How to Stop the Anxiety Shakes and When to Seek Help

Why does your body shake when you are anxious?

Your body goes into what's known as a "fight, flight, or freeze" response when it's subjected to stress and anxiety. This response is how your body reacts naturally to danger. It helps you react to a perceived threat or life-threatening event¹ in order to keep you safe.

During this response, your body becomes flooded with stress hormones, such as epinephrine and cortisol. Your heart rate, breathing, and blood pressure all increase as your body prepares itself to deal with the stressor. In this situation, your body and brain interpret anxiety as a signal to either escape from danger or stand your ground. This primes your muscles to act, which leads to shaking or trembling.

When does shaking from anxiety become a real problem? 

Shaking is a natural physiological response to stress. Through evolution, it developed to help people recognize dangerous situations so that they could escape or defend themselves.

This is why when you face stressful situations in modern life, you get nervous due to this built-in evolutionary response. As you’re facing a situation that's dangerous, scary, or exciting for you, it's natural for you to feel anxious.

The issue isn't the anxiety or the shaking itself. The issue is when you can't control the anxiety you are feeling, even when you're not even facing a stressful situation, in which case you may have an anxiety disorder.² People with an anxiety disorder may find they shake even without being in a dangerous situation.  Types of anxiety² that can cause shaking include:

Generalized anxiety disorder (GAD)

If you have a generalized anxiety disorder (GAD), you are likely to experience excessive worry or anxiety that you are unable or find difficult to control most days for a minimum of six months. The anxiety could be about:

• Work and finances

• Personal health

• Family

• Everyday routine

• Social interactions

• Other life situations

Symptoms include restlessness, irritability, muscle tension, fatigue, difficulty concentrating, or sleep problems. You may also experience shaking in conjunction with anxious thoughts even if there isn’t a clear trigger.

Panic disorder

If you have panic disorder, you may find yourself frequently worrying about when you will experience another panic attack. You actively try to avoid future attacks by avoiding situations, behaviors, or places you associate with panic attacks. Shaking might occur before, during, or after a panic attack.

Post-traumatic stress disorder (PTSD)

With Post-traumatic stress disorder (PTSD), you are living with the chronic effects of trauma and coping with unprocessed traumatic memories. This makes you on alert for ongoing threats or attacks.³ PTSD can lead to physiological changes in the body and its response to the surrounding environment. For instance, you may feel hypervigilant and startle easily. You can start to shake in response to being startled, feeling threatened, or encountering a situation that triggers memories of past trauma.

Is it anxiety or a panic attack?

When you feel a sudden rush of intense emotion or nerves, it's likely your body responding to a situation. You might experience nausea, sweating, or shakiness, among other symptoms. If this is your first experience, you may be wondering if you're experiencing anxiety or a panic attack.

Anxiety and panic attacks are two different conditions.⁴

GAD is often characterized by anxiety or worry about future events, anticipating a negative outcome. Symptoms include general uneasiness and muscle tension and the onset is typically gradual. On the other hand, panic attacks are short bursts of extreme fear that come on suddenly and are characterized by symptoms⁵ including:

• Brief chest pain

• Increased heart rate

• Shortness of breath

• Nausea

• Fear of dying

• Temperature changes, either hot or cold

Panic attacks are triggered by an extreme fear response to a perceived threat occurring right at that moment. The body’s "fight-or-flight" response makes you hardwired to handle immediate danger. Panic attacks typically last less than 30 minutes and can occur once or repeatedly.

Techniques to help with panic attacks

The shaking caused by a panic attack tends to pass as the attack ends. However, if you're wondering how to stop shaking from anxiety, you can try techniques including the following:

• Deep breathing – Slow, deep breaths can help to bring a sense of calm and reduce hyperventilation.

• Exercising – Exercise releases pent-up energy and reduces muscle tension to ease physical stress, and distracts your brain from anxious feelings.

• Progressive muscle relaxation – This is a technique⁶ where you tense different body muscles to release the tension in each one.

• Yoga – Regulate your breathing and calm your body through a variety of flowing poses. Regularly practicing yoga can help decrease your symptoms of anxiety.

• Meditation – This is a practice of focused concentration that brings your mind back to the present moment and allows you to acknowledge your current feelings, whether positive or negative. Meditation can work to reduce feelings of anxiety by also incorporating deep breathing.

Treatments to help with anxiety or panic disorder

Other anxiety or panic disorder treatments can provide a long-term solution, including:

• Psychotherapy – Through cognitive behavioral therapy (CBT), you work with a therapist to recognize unhelpful thought and behavior patterns that perpetuate anxiety, and learn to challenge and modify them. You will also learn specific relaxation, distraction, and exposure strategies to manage panic. Dialectical behavioral therapy (DBT) works on enhancing emotional regulation, managing distressing emotions, and learning mindfulness strategies.

• Exposure therapy/EMDR – This interactive type of psychotherapy helps to reprocess traumatic memories and is recommended for PTSD and trauma.

• Medications – If you experience panic attacks or anxiety frequently, you may want to talk with your doctor about medication. Your doctor may prescribe benzodiazepines,  antidepressants such as SSRIs (which also have evidence in anxiety), or beta-blockers like propranolol.

The lowdown

If you're experiencing shaking and any other physical symptoms of anxiety and/or panic attacks, remember that i's just your body's natural “fight-or-flight” response to a stressful situation.

However, while shaking from anxiety isn't dangerous, that doesn't mean you have to deal with it. There are effective treatments, including relaxation techniques, therapy, and medication. Talk with your doctor to get a treatment plan for managing the shaking and easing your anxiety overall.