How to Recognize Signs and Reduce Stress During COVID-19 Pandemic 

March 23, 2020 – Centreville, VA – Adults and children diagnosed with Essential Tremor (ET), a constellation of closely related neurological syndromes in which motion control is often difficult, may be noticing more difficulty managing their symptoms since the onset of the 24/7 COVID-19 Pandemic news coverage.

“ET patients are often not aware they are experiencing chronic stress or that ongoing, prolonged exposure to stressful situations such as the COVID-19 Pandemic can subtly worsen current levels of movement control, increase tremor, making usual levels of medication less effective,” says Peter Muller, Executive Director of the patient education and advocacy association,

ET affects nearly 10 million Americans, roughly eight times more than Parkinson’s Disease, a motion disorder most people think of when they see ET patients shake. ET is a complex hereditary condition that causes tremor in the hands and frequently in the head and voice. People with ET shake uncontrollably during most activities of daily living, and this is a source of stress, anxiety and depression. External sources of stress, like COVID-19 make matters worse.

One type of environmental trigger for increased tremor is stress. Stress has a negative effect on every person but for people with ET, the release of stress chemicals in the brain can worsen symptoms of motor control resulting in tremor.

On a good day, people with ET shake under normal circumstances doing daily tasks with varying degrees of movement control. However, given any momentary jolt of stress or chronic stress exposure, the shaking can become more exaggerated. Some people find tremors are so severe they are debilitating,

“The brain doesn’t know the difference between stress and taking an appropriate action in response to stress, such as bravery. ETers may find their medications are not as effective and not understand it’s related to prolonged exposure and response to the COVID-19 pandemic,” adds Muller.

Dr. Claudia Testa, a movement disorders neurologist, emphasizes there are many positive steps people with ET can take. “People with ET can use non-medication interventions to decrease stress-induced brain reactions. These include deep breathing techniques, mindfulness, exercise, taking short breaks from activities impacted by tremor to dial down frustration, and taking in important COVID-19 pandemic news in small chunks from trusted sources such as the CDC – that’s the place the White House website links to. Reach out to your support networks to avoid feeling isolated. Talk to your doctor if you think you may need more medication to help with tremor control, or supportive treatment for managing stress.”

Muller encourages ET families to:

  • Limit contact with people who are overly stressed, panicked or obsessed by COVID-19 Pandemic news. ET patients will suffer consequences of participating in debates or fear-based discussions. “There is nothing we can do about another person’s fear except get sucked into it and that’s not healthy for us.”
  • Avoid hateful, mocking social media sites as these are not productive and they are stress producing particularly when you engage any dialogue pro or con! 
  • Take a walk, stretch, do some yoga, make a list of what you are grateful for, sing, smile. These are great ways to reduce stress, anxiety and depression.
  • Connect via phone, FaceTime, Skype or similar with friends, family, ET support group members, and colleagues to reduce isolation.
  • Make routines and schedules to provide structure when normal daily routines get disrupted by pandemic restrictions.

“These are difficult times but let’s not let COVID Pandemic get the best of us emotionally,” says Muller. “Our leaders will not be perfect. So let’s not demand that. Everyone at every level is doing their best. Let’s do our best, too. Together we are all strong. COVID-19 is new for everyone. The important message for people with ET is to look and respond to facts not emotions. Remain resourceful and positive. And if you need help with Essential Tremor, come to  






  • Name calling at TV, disgust with officials managing COVID 19 Pandemic, posting angry diatribes on social media — Redirect your outrage for positive action. Someone needs your help somewhere. Anger won’t change anything.
  • Trouble sleeping — Up all hours worried about what you didn’t get at the grocery store? It’s okay. Barter with a neighbor. Hem a skirt or trade canned goods or cash if they’ll pick up a dozen eggs or whatever you missed on their next run to the store.
  • Moody or short tempered — Routines are more than disrupted and uncertainty is the new norm. So embrace it. Learn to laugh at yourself and not take things personally when others snap, crackle and pop at the slightest inference.

Call your neurologist and/or primary physician to discuss how you are managing stress.






  1. Go on a TV Pandemic News Diet – Stay informed, but not 24/7. Allot one reliable news source that supplies facts without the drama. Set a timer for 60 minutes total engagement per day. Watch at least one funny movie daily instead!
  2. Clean and purge! – Tackle overflowing closets. Prepare donations for future pick up. Love that shirt or outfit? Keep it. If not, lose it. You’ll feel so good (anti-stress chemicals) knowing you’ve helped other and  all that extra closet space!
  3. Thanks for the Memories – Create amazing photo albums freeing up awesome images trapped on your phone and Facebook!
  4. Handmade with Love – Rekindle a hobby using supplies on hand (no pun intended) especially if it is one you abandoned because of tremor. YES! The eye-hand coordination you will regain will surprise you. Rediscover determination. It produces awesome brain chemicals. Say, “I think I can” repeatedly until you succeed.
  5. Bloom where you are planted – Weed the garden! Great exercise, eye-hand coordination! Stretch first. Do a little at a time, please! This is no time to strain or rupture anything!! 🙂
  6. Bake bread from scratch! Never done it before? Make it an adventure! It’s great stimulation for your brain — from the tips of your fingers to the synapses in your cerebellum — Try your hand at sourdough!
  7. Control motion! Squeeze some clay, putty or a stress ball in your hands for a good five minutes a day. This really does relieve stress from your arms and shoulders! Put some energy into it and you’ll be surprised at how relaxed you are after!
  8. Play marbles – Ten marbles on the floor. Grab one at a time and place in a nearby plastic (more quiet than a glass) bowl using only your toes. No marbles? Try grabbing a wash cloth with your toes and placing it in the bowl instead. Do it ten times each foot. Amuse yourself and draw a monkey face on the cloth. Do whatever makes it fun. Trust me, your brain is getting as much of a workout as your toes!!
  9. Listen to calming music or dance to MoTown, Burlesque The Musical, hey, anything to get you up dancing! Try something from the 50’s. Or sing along with any of the Beatles or…anything that makes you happy.
  10. Take a hot bath – Throw in a few lemon slices, sprigs of lavender from your (or a neighbor’s) garden and glow in the aftermath. Curl up with a good read afterward. TV and social media OFF time. Ahhh.





NIH Studies into Motor Movement Disorders

On February 12, 2015, Dr. Dietrich Haubenberger, Director of the Clinical Trials Unit with NIH/NINDS, gave a captivating presentation and discussion on Essential Tremor research and its relationship with other motor movement disorders.

While there continues to be research to find a common factor that can be used in the treatment of ET, it has become increasingly evident that ET may be migrating back to an overall descriptive for multiple sub-categories of specific movement disorders that are being discovered and defined in greater detail.

ET vs Dystonia

As the result of more recent research, it is believed that some previous ET diagnosis may actually be Dystonia. Among the key indicators are, if only one side is affected by tremor and has cramp-like features, it would likely will be Dystonia. Areas that can be influenced are a person’s walking gait and head-eye movement coordination.
A number of musicians, athletes in repetitive motion sports, and writers are known to have Dystonia.

The Cerebellum

The Cerebellum, also known as our ‘Little Brain’, is a clearing house center for muscle movement. While it does not initiate movement, it does mitigate the movement and acts as a gentle braking mechanism to allow coordinated motor movement. Otherwise, our muscle movement would be sporadic and uncontrolled. This coordination between initiated neural pulses and the Cerebellum allows constant adjustments and learning adaptation for fine motor movement.

Time went by quickly during Dr. Haubenberger’s presentation and we all look forward to further presentations and discussions with him in the future as his research continues.

Bruce Edwards
Falls Church Support Group