Essential Tremor

Emotional Support

Because many in society tend to inappropriately attribute tremor to substance abuse, hyperactivity, or emotional disturbances, fear of such reactions may cause ET patients to restrict their social and professional interactions. Some patients, particularly those with severe, disabling tremor, may limit their contact to only those people with whom they are extremely close, such as immediate family members.

Therefore, ET patients must be encouraged to learn as much as they can about their disease to help them better cope with the condition's progression. Once a diagnosis of ET has been established, the natural history of the condition should be explained to patients. In addition, because many patients fear that their tremor may be associated with PD, clinicians may reassure their patients by explaining the differences between the two diseases.

It may also be appropriate to recommend counseling. Use of appropriate coping strategies may substantially reduce stress, thereby preventing possible augmentation of tremor due to anxiety. In addition, patients should be encouraged to explain their condition when meeting new people, since doing so may immediately address any questions, concerns, or misconceptions some may have regarding tremor.

In particular, teachers and classmates of children with ET must be educated about the disease. Otherwise, a lack of understanding may contribute to inappropriate labeling of students (e.g., "hyperactive") and cause affected children to feel an ongoing sense of embarrassment, resulting in their withdrawal from peers and hindering their academic progress. Therefore, parents of young children with ET should be encouraged to contact the students' teachers and carefully explain the disease and its effects. It may also be helpful to provide teachers with basic educational materials that may be used to explain ET and its associated disabilities to other members of the student peer group.

In addition, in those academic settings in which teachers and school staff have not been educated about ET, adolescents with the disorder may be suspected of illicit drug use. Although some adolescent students may be able to sufficiently explain ET to their teachers, others will require assistance from their parents. Placing a written note (signed by the parents and treating physicians) in the student's permanent school file may be helpful in alleviating the natural concerns of teachers and school staff.

Referral to appropriate patient-support organizations will be helpful for most patients. These organizations provide detailed educational materials as well as access to local or regional support systems. The International Essential Tremor Foundation and WE MOVE™ (Worldwide Education and Awareness for Movement Disorders) are international non-profit organizations that may assist patients with ET. (Please refer to Additional Resources.)