Why do my hands shake when I am nervous? Shaky hands and anxiety

You go to hand someone a coffee and the cup rattles on the saucer. You sign a form at the bank and the pen wobbles. You hold your notes in a meeting and watch the paper shake. Then you start worrying that everyone has noticed, and it gets worse.

Here is something most people do not know: everyone's hands shake a little, all the time. It is usually too small to see. Stress, caffeine and tiredness turn that tiny tremor up until it becomes visible. Most shaky hands are this kind, but some tremors are worth getting checked, so those come first.

See a doctor promptly if

• One arm or leg suddenly goes weak, your speech slurs, or one side of your face droops. Call emergency services right away.
• Your hand shakes while it is resting in your lap, and your movements or walking have become slower.
• The shaking comes with weight loss, feeling hot all the time, and a racing heart.
• You are sweaty, dizzy and shaky, especially if you take medication for diabetes.
• The shaking started after you cut down on or stopped drinking alcohol.

The first one can be a stroke and every minute matters. The others are not emergencies, but they have causes a doctor can look for, often with a simple exam or blood test.

What anxiety shakes usually look like

• Your hands are fine at rest and shake when you hold something, write, or reach for something.
• It is much worse in front of people, in meetings, interviews or on dates.
• It is worse on days you slept badly, had a lot of coffee, or skipped a meal.
• Both hands shake about the same, and it settles once you calm down.

If the shaking keeps going for months even when you are not stressed, or someone in your family has the same kind of tremor, it is worth mentioning to a doctor. Knowing what it is tends to take a lot of the worry out of it.

Why nerves show up in your hands

When you are anxious, your body gets ready to fight or run. Adrenaline goes up, your heart speeds up and your muscles tense. In that state the normal small tremor gets several times bigger. Your hands are not shaking because you are weak. They are shaking because your body is working hard to protect you.

The real trouble is the loop that follows. Your hands shake, you worry people will see, you get more anxious, they shake more. After a while just picking up a glass can feel like a test. For a lot of people, the fear of shaking ends up bigger than the shaking itself.

What helps in the moment

1. Slow your breathing just before the moment you are dreading. In for four counts, out for six, three times. The long breath out is the part that tells your body to settle.
2. Squeeze your fists hard for a few seconds, then let go. Do it five times. Using up that tension tends to calm the tremor for a while.
3. Hold cups by the body with both hands, not by the handle. Rest your elbow on the table or against your side.
4. Skip coffee and energy drinks on the day of a presentation or interview.
5. Do not go into a stressful situation on an empty stomach. Even a banana helps.
6. Stop hiding it. Saying "sorry, I am a bit nervous" out loud often makes the shaking smaller, because you are no longer spending energy covering it up.

That last one is the hardest and the most useful. And most people are looking at your face, not your hands.

If it is happening more and more

Shaking that keeps getting worse can be a sign your body has been stuck in alarm mode for a long time. If it comes with a pounding heart, a feeling of dread, trouble sleeping or worry you cannot switch off, it is worth talking to a doctor or therapist about anxiety. It is very common and there is good help for it. If you are having thoughts of hurting yourself, please contact a crisis line now.

Somewhere to set it down

Shaky hands are often the part of you that shows what you have been holding in. In front of people you keep it together, and the tension has to come out somewhere.

Writing down what is weighing on you, anonymously and without anyone watching, can be one small way to let some of that tension out before it reaches your hands.

If the heaviness does not lift, please do not carry it by yourself.
US: call or text 988 (Suicide & Crisis Lifeline) · Elsewhere: findahelpline.com