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Don't Be Embarrassed by Essential Tremors

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While Schneier's group recommends further research to determine whether treating social phobia in these patients is effective, there are simple strategies that can help people with essential tremor cope with potentially embarrassing situations.

"People with essential tremor should remember that stimulants like caffeine or nicotine may temporarily worsen tremor," Schneier says. "Fortunately there are ways to treat the tremor directly and to help minimize the embarrassment."

"Alcohol is a great drug to decrease tremor," William C. Koller, MD, a professor of clinical neurology at the University of Miami School of Medicine, tells WebMD. Koller was not involved in the study. "We tell some patients to have a drink before social engagements -- the effect lasts for about an hour."

But drink in moderation. Too much alcohol makes coordination worse and may trigger alcoholism or medical problems related to its use.

Another strategy both Koller and Lydiard recommend for some is a small dose of a drug called Inderal or other beta-blockers, used only before social outings.

"Beta-blockers tend to reduce the tremor and also can help control the increased heart rate, which accompanies exposure to the feared situation," Lydiard says. "They can relieve performance anxiety in musicians and other performers, as well as in individuals with public speaking fears."

Other treatments for tremor are also available. Doctors of severely affected patients might consider injections of Botox, surgery, or deep brain stimulation.

If you are planning to go out for a social engagement, you might want to postpone taking certain prescription drugs that can aggravate tremor, like thyroid or asthma medications. Be sure you check with your doctor first.

Here are a few other simple tips you can try on your next outing:

  • Place a napkin between cup and saucer to avoid rattling
  • Avoid awkward or uncomfortable positions
  • Use auto dial on a cell phone or have the operator place the call
  • Avoid soup, spaghetti, and other difficult foods
  • Learn deep breathing and other relaxation techniques
  • Explain your condition simply and honestly to people you meet

"From a practical perspective, treating symptoms of social anxiety, regardless of the cause, is worth a try," Lydiard says.

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