What can I do to stop my hand from shaking when I am doing something in front of someone?

Hi Bholu,

It's quite normal to have a slight tremor. For example, if you hold your hands or arms out in front of you, they will not be completely still.

Sometimes a tremor becomes more noticeable, and they can be triggered when you feel stressed such as in social situations.

Shaking or trembling of the hands or other parts of the body are common physical symptoms associated with social anxiety disorder (SAD). Feeling a lack of control over your body can not only increase the intensity of your shaking but may also worsen other anxiety-related symptoms. This uncomfortable symptom may also be present in other anxiety disorders, such as panic disorder, specific phobias, and agoraphobia.

If you are experiencing shaking or trembling because of social anxiety disorder and/or another anxiety disorder, there are treatment options are available.

Causes of Anxiety

When you experience anxiety, it can trigger your body to go into fight or flight mode which is a response meant to keep you safe in times of perceived danger. This response to threats in the environment increases your alertness and prepares your body to take immediate action.

Stress hormones like adrenaline and norepinephrine flood your body, which can increase your heart rate, blood pressure, and the blood flow to your muscles. Muscles may also tense up as they prepare to take quick action, which can lead to shaking or trembling.

Medical research indicates a high correlation between tremor-related medical conditions and social anxiety.

A visit to your doctor can help determine whether your shaking is due to an anxiety disorder or other.

Triggers

Anxiety-related shaking can be triggered by various circumstances. You may notice tremors or shakiness when you are:

• Anticipating an upcoming social interaction
• Attending parties or other social gatherings
• Eating or drinking in public
• Going on a date
• Joining a group conversation already in progress
• Making phone calls
• Meeting new people
• Performing on stage
• Speaking up in a meeting

As well as shaking and trembling, facing a triggering situation can also lead to sweating, an increased heart rate, feeling scared, nausea, and shortness of breath.

Social anxiety disorder-related shaking and tremors may be intensified by high levels of stress and exhaustion.

Feeling fearful or feeling embarrassed about shaking in public can also lead to even more shaking, either in the moment or in anticipation of it. This may result in the avoidance of social situations, which may worsen and prolong the symptoms of social anxiety disorder.

Your Treatment Options

Anxiety-induced shaking or tremors, otherwise known as psychogenic tremors, are generally treated with psychotherapy, medication, or a combination of both. Which treatment option you choose is completely up to you and what you feel comfortable with.

Speaking with your doctor, psychiatrist, and/or therapist can help you make an informed decision about your treatment.

Therapy

Here are some suggestions:

Talk therapies such as cognitive behavior therapy (CBT) or acceptance and commitment therapy (ACT) may be effective treatment options for some who are experiencing shaking, tremors, and other symptoms associated with social anxiety disorder.

For those who are less comfortable, Equine assisted psychotherapy (EAP) or Art Therapy are other treatment methods to explore.

Medications

Some medications may be helpful in reducing or alleviating your shaking and tremors, as well as other symptoms associated with social anxiety disorder. Medications may not work for everyone, it is advised  talk with your medical provider  about the most appropriate course of action for your unique needs.

• Antidepressants: These medications are typically the first-line of treatment.
• Benzodiazepines: Medications can begin working right away to reduce symptoms associated with social anxiety disorder, including shaking. However, the risk of dependence increases the longer you stay on these medications.
• Beta-blockers: By blocking the effect of adrenaline, beta-blockers can be used to cope with infrequent anxiety-provoking situations, such as speeches or performances. They are also able to help some individuals reduce tremors.

How To Get Rid of your Social Anxiety: Tips and Tricks

Coping

There are many strategies you can try that may reduce the symptoms associated with social anxiety disorder, especially shaking and tremors. These techniques may be used in addition to psychotherapy and/or medication.

• Exercise regularly: Exercise and physical activity is a natural anxiety reliever. Exercise releases endorphins and decreases cortisol, resulting in stress hormone reduction and an increase in natural mood boosters.
• Avoid certain substances: An overabundance of substances like alcohol, caffeine and nicotine can intensify social anxiety-related symptoms, including shaking.
• Practice relaxation techniques: When practiced regularly, relaxation techniques such as mindfulness meditation, progressive muscle relaxation and deep breathing can help you feel grounded and can reduce anxiety-related symptoms such as shaking.
• Practice yoga: Yoga is highly effective in reducing anxiety-related symptoms in a variety of anxiety disorders, including social anxiety disorder.

Hand and wrist exercises

Your healthcare provider may refer you to a physical or occupational therapist for treatment or recommend exercises you can do at home. 

Squeezing a stress ball or hand grip for two to 10 seconds, releasing, and repeating 10 times on each hand can be an easy exercise to incorporate into your day. 

Rotating the wrists in a circular motion can keep tendons and ligaments flexible. Moving the hands with intention can keep synovial fluid from building up, which prevents or reduces tremors.

Curling a light hand weight with arms resting on a table and your palms facing up can also strengthen and fine-tune your muscle control.

Weighted hand glove

A weighted glove is a piece of adaptive equipment designed by occupational therapists. The gloves come in various weights. The gloves offer an individual with tremors more hand stability and can reduce the patient’s need for surgery.

Relaxation

Stress, anxiety, and other mental health problems can trigger hand tremors. Relaxation techniques such as breathing exercises, creating a relaxing atmosphere, practicing yoga, and meditating are all worth exploring if stress contributes to tremors. 

Massage therapy can also heal muscles in the hands affected by tremors while reducing stress in the mind and body.

Fatigue is another common cause of shakiness, as getting plenty of rest is important for the body and nervous system to function correctly. The average adult needs approximately 7-9 hours of sleep a night.  

If you need further support with what you are dealing with consider reaching out to BetterHelp for support and guidance with some coping strategies.

Best Wishes,

Gaynor