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Can PTSD Cause Shaking?

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I get shaking and tremors in my jaw and face when I am afraid. I didn't believe that was what it was at first. Kept looking for some med or something that might have been causing it.

Video games may not be a good idea for PTSD people - they can get your adrenaline going because the mind doesn't distinguish between real and fantasy. I avoid movies and TV also - been years since we had one. (Although I sneak a Jon Stewart in when I need to recover from reading the news headlines!)

Coffee is double-edged - on the one hand it can ramp you up but on the other hand it inhibits reuse of glucocorticoids.
 
To all of you it's been reaffirming to read this thread, since I have been in the hospital for the past three weeks. My health issues are too extensive for me to write about on a handheld, but suffice to say I am a frequent ER flyer. And just like most other instances, I presented with angioedema anaphylaxis.

My resting heart rate when unmangaed due to autoimmune disorders is about 140bpm (extremely fast), so when treated with epinephrine in the ER (the usual protocol for compromised and constricted airways), my heart rate doubles to about 300bpm and goes into tachycardic arrhythmia. And I feel as if every single cell in my body is shaking or convulsing, because quite literally they are for the very reasons that others have stated. Which, for me, is physically terrifying but PTSD terrorizing.

I'm not trying to frighten anyone because I am NOT your typical ER patient presenting with typical anaphylaxis (scary as it is), and should never be given epinephrine unless the situation is dire. A glucagon ER protocol is needed in my case, but was not used - hence my extended stay in this "lovely resort". One that has been an unnecessary PTSD nightmare for me with daily PTSD shaking, but without any appreciable relief or benefit of turning off the PTSD "on state" through the release of such adrenaline.

But to Gloria, I once mowed over a bee hive (I'm allergic as well) and was stung over 100 times, so I can relate to your physical pain, your financial epi-pen pain, and your question regarding does the cure hurt worse than the initial sting. All I really want to tell you is that epi-pens are a life-savers, but they were only ever meant to buy someone in crisis time to get to the ER, not eliminate the need.

No one using an epi-pen should go unmonitored afterwards. You should always go to the ER. There where the normal protocol works for the majority, you would have been monitored and given medications to regulate you heart rate, as well as, oxygen, IV isotonic crystalloid solution. You would have also been given appropriate doses of liquid diphenhydramine and corticosteroids (not as fast acting as epinephrine) in advance of the benefits of the epinephrine wearing off.

So if administered correctly, epinephrine provides life-saving short-term care of your symptoms, while IV medications and oxygen counter the negative effects of the epinephrine and provide longer-term care of your symptoms until you are symptom free for a given period of time.

I am sorry for what you experienced. Needing to use an epi-pen is frightening enough, but you shouldn't have suffered all the rest of it. Let alone go unmonitored and untreated for possible adverse and sometimes unsafe heart and airway condition.

Physicians all too often dispense an epi-pen script without proper patient education. Please think of it as only as means to get you to where you can receive proper and individualized care. I surely would not want to see anything worse happen to you, than the sting itself. We have enough on our plates just managing the original physical threat and coping with PTSD!

With much caring regard,
Alex
 
For some reason, I have become immune to gorey stuff on television and my favorite television program was Criminal Minds, Without a Trace, etc. I've seen more than anyone should in real life. I made myself cold about it. Once a soul leaves a body, whatever someone does to the body is just to scare people. The dead person doesn't feel a thing.

I don't do video games but find myself playing blackjack (not for money) and solitaire on my computer for hours very relaxing. I am going to discuss and alternative to epinephrine with my doctor today. It puts my physical body in state of red alert and my mind follows.

I've become a health nut. I take my very specific vitamins religiously, don't drink, avoid sugar and was exercising. My skin, hair and nails have improved tremendously so that organ in my head must be getting some benefit from it also. Thanks for sharing!!!
Hugs,
Gloria
 
No one using an epi-pen should go unmonitored afterwards. You should always go to the ER. There where the normal protocol works for the majority, you would have been monitored and given medications to regulate you heart rate, as well as, oxygen, IV isotonic crystalloid solution. You would have also been given appropriate doses of liquid diphenhydramine and corticosteroids (not as fast acting as epinephrine) in advance of the benefits of the epinephrine wearing off.

So if administered correctly, epinephrine provides life-saving short-term care of your symptoms, while IV medications and oxygen counter the negative effects of the epinephrine and provide longer-term care of your symptoms until you are symptom free for a given period of time.

Dear Alex,

Wow! I am going out the door to see my doctor and printing out what you wrote. I did call the ER and they told me I must come in but I'm such a penny pincher. I hate that one little bug could cost me hundreds of dollars! The only way I can be safe is wear a one piece heavy coverall, thick boots, gloves and netting. I was wearing gloves but my wrist was exposed and one nailed there. Those darn bugs probably have brains smaller than a pin head but are pretty smart! I'm sorry that you are a frequent ER visitor. My neighbors were always asking why the ambulance was always coming to my house. I would have seizures where I cracked my skull and broke my back. I used to laugh that they should park the ambulance in my driveway. One year I had to be taken in 11 times. Last year only twice but the one time I broke my back in three places. I did thnk it was a lovely 7 day vacation after breaking my back though. They gave me delaudin (sp?) and it's like heroin and I tell everyone that it was the best week in my life!

Do take care Alex! I know what 180 pbm feels like. I can't imagine 300 pbm. It's comforting to know that someone out there knows the epinephrine response (although I wish you didn't have to go through what I went through.
Hugs,
Gloria
 
Dear Gloria,

Thank you for your kind words. And really oh so disturbing to hear about your skull fracture and broken back. Was it horse related fall or panicked horse in stall accident? In any case, just extremely glad that you pulled through that frightening ordeal. And sweet to hear your humorous medication induced resort outlook about an experience that was nothing to laugh at. Horse people and PTSDers are a resourcefully tough bunch.

I too love horses, and live in what used to be PA's horse country but not so much anymore. I live right around the corner from where Barbaro (2006 Kentucky Derby winner) was treated, the Pa New Bolton Center. Not that I'm so into the racing side, but do highly enjoy riding competions, fox hunts, and show demonstrations. I just love being around their eloquent beauty - and love brushing them down, though stall work not so much. :)

I have worked and given tours at the New Bolton Center and love being involved with various equine programs for people with disabilities - what a liberating and precious gift. But I am an Engineer and Social Worker by trade, though do find great joy in watching them and photographing them whenever I can. What grace, which is very challenging to capture in pictures, but I like trying.

Though not a true "horsewoman" myself, I have been a "farm hand" and ridden (and fallen off, of course) to round up cattle on my Aunt's farm in South Dakota. I have even ridden atop a Clydesdale - very wickedly cool. I guess I have always viewed my experiences of riding as I do my plaguing medical conditIons (some born with, some acquired, some from injuries, and some the result of abuse) and onging struggle with C-PTSD. You ride nice and smoothly for a while, then come across a rattle snake where the horse rears up and you fall off. But being an appreciable distance away from home, you just have to pick yourself up, dust yourself off, and get back on that horse.

And with regard to the sting and epi-pen, we can't always prevent such events for then we would not be living or feel alive. But often, with an epi-pen and proper ER care, we can live less worry, fewer interrupted days, and without an extended and even more costly in-patient hospital stay. Kind of like the lesser of two evils.

Nice to know that you found my information helpful!!!

Here's to being "infrequent" flyers of the ER. We don't need that added source of stress!!!

Swatting the flies and the bees away,
Alex
 
Yeah, no doubt it's from all that anxiety he is probably going through. Anxiety and panic is treatable though, figuring out what stresses him out could be hard. Through therapy and time doing the right things one can learn to tackle those issues, eventually and hopefully becoming more at peace with oneself. Though Ptsd is not curable, we can live semi normal lives again, strip down what gives the Ptsd it's grip on us.

It's a terrible viscous cycle of symptoms that can feed off one another, leaves us an anxious wreck.
Also leaves us vulnerable to to things like addiction, isolating, numbing..

Stay sober. Don't give in to easy ways out. Push yourself to continue on.
Go to therapy. Go to your doctor. Talk it out.
 
An oldie but a goodie..

"In Men under Stress, Grinker and Spiegel (1945) describe physical symptoms in the acute post-traumatic state that seem to reflect neurochemical changes of the catecholamine system: they describe flexor changes in posture, hyperkinesis, "violently propulsive gait", tremor at rest..." Source: http://www.cirp.org/library/psych/vanderkolk2/

It's terribly distressing to me how many suffer from untreated PTSD and are subjected to many misdiagnoses such as MS, epilepsy, Parkinsons, etc. before coming to the MUCH less invasively diagnosis of PTSD. A simple screening for possible trauma should be at the front end of the diagnostic mapping, not the end.
 
Dear Alex,

Reading your post momtivated me to see my doctor and she (one of the very rare physicians) totally sympathized with me. Her decision was NEVER use the epi-pen unless I start having breathing difficulty. Yes, the arm swollen twice it's size is the better alternative because I could go into cardiac arrest. When my body reacted to much too much adrelanine, of course, it made me have flashbacks and nightmares of the 12-18 hours that I was beaten and held in jail. I was terrified out of my mind the whole time. So benadryl for the stings and if I start to feel my throat close up 911 because you are right, the adrenaline rush needs IV treatment. Thanks so much, Alex. I thought I was again letting my PTSD ruin my life but it wasn't me, it was the epinephrine.

I wish someone would do a blog on epinephrine to let all PTSD sufferers know that they need to be extremely careful with epinephrine and GR555 stated we must not use drugs with PTSD. I am positive that more PTSD sufferers have died from alcohol related symptoms than anything else. So many people in AA are former veterans who say they have to drink. Drinking and drugs take you out of the anxiety and pain for a while but in the end make the problem worse and it will kill you.

Bloomin, Thanks for the info. If psychological stress causes these reactions, then being subjected to the physical symptoms brings about extreme psychological stress. So many times, I read on the forum about hangovers and the shakes making people feel PTSD symptoms more acutely. How do we tell people? But someone who is addicted to alcohol won't listen. I inherited a medical book from 1903 that described "battle fatique" and "hysteria" in women who had been raped or in some way traumatized) The "cure" or treatment (remember this 1903) was a long vacation by the sea or being kept in a very quiet environment. In this book mentally ill or alcoholic people were not blamed for their disease because it was not their fault. It was genetic (being born from inferior bloodlines). In 1903, the medical book also warned that pregnant women should never gaze upon deformed people as their baby would get that deformity. I thought I'd throw that in for a laugh! :p They hadn't even invented penicillin then and most illnesses that are nothing were actually fatal back then.

Remember we do have treatment for PTSD and the understand and treatment is getting better every year. I am hopeful that someday, I will be symptom free. We are the lucky ones!!

Hugs to all,
Gloria
 
To add to what Goria and others have said, epinephrine use micmics what our bodies did during trauma and what they now do under stress. Therefore when such medications are used, our bodies react with a PTSD-like response. And as they say, where body goes, the mind goes as too. Thus setting off a firestorm of PTSD symptoms that cause great suffering - none of which we need.

I also agree with BloominWinter, that this applies as well to people with asthma and COPD who use steroid inhalers. And to other medical conditions and medications. So please don't allow some ill-formed or misguided physician cause you greater distress and pain, by not taking your trauma/PTSD into account when misdiagnosing or treating. For "the medicine" will in fact then be a very "hard pill to swallow".

With that said, we also need physicians not to write off our medical condition because they simply attribute them PTSD symptoms. They can and do independently coexist, as well as, interact and exacerbate each other. I for one would NOT be here today if years ago my gynecologist had attributed my weight loss, weakness, maliase, and difficulty with urinating (with no complaints of abdominal/pelvic pain because I am usually detached from my body) to my office shaking and PTSD symptoms, instead of the Stage II Ovarian Cancer that it was!

Please don't allow the poor reception or indignities we often receive in the medical coummity to prevent you from disclosing your PTSD. It is indeed a very significant part of the context for which all other conditions, diagnoses, and treatments cannot afford to dismiss or to overlook. We don't need suffer more because our symptoms are not holistically approached, by medical and mental healthcare providers alike.

Be your own advocate!!! And get the care you deserve, not the pain you don't!

Take good care,
Alex
 
An oldie but a goodie..

"In Men under Stress, Grinker and Spiegel (1945) describe physical symptoms in the acute post-traumatic state that seem to reflect neurochemical changes of the catecholamine system: they describe flexor changes in posture, hyperkinesis, "violently propulsive gait", tremor at rest..." Source: http://www.cirp.org/library/psych/vanderkolk2/

It's terribly distressing to me how many suffer from untreated PTSD and are subjected to many misdiagnoses such as MS, epilepsy, Parkinsons, etc. before coming to the MUCH less invasively diagnosis of PTSD. A simple screening for possible trauma should be at the front end of the diagnostic mapping, not the end.

Thanks Bloom. And yes often I am like a Parkinsons disease person. The tremors are just there constantly. And when my own 'shakes' came up (PTSD not diagnosed) they wanted to stick me on epileptic pills. I refused. Glad I did or it might never have been diagnosed.
 
Yes it can. I have experienced this when I get anxious around people. Sometimes there is also no trigger for it. At night time when I sleep, my partner told me I shake in my sleep. His ex partner also did this and she was a victim of sexual abuse so it seems to be linked to trauma.

It can be really embarressing sometimes though, especially at work, I pass it off as being a shy and anxious person. I find though during periods of emotional numbness it does not happen as much.
 
My son makes fun of me when I start shaking. He starts shaking and yelling at me. It's only because he loves me and hates it when I get upset but I read him the riot act. I told him that I have been his mother all his life. I've always shaked and he just better get used to the fact that I have PTSD. I told him that in about 20 years, I might be shaking form Parkinson's so just get used to it!!

It is really embaressing. Sometimes it helps to just talk to people when it's happening to diffuse the embaressment a bit!
 
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