Develop a Plan to Manage Stress and Tremor During the Holidays

By Kelsey K. Sewell, PhD     
Licensed Psychologist
Clinical Assistant Professor
Dept. of Psychiatry and Behavioral Sciences
Dept. of Neurology
University of Kansas Medical School

The holidays are touted as a magical time, but sometimes the extra stressors that come with creating or expecting that magic end up impacting our enjoyment. Plus, there is enough to manage without adding frustration about exacerbated tremor due to the extra stress. Developing a plan for managing both stress and tremor during the holidays can help ensure a more enjoyable season.

Your holiday plan:

– Focus on maintaining sleep routines and avoiding sluggishness. Poor sleep worsens tremor, and worsened tremor increases daytime fatigue. Add in traveling, disrupted routines, and the possibility of daytime drowsiness from medications, and your holiday cheer might turn into holiday blahs.Try maintaining a consistent sleep routine as much as possible.Try to avoid napping after poor sleep, so the next night isn’t also disrupted. Get outside for 15-20 minutes (with a walk for bonus points) first thing in the morning to get some natural light—that’s the best way to increase energy. Or consider a bright light therapy box (10,000 lux) to avoid going outside in the cold.

– Pay attention to your caffeine and alcohol intake, which can accidentally add up during brunches and parties over the holidays. To avoid worsening sleep, anxiety, and tremor, keep caffeine below 400mg per day (e.g., four 8oz cups of coffee). Although alcohol may temporarily reduce anxiety and tremors and aid falling sleep, it often disrupts later hours of sleep and causes “rebound” (i.e., worsened) tremor and anxiety the next day.

– Try to sneak in self-care routines. This may require modification to fit the situation, such as recruiting family for a brisk walk during football halftime, briefly reading before bed, or calling a friend for support. Plan excuses to slip away if you’ll need little breaks, e.g., taking the dog outside, a bathroom trip, or volunteering to run to the store for a forgotten item.

– Have a plan for stressful social situations. There is always some predictable social stress when you combine numerous people with different personalities and years of history. Imagine the scenarios that would bug you and prepare a response. Focus on approaches to get through the situation without making it worse. Respond gently and find something to validate (e.g., “I know this is disappointing”). If you’re asking someone to change their behavior, use “I” statements and incentivize your request (e.g., “It hurts my feelings when you criticize me. Can we focus on enjoying our time together, maybe play a family game?”). You can’t control other people, but how you respond can often greatly influence the situation.

–Stay mindful by internally checking in. Having visible symptoms like tremor can cause social anxiety, and it helps to catch both stress and anxiety early. Are you feeling tense? Is your heart rate up? Are you hyper-aware of others noticing your tremor? Are you feeling overwhelmed by the packed house and cacophony of sounds? Identify support people who can check in as well. Then have an excuse prepared and take a short break.

One nice, free app with multiple resources for stressful situations is “Virtual Hope Box.” Explore the short relaxation exercises under “Relax Me.” Breathe slowly and deeply, expanding your belly and stretching your diaphragm on the inhale. Mentally recite a calming word on the exhale. Focus only on your breath and whenever you notice your mind wandering, gently return to your breath. You could even do this for 2-3 minutes in the bathroom.

I’m wishing you a balanced holiday season! Last note: If you often feel like stress, depression, social anxiety, and/or tremor feel difficult to manage, working with a cognitive behavioral therapist who specializes in health psychology can help.