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Can anxiety cause tics?

profile picture of Bianca Clarke
Cognitive Behaviour Therapist
07 March 2024
Next review due March 2027

Tics are short, sudden, and repetitive movements or sounds that are often triggered by anxiety or stress. People can start having tics at any time in life. They may come and go quickly, or could be a sign of a tic disorder, such as Tourette’s syndrome. Here I’ll discuss the different types of tics, common causes, and ways you can manage them.

man relaxing on the sofa with headphones on

What are the different types of tics?

There are two main categories of tics: motor and vocal. Motor tics involve movements of the body, and vocal tics include sounds or words. You may experience one or both types of tics, and symptoms can vary between people.

Examples of motor tics include:

  • head jerking or shaking
  • blinking
  • hitting or kicking
  • finger cracking
  • muscle tensing
  • shoulder shrugging
  • jumping, skipping, or hopping

Examples of vocal tics include:

  • sniffing
  • grunting
  • coughing or throat clearing
  • whistling
  • saying nonsensical words or phrases
  • swearing
  • repeating other people’s words

Tics can be classed as simple or complex. Simple tics usually use one muscle group (areas of muscles in one part of the body, such as the chest). Sniffing or coughing would be examples of simple tics. Complex tics may engage more than one muscle group and can often seem like the person is doing them on purpose. These include things like finger cracking, jumping, or repeating words.

What can cause tics?

If your tics began in childhood and lasted longer than a year, you may have been diagnosed with Tourette’s syndrome. Tourette’s is a disorder that affects the brain and nervous system. The exact cause is unknown, although evidence suggests it can be passed on from your parents.

Factors such as stress and anxiety can make tics worse in individuals with Tourette’s. This is thought to happen because chemicals in the brain are released when we get anxious or excited. This can trigger uncontrollable movements or sounds. Research also suggests that areas of the brain that control emotions can be activated during a tic. Our emotional experiences could be a major trigger for tics, which may tie into why tics can be caused by anxiety.

You may experience tics without having Tourette’s syndrome. An example of tics without a known cause are ‘functional’ tics. These are involuntary physical movements caused by a miscommunication in the brain.

They’re most common in teenage girls and are mainly driven by anxiety. Tics can occur in conditions where anxiety is commonly experienced, such as obsessive-compulsive disorder (OCD), ADHD, or Generalized Anxiety disorder (GAD).

Tics are common and nothing to worry about, even if the cause is unknown. If you think you have tics, your doctor can help you identify your symptoms and possible triggers.

How can you manage tics?

Not all tics need to be treated. But if your tics are interfering with your day-to-day life, you might want to learn how to manage them. Here are some ways that may help you manage or control your tics better.

Behavioural therapies

The aim of behavioural therapy is to change behaviours that you may have learned or gotten used to. Comprehensive behavioural intervention for tics (CBIT) is a programme used to help people reduce their tics by unlearning habits. It can also teach you how to relax better, and deal with situations that make your tics worse. Evidence suggests that behavioural therapy can be as effective at treating tics as medication.

Medication

If you’re happy to, you can take medication for your tics. Treatment should be given by a specialist who is experienced in tic disorders. This may be a type of medicine called Alpha-2-adrenergic agonists, or antipsychotics, which both aim to reduce movement. Botulinum toxin injections (such as Botox) may be used if motor tics in your face or neck are severe.

Anxiety management

If anxiety or stress make your tics worse, you can take steps to reduce your anxiety. Management techniques such as cognitive behavioural therapy (CBT), talking therapy, or anti-anxiety medications may be effective.

Management of other conditions

It may be helpful to treat other underlying conditions which could be causing your tics or making them worse. ADHD and OCD can be managed using medication and behavioural or psychological therapy.

Shift your focus

Tics can be made worse by focusing on them. You could try to engage in distractions when you feel a tic coming on, such as having a conversation with a friend or listening to music.

Tics are not always something we can control, but they’re nothing to be ashamed of. If your tics are impacting your daily life, you can speak to your doctor and discuss ways to manage your tics that work best for you.

 


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profile picture of Bianca Clarke
Bianca Clarke
Cognitive Behaviour Therapist

 

Co-author

Annie Fry, Health Content Editor at Bupa UK

    • Tic disorders. BMJ Best Practice. bestpractice.bmj.com, reviewed January 2024
    • Tics and Tourette’s syndrome: what have you learnt today? NHS Great Ormond Street Hospital for Children. gosh.nhs.uk, accessed 22 February 2024
    • Leisman G. & Sheldon D. Tics and Emotions. Brain Sci. 2022 Feb; 12(2): 242. doi: 10.3390/brainsci12020242
    • Functional tics. NHS Great Ormond Street Hospital for Children. Gosh.nhs.uk, accessed 23 February 2024
    • Cognitive Behavioural Therapy (CBT). Mind. Mind.org.uk, published September 2021
    • Talking therapy and counselling. Mind. Mind.org.uk, published September 2021
    • Psychiatric medication. Mind. Mind.org.uk, published September 2021

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