Also, we take an extensive drug history because many medications can cause tremors: lithium, valproate (which is a seizure medicine), antipsychotics, and antidepressants. Other commonly used drugs can cause tremor, especially caffeine. I think everyone’s experienced that when they have too much coffee, they can get the shakes. Thyroid disease can cause tremor, and there’s something called enhanced physiologic tremor, so everybody has somewhat of a tremor.
Some people have more of a physiologic tremor than others, and that can become exaggerated in times of anxiety or different situations, so we can have an enhanced physical tremor that actually isn’t pathological. It’s a normal phenomenon.