Managing Tics: Overcoming Nervous Habits Like Nose Twisting and Eye Blinking - Neurology

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Repeated nose wrinkling and blinking?


Since elementary school, I have experienced an uncontrollable urge to twist my nose or blink repeatedly.
If I try to resist these actions, I feel uncomfortable.
Initially, I also had intrusive thoughts that I found unpleasant and wanted to stop, but it was difficult to do so.
However, over time, this situation has become less bothersome (though it still occurs occasionally in adulthood, it is not as frequent as it was in childhood).
I am aware that these behaviors tend to increase when I feel anxious or stressed.
Recently, with graduation and job hunting, I am particularly concerned about maintaining a neutral facial expression during interviews, as I fear being perceived negatively or labeled as having low stress tolerance.
I would like to know how to improve this situation, as it has started to become quite distressing.

Serene Yang, 20~29 year old female. Ask Date: 2018/08/28

Dr. Cai Zongzhang reply Neurology


Hello, based on your description, it is advisable for you to seek assistance from a psychiatrist.
The psychological aspects related to nose pinching or blinking should be addressed.
In the meantime, I recommend that you try to relax.

Reply Date: 2018/08/28

More Info


Managing tics, such as nose twisting and eye blinking, can be a challenging experience, especially when these behaviors become more pronounced during stressful situations like job interviews. It sounds like you are dealing with a form of tic disorder, which can often be exacerbated by anxiety and stress. Understanding the nature of your tics and implementing strategies to manage them can significantly improve your comfort and confidence in social situations.

Tics are involuntary movements or sounds that can be difficult to control. They often occur in response to stress, anxiety, or excitement. In your case, it seems that your tics are more prominent during periods of heightened anxiety, such as during interviews or significant life transitions. This is a common experience for many individuals with tic disorders, as stress can trigger or worsen symptoms.

Here are several strategies that may help you manage your tics more effectively:
1. Awareness and Monitoring: The first step in managing tics is to become aware of when they occur. Keeping a journal to track your tics can help you identify triggers and patterns. Note the situations in which your tics increase, your emotional state at the time, and any other relevant factors. This awareness can empower you to anticipate and prepare for situations where you might feel anxious.

2. Relaxation Techniques: Since you’ve identified that your tics are related to anxiety, incorporating relaxation techniques into your daily routine can be beneficial. Practices such as deep breathing, progressive muscle relaxation, mindfulness meditation, or yoga can help reduce overall anxiety levels. When you feel more relaxed, you may find that your tics are less frequent or intense.

3. Cognitive Behavioral Therapy (CBT): Consider seeking the help of a mental health professional who specializes in CBT. This therapeutic approach can help you address the underlying anxiety that may be contributing to your tics. CBT can also teach you coping strategies to manage your anxiety in high-pressure situations, such as interviews.

4. Habit Reversal Training: This is a specific behavioral therapy technique that involves becoming more aware of your tics and learning to replace them with a competing response. For example, if you feel the urge to twist your nose, you might practice a different, less noticeable behavior that you can do instead. This technique requires practice and patience but can be effective in reducing tic frequency.

5. Practice in Safe Environments: Before your interviews, practice your responses and body language in a safe environment, such as in front of a mirror or with a trusted friend. This can help you become more comfortable with your expressions and reduce anxiety about how you might be perceived.

6. Gradual Exposure: Gradually expose yourself to situations that trigger your tics in a controlled manner. Start with less stressful scenarios and work your way up to more challenging situations, like interviews. This can help desensitize you to the anxiety associated with these situations.

7. Medication: If your tics are significantly impacting your daily life and self-esteem, it may be worth discussing medication options with a healthcare provider. Certain medications can help manage tics and reduce anxiety.

8. Support Groups: Connecting with others who experience similar challenges can provide emotional support and practical advice. Look for local or online support groups for individuals with tic disorders or anxiety.

In conclusion, managing tics involves a combination of self-awareness, relaxation techniques, behavioral strategies, and possibly professional support. By understanding your triggers and implementing coping strategies, you can reduce the impact of tics on your life, especially in high-stress situations like job interviews. Remember, it’s essential to be patient with yourself as you work through these strategies, and seeking professional help can provide additional support tailored to your needs.

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