Nervous Tics: Symptoms, and Examples, and Treatment

Do you ever notice yourself tapping, twitching, or clearing your throat when you’re feeling particularly anxious? You may have a nervous tic, a minor but potentially uncomfortable or embarrassing habit that results from periods of stress or unease.

Tics, or involuntary movements or vocal sounds, can arise from a number of conditions, including neurological disorders, anxiety, and obsessive-compulsive disorder (OCD). While tics vary from person to person, they usually involve physical movements like lip twitching or eye blinking, or vocal tics like throat clearing or coughing.  

When tics result from periods of intense anxiety, they’re usually referred to as anxiety or nervous tics. While nervous tics aren’t always preventable, tools that help to minimize stress may help make them infrequent or more minor. Read on to learn more about  common examples of nervous tics, what causes them, and how to get treatment.

What are anxiety tics?

Episodes of serious worry or unease usually start in the mind, but they often have effects on the body as well, like a racing heart, sweaty palms, or an upset stomach. In the case of anxiety tics, uneasy feelings result in uncontrollable movements, called motor tics, or involuntary sounds, known as vocal tics. While these aren’t necessarily harmful to your health, they can be embarrassing and debilitating, especially when they’re frequent. 

“If you get anxious and your adrenaline is pumping, that’s a lot of energy in the body right there and the tic may be a way to get it out,” says Dr. Patrick McGrath, psychologist and Chief Clinical Officer at NOCD. “There are various types of nervous habits and this is just one of those examples.”

Motor tics

• Blinking: Quick fluttering of the eyelids or eye jerks
• Tongue movements: Sticking out or rolling the tongue
• Head movements: This can look like twitches or jerks of the head and neck
• Squatting and hopping: Moving up and down with the legs or bending the knees repeatedly
• Tapping: Repeatedly tapping a surface or part of the body
• Shoulder shrugs: Moving the shoulders up and down

Vocal tics

• Grunting, hissing, or humming: Unintentional sounds made with the vocal cords 
• Sniffing: Sniffling when there’s no sign of nasal congestion
• Snorting: Short breaths through the nose
• Coughing or throat clearing: Persistent coughing not related to coughing or choking

What causes anxiety tics?

While anxiety tics are usually temporary, understanding their root cause is crucial to preventing them in the future. Ticking behaviors like tapping or sniffing may seem simple on the surface, but the biological systems that contribute to the behaviors are complex. 

Anxiety tics occur when your body’s stress response—the hormone system that controls your reaction to fear or anxiety— sends signals in your brain that result in involuntary movements and vocalizations. Recent research suggests that anxiety tics may be associated with unusual dopamine signaling in the basal ganglia, the region of the brain that’s involved in motor function and the stress response. 

“Tics can indeed show up when a person is experiencing heightened emotional tension, which may temporarily worsen during times of stress,” says Dr. Nicholas Farrell, a licensed clinical psychologist and a Regional Clinical Director at NOCD. As a result, when anxiety is heightened, tics may also be more intense or frequent.

Tics aren’t always a symptom of anxiety, however, and may be caused by other physical disorders, genetics, or mental health conditions. 

Common triggers for anxiety tics

Since nervous tics are the result of anxiety or stress episodes, they are triggered by similar life events or emotional states. These vary from person to person, but some common triggers may include:

• Relationship conflicts
• Grief and loss
• Financial or work stress
• Major life transitions like moving 
• Caring for children
• Jam-packed schedules or overwhelming responsibilities
• Lack of sleep
• Illness

Understanding anxiety tic episodes 

A nervous tic episode is the period in which anxiety or stress bring about the involuntary motor or vocal tic. Some people only experience tics during periods of intense stress or anxiety, and find that they subside once the situation that was causing the unease is resolved. For example, a person that taps their fingers on their desk when they’re overwhelmed at work will only perform that tic in a specific setting.

Others, however, may find that anxiety tics last for longer periods of time, particularly in cases where they’re dealing with chronic anxiety or another mental health disorder. 

Are anxiety tics the same as a tic disorder?

Anxiety tics and tic disorders are separate and distinguishable conditions. While anxiety tics are triggered by varying emotional states, tic disorders meet specific clinical criteria and typically persist over time, rather than being triggered occasionally.

Types of tic disorders include Tourette syndrome, chronic motor disorder, facial tic disorder, and transient tic disorder. They are different from nervous tics because they stem from ongoing nervous system malfunction, rather than from occasional anxious episodes. The exact cause of these disorders is unknown, but researchers believe it to be a combination of brain abnormalities, genetics, and environmental factors. 

Tics vs. stimming vs. compulsions: What’s the difference?

To the untrained eye, tics, stimming, and compulsions may appear similar. Tapping your fingers on your desk, for example, could be an example of any of the three. What distinguishes them is the mental state behind the behavior, and how it impacts a person’s life. 

Stims or “self-stimulatory behaviors” are behaviors like twirling your hair or bouncing your knee up and down that virtually everybody engages in. Some do it to counteract an overwhelming sensory input, and others do it when they’re bored. We can think of stims as something we do when we’re trying to “keep it together” and regulate our sensory systems. 

Tics are different from stims because they’re brought on from what’s called a premonitory urge, which is an intense, distressing sensation before the tic occurs. It’s similar to the feeling you get right before you have to sneeze—you can’t stop it, you just have to let it happen. Tics are also more likely to disrupt everyday life or be a source of embarrassment than stims are.

“Bouncing your knee up and down isn’t impacting your life or bothering someone else,” says Dr. McGrath. “On the other hand, the tic is usually kind of something that appears out of nowhere. If you and I are having a discussion and all the sudden my head twitches, that interferes with my ability to communicate.” 

Compulsions, meanwhile, are repetitive and ritualistic behaviors that are most often associated with OCD, a mental health condition characterized by obsessive thoughts and compulsions intended to reduce the distress caused by those thoughts. 

Some compulsive behaviors are, on the surface, similar to the physical appearance of stims or tics. But in this instance, OCD-related obsessions cause the compulsion. For example, it may appear that a person who taps their fingers on their desk has a tic, but they may really be counting out specific numbers or making a mental list to neutralize an obsessive thought. 

OCD and tics, further explained

Having tics doesn’t mean that you have OCD, however, “tics do occur more often in people with OCD than in people without it,” says Dr. McGrath. Researchers believe that OCD and tics frequently appear together because of similar abnormalities with dopamine pathways in the brain. 

Further, there are some cases in which symptoms of OCD and Tourette overlap, a condition that researchers call Tourettic OCD. In Tourettic OCD, tics, compulsions, and their preceding premonitory urges are overlapping and tightly intertwined. The need to perform tics in a complex and precise way, known as the “just right phenomenon,” is the main characteristic of Tourettic OCD because it combines the premonitory urges of tics and the anxious obsessions of OCD. 

How to stop a tic

If you have an underlying condition like Tourette syndrome or OCD, seeking specialized treatment for your disorder is the best way to address tics. But if not, there are a few things you can do to stop a nervous tic:

• Mindfulness: Change your focus to something other than the tic, like the temperature of the room around you or the feeling of the clothes on your skin.
• Breathwork: Structured and focused breathing helps address feelings of heightened anxiety, which can, in turn, minimize nervous tics.
• Get moving: Go for a walk or take a stretch at your desk to change your focus to something other than anxious thoughts and their associated tic.
• Maintain a healthy lifestyle: Nutritious foods, good sleep, and regular exercise are key to minimizing stress, as well as any tics that may be born of anxious episodes.
• Seek professional help: If your tic and the anxiety that causes it are persistent enough, consider seeking the help of a mental health professional to treat the underlying worry and unease.

“Very often, people who have a nervous tic will only experience it when they’re feeling nervous and therefore they may never come to treatment for it,” Dr. McGrath says. “But if they’re more and more nervous all the time and the tic is then happening more, seeking professional help may be what they need.”

Clinicians use a technique called habit reversal training (HRT), a type of behavioral therapy, to help people gain control over unwanted habits or behaviors, including nervous tics. Psychologist Nathan Azrin developed the technique in the 1970s, and it has since been refined and adapted for various conditions, including tic disorders.

“A tic is kind of a build up of energy and then a release of it,” Dr. McGrath says. “To deal with tics we use HRT to teach patients to do something the opposite of the tic. For example, if their tic is constantly raising one shoulder, we’ll encourage them to instead drop their shoulder to create awareness of the tic and prove that the energy can dissipate on its own. Tics seem like they appear out of the blue until you make someone aware of it.”

Can medications stop anxiety tics?

While no single drug is a cure-all for tics, medications like selective serotonin reuptake inhibitors (SSRIs) may be effective in addressing nervous tics because they help treat the underlying cause. It’s important to collaborate with a doctor to determine which medication plan might be right for you. 

Bottom line on anxiety tics

Nervous or anxiety tics come in all shapes and sizes, and they have varying impacts on daily living. They are involuntary, and emerge as a result of your body’s response to a change in your emotional state. 

While “anxiety tic” isn’t a clinical term on its own, it is the symptom of a number of mental health disorders, Dr. McGrath says. When tics occur without the presence of stress or anxiety, and persist over time, they may be the result of a tic disorder. 

For some people, tics are irregular and go away on their own. But in cases where a tic is impacting your daily life and resulting in embarrassment, or making it challenging to communicate, it’s important to seek treatment from a professional. A clinician can help you identify the underlying cause of your tic and develop a treatment plan that suits your needs.