What Are ADHD Tics?

Tics are repetitive, sudden movements you make without wanting or meaning to. Tics that happen very often every day and that go on for longer than a year may be part of a tic disorder, such as Tourette's syndrome.

While attention deficit hyperactivity disorder (ADHD, condition in which people appear hyperactive and impulsive and have trouble paying attention) itself doesn’t cause tics, people with ADHD can have a co-occurring tic disorder. Less than 10% of people with ADHD have a tic disorder like Tourette's syndrome, but 30%–60% of those with Tourette's syndrome have ADHD.

If you or your child has been diagnosed with ADHD, you may be wondering whether the tics have anything to do with ADHD. In this article, the types of tics, other conditions that occur with ADHD and treatment will be explored.

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Types of Tics

Tics are repetitive, sudden movements you make without wanting to make them. These tics may vary in complexity, severity, and in how long they’re likely to last.

Sound

Sound or phonic tics are involuntary sounds made with your mouth or vocal cords and can be simple or complex, as follows:

  • Simple phonic tics usually are meaningless noises. Common examples include blowing, coughing, throat clearing, grunting, sniffing, or hiccuping.
  • Complex phonic tics are words or phrases that include obscenities, echoing what others say, and repeating one’s own statements.

Tics can be suppressed and usually improve when the affected person is distracted. However, the tics can reappear anytime.

Motor

Motor tics are involuntary movements caused by spasm-like contractions of muscles and are classified as either simple or complex.

  • Simple motor tics involve only a single muscle or group of muscles and are brief, such as eye blinking, nose twitching, shoulder shrugging, or extending or flexing a limb. Simple motor tics typically last less than a second.
  • Complex motor tics are more involved and often resemble normal movement such as jumping, hitting, throwing, or touching; however, they often occur in inappropriate settings or include inappropriate or obscene gestures.

Recap

The main symptom associated with a tic disorder is the presence of tics, which are sudden, brief, involuntary, or semi-voluntary movements or sounds.

ADHD and Coexisting Conditions

Tourette's syndrome coexisting with ADHD is common. Studies have indicated that 30%–60% of children with Tourette's also have ADHD. In children who develop tic disorders and ADHD, the ADHD usually develops two to three years before the tics.

Tourette's syndrome is also associated with obsessive-compulsive disorder (OCD) as well as ADHD. According to the Centers for Disease Control and Prevention (CDC), 86% of children with Tourette's syndrome also have at least one other behavioral, mental health, or developmental condition, and the most common of these are ADHD and OCD. However, boys are more likely to be diagnosed with ADHD and girls are more likely to be diagnosed with OCD.

Recap

Research has found that as many as 90% of children with Tourette's also had ADHD. In children, ADHD usually develops two to three years before the tics.

Tics Disorders in Children 

Tic disorders usually start in childhood, first presenting at approximately 5 years of age. In general, they are more common among males compared to females.

The most common tic disorder is called provisional tic disorder. It may affect up to 10% of children during the early school years. Provisional tics usually go away by themselves in less than a year. Some may get worse with anxiety, tiredness, and some medications.

Recap

Tic disorders usually first present around the age of 5. The most common form of tic disorder usually goes away by itself within a year.

Tics Disorders in Adults

It's quite uncommon for tics to occur for the first time in adulthood. Adult-onset tics usually are a recurrence of childhood tics. People may be unaware that they had tics as children, or they may have been too young when they had them to now recall.

A meta-analysis of two studies assessing adults for Tourette's syndrome revealed a prevalence of tics of just 0.05%.

Recap

It's rare for a tic disorder to start in adulthood, normally, if tics occur in adulthood, they are a recurrence of childhood tics.

ADHD and Mental Health  

Roughly 80% of those with ADHD are diagnosed with at least one other mental health disorder during their lifetime. The most common ADHD comorbidities (co-occurring conditions) are anxiety and depression.

Anxiety 

Up to 30% of children and up to 50% of adults with ADHD may also have an anxiety disorder. Patients with anxiety disorders often worry excessively about a number of things and may feel edgy, stressed out, tired and tense, and have trouble getting restful sleep. 

If you have both ADHD and anxiety, the symptoms of both conditions may seem more extreme. For example, anxiety may make it even more difficult for someone with ADHD to pay attention and follow through on tasks.

Depression 

Many children and adults with ADHD also experience depression, a mood disorder that presents with feelings of deep sadness and lack of interest in normally enjoyable activities. For example, researchers have found that adolescents with ADHD are significantly more likely to develop depression than those without ADHD.

Some of the symptoms of depression overlap with the symptoms of ADHD, which can make it hard to tell the two apart. For instance, restlessness and boredom can be symptoms of both ADHD and depression. 

It is estimated that 70% of people diagnosed with ADHD may also experience depression in their lifetime.

Recap

Roughly 80% of those with ADHD are diagnosed with at least one other mental health disorder sometime during their life. Coexisting conditions include anxiety and depression. Sometimes the symptoms of anxiety and depression can make ADHD symptoms feel worse.

Managing Tics 

Some tics go away on their own or are so mild that you may not want or need to treat them. For others, there are some treatment options to try, including:

Comprehensive behavioral intervention for tics (CBIT): An evidence-based type of behavioral therapy (using practical methods based on the best, most current research) for Tourette’s syndrome, CBIT includes habit reversal, relaxation techniques, and education about tics.

Medication: Some ADHD medications have a positive effect on tics. If tics don’t respond to your current ADHD treatment, it may be necessary to try another medication. Speak to your healthcare provider about what medications best suit your situation.

Try to reduce stress and anxiety: Stress and anxiety are known to increase the severity of tics. Try stress-relieving techniques like yoga, meditation, and deep breathing to help you relax.

Recap

Tics may be treated with behavioral therapy, medication, stress-relieving techniques or a combination of all three.

Summary

ADHD by itself doesn’t cause tics, but many people with ADHD have another disorder that does cause them. Tic disorders, including Tourette's syndrome, can coexist with ADHD.

ADHD can also coexist with other mental health disorders like anxiety and depression, with overlapping symptoms and one condition sometimes making the other worse.

Tics that start in childhood often go away by themselves, but treatment is also available and can include medication, behavior therapy, and techniques to reduce your stress levels.

A Word From Verywell

If you or a child in your care are experiencing tics and ADHD, it’s important to talk with a healthcare professional so you can get help for the condition that may be causing this symptom. You may be able to improve your symptoms with medication, behavior therapies, and a reduction in your stress levels.

Frequently Asked Questions

  • Does untreated ADHD cause tics?

    Yes, in a way. Untreated ADHD can cause stress, which, in someone with a tic disorder such as Tourette's syndrome can make tics worse.

  • What do ADHD tics look and feel like?

    ADHD does not cause tics by itself. If you have a tic disorder you may experience movements such as eye blinking, shoulder shrugging, neck twisting, flaring nostrils, clenching fists, jerking arms, kicking, and curling toes. Tics can also be vocal.

  • How do you get rid of ADHD tics?

    If you have a tic disorder, you may be offered behavioral therapy, medication, advice on stress-relieving activities or a combination of all three.

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