Stimming, ADHD, and tics are different conditions but they may be linked in some people. For instance, stimming is sometimes a behavioral trait of ADHD, and excessive stimming often develops into significant motor tics. However, these conditions don’t necessarily appear together.
The problem is that stims and tics often have overlapping symptoms, which makes them harder to diagnose. The relationship between stimming, ADHD, and tics goes even deeper, and the best way to understand how the three are related is to study the nature of each of these conditions.
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Stimming: What Is It, and Why Do People Do It?
Stimming is a type of repetitive behavior that’s subconscious in nature. It may help a person to get distracted from boredom, anxiety, or frustration. It is a type of self-stimulating behavior, but not entirely; rather it also serves as a self-soothing activity for unpleasant emotions. Moreover, positive overreacting, such as excessive happiness, may cause stimming too. To understand it better, let’s review the examples.
Types of Stimming Behaviors
Stimming can range from subtle to more alarming types, from twisting hair to rubbing the skin to nail-biting and hair-pulling. One thing common for all types of stimming is that they are purely sensation-seeking. When stims become dangerous enough to cause physical damage, they are considered self-injurious behavior (SIB).
Stimming behaviors fall into five categories:
Auditory stims involve the sense of hearing and response to sound. These include:
- Humming, grunting, or shrieking.
- Covering and uncovering ears.
- Finger-snapping, tapping on objects, or tapping on ears.
- Repetitive speech (song lyrics, movie lines, and book sentences).
Stimming involves sending stimuli to the eyes, like blinking a lot or fixating on a single spot. Other examples include:
- Staring at objects for a long time (ceiling fans, lights, etc.).
- Peering at things from the corners of your eyes (eye-tracking).
- Lining things up (object placement).
- Repetitive blinking.
- Turning lights on and off.
Olfactory (Smell) Stimming
Sometimes the person engages in stimming activities that involve taste and smell. Some of the repetitive actions are:
- Placing objects in the mouth to taste them.
- Sniffing random objects.
Vestibular (Movement) Stimming
When stimming involves moving the whole body, it may include activities like:
Tactile stimming involves the sense of touch. Behaviors in this category of stimming include the following:
- Rubbing or scratching the skin with hands or objects.
- Hand flapping (when happy, anxious, excited, etc.).
- Tapping the hands and/or feet on hard surfaces.
- Repetitive clenching and unclenching of hands.
Why Does Stimming Happen?
Stimming is a subconscious coping mechanism developed to counteract strong emotions and boredom. It can get habitual over time if it becomes associated with relaxation or concentration and seems to be a form of self-regulation. Other reasons include overstimulation and chronic pain.
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Is Stimming a Sign of ADHD?
Stimming is not necessarily an ADHD symptom. Still, it is similar to fidgeting in some cases, which is a common ADHD symptom. Both fidgeting and stimming seem to help a person calm down and can become habitual.
Fidgeting vs. Stimming — Are They the Same Thing?
Fidgeting is making many small movements in slightly stressful situations or because of boredom. Usually, fidgeting occurs subconsciously, especially when performing monotonous tasks. Fidgeting refers to a wide range of activities, including:
- Playing with hair.
- Moving body parts.
- Tinkering with personal items like pens, jewelry, and clothing.
Fidgeting and stimming are similar as they both are performed to soothe and relax a person and enhance concentration. Unlike general fidgeting, stimming has more manifestations, and they are more complex. In addition, stimming is a symptom of autism spectrum disorder (ASD), while fidgeting is a form of excessive movement that can be a sign of ADHD-related hyperactivity.
The Link Between Stimming and ADHD
There are three types of ADHD: hyperactive, inattentive, and combined. People with hyperactive ADHD have the highest tendency to fidget and stim. It feels like a constant urge to move and difficulty staying still or sitting quietly. This restlessness persists more in children than adults who struggle more with self-control and excessive talking. Other classic symptoms of hyperactive ADHD include talkativeness, lack of concentration, impulsiveness, impatience, and recklessness.
The connection between stimming and ADHD lies in how the ADHD brain works. A person may
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How to Differentiate Between Typical and Atypical Stims?
Typical stims include foot tapping, cracking knuckles, and playing with hair. They are generally considered normal and non-disruptive since everyone else does it at some point. Atypical stims are abnormal and repetitive actions that can be harmful. These include covering ears in noisy places, walking on tiptoes, jumping repeatedly, and chewing on non-edible items (like clothing or hair). Typical stims are often manageable, the patient has to find the right techniques together with a healthcare provider. When it comes to atypical stims, they may be a warning sign of a more serious underlying disorder.
Why Stimming Can Be Misdiagnosed as ADHD?
While stimming is a standard symptom of ASD, it may also be a sign of ADHD, obsessive-compulsive disorder, and schizophrenia. To make the right diagnosis, a healthcare provider will evaluate your overall state, including other symptoms, their impact on daily life, and your health history. The co-occurrence of
A tic is an involuntary repetitive twitch, movement, or sound. People with tics can’t control them, even though they’re fully aware of what is happening. Tics, like hiccups, are involuntary and challenging to halt. Children can develop tics at a young age, which can scare some parents into thinking they may persist.
Tics are also amplified by stress and illness and sometimes hinder recovery. However, some persistent tics usually indicate an underlying condition so it is advisable to consult a health professional.
Types of Tics
Tics can be classified based on their complexity. Simple tics involve small actions while complex tics engage most of the body. Furthermore, tics can be categorized into various categories:
- Simple motor tics. They usually involve a movement of a single muscle or a simple activity: lip biting, eye blinking, wrinkling the nose, and head twitching.
- Complex motor tics. These involve more than one muscle group. They usually appear very intentional, even though they’re just as involuntary as simple tics. They include: jumping, skipping, kicking, sniffing objects, and mimicking others’ body movements.
- Simple vocal tics.
Simple vocal tics [4*]often involve basic sounds, such as grunting, hissing, clearing the throat, barking, and coughing.
- Complex vocal tics. These may seem quite intentional even though they are usually beyond the person’s control: making animal sounds, yelling, calling out, and repeating certain words and phrases.
Types of Tic Disorders
Tics, while not always indicative of an underlying problem, can be normal when occasional or if they occur only during stressful moments. However, if the tic worsens over time, it could indicate a disorder. According to the Diagnostic and Statistical Manual of Mental Disorders, there are three prominent types of tic disorders:
- Provisional tic disorders. This is the most common type of tic disorder which occurs before the age of 18 and lasts less than a year.
- Persistent (chronic) tic disorders. These are more noticeable, often with paired motor and vocal tics, but usually not simultaneously. The condition is present for at least a year.
- Tourette’s syndrome. It is characterized by multiple motor and at least one vocal tic, impacting daily life and social interactions.
What Causes Tic Disorders?
The causes of tics include biological and environmental. In the first case, tics result from tension brought on by the dislocation of a joint in the upper cervical vertebrae. This tension, in turn, affects the spinal cord and brainstem which are important for sensory stimulation. So, undue pressure can cause motor and vocal tics. When it comes to environmental factors, chronic stress and traumatic experiences can lead to severe psychological distress that causes tic disorders.
How to Differentiate Between Stims and Tics?
Tics and stims share some characteristics, but they are different in several aspects. First, tics can exist independently or as a part of conditions such as Tourette’s, while stimming is commonly associated with ASD and ADHD. Second, tics are involuntary, unlike stimming which is subconsciously soothing. Finally, tics usually vary between individuals, whereas stims can be similar in different people.
To better understand the nature of each condition, here’s a hypothetical scenario involving a person waiting for their turn for a job interview. Because of nervousness and anxiety, this person might start stimming (for example, foot tapping) but find it possible to stop, calm down, and control movements to remain still. In the case of tics, they are almost impossible to stop. So, when anxiety increases, this person is unable to stop despite any efforts, and repression fuels tics instead.
These scenarios reveal a significant difference between stims and tics. The former is a behavior that we call up to deal with boredom or stress. The latter, however, is uncontrollable, especially in a stressful environment.
Can Stimming That Is Caused by ADHD Lead to Tics?
Stimming is a natural response to ADHD, helping counteract inattention and hyperactivity symptoms, and it differs from tics. However, there is a link between ADHD and tics with many children having both Tourette’s syndrome and ADHD.
The Link Between ADHD and Tics
Tics are not a native symptom of ADHD. They can be a result of a co-occurring condition that impacts shared brain areas, leading to symptom overlaps. Children with ADHD, especially, might seem to have several tics as they squirm, fidget, and make noise whenever they’re hyperactive. These conditions become even harder to diagnose when they’re accompanied by learning disorders, OCD, and depression.
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Stims and tics can eventually become problematic. When they start to interfere with day-to-day life or draw negative attention, it may lead to feelings of being stigmatized or neglected. Managing stims can be challenging since they become habitual and shouldn’t be managed using negative reinforcement. It should be a gradual and adaptable approach that accommodates the sensory and emotional needs using other activities or techniques instead of stimming. For example, stimming while working can be considered productive if it improves your focus, but if it bothers you, you can find other tips that increase concentration.
Here are some ways to reduce the impact of stims and tics in your life:
- Use stress-management techniques. Try to reduce daily stress and avoid undue tension whenever you can.
- Create a daily routine of your most important tasks and stick to it.
- Exercise and meditate to improve self-control.
- Replace your most destructive stims with acceptable motor activities. A stress ball can be useful if you have restless hands.
- Avoid strongly scented products to prevent sensory overload, consider neutrally-smelling environments instead.
- Engage in creative activities like playing an instrument to redirect the brain’s focus.
- Take warm baths with Epsom salts: they can relax the muscles and decrease inflammation and tension caused by tics.
- Use chewing gum to offer sensory relief for tics and stims, but avoid gum if breathing tics are present.
- Seek comfort in talking to family or friends to release pent-up anxiety and soothe your nerves during stressful situations.
- Seek the guidance of a behavior specialist to learn how to manage your condition.
The link between stimming, tics, and ADHD is irrefutable, yet having one of these conditions doesn’t necessarily mean that you’ll get the other two. Stimming is a fairly natural behavior, so you shouldn’t be worried that you might have ADHD if you experience a small degree of stimming. However, you should not ignore the warning signs, especially when you notice excessive stimming or tics. It’s advisable to seek professional advice if self-stimulatory behaviors get out of control.