What are anxiety tics, and how can I treat them?

What Are Anxiety Tics?

Anxiety tics, or twitches, are involuntary movements or muscle spasms that often occur during times of heightened stress or anxiety. They may appear as muscle spasms in areas such as the eyes, arms, legs, neck, or throat, or as nervous habits like jaw clenching, hair twisting, skin picking, nail-biting, or teeth grinding.

Examples of anxiety tics include:

• Jerking the head
• Rapid blinking
• Scrunching the nose
• Tongue movements
• Grimacing
• Shoulder shrugging

These tics can be frustrating because they happen suddenly and without control, often surprising both the person experiencing them and those nearby. Physically, they feel like quick, jerky movements that are difficult to stop, making them inconvenient and sometimes uncomfortable.

In some cases, anxiety tics can involve more complex movements, like hopping or squatting, though these are less common and typically occur only when a tic disorder is also present.

Officially, “tics” refer to repetitive movements or sounds associated with tic disorders, which differ from anxiety twitches in their underlying causes. People with anxiety disorders such as obsessive-compulsive disorder (OCD) or generalized anxiety disorder (GAD) may also experience tics if they have a co-occurring tic disorder. 

Types of Tics

There are two main types of tics: motor and vocal. 

• Motor tics involve sudden, involuntary physical movements such as repeated blinking, muscle spasms or twitches in the neck, eyes, nose, throat or mouth, shrugging, or grimacing and making faces. 
• Vocal tics are involuntary sounds made by someone. Examples of vocal tics include clearing your throat, clicking sounds, or grunting. 

Within these categories, tics can also be classified as simple or complex. Simple tics last only a moment and involve fewer muscles, such as spasms, grunting, grimacing, or blinking. Complex tics use multiple muscles, and can sometimes have a pattern of multiple actions in a row. These tics may involve jumping, hand gestures, or repeatedly touching or smelling objects. Both tics and anxiety twitches can be classified into each category.

These tics often result from having a tic disorder. There are three such disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-5: 

1. Tourette’s
2. Persistent motor or vocal tic disorder
3. Provisional tic disorder

Tic disorders can share symptoms but differ in the type of tics present and how long the symptoms last. However, if only specific patterns like muscle twitches are present, the symptoms may be a result of anxiety twitches.

Anxiety Tics vs. Tourette's

There is a difference between Tourtette’s syndrome and anxiety tics, which is why it is possible to experience tics without having Tourette’s. 

• Tourette’s syndrome: Tourette’s is a neurological disorder where tics—both motor and vocal—are triggered by a premonitory urge, like a physical sensation, and must last for at least a year to meet criteria defined by the DSM-5. While tics in Tourette’s may worsen during emotional stress, they aren’t caused by anxiety. Instead, Tourette’s has genetic, chemical, and environmental roots, and it usually begins before age 18.

If the only symptom you’re experiencing is uncontrollable muscle movements or nervous habits like unconsciously biting your nails when you’re anxious or stressed—and you aren’t diagnosed with a tic disorder—then you’re likely being plagued by anxiety twitches, aka anxiety tics.

• Anxiety tics: Unlike Tourette’s syndrome, anxiety twitches don’t have a formal diagnosis or specific criteria. They are generally short-lived movements or habits that occur in direct response to heightened stress or anxiety. Anxiety twitches aren’t driven by a neurological urge, and anyone can experience them at any stage of life. They are usually seen as a temporary physical response to emotional tension.

What Causes Anxiety Tics?

Stress and anxiety can lead to physical tension, sometimes resulting in nervous twitches like jaw clenching, skin picking, or nail biting. Anxiety can also trigger heightened muscle tension, as neurotransmitters are released in response to intense stress, causing abnormal spasms or twitching. While these symptoms may resemble tics seen in tic disorders, they have different causes.

Tics associated with tic disorders, such as Tourette’s, have no single cause. Although stress, lack of sleep, and caffeine can increase tic frequency, they are not the underlying cause, unlike with anxiety twitches, which are directly triggered by stress and anxiety.

Triggers for Anxiety Tics

Triggers for anxiety tics are unique to each person and can arise from highly stressful situations. For example, anxiety tics could be triggered if you feel extreme pressure from a demanding job, if you lose a loved one, or after experiencing some other personal loss. Anxiety tics might also be triggered by severe illness, intense social interactions, or overwhelming, major life changes. Each of these triggers can heighten stress levels and contribute to the onset of tics. 

Are Tics from Anxiety Normal?

Twitches like eye twitching, repeatedly clearing your throat, or picking at your skin are normal responses to the stress that your body is trying to manage. However, they are usually a sign that you’re overwhelmed with anxiety or stress. Often, these twitches go away on their own, but it’s best to be aware of them and why they’re happening, and try to lower your stress levels if possible. The best way to identify whether you’re having an anxious twitch is by talking to a medical professional about your anxiety. They’ll be able to assess your condition, examine your symptoms, and prescribe the best treatment plan for you.

How to Stop Anxiety Tics

Anxiety twitches usually resolve on their own, but the best way to support this process is to identify and manage the underlying stressor. Start by considering what might be causing your anxiety. Once you’ve identified the source, you can work on managing your stress by recognizing your triggers and learning how to release stress, rather than holding it in your body. Practicing these strategies can actively reduce your anxiety twitches.

Managing anxiety tics can also include self-care strategies and professional support, such as therapy or medication. Although anxiety twitches aren’t treated as a formal disorder like tic disorders, here are some effective ways to reduce their symptoms.

Lifestyle Changes to Manage Anxiety Tics

• Prioritize sleep: Lack of sleep can intensify anxiety and consequently your tics. 
• Exercise:  Activities like walking, yoga, or playing a sport can be particularly helpful for releasing endorphins and lowering stress. 
• Stay hydrated and eat a healthy diet: Proper nutrition and hydration can impact your mental and physical well-being, which in turn may help reduce anxiety and tics.
• Practice meditation or mindfulness: Mindfulness, meditation, deep breathing, and progressive muscle relaxation are all great tools to have in your kit to manage anxiety and reduce related symptoms, like tics.  
• Limit stimulants like caffeine and sugar: Stimulants can heighten anxiety, which may lead to an increase in tics. 
• Work on time management and organization: Managing time effectively and minimizing last-minute stressors can help reduce overall anxiety. 

If your anxiety twitches persist, or if your anxiety symptoms feel like too much for you to handle, consider seeking help from a mental health professional. Therapy can provide more individualized care and advice for your anxiety.

Therapy Techniques to Treat Anxiety Tics

• Cognitive Behavioral Therapy (CBT): CBT helps people recognize and change thought patterns and behaviors that may cause anxiety. This can help you manage stress more effectively. 
• Habit Reversal Therapy (HRT): This type of therapy can help you become more aware of the triggers for your tics and then replace the tic with a less disruptive behavior. 
• Exposure and Response Prevention (ERP): ERP can help you delay responding to the urge to tic. Over time, this can help weaken the link between your anxiety and the need to have a tic.  
• Comprehensive Behavioral Intervention for Tics (CBiT): Similar to HRT, CBiT helps you learn alternative behavioral responses to suppress or replace tics. 

If you need further help stopping your anxiety tics, there are certain medications a psychiatrist or healthcare provider can prescribe to help reduce anxiety.  Often medications and therapy are used in combination. 

Medications for Treating Anxiety Tics

• Selective Serotonin Reuptake Inhibitors (SSRIs). SSRIs like fluoxetine (Prozac), escitalopram (Lexapro), and citalopram (Celexa) are often prescribed for anxiety to help regulate mood and minimize anxiety symptoms.
• Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs). SNRIs, such as venlafaxine (Effexor) or duloxetine (Cymbalta), work similarly to SSRIs but also affect norepinephrine levels. They are effective for treating both anxiety and tics.
• Benzodiazepines. Medications like clonazepam (Klonopin) and lorazepam (Ativan) are sedatives used to manage severe, acute anxiety in the short term. 

Final Thoughts

Understanding what causes anxiety tics is crucial for managing them effectively, as anxiety is a common trigger for these sudden movements or sounds. By recognizing anxiety tics symptoms and incorporating techniques like stress management, lifestyle changes, and, if necessary, professional treatment, like therapy and medication, you can significantly reduce the impact of anxiety tics on their daily lives. To get your anxiety tics under control, consider starting with a therapist to help you manage symptoms of anxiety.