Anxiety Shaking: Causes and Tips to Treat

Kristin Hall

Reviewed by Kristin Hall, FNP

Written by Geoffrey C. Whittaker

Published 09/15/2021

Updated 09/16/2021

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. 

According to The National Institute of Mental Health (NIMH), anxiety disorders are a collection of mood disorders that represent problematically intense feelings of panic, unease and tension. 

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. 

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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.

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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 an anxiety treatment online evaluation with our experts, and check out our online therapy offerings.

9 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in clinical neuroscience, 19(2), 93–107.
  2. Taylor C. B. (2006). Panic disorder. BMJ (Clinical research ed.), 332(7547), 951–955. Retrieved from
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  4. Lakhan, S. E., & Vieira, K. F. (2010). Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review. Nutrition journal, 9, 42.
  5. Murrough, J. W., Yaqubi, S., Sayed, S., & Charney, D. S. (2015). Emerging drugs for the treatment of anxiety. Expert opinion on emerging drugs, 20(3), 393–406.
  6. [Internet]. Cologne, Germany: Institute for Quality and Efficiency in healthcare (IQWiG); 2006-. Treatment options for generalized anxiety disorder. 2008 Feb 14 [Updated 2017 Oct 19]. Available from:
  7. U.S. Department of Health and Human Services. (n.d.). Any Anxiety Disorder. National Institute of Mental Health.
  8. Pal P. K. (2011). Guidelines for management of essential tremor. Annals of Indian Academy of Neurology, 14(Suppl 1), S25–S28.
  9. U.S. Department of Health and Human Services. (n.d.). Generalized anxiety disorder: When worry gets out of control. National Institute of Mental Health.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kristin Hall, FNP

Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership. 

She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH

Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare. 

Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.

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