ET, depression, & anxiety

Essential tremor (ET) can have a devastating impact on the quality of life for individuals with moderate to severe tremor. Depression and anxiety—in particular social anxiety—are common companions for many of these people.

Depression can generally be well-controlled with medication, supplemented in some cases with counseling. It can affect the way an individual eats, sleeps, feels and thinks. Often under-recognized and under-treated in persons with ET, it is therefore important to know the symptoms of depression:

  • Persistent sadness or anxiety
  • Excessive crying or tearfulness
  • Feeling hopeless, pessimistic, worthless, helpless or irritable
  • Loss of interest or pleasure in activities that were once enjoyed
  • Fatigue
  • Difficulty concentrating, remembering, making decisions
  • Difficulty falling asleep, early-morning awakening, or oversleeping
  • Loss of or gain of appetite and weight
  • Thoughts of death or suicide
  • Persistent physical symptoms that do not respond to treatment, such as headaches and digestive disorders

If you have any of these symptoms, and suspect you might have depression, contact your doctor. Anxiety disorders cause people to feel frightened, distressed and uneasy. Left untreated, ongoing anxiety can reduce productivity and diminish quality of life. Each year, more than 40 million Americans are affected by anxiety disorders.

Many persons with ET experience social anxiety, a form of anxiety experienced as shyness or a fear of public places, performance, public speaking, social situations, interactions with others, and being evaluated or scrutinized by other people. The term social anxiety also is used to describe anxiety brought about by anticipating embarrassment or shame. Persons with social anxiety experience the physical symptoms of anxiety, including confusion, pounding heart, sweating, shaking, blushing, muscle tension, upset stomach, and diarrhea. For persons with ET, tremor often worsens.

Social anxiety, according to WebMD, may be caused by an imbalance of the neurotransmitter serotonin. Neurotransmitters are chemical messengers moving information from nerve cell to nerve cell in the brain. If they are out of balance, the way the brain reacts to stressful situations is altered, possibly leading to anxiety. It is believed that social anxiety runs in families.

The most effective treatment of social anxiety is cognitive-behavior therapy (CBT). Several medications may also help ease the symptoms of social anxiety, but persons with ET need to ensure that their physician knows that some of these, including Selective Serotonin Reuptake Inhibitors (SSRIs) antidepressants like Paxil, Prozac, or Zoloft, can make tremor worse.

Counseling to improve self-esteem and social skills, as well as relaxation techniques such as deep breathing and meditation may also help.