Why Do People With Social Anxiety Disorder Shake

Why Do People With Social Anxiety Disorder Shake Social Anxiety Disorder Symptoms Print Why Do People With Social Anxiety Disorder Shake? By Arlin Cuncic Arlin Cuncic, MA, is the author of Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder and 7 Weeks to Reduce Anxiety. Learn about our editorial policy Arlin Cuncic Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on January 21, 2020 Social Anxiety Disorder Overview Symptoms & Diagnosis Causes Treatment Living With In Children Verywell / Nusha Ashjaee In This Article Table of Contents Expand Causes Triggers Treatment Coping View All Shaking or trembling of the hands or other parts of the body is a common physical symptom you may experience as part of  social anxiety disorder (SAD). When your shaking results from anxiety, it is a result of the fight-or-flight response. As much as you might feel terrible in the moment that you are shaking, and that the whole world can see just how nervous you areâ€"remember that people dont really notice as much as you think they do. Causes When you shake because of anxiety, it is a result of the fight-or-flight response. This physiological response to threats in the environment increases your alertness and prepares your body for exertion. In the absence of a real physical threat, your body becomes revved up to fight a lion or tiger, but more likely what you are facing is a stranger or an audience. If you are in an anxiety-provoking social or performance situation, your body will release the hormone epinephrine (also known as adrenaline).?? Epinephrine directs blood to your skeletal muscles. You may also experience increased heart rate, blood pressure, and blood sugar. A second hormone, norepinephrine, is also released and involved in many of these changes in your body. When your body starts to quiver, it is as a result of all of these complex internal processes. Shaking can also result from a medical condition such as Parkinsons disease or be the side effect of some medications. When shaking is the result of a medical condition or medication, a medical doctor will determine the best course of treatment. Triggering Situations Common situations in which you might notice your hands or body shaking include when you are: Pouring drinksRaising a drink to your mouthHolding silverwareSigning a checkWriting in front of othersHolding papers during a presentation Shaking and Social Anxiety If you struggle with social anxiety disorder, you probably have problems with shaking in front of others.?? Have you ever had trouble raising a glass to your lips or holding notes during a speech without shaking? You might even notice your legs shaking or your lips quivering. Often these symptoms are also kept going by a cycle of negative thinking. Oh no, Im starting to shake! You think. Guess what that causes? More shaking. Tense muscles. You trying to control your shaking, hiding your hands behind your backâ€"doing things to try and hide it from others. Unfortunately, fighting against your anxiety and using avoidance strategies will tend to make your shaking worse. But dont worryâ€"there are things you can do to shake less. Treatment People who shake because of anxiety may be treated with either medication or talk therapy. Beta-blockers are sometimes used to cope with infrequent anxiety-provoking situations, such as speeches or performances. These medications treat the symptoms of anxiety by blocking the effect of adrenaline  but do not address underlying psychological issues. Talk therapies such as cognitive-behavioral therapy (CBT) or acceptance and commitment therapy (ACT) can be helpful for changing your thought patterns that contribute to social anxiety symptoms. Contact a mental health professional (or get a referral from your doctor) to receive one of these therapies (if you are diagnosed with anxiety), or try them out as self-help methods on your own. Find an Anxiety Therapist Online How to Cope Things that may make your shaking worse (and that you can avoid):?? Lack of sleepCaffeine Positive strategies that you can use to manage shaking: MeditationRegular exerciseManaging stressAcknowledging your anxietyPracticing deep breathing While you may never be fully free of shaking, by following a lifestyle that includes positive measures to combat stress and shaking is a good first step. Rememberâ€"people probably notice a lot less than you think. If you ever find yourself shaking in front of someone, dont try to control it, as that will only make the shaking worse. Instead, focus on something else and move your mind along with so that it doesnt become fixated  on the physical symptom and degenerate into a panic attack. A Word From Verywell Everyone gets nervous from time to time. However, if you find that your shaking is having a significant negative effect on your daily functioning, it is important to seek help. Shaking that results from social anxiety disorder can be treated with medication or therapy.