Ask The Doctor: Nervous Tic Health Article
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Michael Craig Miller, M.D., is editor-in-chief of the Harvard Mental Health Letter and an assistant professor of psychiatry at Harvard Medical School. Dr. Miller has an active clinical practice and has been on staff at Beth Israel Deaconess Medical Center for more than 25 years.
Question:
When I get nervous, I get a tic that affects the left side of my face, including my eye. What can I do about this? Is there anything I can take for it?
Answer:
This kind of problem is quite common. Without a specific description of the tic, I'll make some general observations, especially since people have different ideas of what they mean when they use the word "tic."
Tics are defined as involuntary, sudden, rapid and repetitive movements. Because you describe your tic as confined to the left side of your face, I am assuming you are having what is called a simple motor tic. This kind of tic involves just one muscle group. For example, a person might have a repetitive eye blink, a shrug of the shoulders or a quick head movement.
Tics do have a tendency to get worse when people are emotional — anxious, excited or angry. They can also get worse when people are fatigued.
It is possible that your tic is actually a twitch, which may be a sign of a small bit of damage or irritation to one of the nerves that controls facial muscles. A twitch can also get worse when you're nervous. Twitches can occur, for example, when arthritis causes small changes in the spine. The root of the nerve may get squeezed as it comes out of the spinal cord. Make sure your doctor is aware of your symptoms.
If the problem only comes on when you are nervous, then it makes sense to treat the anxiety. You could talk to a mental health professional to understand what causes your anxiety, and learn techniques to control it. If your anxiety is occasional or limited to specific situations, you might take a low dose of an anti-anxiety medication. Often a benzodiazepine like clonazepam (Klonopin) or lorazepam (Ativan) can be taken as needed. If the anxiety is related to performance situations (like public speaking), a beta-blocker, such as propranolol, may help if it is taken before you get into that situation.
If you find you are almost always nervous, the annoying tic may only be a small part of your distress. In that case, you'll benefit from having the problem evaluated by a psychiatrist. Anxiety disorders are very treatable and you might get a great deal of relief.