ANother question on trembling

I asked a question on Feb.2 with the subject Muscle shaking...anxiety disorder. I wondered if I could follow up a little? First I have signed up for your MasteringStress Etherapy,which is a help,  and also am working with a local therapist.

If you reveiw what I wrote in my initial post, you will note I had questions about muscle shaking and anxiety. My muscle shaking is constant, but not at rest,stength not affected, worse in the morning,only on the negative motion and postural,is in my hands, arms, shouldres, thighs...in short, where you would feel shaking if you were nervous, I suppose.It started after I started being concerned about my health, but didn't feel overly worried at that point. Specifically, my questions are

1.I know you said muscle shaking could defintitely be anxiety...but since it started before I really felt high anxiety, could that just be that the anxiety was repressed? It did get worse as the anxiety built, especailly after the anxiety reaction to the Zoloft. I feel I can't let go of this worry it could be something more since it started weeks before the first anxiety episode, so a definitive opinion from you would help me heal my anxiety. My doctor did a brain mri which was normal, thyriod, liver tests normal, blood pressure only slightly elevated, heart rate normal...so he feels no neurological or adrenal causes...in fact, he says no cause can he see, except anxiety. Would you agree with that, and if so, why did the shaking not go away after the relief from the normal MRI? If I can convince myself to accept this as anxiety, even as I get better, can I expect the shaking to hang around awhile?

2. Since I had an adverse reaction to Zoloft, is it worth discussing trying another ssri, or is it likely they would all affect me the same? I am taking .5 of Xanax XR every moring which is helping enough for me to function and even enjoy some days, but I can still get myself worked up if I overthink it all. Since I am functioning, should I just trust in therapy to get me there? Am I hoping for a miracle in apill, or is it reasonable to expect feeling good most of the time at this point? I feel good a little more than half the time now, big improvement over a few weeks ago.I miss my happy life, am afraid I will get depressed if this goes on much longer, I am usually pretty happy and optomistic, although I do see improvements every week, and it's only been 4 weeks since the Zoloft anxiety uncovered my GAD.

3. Can you give me some concrete exercise to allow me to learn to let go of the things we overworry about, which I know is a prime problem for many of us? Sorry so much, but reassurance is the path to healing for me!

Finally, anyone who has a simliar problem with muscle shaking would like to correspond and support each other? I find too much searching on these forums just give you more to worry about!

Thanks so much!!!

[Roger Gould, M.D.]

First of all, I am glad to hear that you have improved in such a short period of time, and that you are working my program and with a therapist.  That is the right direction because the answer to most of your questions will occur when you discover the root causes of your anxiety. Shaking is anxiety, even before you felt the anxiety. They are from the same source. So yes, it can occur.  You can expect the shaking to go away as you understand the source so trying additonal medications at this time is probably not warranted, especially since the xanax is helping already.   Letting go requires you to understand that your worry about your symptoms is just a false layer of anxiety that keeps you from the source. Try to penetrate to the source by asking yourself what thoughts preceeded your symtpom episodes, and deal with those thoughts that are directly related to the frustrations in your current life.