Hello and welcome to Healthcare Magic. Thanks for your query.

Your symptoms are indicative of an anxiety disorder, more specifically like in your case, anxiety disorders result in much distress and dysfunction in personal, social and occupational life.

Now, since this has been a long-standing problem, and since you also seem to be an anxious person by nature itself, you need a comprehensive psychological assessment in order to plan treatment appropriately. The psychological assessment will include a detailed history (present, past, childhood, personal, social, marital, occupational, etc.), a personality assessment and clinical scales to rate your anxiety level.

Once a clear picture is obtained about the diagnosis and the severity of your problem, then treatment can be initiated accordingly. There are effective treatment options - in the form of medication or psychological techniques (like counselling / psychotherapy / behaviour therapy) which will help you control your anxiety and overcome this problem. This anxiety problem also seems to have reduced your self-confidence and performance, thereby resulting in poor self esteem and a negative attitude. Counselling can address this issue and help you gradually build up your self-confience and self-esteem. So, I would strongly advise you consult a psychiatrist for a detailed evaluation and further treatment. When there are good treatment options available, you don't have to be suffering silently.

Inderal (Propranolol) is a "beta blocker" medication which used in treating hypertension as well as anxiety disorders. It has a beneficial effect in reducing the physical manifestations of anxiety like shaking of the hands, rapid heart beats, etc. Like every other medication, Inderal also has some side effects like tiredness, dizziness, sleep problems, nausea, vomiting, diarrhea or constipation. Most people using this medication do not have serious side effects. However, you should tell your doctor immediately if any of these unlikely but serious side effects occur: shortness of breath, blue fingers/toes, swelling ankles/feet, mental/mood changes (e.g. depression), numbness/tingling of arms/legs, very slow heartbeat or fainting.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist

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Hello again and thanks for your query.

The causes of anxiety disorders are multi-factorial - that is, both biological as well as psychological factors are responsible.

Persons with these disorders have some biological disturbances, such as certain neuro-chemical imbalances in the brain. This imbalance can cause symptoms like shaking of the hands, rapid heart beating, feeling out of control, fearfulness, etc. To a certain extent, these disorders can also be genetic or heriditary.

There are also psychological factors involved - like negative experiences in childhood, negative attitude, poor self-esteem and anxious personality characteristics.

Whatever may be the cause, the important thing is that since you are suffering due to this problem, you need help. Inderal is a medication commonly prescribed for tremors and physical manifestations of anxiety. Remember, that though I had given you a big list of side effects, it doesnt mean that you will get all of them. Side effects are usually minimal and seen only in a very small percentage of persons taking the medication. So, if Inderal is helping you with your symptoms, I would advise you to continue it and not be too worried about the side effects. In addition, there are also certain other anti-anxiety medication which can also help you decrease your problems. So, please discuss these options with a psychiatrist after a detailed avaluation.

I'm sure that with appropriate therapy as well as motivation from your side, you will soon be able to overcome your problems. (Also, you don't have to worry about confidentiality, as all your communications will be kept confidentially and your privacy will be respected)

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist

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Hello again and thanks for writing in.

It is definitely possible to overcome your problem if you take regular treatment and put in efforts from your side with motivation and determination.

In your case, the cause for your symptoms of uncontrollable shaking of the hands and head could be due to the neuro-chemical imbalances in your brain. So, you need to take medication in order to correct this imbalance, as well as take counselling to eliminate your negative thoughts and improve your self-confidence.

So, please consult a psychiatrist in your town / city and he will be able to do a detailed psychological assessment for you and then plan your medication and counselling accordingly.

I will also strongly recommend that you join yoga or mediation classes. You should also try some relaxation therapies like XXXXXXX breathing, relaxation music, etc. Eat a healthy, nutricious and well-balanced diet. You can also take a multi-vitamin supplement (like Zincovit). Exercise regularly. Avoid alcohol or smoking and try to follow an active and healthy lifestyle.

Importantly, stay positive and motivated, and take regular treatment. I can assure you that if you follow all these suggestions, you will soon be able to overcome your problems.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist

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