Understanding The Background Of Tics — Is Anxiety Involved?

Tics are uncontrollable muscle movements that occur in a repetitive, irregular motion. Motor tics can present in various parts of the body, while vocal tics manifest through throat clearing, sniffing, grunting, and other repetitive sounds.

Nervous tics, on the other hand, are repetitive non-rhythmic, involuntary movements or sounds that occur in sudden bursts. Nervous tics are to be distinguished from nervous habits, such as biting your fingernails, which can be a response to anxiety.

If you experience an attack of nervous tics, you may have an urge to persist with the motion that you have no control over. You may be able to suppress these actions for a while until it becomes too overwhelming.

Tics tend to develop in early childhood, and they are more prevalent in boys than in girls. Generally, a tic is a temporary disorder that disappears after about a year or so. However, there are extreme cases of a chronic tic disorder that continues for multiple years. A chronic tic disorder is a condition involving rapid uncontrollable movements or vocal outbursts.

Types of tics

Tics fall into two broad categories: motor and vocal. Motor tics comprise sudden involuntary movements, while vocal tics consist of uttered sounds.

Motor tics include:

• Eye blinking

• Muscle twitches, such as twitching of the eyelids, eyebrows, nose, mouth, or neck 

• Head jerking

• Shoulder-shrugging

• Sniffing

Vocal tics include:

• Throat clearing

• Grunting

• Making clicking sounds

Types of nervous tics

There are two types of nervous tics: simple and complex.

Simple tics last for only a few seconds with few muscles involved. Examples include:

• Neck jerking

• Eye blinking

• Facial grimacing

• Throat clearing

• Sniffing

• Grunting

Complex tics last longer and they engage multiple muscles.

Complex motor tics include:

• Hand motions

• Squatting

• Jumping

• Repeated smelling of an object

• Touching an object repeatedly

Complex vocal tics include:

• Repeated speech (palilalia)

• Repeating another person's speech (echolalia)

• Uttering obscene words (coprolalia)

• Uttering complete sentences or words

Are tics a symptom of anxiety?

When you are anxious, you might experience tics such as twitching eyes, legs, arms, or a spasm in your throat muscle. These physical sensations may even last for a few days before disappearing.

These tics are a symptom of anxiety that occur as a result of muscle tension caused by stress. When you are anxious, your body releases more adrenaline. Anxiety triggers the release of this hormone as a fight-or-flight reaction in response to a perceived threat. For instance, if you are walking along a street and encounter a crowd that is rioting, your body may automatically pump more blood and oxygen to your muscles and lungs so you can either pass through the crowd (fight) or run away (flight).

Medical professionals suggest that tics occur when your body goes into survival mode.

Certain anxiety disorders include tics among their symptoms. However, it should be noted that anxiety disorders are not the most common cause of tics.

1. Generalized anxiety disorder (GAD)

Generalized anxiety disorder is where you feel generally tense, stressed, and worried. These feelings persist even when there is no identifiable cause, or the cause seems irrational. When you have GAD, you may always be worrying about work, family, money, and your health, but you may not be able to pinpoint the exact cause of the worry.

 Symptoms of GAD include:

• Muscle tension

• Headaches

• Chronic fatigue

• Uncontrollable twitching

• Dizziness

• Irritability

• Lump in the throat

2. Social anxiety disorder (SAD)

Social anxiety disorder causes you to feel overwhelmingly anxious in social situations. When you have SAD, you can become overwhelmingly self-conscious and overcome by the fear that someone is watching and judging your actions.

At the same time, you may feel embarrassed by your actions and afraid of socializing. Social phobia (another name for this condition) and GAD share similar symptoms of SAD.

How anxiety causes tics

Anxiety triggers the release of neurotransmitters or chemicals used by the body to send messages to the muscles. When you experience anxiety, the release of these chemicals triggers muscle movement despite there being no need for it.

As a result, your muscles move or twitch. Hyperventilation, or fast breathing, is another side effect of anxiety. When you breathe normally, your lungs take in oxygen on the inhale, then release carbon dioxide on the exhale. Hyperventilating means you breathe out more, releasing excessive excess carbon dioxide while not taking in enough oxygen. When your carbon dioxide levels are depleted, the blood vessels responsible for supplying blood to the brain constrict. This causes you to experience lightheadedness, tingling fingers, and eventually a loss of consciousness.

Treating and managing tics

If you suffer from tics, it is important to learn strategies to suppress and manage them. Counseling can be effective in understanding how to manage tics and their side effects. Therapy is also effective in relieving discomfort and assisting with situation management.

A doctor can diagnose you as having tics by evaluating your physical condition and medical history. You should provide your doctor with details of your symptoms, when the tic started, and how often it happens. Your doctor may order some or all of the following four tests to rule out any other illnesses:

• Blood tests

• Brain MRI or CT scan

• Muscle electromyogram (EMG)

• Nerve conduction test

If your doctor confirms that you have anxiety tics, they will refer you to a psychologist or psychiatrist for further assessment and treatment. These mental health professionals can offer psychotherapy and/or medication as treatment options.

Taking preventive anxiety measures is another helpful approach to reduce the likelihood of unwarranted muscle movement. These measures can include:

• Change in diet

• Getting sufficient sleep (approximately eight hours per night)

• Avoiding energy drinks or excessive caffeine

• Staying hydrated

• Exercising regularly

When should you see a doctor?

Tics are usually a temporary disorder that disappears after a while. However, if you or a loved one is experiencing involuntary movements,  especially if they persist, make sure to consult a medical professional as soon as possible. Any abnormal involuntary movement may need to be investigated by a neurologist.

The lowdown

Tics, muscle movements, and twitching can be uncomfortable and, at times, embarrassing. As tics are generally a symptom of anxiety, by managing the causes of stress, you can help to treat or manage tics.

When tics occur in children, they tend to disappear after a few months to a year. However, persistent tics in children or adults require medical intervention. Healthcare professionals will carry out tests to diagnose you, and you may be referred to a psychologist or psychiatrist who can provide therapy and/or medication. Counseling and other forms of therapy may help you to manage tics and their side effects.