One of the side effects of certain medications is tardive dyskinesia — a movement disorder that causes involuntary facial movements, such as puffing of the cheeks, grimacing or frowning, smacking of the lips, and sticking the tongue out. The disorder can cause repetitive finger movements and thrusting or rocking of the pelvis also.
Research shows that 2 to 25 percent of people who take typical or atypical antipsychotics will eventually develop tardive dyskinesia. The condition can also be caused by long-term use of some Parkinson’s disease medications.
How Stress Impacts Tardive Dyskinesia
Tardive dyskinesia is what’s known as a hyperkinetic movement disorder. Like the movement disorders chorea and tremors, it’s characterized by excessive involuntary movements and can be made worse by stress.
“When people are upset, agitated, or have heightened emotions or stress, their tardive dyskinesia movements get worse,” says Jessica Tate, MD, a specialist in movement disorders at Atrium Health Wake Forest Baptist in Winston-Salem, North Carolina.
What’s more, she adds, stress can be a “very common complaint” among patients with the condition.
Indeed, stress and tardive dyskinesia can sometimes create an unfortunate cycle. Stress can make symptoms worse, which can bring additional distress or social embarrassment and further exacerbate unwanted movements, Dr. Tate notes.
The reverse can also be true. “I have had people with tardive dyskinesia and other movement disorders who have experienced an improvement in symptoms and quality of life when they find strategies to manage or reduce stress,” she says.
Tate recalls a patient in a high-stress occupation who struggled with unwanted movements. “He was close to retirement, and once he stopped working, it made a world of difference in his symptoms, because it reduced his stress level so much,” she says.
Although most of us can’t stop working or totally eliminate stressors, it does show that there can be a real connection between stress and tardive dyskinesia, Tate adds.
Ways to Reduce Stress and Ease Tardive Dyskinesia Symptoms
The research on stress and tardive dyskinesia is limited, but it’s a good idea to try the lifestyle habits that are traditionally associated with lowering stress levels, she says.
Try mindfulness and meditation. These relaxation techniques “have been effective in improving symptoms and quality of life,” Tate says. One study found that people who completed four weeks of mindfulness-based cognitive therapy and stress reduction saw an improvement in their tardive dyskinesia symptoms both in the sessions and afterward.
Exercise. Any exercise can help ease your stress levels, especially if you enjoy doing it, says Tate. “I tell my patients that many different types of exercise can have benefits — in the pool, on a bike, on an exercise machine — just as long as it gets the heart rate up for 30 minutes,” she says.
There’s also evidence that less aerobic forms of exercise, including stretching, yoga, and tai chi, may have benefits, according to Tate. Some research has found that yoga could reduce some drug-induced side effects in people with schizophrenia.
Get a better night’s sleep. A bad night of sleep can set you up for a stressful day. And, in fact, one study found that people with Parkinson’s disease who got poor sleep had a higher incidence of dyskinesia. Improving nighttime sleep quality may reduce tardive dyskinesia in people with Parkinson’s, the authors say.
Take up a hobby. “Carving out time to pursue a hobby or interest that you’re passionate about can make a big difference in quality of life,” Tate says. As with exercise, it doesn’t really matter what extracurricular activity you choose, as long as it brings you joy, which will probably lower your stress levels, too.
Join a support group. Finding support is a big part of dealing with the stress of something chronic, such as tardive dyskinesia, according to Tate. “Although having understanding friends and family is huge, I think it can be even more important to find a support group and interact with people who are going through the same thing, who actually have that insight,” she says.
“With so many online communities, even if there’s nothing in your town or city, there’s likely an online community that you can access,” she adds.
Tardive dyskinesia, or involuntary movements such as puffing the cheeks, grimacing, frowning, or smacking the lips, can be a side effect of certain medications, such as antipsychotics.
Stress doesn’t cause tardive dyskinesia, but it can make symptoms worse.
Taking steps to reduce stress by exercising, practicing mindfulness meditation, pursuing a hobby, prioritizing sleep, and seeking support may also help ease tardive dyskinesia symptoms.
Alex Dimitriu, MD, is dual board-certified in psychiatry and sleep medicine. He helps his patients optimize peak performance by day and peak restorative sleep by night, and he brings a deep respect for science and spirituality into his work.
Dr. Dimitriu has been recognized by The New York Times, Discover magazine, Men’s Health, Cosmopolitan, and NBC News, among other media outlets. He is a medical reviewer for Business Insider and the Sleep Foundation, and is a contributing author to the Encyclopedia of Sleep Medicine.
Becky Upham has worked throughout the health and wellness world for over 25 years. She's been a race director, a team recruiter for the Leukemia and Lymphoma Society, a salesperson for a major pharmaceutical company, a blogger for Moogfest, a communications manager for Mission Health, a fitness instructor, and a health coach.
Upham majored in English at the University of North Carolina and has a master's in English writing from Hollins University.
Upham enjoys teaching cycling classes, running, reading fiction, and making playlists.
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Santoro MA et al. Improvement of Tardive Dyskinesia During Mindfulness Meditation. Neurology International. August 30, 2021.
Verma M et al. Effect of Integrated Yoga on Anti-Psychotic Induced Side Effects and Cognitive Functions in Patients Suffering From Schizophrenia. Journal of Complementary and Integrative Medicine. March 2019.
Mao C et al. Poor Nighttime Sleep Is Positively Associated With Dyskinesia in Parkinson’s Disease Patients. Parkinsonism & Related Disorders. December 21, 2017.
