Anxiety Tics Explained

Understanding and Overcoming the Mind-Body Connection
When 14-year-old Emily started blinking excessively during her final exams, her parents chalked it up to allergies. As time passed, the blinking turned into shoulder shrugs, grunts, and occasional jerky movements which all worsened when she was stressed. After months of concern, a visit to a psychiatrist revealed a surprising discovery: anxiety-related tics.

Emily's story is not uncommon. Many people experience involuntary movements or sounds known as tics, especially during times of high stress or anxiety. These tics can range from subtle muscle twitches to noticeable vocal outbursts, and they often go undiagnosed.

What Are Anxiety Tics?
Tics are sudden, repetitive, non-rhythmic movements or vocalizations that can be difficult or impossible to control. They can occur in the context of several conditions, but many are linked to stress and anxiety.

While tics are most often associated with Tourette Syndrome, they can also be stress-related or transient, especially in children and teens.

Examples of Motor Tics:

• Eye blinking
• Facial grimacing
• Shoulder shrugging
• Head jerking
• Arm movements

Examples of Vocal Tics:

• Throat clearing
• Sniffing
• Humming
• Grunting
• Repeating certain words or phrases

Are Anxiety Tics Common?
Yes. According to the CDC, approximately 1 in 50 children in the U.S. has a tic disorder with many cases connected to anxiety or emotional distress.

A 2021 study published in JAMA Neurology found that stress is one of the most frequently reported triggers. The same study noted a rise in stress-induced tic behaviors in adolescents following the COVID-19 pandemic, especially among girls.

Tics aren’t limited to children. Adults with generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), or panic disorder may also experience tics as part of their symptoms.

What Causes Anxiety Tics?
The exact cause of anxiety tics isn't fully understood, but researchers believe it's a combination of neurological, genetic, and psychological factors.

1. Neurological Sensitivity
The brain circuits that regulate movement and emotion, basal ganglia and dopamine pathways, are often overactive in individuals with tics. Stress can increase this activity which makes the body more reactive.

2. Anxiety and Overarousal
Anxiety puts the body in a state of "fight or flight." This heightened arousal increases muscle tension and sensitivity which can make tics worse or create them.

3. Genetics
Tics and anxiety often run in families. If a parent or sibling has experienced them, the risk is higher.

4. Psychological Stress
Major life changes, school pressure, family conflict, or trauma can trigger or worsen tics. Many children experience their first tics during times of high emotional stress.

How Are Anxiety Tics Diagnosed?
There is no single test for anxiety tics, but a thorough evaluation by a psychiatrist or neurologist can help determine the cause and rule out other conditions like:

• Tourette Syndrome
• Chronic Tic Disorder
• OCD
• Autism Spectrum Disorder (ASD)
• ADHD
• Functional Neurological Symptom Disorder

The psychiatrist may ask:

• When did the tics begin?
• Do they change over time?
• Are they worse in stressful situations?
• Do you feel relief after the tic?
• Are there any other symptoms?

It’s also important to assess for co-occurring conditions. Up to 50% of people with tics also have ADHD, and up to 40% have anxiety or OCD according to the Tourette Association of America.

Are Anxiety Tics Permanent?
In many cases, no. Anxiety-related tics are often temporary, especially in children. With the right treatment and emotional support, they tend to fade or resolve over time.

If left untreated, they can worsen or become part of a more chronic condition.

Treatment Options for Anxiety Tics
Treatment is available and effective. A combined approach involving both psychiatric care and therapy often leads to the best outcomes.

1. Cognitive Behavioral Therapy (CBT)
CBT is the gold standard for anxiety and related tics. It helps patients:

• Identify and reduce triggers
• Learn relaxation techniques
• Challenge unhelpful thought patterns
• Practice Habit Reversal Training (HRT) to manage tics

In fact, the Comprehensive Behavioral Intervention for Tics (CBIT) has been shown to reduce tic severity by 30–50% in multiple studies.

2. Medication Options
If tics are interfering with school, work, or relationships, medications can be helpful. Options include:
For Anxiety:

• SSRIs (e.g., sertraline, fluoxetine)
• Buspirone
• Hydroxyzine (for short-term use)

For Tics:

• Guanfacine (also treats ADHD and anxiety)
• Clonidine (especially for children)
• Risperidone or aripiprazole (used for more severe or chronic cases)

Medication is not always necessary, but in moderate to severe cases, it can significantly improve quality of life.

Supplements for Anxiety Tics
Some people prefer natural options, especially as a first step. While not a substitute for medical care, the following supplements have shown promise:

• Magnesium: May reduce muscle tension and tics; often used before bedtime
• L-Theanine: Found in green tea, promotes calmness
• Omega-3 fatty acids: Supports brain health and mood regulation
• Vitamin B6: Important for nervous system function

Always consult your psychiatrist before starting supplements, especially if you’re already taking medications.

Natural Strategies for Managing Tics
Here are a few simple things that can make a big difference:

1. Mindfulness and Meditation
These practices help calm the nervous system and improve awareness of physical sensations. Apps like Calm, Headspace, and Insight Timer can guide beginners.

2. Regular Exercise
Physical activity reduces anxiety and channels energy in a healthy way. It also promotes better sleep.

3. Sleep Hygiene
Poor sleep can make tics much worse. Stick to a consistent bedtime, reduce screen time at night, and keep the bedroom cool and quiet.

4. Avoiding Triggers
Caffeine, video game overstimulation, and sugar may increase tic frequency in some people. Keeping a journal can help track patterns.

5. Supportive Environments
Children with anxiety tics do best in calm, predictable environments. Praise efforts, not outcomes, and avoid drawing attention to the tics.

Working with a Psychiatrist and Counselor
Managing anxiety tics is not a one-person job. It takes a team approach, and that starts with the right professionals.

Why a Psychiatrist Matters:

• Diagnoses the root cause (e.g., anxiety vs. neurological)
• Provides medication if needed
• Coordinates care with therapists and primary care providers

Why a Counselor Matters:

• Provides a safe space to talk about fears, frustrations, or bullying
• Offers strategies to manage anxiety in daily life
• Helps the entire family system adjust and support healing

The combination of medication and therapy is often more effective than either alone.

A Message of Hope
Tics can be frustrating, embarrassing, and scary, but they are manageable. Emily, the teenager from the beginning of this article, began therapy, worked with a child psychiatrist, and started a small dose of guanfacine. Within three months, her tics had reduced by 80%, and she felt more confident at school.

Thousands of children, teens, and adults just like her experience anxiety-related tics and recover.

If you or your child is experiencing tics that may be linked to anxiety, don’t wait. The earlier you seek help, the better.

At Your Family Psychiatrist, we offer psychiatric evaluations and treatment plans for children, teens, and adults with anxiety, tics, and other mental health concerns. Our collaborative care model ensures you get comprehensive support from a caring team of professionals.

Request your appointment online today.