Stims include humming, tapping, or nail biting unconsciously. If your ADHD stimming soothes you, great! If it distracts or embarrasses you, there are ways to manage it.
Self-stimulation or “stimming” refers to self-soothing, mostly unconscious repetitive sounds or movements. Almost everyone stims: think hair twirling or nail-biting.
For folks with conditions such as autism or attention deficit hyperactivity disorder (ADHD), stimming may be harder to control, however.
Stimming behavior can look very much like tics.
Tics are also repetitive movements, but unlike stims, they are involuntary, anticipated, and not particularly pleasurable. Tics are features of Tourette syndrome (TS) and other Tic disorders (TD).
While ADHD stimming differs from autism spectrum disorder (ASD) stimming and tics, ADHD, ASD, and TD symptoms overlap. If you have ADHD, you may also have another coexisting condition that causes stimming or tics.
If your stimming does not put you at risk or cause you embarrassment, you may choose not to worry about it.
But if your stims worsen your distractedness or seem to be intensifying, having a medical professional test for coexisting conditions may ensure you get the most effective treatment.
Vocal stimming involves making sounds with your mouth or breath. Examples of vocal stimming include:
- verbal noises
- humming
- shrieking
- repeating words or phrases, including from books, movies, or echoing someone else
Auditory stimming is related to vocal stimming. Some common auditory stims involve:
- tapping tables
- tapping ears
- snapping fingers
Types of stims
Stimming can engage any one of the senses or parts of the body. Whether or not you have ADHD, you may find yourself engaging in the following stims:
- touch stimming, such as skin rubbing, hand moving, and tapping
- motor stimming, including pacing, rocking, and spinning in circles
- taste stimming (involves smell and taste) for example, smelling objects or people, licking objects, or putting objects in your mouth
Is vocal stimming a symptom of ADHD?
Verbal stims that may be common with ADHD are often symptoms of hyperactivity and impulsivity, as presented by the
- blurting
- humming
- singing or repetitively quoting from a movie or video
What are some ADHD stims?
Other ADHD stims involve different senses and parts of the body.
ADHD stims often look like restlessness:
- fidgeting
- biting nails
- biting inside of cheeks
- foot-tapping
- pacing
- knuckle cracking
- spinning
- jumping
ADHD stims may look like disinterest or even defiance. Still, they often result from unconscious efforts to cope with brain differences that make daily functions challenging.
These include:
- executive functioning challenges
- self-regulatory challenges
- impulsivity
Causes
A
Restlessness. Restlessness may lead to a decreased ability to control motor behaviors. While most folks blurt, hum, or fidget from time to time, people with ADHD have a harder time stopping once they start.
Sensory processing differences. If you live with ADHD, one feature of your experience may be hypersensitivity. This means that your mind can’t always discern which sound or sensation of many is important.
If you find yourself chewing your pen or singing while working, you may be unconsciously offering yourself the sensory input needed to stay present and grounded in your body and the task.
Impulsivity. Impulsivity with ADHD can make it hard to delay gratification. Most people stim because it feels good immediately. Once the habit of stimming starts, it reinforces itself.
Triggers
Triggers for ADHD stimming involve situations or tasks that tax executive functioning skills or worsen challenged impulse control, hyperactivity, and self-regulation. Some examples include:
- boredom
- overwhelm when coping with prioritizing tasks
- distractions
- poor sleep can worsen executive functioning skills
- lack of exercise or mandatory sitting for long periods
- fear, stress, or excitement
Autism spectrum disorder
Often, ADHD stimming looks similar to the repetitive verbal stims and stereotyped movements performed by people with autism spectrum disorder (ASD).
ASD is a spectrum of conditions that affect speech and nonverbal communication.
Some vocal stims associated with ASD include shrieking, humming, and echoing words or phrases from books or movies.
| ADHD | ASD |
|---|---|
| stims cope with feelings | stims communicate feelings |
| differences in brain regions responsible for repetitive speech patterns | differences in brain regions responsible for repetitive speech patterns |
| last longer than ADHD stims |
A
One observation the analysis explores — though more research is needed — is that the condition overlap may support the theory ADHD is a mild subset of ASD.
Tourette syndrome and tic disorders
Tourette syndrome (TS) is a severe tic disorder that develops at a young age. While tics are repetitive movements that look like stims, the experience of tics is different.
| ADHD | TS |
|---|---|
| stims are unconscious but can be stopped and started | tics feel uncontrollable |
| stims can be soothing or focusing | tics are unpleasant |
| relief is felt from doing the stim | relief is felt when they’re over |
| differences in the brain’s dopamine transmitters and receptors may be a factor | differences in the brain’s dopamine transmitters and receptors may be a factor |
Tics usually onset with a precursor feeling, generalized or local to one body part.
While ADHD does not cause tics, one
- the brain differences may increase the chances of developing both conditions
- 80% of folks with ADHD have a co-occurring condition
- 7% of children with ADHD also have TS
Even if you have a mild tic disorder with ADHD, you may be directed to treat ADHD symptoms first.
Reviewers suggest that the symptoms of TD may be helped by treatments for ADHD.
Stims with ADHD are not harmful and can be helpful to self-regulate. But if stims are causing more disruption than self-soothing, there are options.
Often the recommended prescription, behavior, and treatments for ADHD can reduce stims, even when co-occurring disorders are present.
Medication
Effective medications for ADHD can help with stimming behaviors. Stimulants commonly prescribed are:
- amphetamine/dextroamphetamine
- methylphenidate
- dexamphetamine
If you or your doctor are worried about side effects, you might try nonstimulant medications:
- guanfacine
- atomoxetine
- clonidine
Executive functioning help
Having a coach assist you with executive functioning challenges may relieve stress and remove triggers for stimming. A trained professional can help you develop skills in:
- time management
- prioritizing activities
- organizing space
Behavioral therapy
If you’re concerned about how your stims appear or if they’re distracting, you may wish to ask about “habit reversal training.” You can learn to substitute:
- gum chewing for hair chewing
- toy squeezing for blurting out responses
- stretching for jumping up at inopportune times
Lifestyle changes
You may be able to reduce stress and stimming behaviors by managing other triggers. Changes to consider include:
- more sleep
- planned exercise breaks
- planned rewards for work accomplished
Self-advocacy
Living with a mental health condition may often mean self-advocating for your wellness at work, with family, or in social settings. On the job or at school, this might look like:
- Proactively inform your boss or co-workers, teachers, or classmates you collaborate closely with that your brain uses vocal stims to focus, and it doesn’t mean you’re not listening.
- Ask whether they find it distracting, and would lowering your volume or putting your hands beneath the table be a fair accommodation?
Treatments for executive functioning challenges such as medication or coaching might help relieve stress and reduce stimming.
You may wish to consult your doctor about stimming symptoms if they worsen or if you develop tics.
But if your stims soothe you and keep you on task, you may choose simply to live with them.