Essential tremor usually develops gradually during middle age or later in life. Symptoms may remain mild or increase in severity over time. Stress, fatigue, anxiety, and hot or cold weather can worsen the disorder. Severe tremor may cause difficulty performing activities of daily living, such as:
- Brushing hair and teeth
- Holding a glass without spilling
- Performing self-care (e.g., getting dressed, shaving, putting on makeup)
- Using eating utensils
- Writing and drawing
Tremor is usually more severe during fine motor activities such as writing or threading a needle and does not occur during rest or sleep. If it occurs in the voice box, speech will be affected.