Have you ever tried to hold back a cough or a sneeze? It’s uncomfortable. You also can’t resist for more than a couple of seconds.
This feeling is similar to having tics. Tics refer to sudden and repetitive sounds, muscle movements, or twitches that could be considered involuntary and hard to control. Examples include grimacing, blinking, clearing your throat, or repeating certain words and phrases.[1]
A person who experiences tics may be able to hold back the urge to make these movements or sounds for a brief period. But they’ll feel progressively uncomfortable until they eventually cave in.
If you have attention-deficit/hyperactivity disorder (ADHD), you may have experienced this sensation before. Though not largely discussed, tics are common, and around 20-30% of individuals with ADHD symptoms also meet the criteria for a diagnosis of a tic disorder.[2]
A mix of treatment and therapy can help reduce symptoms so they’re less likely to interfere with your daily life.
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Does ADHD Cause Tics?
ADHD doesn’t cause tics. However, ADHDers are more likely to experience them.
According to the DSM-5 criteria, there are three main types of tic disorders. They are as follows:[3]
- Tourette’s Syndrome: This condition affects the brain and nervous system, leading to multiple long-term tics involving movement and sound. People with this condition have experienced tics for at least one year.
- Persistent/Chronic motor or vocal tic disorder: This disorder leads to either motor or vocal tics that have persisted for at least a year.
- Provisional tic disorder: Individuals with this condition have experienced either motor or vocal tics or both, but their symptoms have not persisted for more than a year.
Adult ADHD can occur with Tourette’s syndrome or other tic disorders, meaning an individual may experience both conditions. Research has shown that the most common mental health condition that co-occurs with Tourette’s syndrome is ADHD.[4]
So it isn’t surprising that ADHD and Tourette’s syndrome can happen together. Scientists have found that both are associated with genetic factors. Plus, both are also linked to abnormal levels of chemical messengers in the brain, including dopamine.[2,5]
What Are Tics?
Tics are movements that occur suddenly (motor tics) or repetitive sounds (vocal tics) made by an individual.
Examples of tics include:
- Blinking repeatedly
- Muscle clenching and unclenching
- Humming
- Saying the same word or phrase over and over
What Triggers ADHD Tics?
There are various possible triggers of ADHD tics, including:[6]
- Stressful or anxiety-inducing events
- Boredom and a lack of stimulation
- Feelings of nervousness or worry
- Feelings of excitement or anger
Sometimes, seeing another person do a specific action, like grimacing, may cause someone with tics to do the same.[6]
What Kind of Tics Can Be Seen in ADHD?
Most of the time, tics disorders develop in childhood but may go unnoticed or undiagnosed. Symptoms can wax and wane or even resolve in adulthood. But in other cases, they can be a chronic condition.
It’s important to differentiate between tics and ADHD stimming, which also involves repetitive movements and sounds. They may have overlapping signs. However, ADHD stimming feels pleasant and can typically be stopped and started at will. On the other hand, ADHD tics can feel uncomfortable and are usually beyond a person’s control.
They can be divided into two main categories:
1. Motor Tics
These are fast, repetitive, and spasm-like movements. You might notice a strange bodily sensation before experiencing a tic, which becomes progressively uncomfortable over time.
Some symptoms include the following:[1]
- Muscle jerking involving the arms and legs
- Clenching and unclenching the jaw
- Blinking or grimacing
- Shoulder shrugging
- Nose twitching
- Lip licking
These are usually harmless, but they can be a cause of concern if you drive or operate heavy machinery.
2. Vocal Tics
These can range from subtle sounds to louder noise or yelling. They may present as:
- Blurting out inappropriate words
- Repeating words and phrases
- Yelling or shouting
- Clearing the throat
- Coughing
- Humming
- Grunting
- Snorting
- Barking
If these symptoms affect your social life, relationships, and career, it’s always best to seek professional advice and treatment.
Treatments for ADHD and Tics
Tics can be understandably frustrating to deal with. But the right medications and therapy can help you better manage them and minimize their impact on your daily functioning.
Your doctor will assess your ADHD symptoms and tic disorder and may recommend a treatment plan that first targets the symptoms that affect you most.
The following are some possible treatment approaches for managing tics.
Medications for ADHD Tics
The only FDA-approved medications for managing tics include haloperidol, pimozide, and aripiprazole, which are generally reserved for moderate or severe cases.[2]
Alternatively, your doctor may recommend guanfacine, which is less likely to cause side effects and is typically the primary choice for treating mild to moderate tics in ADHD.[2]
Research has proven that stimulants are a safe and effective way to treat ADHD in those who also experience tics, although additional treatment and therapy may be required to manage tics.
Therapy for ADHD Tics
Comprehensive behavioral intervention for tics (CBIT) is a behavioral therapy designed to manage tic disorders in adults. It has even been shown to be as effective as medications.
This type of therapy teaches you how to spot tic behaviors and possible triggers, as well as identify early signals. You’ll also learn how to develop and practice “competing responses,” which are actions that physically oppose and prevent you from giving into your tic until the urge subsides.[7]
ADHD Tics Don’t Always Require Treatment
ADHD doesn’t cause tics, but the two often co-occur. It’s not a must to get treated, especially if they are mild and have minimal to no impact on how you go about your daily life.
However, if they affect your social life, relationships, and self-confidence, you may seek advice from a healthcare professional. Fortunately, both ADHD and tics can be managed by medications and therapy – either concurrently or one after the other – to minimize their impact on your daily activities.
The first step to proper treatment is getting the correct diagnosis. If you’re concerned you may have ADHD, check out ADDA’s ADHD test for adults. This screening test serves as a symptom checklist that can help you better understand your condition and decide on what steps to take next.
References
[1] Ogundele, M. O., & Ayyash, H. F. (2018). Review of the evidence for the management of co-morbid Tic disorders in children and adolescents with attention deficit hyperactivity disorder. World journal of clinical pediatrics, 7(1), 36–42. https://doi.org/10.5409/wjcp.v7.i1.36
[2] Coffey, B.J. Complexities for Assessment and Treatment of Co-Occurring ADHD and Tics. Curr Dev Disord Rep 2, 293–299 (2015). https://doi.org/10.1007/s40474-015-0061-7
[3] Centers for Disease Control and Prevention. (2022, August 22). Diagnosing tic disorders. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/tourette/diagnosis.html
[4] Robakis D. (2017). How Much Do We Know about Adult-onset Primary Tics? Prevalence, Epidemiology, and Clinical Features. Tremor and other hyperkinetic movements (New York, N.Y.), 7, 441. https://doi.org/10.7916/D8SQ95ND
[5] Rizzo, R., Gulisano, M., Calì, P. V., & Curatolo, P. (2013). Tourette Syndrome and comorbid ADHD: current pharmacological treatment options. European journal of paediatric neurology: EJPN: official journal of the European Paediatric Neurology Society, 17(5), 421–428. https://doi.org/10.1016/j.ejpn.2013.01.005
[6] Tourette Syndrome | National Institute of Neurological Disorders and Stroke. (2023, February 1). Www.ninds.nih.gov. https://www.ninds.nih.gov/health-information/disorders/tourette-syndrome
[7] Kim, K. M., Bae, E., Lee, J., Park, T. W., & Lim, M. H. (2021). A Review of Cognitive and Behavioral Interventions for Tic Disorder. Soa–ch’ongsonyon chongsin uihak = Journal of child & adolescent psychiatry, 32(2), 51–62. https://doi.org/10.5765/jkacap.200042
