Body Tremors: Are They Related to Anxiety or Something More?

Whole body tremors while lying down?

Hello, doctor.
Last summer, I frequently sought medical attention due to various physical symptoms, and I was later diagnosed with anxiety disorder.
Currently, as a graduate student, I am struggling to write my thesis and have been relying on exercise and a regular routine to combat it.
Before being diagnosed with anxiety disorder, I experienced intense body tremors before sleep, particularly noticeable in my chest (which I initially mistaken for palpitations).
However, after learning it was anxiety disorder, the tremors subsided.
Recently, though, I have been experiencing severe tremors every night before sleep or when lying down.
Initially, I also mistook this for palpitations, but when I placed my hand on my chest, I noticed my heart rate was not as fast as the tremors, confirming it was indeed tremors.
In addition to the pre-sleep tremors, my family has noticed that my hands tremble while eating.
Now, I am hesitant about whether I need to see a neurologist.
I searched online about tremors and found information on Parkinson's disease, which made me anxious.
Furthermore, since last summer, my vision has appeared as if I am looking through a shaking haze.
I consulted an ophthalmologist, and aside from floaters, there were no other issues.
Could this be related to my body tremors? Are these symptoms purely related to anxiety disorder, or do I need to see a neurologist?

Juer, 20~29 year old female. Ask Date: 2016/02/24

Dr. Ding Shuyan reply Psychiatry

Hello, some cases of anxiety disorders may exhibit symptoms such as trembling, and hand tremors are often more noticeable.
Given your age, the likelihood of Parkinson's disease is quite low.
If you are taking any medications, some of them may have tremors as a side effect, so it would be advisable to consult your physician if you have been prescribed any medication.
I recommend that you first return to a psychosomatic or psychiatric clinic for evaluation, and then we can discuss the neurologist's recommendations after the psychiatrist has seen you.
Wishing you all the best, Dr.
Ding Shuo-Yan.

Reply Date: 2016/02/24

More Info

It's understandable to feel concerned about your symptoms, especially when they involve tremors and other physical sensations. Based on your description, it seems that you have been experiencing significant anxiety, which can manifest in various physical symptoms, including tremors.
Anxiety disorders, particularly generalized anxiety disorder (GAD), can lead to a range of physical symptoms due to the body's response to stress. When you experience anxiety, your body goes into a "fight or flight" mode, releasing stress hormones like adrenaline. This can cause physical reactions such as increased heart rate, muscle tension, and tremors. The tremors you are experiencing, especially when lying down or before sleep, could be a result of heightened anxiety levels.
The fact that you initially mistook the tremors for palpitations suggests that your body is reacting to anxiety in a way that can be confusing. It's not uncommon for individuals with anxiety to misinterpret physical sensations, leading to increased worry and further anxiety. The tremors may also be exacerbated by your current stressors, such as the pressure of writing your thesis.

Regarding your visual symptoms, such as seeing a "hazy" image, this could also be related to anxiety. Anxiety can affect concentration and perception, leading to feelings of unreality or visual disturbances. However, since you have already consulted with an ophthalmologist and ruled out significant eye issues, it’s likely that these symptoms are also linked to your anxiety.

While your symptoms may be primarily anxiety-related, it is always wise to consult a healthcare professional if you have concerns about neurological conditions such as Parkinson's disease, especially given your family history or other risk factors. A neurologist can perform a thorough evaluation, including neurological exams and possibly imaging studies, to rule out any underlying conditions.

In the meantime, here are some strategies that may help alleviate your symptoms:
1. Mindfulness and Relaxation Techniques: Practices such as deep breathing, progressive muscle relaxation, and mindfulness meditation can help reduce anxiety and its physical manifestations. These techniques can help ground you and reduce the intensity of your symptoms.

2. Regular Exercise: Continuing your routine of regular physical activity is beneficial. Exercise is known to reduce anxiety and improve overall well-being. It can also help regulate sleep patterns, which may reduce the frequency of your tremors.

3. Sleep Hygiene: Ensure you have a consistent sleep schedule and create a calming bedtime routine. Good sleep hygiene can significantly impact anxiety levels and help reduce nighttime tremors.

4. Cognitive Behavioral Therapy (CBT): If you haven't already, consider seeking therapy, particularly CBT, which is effective for anxiety disorders. A therapist can help you identify and challenge irrational thoughts that contribute to your anxiety and teach you coping strategies.

5. Limit Stimulants: Reducing or eliminating caffeine and other stimulants can help decrease anxiety levels and reduce tremors.

6. Stay Connected: Talk to friends or family about your feelings. Sometimes, sharing your concerns can help alleviate anxiety.

If your symptoms persist or worsen, or if you develop new symptoms, it is essential to follow up with your healthcare provider. They can help determine whether further evaluation is necessary and guide you on the best course of action for your situation. Remember, managing anxiety is a process, and seeking help is a positive step toward feeling better.

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