Alcohol Tremors and Shakes - a Sign of Addiction?

Alcohol Tremors and Shakes – a Sign of Addiction?

Uncontrollable shaking is a common tell-tale sign that a person suffers from alcohol use disorder (AUD) and can also be referred to as ‘alcohol tremors’. When they get to the point that their hands or other body parts are shaking, this is usually a symptom of withdrawal from alcohol. However, there are some other reasons why a person suffering from alcohol use disorder might shake uncontrollably.

Alcohol withdrawal causing shakes

Alcohol acts as a depressant of the central nervous system – this means that it slows down brain activity and reduces stimulation levels. When someone is a heavy drinker, the brain becomes used to the reduced levels of stimulation and releases more chemicals to counteract this and to keep you more alert.

When someone has been drinking heavily and then suddenly stops drinking, the brain still releases these extra chemicals causing an increase in activity in the nervous system.

This over-abundance of activity within the nervous system leads to symptoms such as excessive sweating, anxiety, and uncontrollable shaking.

While tremors and shakes are a common side-effect of an alcohol use disorder, they can also occur in people who don’t feel that they have a dependency on alcohol. For example, one session of particularly heavy drinking can result in shaking as the alcohol leaves your system.

However, if you do develop tremors after drinking – even if you don’t feel that you have a problem – it is advisable to rethink your alcohol consumption.

How to tell if you have an alcohol dependency

If you are at all worried about your alcohol intake, it is a good idea to cut it down. In more extreme cases, you will need to cut out alcohol in a controlled and safe environment as many side-effects of withdrawal can be dangerous and even fatal.

If you can relate to any of the following, you may suffer from alcohol dependence and should seek medical treatment:

You often drink more than you said you would or expected to
You often promise yourself that you will cut down, but never do
Thinking of your next drink, buying alcohol, or recovering from the effects of alcohol takes up a lot of your time
You feel like you need to drink in order to feel normal
You continue to drink even though it has negative effects on your personal or work life
You have lost interest in other activities that do not involve drinking
You use alcohol even when it is dangerous, for example, when you are driving
You find that you need more alcohol than before to feel the desired effect
You have obvious withdrawal symptoms if you haven’t had a drink for several hours

What are other signs of alcohol withdrawal?

Tremors and shakes are not the only side-effects of alcohol withdrawal. Other common side-effects include:

Nausea
Vomiting
Diarrhoea
Fever and chills
Excessive sweating
Depression
Anxiety
Irritability
Fatigue
Insomnia
Hallucinations
Delirium tremens (DTs)
Seizures
Disorientation or confusion

Side-effects vary from person to person, and they can depend on many factors such as how heavily the person drank before. Side-effects such as delirium tremens and seizures usually occur in the most extreme cases of alcohol withdrawal, and they can be dangerous and even life-threatening.

What is the difference between alcohol tremors and delirium tremens (DTs)?

Many people joke that they have DTs if they are suffering from hangover shakes. However, DTs is a severe and sometimes fatal withdrawal symptom of alcohol abuse. It is rare, occurring in no more than 5% of people who experience other withdrawal symptoms (1).

Delirium tremens usually last between 1 and 3 days, however, in extreme cases they can last for up to 8 days.

Symptoms of delirium tremens include:

Seizures
Hypertension
Hyperthermia
Tachycardia
Arrhythmia
Disorientation and confusion
Hallucinations
Respiratory failure
Death

Delirium tremens is not a permanent condition and most people do recover with medical help.

It is estimated that fewer than 5% of people who present with delirium tremens die from it (2). However, if you recover from delirium tremens and continue to drink, you increase your chances of developing DTs in the future (3).

Other alcohol-related side-effects that can lead to tremors and shakes

Long-term, heavy alcohol consumption can permanently damage the cerebellum – the part of the brain that controls balance and movement. When this part of the brain is impaired, fine motor skills are also impaired, and this can result in visible shaking or trembling. This is called cerebellar ataxia (4).

Damage to the cerebellum does not only cause shaking, but it can also cause life-long problems with balance, involuntary eye movement, poor coordination, muscle weakness and a numbness or tingling feeling in your toes or fingers.

Once the cerebellum is damaged, the damage cannot be reversed, however, it can worsen if you continue to abuse alcohol.

Another alcohol-related side-effect that causes shaking is linked to liver damage. The chronic liver disease leads to a change in brain chemistry known as hepatic encephalopathy.

Hepatic encephalopathy can lead to problems with fine motor skills as well as hand tremors known as asterixis (5).

Asterixis, also known as ‘liver flap’, is a condition that causes a flapping like tremor to occur in the hands when they are outstretched. While hepatic encephalopathy can be treated by medication, dialysis, or a liver transplant, it is a serious condition that can be fatal.

If you feel that you drink too much and too often and have found that you also suffer from shakes or tremors, it is advisable to visit your healthcare provider to discuss your treatment options.

Overcoming alcohol addiction – what treatment is available?

There are several different treatment options available to help you overcome your addiction to alcohol. The treatment that will best work for you depends on the severity of your addiction and whether or not you feel able to go through the process alongside other commitments such as work or school.

Some of the most common treatment options include:

Residential rehabilitation: At a residential rehabilitation facility, you will be checked in as an inpatient for a certain period of time – usually between one week and 90 days. During this time, you will have access to medical professionals who can prescribe medication to combat the withdrawal symptoms as well as mental health professionals to help you get to the bottom of what drove you towards addiction. You will learn the importance of nutrition and be served healthy meals and snacks as well as partake in mindfulness activities such as yoga or meditation.
Outpatient rehabilitation: As an outpatient, you will have access to medical professionals at certain times of the day within a clinical setting. You will be prescribed any necessary medication and be referred to therapy, however, you will still live at home during the process. Many people find that this works better for them as they can still attend work or school throughout their recovery, however, it can be difficult for some people as they are still surrounded by any triggers that may have caused them to drink before.
Peer support groups: Peer support groups such as Alcoholics Anonymous happen in most cities and are usually free to attend with the exception of a small donation. They usually don’t come with a mental health professional, but a chairperson will usually oversee the meeting and make sure everyone stays on topic. Family and friends can attend these meetings with you to gain a better understanding of your journey, or you can attend alone if you prefer. These groups are helpful because they introduce you to people on the same journey as you, and they can also keep you accountable for your actions.
Therapy: Whether you choose one-to-one therapy, family therapy, cognitive behavioural therapy, or a combination of the above, therapy is a very beneficial step on your journey to sobriety. Addiction often occurs alongside other mental health issues such as depression, and you need to address the underlying issues before you can move on with your life alcohol-free. These sessions can also help you change your outlook and mindset, so you approach things in a more positive way. Family therapy is beneficial if your drinking has led to a breakdown in a relationship as it can help you to repair the relationship and overcome any other issues that might have arisen.