What causes post-stress tremors and shakiness?

From the Guidelines

Post-stress tremors and shakiness are most likely caused by the lingering effects of stress hormones, such as cortisol and adrenaline, which can remain elevated for hours or even days after a stressful event, as supported by the latest guidelines on anxiety management 1. When you experience anxiety, your body releases these hormones, which can cause physical symptoms like trembling, muscle tension, and fatigue even after the immediate stress has passed. This is sometimes called an "anxiety hangover" or post-stress response.

Key Factors to Consider

• The symptoms of post-stress tremors and shakiness can be similar to those experienced by individuals with post-traumatic stress disorder (PTSD), as outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) 1.
• However, the latest guidelines on anxiety management suggest that these symptoms can be managed with relaxation techniques, lifestyle modifications, and, if necessary, anti-anxiety medications or cognitive behavioral therapy 1.

Management Strategies

• To help manage post-stress tremors and shakiness, try practicing relaxation techniques such as:
  • Deep breathing
  • Progressive muscle relaxation
  • Gentle yoga
• Additionally, staying hydrated, eating regular meals, and getting adequate rest can also help your body recover.
• Limit caffeine and alcohol, as these can worsen trembling sensations.
• If these symptoms occur frequently or severely impact your daily functioning, consider speaking with a healthcare provider about possible treatments, which might include anti-anxiety medications like benzodiazepines for short-term use or SSRIs for longer-term management, along with cognitive behavioral therapy to develop coping strategies for stress 1.

From the FDA Drug Label

Motor Tension (trembling, twitching, or feeling shaky; muscle tension, aches, or soreness; restlessness; easy fatigability); Panic disorder (DSM-IV) is characterized by recurrent unexpected panic attacks, i.e., a discrete period of intense fear or discomfort in which four (or more) of the following symptoms develop abruptly and reach a peak within 10 minutes: (1) palpitations, pounding heart, or accelerated heart rate; (2) sweating; (3) trembling or shaking;

The cause of post-stress tremors and shakiness is anxiety and panic disorder, which can be characterized by symptoms such as trembling, twitching, or feeling shaky, and motor tension.

• Key factors that contribute to these symptoms include:
  • Motor tension: trembling, twitching, or feeling shaky
  • Panic attacks: recurrent unexpected panic attacks with symptoms such as trembling or shaking
  • Anxiety disorders: generalized anxiety disorder, panic disorder, and anxiety associated with depression 2

From the Research

Post-Stress Tremors and Shakiness

• Post-stress tremors and shakiness can be caused by the body's physiological response to stress, which can lead to increased heart rate, blood pressure, and muscle tension 3.
• Relaxation techniques such as progressive muscle relaxation, deep breathing, and guided imagery have been shown to be effective in reducing stress and promoting relaxation, which can help alleviate post-stress tremors and shakiness 3.
• Cognitive-behavioral therapy (CBT) has also been found to be effective in treating anxiety disorders, which can contribute to post-stress tremors and shakiness 4, 5.
• Self-care activities, such as engaging in regular exercise, healthy eating, and getting enough sleep, can also help reduce stress and promote relaxation, which can help alleviate post-stress tremors and shakiness 6.
• Meditation techniques have been shown to be more effective than relaxation therapies in reducing anxiety, which can contribute to post-stress tremors and shakiness 7.

Physiological Response to Stress

• The body's physiological response to stress can lead to increased heart rate, blood pressure, and muscle tension, which can cause post-stress tremors and shakiness 3.
• The physiological response to stress can also lead to changes in electrodermal activity and heart rate, which can be measured and used to assess the effectiveness of relaxation techniques 3.

Effective Treatments

• Relaxation techniques such as progressive muscle relaxation, deep breathing, and guided imagery have been shown to be effective in reducing stress and promoting relaxation, which can help alleviate post-stress tremors and shakiness 3.
• CBT has also been found to be effective in treating anxiety disorders, which can contribute to post-stress tremors and shakiness 4, 5.
• Meditation techniques have been shown to be more effective than relaxation therapies in reducing anxiety, which can contribute to post-stress tremors and shakiness 7.