Facial Tics and Anxiety
Facial tics, such as an eyelid, lip, eyebrow, cheek, or any muscle or muscle groups in the face twitch uncontrollably, are common anxiety symptoms, including anxiety and panic attack symptoms.
Many anxious and hyperstimulated people get facial tics.
This article explains the relationship between anxiety and facial tics.
Article Menu
Facial Tics Common Anxiety Symptom Descriptions
- A certain muscle, group, or group of muscles in the face twitch (jerk) involuntarily. Even if you try and relax the muscle or group of muscles, the twitching continues.
- An eyelid, lip, eyebrow, cheek, or any muscle or muscle groups in the face twitch uncontrollably.
- A part or parts of your face twitch, jerk, or spasm.
- Involuntary muscle twitches of spasms anywhere on the face.
Facial tics can affect one area of the face only, shift and affect another area or areas, migrate all over, and affect many areas of the face repeatedly.
Facial tics can:
- Occur occasionally, frequently, or persistently.
- Precede, accompany, or follow an escalation of other anxiety symptoms or occur by itself.
- Precede, accompany, or follow a period of nervousness, anxiety, fear, and stress, or occur "out of the blue" for no reason.
- Range in intensity from mild, to moderate, to severe.
- Come in waves where it’s strong one moment and eases off the next.
- Occur for a while, subside, and then return for no reason.
- Change from day to day, moment to moment, or remain as a constant background during your struggle with anxiety disorder.
This symptom can seem more noticeable when undistracted, resting, trying to sleep, or waking up.
Facial tics can seem more disconcerting when in important meetings or social settings.
It’s also common for facial tics to stop when resting or sleeping and resume upon waking up.
Many people notice that the twitching worsens as stress elevates, but it does not necessarily lessen when stress is reduced.
All the above combinations and variations are common.
To see if anxiety might be playing a role in your symptoms, rate your level of anxiety using our free one-minute instant results Anxiety Test, Anxiety Disorder Test, or Hyperstimulation Test.
The higher the rating, the more likely anxiety could be contributing to or causing your anxiety symptoms, including feeling like impending doom symptoms.
---------- Advertisement - Article Continues Below ----------
---------- Advertisement Ends ----------
Causes
Medical Advisory
Talk to your doctor about all new, changing, persistent, and returning symptoms as some medical conditions and medications can cause anxiety-like symptoms.
1. Anxiety-Activated Stress Response
Anxious behavior, such as worry, activates the stress response, which secretes stress hormones into the bloodstream, where they travel to specific locations to immediately prepare the body for emergency action – to fight or flee. This instinctual survival reaction is often referred to as the Fight or Flight Response.[1][2]
Since stress responses push the body beyond its internal balance (equilibrium), stress responses stress the body. As such, anxiety stresses the body.
Regarding this symptom, muscle movements are controlled by nerve impulses. For example, a muscle contracts (tightens) when it receives a nerve impulse and releases (relaxes) when the nerve impulse stops.
The body comprises muscles that respond to involuntary nerve impulses (where the body decides when and how to use them) and voluntary nerve impulses (where we decide when and how to use them).
The body also is made up of three kinds of muscles:
- Smooth muscles: muscles that respond to nerve impulses automatically controlled by the body’s nervous system, such as the bladder, blood vessels, and those involved with the digestive system. Smooth muscles can contract and remain so until the body releases them.
- Skeletal muscles: muscles that respond to voluntary nerve impulses, such as those in the arms, hands, legs, chest, back, etc. Skeletal muscles can contract and remain so until we decide to release them.
- Cardiac muscle: this muscle is controlled involuntarily. Its features are consistency and endurance. This type of muscle is only found in the heart and is a twitch muscle only (contracts, then immediately releases).
When the body’s nervous system and muscle tensions are normal, nerve impulses and muscle responses function normally. However, when a stress response is activated, such as from anxious behavor, many body-wide changes occur [1][2][3].
Some of the stress response changes include:
- Quickly converts the body’s energy reserves into “fuel” (blood sugar) to provide an instant boost of energy.
- Increases heart rate, respiration, and metabolism due to the boost in energy.
- Stimulates the sympathetic nervous system, increasing nervous system activity to be more sensitive and reactive to danger.
- Heightens most of the body’s senses to be more aware of danger.
- Increases activity in the amygdala (the brain’s fear center) and decreases activity in the pre-frontal cortex (the rationalization area of the brain) so that our attention is focused on the threat and away from thoughts that could be distracting.
- Shunts blood to parts of the body vital to survival, such as the brain, arms, legs, and vital organs, and away from parts less vital for survival, such as the stomach, digestive system, and skin. It accomplishes this by constricting blood vessels in certain parts of the body and dilating them in others.
- Tightens muscles to make the body more resilient to injury.
To name a few.
Visit the “Stress Response” article for the many ways it can affect the body.
Rapid onset of energy; increased heart rate, respiration, and metabolism; increased nervous system activity; and muscle tension can cause acute muscle twitching, including on the face, which is called facial tics.
An active stress response is a common cause of acute facial tics.
2. Stress-Response Hyperstimulation
When stress responses occur infrequently, the body recovers relatively quickly from its changes. However, frequently activated stress responses, such as from overly anxious behavior, can prevent the body from completely recovering. Incomplete recovery can leave the body in a state of semi-stress-response-readiness, which we call “stress-response hyperstimulation” since stress hormones are powerful stimulants.
Hyperstimulation is also often referred to as “hyperarousal,” “HPA axis dysfunction,” or “nervous system dysregulation.”[4][5]
Visit our “Hyperstimulation” article for more information about the many ways hyperstimulation can affect the body and how we feel.
Hyperstimulation can cause the changes of an active stress response even though a stress response hasn’t been activated.
Just as an active stress response can cause acute facial tics, hyperstimulation can cause chronic facial tics symptoms.
But that’s not all. Hyperstimulation can cause facial tics in other ways, too. For instance, hyperstimulation can cause:
- Nervous System Excitation and Dysregulation: A chronically stimulated nervous system can act erratically and cause all kinds of nervous and somatic system anomalies, such as facial tics.
- Homeostatic Dysregulation: Homeostasis is the body’s ability to automatically maintain a stable internal environment despite changes in the external environment. Hyperstimulation can cause homeostatic dysregulation, leading to internal regulation problems, which can affect the nervous and somatic systems, causing facial tic symptoms.
- Hormone changes: Hormones play a crucial role in homeostasis and many bodily functions, which can affect the nervous and somatic systems. Since stress hormones affect other hormones, hyperstimulation can cause nervous and somatic system problems, such as facial tics.
- Sleep disruption and fatigue: Hyperstimulation taxes the body’s energy resources harder than normal, leading to sleep deprivation and fatigue, exacerbating hyperstimulation and its symptoms, including facial tics.
Any combination of the above changes can cause many abnormal behaviors that present as symptoms, such as muscles in the face that pulse, throb, twitch, spasm, or contract uncontrollably as the hyperstimulated nervous system sends erratic nerve impulses to facial muscles and muscle groups.
These erratic nerve impulses can be sent to any of the body’s skeletal muscles at any time and to any degree. A wide variety of contractions, from slight (pulsing) to dramatic (twitching or painful spasms) or from rhythmic to sporadic, can occur, including on the face.
Years ago, the terms “nervous tic” or “nervous twitch” were used to describe muscle twitching due to chronic stress and anxiety.
Other Factors
Other factors can create stress and cause anxiety-like symptoms, as well as aggravate existing anxiety symptoms, including:
- Medication
- Recreational drugs
- Stimulants
- Sleep deprivation
- Fatigue
- Hyper and hypoventilation
- Low blood sugar
- Nutritional deficiencies
- Dehydration
- Hormone changes
- Pain
Select the relevant link for more information.
---------- Advertisement - Article Continues Below ----------
---------- Advertisement Ends ----------
Treatment
When other factors cause or aggravate this anxiety symptom, addressing the specific cause can reduce and eliminate this symptom.
When an active stress response causes this symptom, ending the active stress response will cause this acute anxiety symptom to subside.
Keep in mind that it can take up to 20 minutes or more for the body to recover from a major stress response. But this is normal and needn’t be a cause for concern.
When hyperstimulation (chronic stress) causes facial tics, eliminating hyperstimulation will end this anxiety symptom.
You can eliminate hyperstimulation by:
- Reducing stress.
- Containing anxious behavior (since anxiety creates stress).
- Regular deep relaxation.
- Avoiding stimulants.
- Regular light to moderate exercise.
- Eating a healthy diet of whole and natural foods.
- Passively accepting your symptoms until they subside.
- Being patient as your body recovers.
Visit our “60 Natural Ways To Reduce Stress” article for more ways to reduce stress.
Recovery Support members can view chapters 5, 6, 7, 14 and more for more detailed information about recovering from hyperstimulation and anxiety disorder.
As the body recovers from hyperstimulation, it stops sending symptoms, including this one.
Symptoms of chronic stress subside as the body regains its normal, non-hyperstimulated health.
However, eliminating hyperstimulation can take much longer than most people think, causing symptoms to linger longer than expected.
As long as the body is even slightly hyperstimulated, it can present symptoms of any type, number, intensity, duration, frequency, and at any time, including this one.
Since worrying and becoming upset about anxiety symptoms stress the body, these behaviors can interfere with recovery.
Passively accepting your symptoms – allowing them to persist without reacting to, resisting, worrying about, or fighting them – while doing your recovery work will cause their cessation in time.
Acceptance, practice, and patience are key to recovery.
Other causes of nervous tics:
Habituated behavior - Sometimes nervous tics can turn into habituated behavior where they occur as part of an automatic mannerism. Working to break this habit can eliminate habituated nervous tics over time.
Diet – Consuming stimulants like caffeine, can stimulate the body and cause nervous tics. A lack of certain nutrients might also cause nervous tics. If you believe diet may play a role, you may want to work with a nutritional therapist to see if diet is a factor in your facial tic.
Neurological problem - There are also neurological causes for nervous tics. But they are generally rare. If you believe your nervous tic isn’t stress- and anxiety-related, diet-related, or habituated behavior, you may want to talk with a neurologist for more information.
Medical problem – Medical conditions can cause and aggravate nervous tics. It’s important to talk with your doctor so that you can rule out other medical causes.
Medication – Some medications can also cause nervous tics. If you believe you have addressed everything else, yet your nervous tic remains, you may want to talk with your doctor and pharmacist about your medication. If your medication is the cause of your lingering nervous tic, simply changing medications might eliminate this symptom.
Recreational drugs – Some recreational drugs, such as alcohol, can cause nervous tics. Because of the potential for serious long-term harm, we recommend avoiding all recreational drugs.
Comments
Everyone gets the odd facial/tic/twitch from time to time. This is normal. And many anxious and stressed people experience facial tics.
Recovery Support
The Recovery Support area of our website contains thousands of pages of important self-help information to help individuals overcome anxiety disorder, hyperstimulation, and symptoms.
Due to the vast amount of information, including a private Discussion Forum, many of our Recovery Support members consider it their online recovery support group.
Therapy
Unidentified and unaddressed underlying factors cause issues with anxiety. As such, they are the primary reason why anxiety symptoms persist.
Addressing your underlying factors (Level Two recovery) is most important if you want lasting success.
Addressing Level Two recovery can help you:
- Contain anxious behavior.
- Become unafraid of anxiety symptoms and the strong feelings of anxiety.
- End anxiety symptoms.
- Successfully address the underlying factors that so often cause issues with anxiety.
- End what can feel like out-of-control worry.
All our recommended anxiety therapists have had anxiety disorder and overcame it. Their personal experience with anxiety disorder and their Master's Degree and above professional training give them insight other therapists don't have.
If you want to achieve lasting success over anxiety disorder, any one of our recommended therapists would be a good choice.
Working with an experienced anxiety disorder therapist is the most effective way to treat anxiety disorder, especially if you have persistent symptoms and difficulty containing anxious behavior, such as worry.[6][7][8]
In many cases, working with an experienced therapist is the only way to overcome stubborn anxiety.
Research has shown that therapy is the most effective treatment for anxiety disorder, and distance therapy (via phone or the Internet) is equally, if not more effective, than face-to-face in-person therapy.[9][10][11]
---------- Advertisement - Article Continues Below ----------
---------- Advertisement Ends ----------
Common Anxiety Symptoms
Additional Resources
- For a comprehensive list of Anxiety Disorders Symptoms Signs, Types, Causes, Diagnosis, and Treatment.
- Anxiety and panic attacks symptoms can be powerful experiences. Find out what they are and how to stop them.
- How to stop an anxiety attack and panic.
- Free online anxiety tests to screen for anxiety. Two minute tests with instant results. Such as:
- Anxiety 101 is a summarized description of anxiety, anxiety disorder, and how to overcome it.
Return to our anxiety disorders signs and symptoms page.
anxietycentre.com: Information, support, and therapy for anxiety disorder and its symptoms, including facial tics anxiety symptoms.
References
1. Chu, Brianna, et al. “Physiology, Stress Reaction.” StatPearls, 7 May 2024.
2. Godoy, Livea, et al. "A Comprehensive Overview on Stress Neurobiology: Basic Concepts and Clinical Implications." Frontiers In Behavioral Neuroscience, 3, July 2018.
3. Patriquin, Michelle A., and Sanjay J. Mathew. “The Neurobiological Mechanisms of Generalized Anxiety Disorder and Chronic Stress.” Chronic Stress (Thousand Oaks, Calif.), U.S. National Library of Medicine, 2017.
4. Teixeira, Renata Roland, et al. “Chronic Stress Induces a Hyporeactivity of the Autonomic Nervous System in Response to Acute Mental Stressor and Impairs Cognitive Performance in Business Executives.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2015.
5. McEwen, Bruce S. “Neurobiological and Systemic Effects of Chronic Stress.” Chronic Stress (Thousand Oaks). U.S. National Library of Medicine, 2017.
6. Hofmann, Stefan G., et al. “The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-Analyses.” Cognitive Therapy and Research, U.S. National Library of Medicine, 1 Oct. 2012.
7. Leichsenring, Falk. “Is Cognitive Behavioral Therapy the Gold Standard for Psychotherapy?” JAMA, American Medical Association, 10 Oct. 2017.
8. DISCLAIMER: Because each body is somewhat chemically unique, and because each person will have a unique mix of symptoms and underlying factors, recovery results may vary. Variances can occur for many reasons, including due to the severity of the condition, the ability of the person to apply the recovery concepts, and the commitment to making behavioral change.
9. Kingston, Dawn.“Advantages of E-Therapy Over Conventional Therapy.” Psychology Today, Sussex Publishers, 11 Dec. 2017.
10. Markowitz, John, et al. “Psychotherapy at a Distance.” Psychiatry Online, March 2021.
11. Thompson, Ryan Baird, "Psychology at a Distance: Examining the Efficacy of Online Therapy" (2016). University Honors Theses. Paper 285.