Brief Answer:
essential tremor vs performance anxiety disorder..

Detailed Answer:
Hello XXXXXXX Welcome to HCM,
I've gone through your query and understand your concern..

Now from your description, it's quite clearly only 2 possible differential diagnosis i.e. essential tremor vs performance anxiety disorder..

First and foremost, few lab investigations should be done to look further in this, eg. a complete Thyroid function test, Serum electrolytes, 12 lead ECG, LFT and KFT.. there's no urgency, but do get them done at one go as per your convenience..

Secondly, your doctor was partly right, as a large part of essential tremor is non-curable as there's complex genetic mutations are responsible for this, effects of which is still in research level , but let's just focus on the treatable and curable part at first as it's quite a possibility..


For the lack of confidence part, try to practice and prepare beforehand (a day before the main event), a good stage preparation almost always deliver..so don't loose hope.. try to engage in conversation with Positive attitude people which'll boost you up to a great extent..

Yes, those shaking can be a part of over-attention as well as the body's fright-flight-fight response where there's release of stress hormones (catecholamines) thus keeps on happening even during those other scenario also..

Try to avoid triggering factors like excessive use of caffeinated drinks (not more than 2 cups of coffee/tea per day, avoid caffeinated fizzy drinks), excess sugary drinks, alcohol, smoking in the first place..

Start doing Meditation every day morning for half an hour (Google it for proper training videos and session), it's highly effective if practiced properly and regularly..

The next step is to consult a Neurologist(specifically) for a thorough clinical examination (Systemic Neurological examination) along with few performance tests (eg. drawing a circle, straight lines, holding a glass properly, drinking from it without spilling, walking in straight line etc.)..this will mostly rule out if there's any significant neurological involvement and all those above mentioned lab tests too, and based on their result, low dose Beta blocker like Propranolol can be initiated and observe how you stay (remember, medicine is not the first choice here, first the exact cause has to be detected after thorough evaluation)..

There're other alternatives like relaxation therapies, psychological counselling, behavioral therapies by Psychologist but that's secondary, so primary focus should be on those step-wise approaches as I've mentioned above..

Do let me know how you stay in the due course..

For future reference you can always get in touch with me, below is my Direct follow-up link through which you can contact me directly anytime anywhere, I'll be happy to help -

http://www.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=71041



Take Care
Kind Regards

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