Can Anxiety Cause Tics

Can Anxiety Cause Tics?

Writen By: Sadia Mirza
Reviewed By: Huma Khan
Publish Date: January 30, 2024

In a stressful situation, have you ever found yourself nervously tapping your foot or repeatedly blinking your eyes? You might have wondered at that time if these sudden, repetitive movements were just a result of anxiety or if there was something more to them. This might have also raised the question, Can anxiety cause tics?

Well, you’re not alone in pondering this. After all, anxiety can manifest in various physical symptoms, so it’s natural to wonder if tics are one of them. This raises a lot of concerns about the connection between tics and anxiety. 

In this article, we will explore your burning questions regarding anxiety and tics. We will talk about the mechanisms behind anxiety and tics, the symptoms of anxiety-related tics, and how they are diagnosed. Furthermore, you are also going to read about the treatment options regarding anxiety tics. So are you ready to find the answer to your question, ‘Can anxiety cause tics? If yes, then read with us.

What is a TIC?

Tics are defined as frequent, rapid, involuntary movements or sounds made by the muscles or voice. Controlling these movements can be challenging for the person experiencing them.  They can involve various muscle groups, leading to physical movements or vocalizations like grunts, clicks, or even words or phrases.

Types of Tics

Tics disorder can mainly be divided into two types. Motor Tics and Vocal Tics.

Motor Tics

Motor Tics involve the movement of muscles. These movements are caused by the contraction of muscles involving the mouth, eyes, head, shoulders, neck, or face. Motor tics can be simple or complex. 

Simple Motor Tics

It is the type of motor tics that involve the movement of only one muscle group or body part. They can be embarrassing or painful but they are not harmful. Its examples are:

  • Blinking eyes or eye jerks.
  • Twitching head or head jerks.
  • Shrugging shoulders.
  • Hopping and squatting.
  • Movements of the tongue, like sticking the tongue out.
  • Finger movements.

Complex Motor Tics

It involves the movement of more than one muscle group. Complex motor tics make it feel as if the person is moving intentionally. These tics interfere with daily life and can be harmful, such as banging the head or biting your lip. Examples include:

  • Touching things or people.
  • Facial grimacing, such as raising eyebrows or frowning.
  • Self-harmful behaviors.
  • Biting.
  • Hitting.
  • Jumping.
  • Clapping.
  • Throwing.

Vocal Tics

Vocal Tics are sounds that are produced by a person going through tics and they are unintentional and uncontrollable. Like motor tics, vocal tics are also simple and complex. 

Simple Motor Tics

Simple vocal tics involve just a single sound or short phrase. It doesn’t have any meaning or intent. It occurs frequently and involuntarily. Examples include:

  • Humming.
  • Clearing the throat.
  • Snorting.
  • Sniffing.
  • Grunting.

Complex Motor Tics

It involves more than one sound or word, including phrases or sentences sometimes. The words or phrases may have some meaning but not always. It may be less frequent than simple vocal tics. Its examples are:

  • The person may repeat their own word (palilalia).
  • Or they may repeat other people’s words (echolalia).
  • They may use obscene words (coprolalia).

Chronic Tics versus Transient Tics

There are visible differences between chronic and transient tics.

            Chronic Tics          Transient Tics
Its duration is more than one year.Its duration is less than one year.
It occurs frequently, like several times per day or nearly every day.It may come and go, but it does not occur daily.
It can range from mild to severe.It is usually mild.
It may require treatment, depending on its severity.It usually doesn’t require treatment.

Types in DSM-5

According to the DSM-5, there are three types of tic disorders, which are Tourette syndrome, persistent motor or vocal tic disorder, and provisional tic disorder.

  • Tourette Syndrome: Tourette syndrome is a neurodevelopmental disorder characterized by both motor and vocal tics lasting for more than one year, typically starting in childhood.
  • Persistent Motor or Vocal Tic Disorder: This disorder involves either motor or vocal tics (but not both) that have been present for more than one year, occurring frequently, but not as part of Tourette syndrome.
  • Provisional Tic Disorder: Provisional tic disorder involves the presence of one or more motor and/or vocal tics, but they have been present for less than one year.

Prevalence 

Research shows that the number of people in the US with persistent tic disorders and Tourette syndrome is about 1.4 million.

Another study shows that tic disorder is higher in children as compared to adults. About 5-30 out of ten thousand children and only 1-2 out of ten thousand adults have tic disorder. Additionally, the research indicates that tics are more common in men than in women.

Now that we understand what tics are, let’s talk about anxiety. This will help us answer your question, “Can anxiety cause tics?” and explain how these two conditions are connected.

What is Anxiety?

Anxiety is a natural human emotion and stress response, which is indicated by feelings of worry, uneasiness, apprehension, and nervousness. It’s our body’s normal reaction to uncomfortable situations, preparing us for challenges and potential danger. 

However, when these feelings become excessive and interfere with daily life, it might indicate an anxiety disorder. 

Types of Anxiety Disorder

There are many types of anxiety disorders, which include:

1.Generalized Anxiety Disorder (GAD)

2. Panic Disorder

3. Social Anxiety Disorder

4. Separation Anxiety Disorder

5. Phobias

Symptoms of Anxiety

Anxiety manifests itself in many ways. They exhibit both physical and emotional symptoms. Let’s take a look at them:

  • Pounding heart 
  • Shallow breathing
  • Dizziness
  • Sweating
  • Trembling
  • Muscle tension
  • Nausea
  • Headache
  • Fatigue
  • Difficulty sleeping
  • Excessive worry and fear
  • Feeling on edge or restless
  • Difficulty concentrating
  • Irritability
  • Difficulty controlling thoughts
  • Feeling detached from oneself or surroundings.

Can Anxiety cause Tics? The Relationship Between Anxiety and Tics

Tics and anxiety have a complicated relationship that raises the question, “Can anxiety cause tics?” Well, the answer is yes. It’s actually quite common for people dealing with anxiety to also experience tics, those sudden muscle movements or sounds that are hard to control. 

When anxiety and tics occur together, it’s called comorbidity, which basically means having two conditions at the same time. Research shows that anxiety is associated with chronic tic disorder and it may be due to activation of the hypothalamic-pituitary adrenal system in reaction to stress.

Studies have also found that depression and anxiety often go hand in hand with Tourette’s syndrome, showing how these conditions can overlap.

How does anxiety cause Tics?

So, when we ask, “Can anxiety cause tics?” The answer is yes, and there are many reasons why it happens.

  • Anxiety tics, also called ‘Nervous Tics’, mostly come from stress. When we’re stressed or nervous, our muscles can tighten up and make us jerk or spasm uncontrollably. This is because stress makes our body release chemicals like adrenaline, which can trigger these tics.
  • Anxiety can also make us breathe too fast, which can make our muscles twitch and lead to more tics.
  • Different things can make us anxious, like stressful situations or worries. When these happen, our body’s stress system, called the hypothalamic-pituitary adrenal (HPA) axis, can get activated, releasing more chemicals in our brain. This can make areas like the basal ganglia more excited, which, according to research, are linked to tic disorders.
  • Anxiety tics also develop due to certain lifestyle factors, such as poor sleep, consuming excessive caffeine, and substance abuse, which can also make anxiety worse and lead to more tics.

Common Scenarios Where Anxiety May Trigger Tics

There are many common scenarios that result in anxiety twitching and tics. They are:

Stressful Situations

Many stressful situations, such as public speaking, exam time, social interactions, work deadlines, and financial difficulties, cause tics. All these situations trigger stress and tension, resulting in tics.

Anxiety Attacks

During the peak of an anxiety attack, there is a surge of adrenaline and a heightened nervous system, triggering both motor and vocal tics. 

Post-traumatic stress disorder

Individuals with PTSD may experience tics as a reaction to triggers that bring back traumatic past memories.

Underlying Chronic Anxiety

Individuals with chronically heightened anxiety may experience tics even without any specific situations, as anxiety itself causes tics.

Illness or Physical Fatigue

When our body is physically depleted, it becomes less resilient to the effects of anxiety, which leads to more severe or frequent tics.

Lack of Sleep

When you are sleep-deprived, it exacerbates anxiety symptoms, making individuals more prone to tics.

Caffeine or Stimulant Use

Excessive use of caffeine can heighten anxiety and muscle tension, which results in tics and anxiety twitching.

What Do Anxiety Tics Look Like?

Some common signs of anxiety tics are as follows:

Motor Tics (Movements)

  • Facial tics: Eye twitching, blinking, grimacing, eyebrow-raising, jaw clenching, nose twitching, lip twitching, or smacking.
  • Head and neck tics: Head shakes, neck jerks, shoulder shrugs.
  • Limb tics: Tapping fingers or toes, leg shaking, arm twisting, clenching fingers, flicking of the wrist.
  • Trunk tics: Stomach tensing, squirming, twisting.

Vocal Tics (Sounds)

  • Sniffing, snorting, or clearing the throat.
  • Grunting, sighing, or whimpering.
  • Clicking tongue, snapping fingers, or whistling.
  • Saying words or phrases repeatedly (echolalia).

Diagnosis of Anxiety-Induced Tics

Tic disorders are diagnosed based on their signs and symptoms. The age of the child must be under 18 for a tic disorder to be diagnosed. 

The doctor may take your physical examination to rule out any underlying medical conditions and take your history of tics. The doctor will ask about their type, frequency, duration, triggers, and associated symptoms like anxiety to get a better idea of tics.

Your mental health assessments will also be done to assess anxiety. A mental health professional will use standardized criteria like the DSM-5 to evaluate the features and duration of the tics to determine if they meet the criteria for a specific tic disorder, such as Provisional Tic Disorder or Tourette Syndrome.

  • The criteria to diagnose transient tics is to watch out for the presence of one or more tics that occur for less than 12 months in a row.
  • If one or more tics occurred almost daily for 12 months or more then they are diagnosed as chronic motor or vocal tics.
  • Tourette syndrome is diagnosed by the presence of both motor and vocal tics that occur almost daily for 12 months or more. 

To check out the cause of tics other than anxiety, a doctor may suggest blood tests, MRI scans, or other imaging.

Differentiating Anxiety-Induced Tics from Other Tic Disorders

Can Anxiety Cause Tics

Treatment Approaches 

If tics are mild, they go on their own, but severe tics need to be treated. There are many treatment options available:

Behavioral Therapies

  1. Habit Reversal Therapy (HRT)

This therapy helps you be aware of your tics by identifying your triggers and replacing them with competing and healthy behaviors. It’s considered the first-line treatment for tics.

  1. Comprehensive Behavioral Intervention for Tics (CBIT)

This type of therapy combines HRT with relaxation techniques and education about tics, and the aim is to manage both tic severity and anxiety.

  1. Exposure and Response Prevention (ERP)

This therapy helps you slowly and gradually to be able to confront situations that trigger tics. It also helps you learn to resist the urge to tic in a safe and controlled environment.

  1. Acceptance and Commitment Therapy (ACT)

This therapy helps you accept your tics and be ok with them and commit to living a meaningful life despite them. When you accept tics without any judgment, it helps you to treat them more effectively.

Medications

There are many medications that can help treat anxiety-related tics. 

  • Selective Serotonin Reuptake Inhibitors (SSRIs)

If your anxiety is a significant contributor to the tics, then SSRIs can be a helpful medicine for that.

  • Alpha-2 adrenergic agonists

Like clonidine and guanfacine, these medicines can help reduce tic frequency and intensity.

  • Antipsychotics

While typically used for severe tic disorders, these medications may be considered in some cases of anxiety-related tics. 

The best treatment approach depends on the individual’s specific situation and needs. It is better to consult a healthcare professional experienced in tic disorders for accurate diagnosis and effective treatment planning.

Best Tips for Managing Anxiety-Related Tics

Here are some of the best tips to manage anxiety-related tics:

  • Engage in exercise regularly for almost 30 minutes most days of the week. Exercise is a natural stress reliever and helps with anxiety, which can benefit tic management. 
  • When you’re well-rested, you’re better equipped to manage stress and tics so try to sleep for 7-8 hours each night. 
  • Eating a balanced and nutritious diet that is rich in fruits, vegetables, and whole grains. Try to avoid processed foods, sugary drinks, and excessive caffeine, which can worsen anxiety and tics.
  • Having a support system can make you feel heard and understood. Surround yourself with supportive people who understand your condition and won’t judge you.
  • Learn as much as you can about tics and anxiety. The more you know, the better equipped you’ll be to manage them.

Conclusion

This blog post Can anxiety cause tics? has shed light on both anxiety and tics and the reasons why anxiety causes tics. It also gives you treatment options and tips to manage it and not feel alone if you’re going through tics.

Many people don’t know that when they are going through tics, it can be due to anxiety and stress. So, there is a need to make more people aware of this issue so they may feel heard, seen, and understood when going through anxiety-induced tics.

If you are going through tics and they are severe, then you should seek professional therapy. Plus, with therapy, you can also try to manage it on your own by following a healthy lifestyle. Any type of mental health condition we go through needs our attention and it is better to treat it when it is mild and does not affect our daily lives.

FAQs

Do anxiety tics go away?

When anxiety tics are mild, they go away on their own but severe anxiety tics need to be treated by a professional.

What do tic attacks feel like?

During a tic attack, an individual going through it can feel variety of physical and emotional sensations such as an overwhelming urge to move or make a sound, a feeling of tension or energy building up in the body, a sense of release or satisfaction when the tic is performed, increased anxiety or stress, difficulty concentrating, and embarrassment or shame. Sometimes tic attacks can be so severe interfering in daily activities such as eating, sleeping and at work.

How do you stop stress tics?

Stress tics can be triggered by stress and anxiety. There are several ways to reduce stress tics:

  •  Identify the situations and activities that trigger stress tics. After knowing triggers, try to avoid and minimize these triggers and make effective approaches for them.
  • Practice relaxation techniques into your daily routine to help manage stress levels. This could include deep breathing exercises, meditation, yoga, or progressive muscle relaxation.
  • Ensuring adequate sleep, a balanced diet, and regular exercise can be helpful for stress tics. Maintaining a healthy lifestyle can help reduce overall stress levels and promote physical and mental well-being.
  • Seek professional therapy as a professional can better help you with their treatment approaches and options that work best for your stress tics.

What are anxiety tics?

Anxiety tics are involuntary and repetitive movements of your body muscles and producing sounds due to anxiety and they seem to be out of your control. The anxiety tics happen in situations of heightened anxiety and stress. 

How long does a tic episode last?

The duration of a tic episode can vary significantly, ranging from a few seconds to several hours. In most cases tics persist for longer periods, up to several hours. The frequency and severity of tics can also vary from person to person, and may be influenced by factors such as stress, anxiety, or fatigue

At what age do tics peak?

While tics can occur at any age, they typically peak in severity during adolescence, between the ages of 11 and 14. The age range between 11 and 14 is the time when tics are most noticeable and frequent. After this peak, tics often decrease in severity or disappear altogether. However, in some cases, tics may persist into adulthood.

Can anxiety cause Tourette’s syndrome?

While anxiety and Tourette’s syndrome (TS) are often linked, anxiety is not the direct cause of TS. Tourette’s is a complex neurological disorder with a genetic component, and its exact cause remains unknown. 

Research shows that environmental factors play a role in developing TS plus, while genetic factors are thought to be the primary contributors to the development of Tourette’s syndrome disorder. So, Anxiety can worsen Tourette’s symptoms, it’s not directly the cause of the syndrome. This means anxiety can amplify the tics, making them more frequent or intense, but it doesn’t trigger the development of Tourette’s itself.

What other mental health conditions can cause tics?

Mental health conditions other than anxiety that can cause tics are: Attention deficit hyperactivity disorder (ADHD), Tourette syndrome, obsessive-compulsive disorder (OCD), and autism spectrum disorder.