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I start the day with a fine hand tremor, courtesy of lithium and caffeine, and it fades throughout the day. It may kill my banjo hobby, and my signature is worse than my doctor's, but that's about it. It has gotten more pronounced over the course of my year on lithium...maybe I'm just not as well hydrated as I used to be.

If you alarm me, however, this turns into a marked coarse tremor...hands shaking hard on the steering wheel (scary), or (the most embarassing), smiling for the new driver's license photo and having the whole left side of my face go haywire.

You, too? Please don't say beta-blockers, I'm already on five meds and afraid of sleepiness. Deep breathing? (Meds are Abilify 10 mg, lithium 900, Depakote 375, Lamictal 125, Adderall 5).


shakes, rattles and rolls

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I have essential tremor (tremor for no good reason). It started when I was in my teens. Here's what I've found.

Ditch the caffeine. It's a major contributor to tremor. It will be awful for the first few days. Bad headaches, general malaise, sleepiness, grumpiness (hmmm, most of the seven dwarves, it seems). After that, it will be a few weeks before you feel completely awake without the caffeine. After that, it's great.

Any kind of excited state, whether it be nervousness, anger, embarrassment, fear, will make the tremor worse. I've learned to pay it no mind. You can prevent drawing attention to it by avoiding picking stuff up when it's bad, such as anything with liquid in it or papers or anything that will obviously shake when you're holding it. Try not to be self-conscious about it. It makes it worse.

My tremor will respond briefly to a kind of biofeedback where I will my writing hand to be still for a bit so I can write something down. A few minutes of forced relaxation helps too, such as deep breathing with eyes closed. Isn't that what bathrooms are for?

Now I'm not recommending this per se, but alcohol helps. I have no idea how lithium and alcohol get along. It just happens to be a nice side effect of a small amount of the demon drink.

That's all I can think of, other than the propranolol.

Good luck,


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