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Set an onset of shaking

I had my first what they say was a panic attack March 24 2018.  I started shaking that day and I haven’t really stopped mostly in my hands and arms. But my face neck&head will feel like they’re shaking and I have pressure in my face. This all comes and goes but  happens every day almost all day.  Even when I’m completely relaxed it still happens  Can anyone help?!?!?
1 Responses
987762 tn?1331027953
Hi and welcome,

"Features on Examination Supportive of the Diagnosis of Psychogenic Tremor

-Shaking with changing frequency, amplitude direction, and anatomic distribution

-Movements disappear with distraction maneuver or pressing on a particular spot

-Application of a tuning fork with a suggestion that vibration may increase or suppress the tremor

-Non-patterned abnormal postures and spasms

-Bizarre gait (astasia–abasia), knee-buckling gait, bouncing stance

-Deliberate slowness (with “effort”) carrying out requested voluntary movement

-Abnormal speech pattern (hesitant and slow, bursts of verbal gibberish; changing dialects and accents)

-Facial grimacing, alternating facial contractions (may resemble hemifacial spasm)

-Movements and postures incongruous with recognized disease patterns or with expected physiologic abnormalities

-Manifesting exhaustion, excessive fatigue

-Obvious psychiatric disturbances (depression, anxiety)

-Multiple somatizations and undiagnosed conditions

-La belle indifference

-Delayed and excessive startle (bizarre movements in response to sudden, unexpected noise or threatening movement)

-Presence of additional types of abnormal movements that are not known to be part of the primary or principal movement disorder pattern that the patient manifests

-Convergence spasm and other dysconjugate oculomotor abnormalities"
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4161970/

Psychogenic tremor (PT) is very commonly associated with mental health conditions like anxiety, depression, conversion disorder etc etc but PT can also be tricky to diagnose correctly because it's generally assumptive.  It's very likely when you were assessed your tremor had a few consistencies with PT, the above list are all the typical signs suggestive of a psychogenic causation that do not support a physiological organic causation....

Assuming what you are experiencing is more likely than not to be psychogenic in nature, the visible tremor and feelings are basically a physical reflection of your psychological health and the tremor should be less obvious when you are mentally and or physically distracted-busy-occupied etc and more visibly obvious when your not.......so it wouldn't be unexpected to be more aware of the tremors whilst you feel you are mentally and physically in a relaxed state, because you are actually free from external and internal distractions and able to pay more attention or focus more onto the tremors.

"There is no consensus even among the experts about the best treatment approach to patients with F/PMDs. Actually, psychological therapy (22) as well as different physical approaches (23, 24) seem to improve symptoms, but well designed prospective studies are needed. Therefore, a common agreement is that treatment begins when the physician has made the diagnosis and mostly depending on the way of explaining F/PMDs to the patient, as well as a very close working relationship between neurologist, consulting psychologist, and frequently physical therapist, is crucial in obtaining symptom remission in many subjects. The objective of effective treatment is not only to provide symptom remission in the short term but also to evaluate the causes that produced the heterogeneous symptomatology and to assess feasible strategies to remove them (25)."
https://www.frontiersin.org/articles/10.3389/fneur.2015.00037/full

I would suggest you consider seeking psychological support with a therapist, psychologist or psychiatrist to assess a potential psychological underlying causation and if necessary, explore the varied treatment options that are available, educational understanding, and provide you with practical guidance in your working and private life....

I hope this helps.....JJ
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