your anxiety? Does it disrupt your work day? Does it prevent you from engaging in social situations and other daily activities? Is it affecting your quality of life?
Is your anxiety so bad that you shake?
Believe it or not, many people suffer from such severe anxiety that they’re impaired not just by negative thoughts and worry, but by physical symptoms including, yes, tremors.
Anxiety shaking is one of the common symptoms of social anxiety disorder and other types of anxiety that can make daily life difficult and, at times, embarrassing.
Nobody wants to be seen as “shaky” and nobody wants to feel like the outward appearance of their body reflects the worst parts of their brain chemistry.
Anxiety shaking is part of the flight response that we want to control, but for people with anxiety or severe anxiety, that control can be hard to get.
Thankfully, there are ways to control tremors and take back confident command of your body, voice and the other things plagued by these physical responses.
First, though, we need to explain some things about anxiety and how physiological responses for people with anxiety happen.
Before we explain why anxiety can give you the shakes, it’s important to understand a little about what anxiety is.
Anxiety symptoms commonly include things like restlessness, recurring muscle tension, insomnia or difficulty sleeping, a recurring feeling of being on edge or wound-up, patterns of difficulty concentrating, frequent fatigue and regularly present feelings like irritability and uncontrollable worry.
For a diagnosis, you’ll have felt many of these things for at least six months.
Sound familiar? You’re not alone. More than 30 percent of American adults will have an anxiety disorder during their lifetime.
The most common anxiety disorder form is generalized anxiety disorder, or GAD, which is defined by a period of months or years of anxious worry.
We don’t know everything about anxiety, including its root cause or a “cure” for it. What we do know is that anxiety occurs due to imbalances of chemicals and neurotransmitters in the brain, similar to another common mood disorder, depression.
Let’s focus on the topic at hand: tremors and shaking.
According to the NIMH, one of the symptoms of generalized anxiety disorder (GAD) is trembling or twitching.
This often manifests in the form of shaky hands, but it can affect any part of the body really, even making some people believe they may be having a heart attack.
Tremors or shaking are sometimes symptoms of anxiety. Stress and anxiety can often increase the symptoms of this particular effect.
For many people, the shaking can be accompanied by an increase in heart rate and even a panic attack.
Anxiety shaking is the physical embodiment of anxiety symptoms — the fight or flight response engaged in a physical manifestation of fear.
Anxiety-provoking events may cause shaking and tremors, especially in social situations that involve embarrassment — like public speaking situations, for instance.
Studies show that there are several ways to treat anxiety-related tremors and shaking, and they overlap significantly with the general treatment list for anxiety itself.
For instance, things like cognitive behavioral therapy may help, as well as medications like propranolol (a beta-blocker) or lorazepam, which is a specific type of medication in the benzodiazepine family.
Lifestyle changes like cutting down on smoking and alcohol intake, as well as getting better sleep, exercising and participating in some mindful meditation and relaxation techniques can help you regulate these tremors.
You should also caffeine intake.
Of course, that’s all to say that your first step if you’re experiencing shaking as a result of constant anxiety should be to see a healthcare professional.
Taking your symptoms into account, they’ll be able to help you down the right path to treatment.
Tremors and shaking as a result of intense anxiety will also typically go away or be reduced in severity by treatments that address the anxiety itself. So, let’s talk about a few of your options.
The first is antidepressants which, in many cases, can offer anti-anxiety benefits alongside their depression benefits as on- or off-label uses.
Most healthcare professionals will start patients off with selective serotonin reuptake inhibitors, or SSRIs, and employ other antidepressants only if SSRIs fail.
But even if you’re prescribed medication, you might benefit from additional therapies, including, well, therapy.
Anxiety disorder and panic disorder are known to generally respond well to therapy, and specifically to the popular therapeutic technique Cognitive Behavioral Therapy (CBT).
CBT helps anxiety disorder sufferers to break out of panic loops and address their symptoms by recognizing disordered patterns of thought and teaching coping strategies to reduce the frequency and severity of attacks.
A healthcare professional may also suggest that you address certain lifestyle, career, and relationship factors — diet, exercise and patterns of substance abuse may be contributing to or exacerbating your symptoms.
If you’re experiencing tremors or shaking due to your anxiety, chances are that it’s pretty severe. Severe anxiety needs treatment — immediate, professionally guided treatment.
We’ve mentioned several resources for learning more throughout this article, and while reading is a good thing, talking to a mental health professional is a great thing is, as we mentioned, your first step.
Don’t avoid the problem — it won’t go away, and it may worsen without help. Consider scheduling a telepsychiatry evaluation with our experts, and check out our online therapy offerings.