Tardive Dyskinesia and Anxiety: 7 Tips for Coping

Anxiety can also come from frustration over not being able to control your body, or from monitoring your symptoms closely, says Dr. Rush. “Over time, this can create a cycle in which worry and increased attention to the movements make them feel even more prominent, which can then intensify anxiety.”

“For successful coping, we want to help the nervous system settle, reduce the amount of attention [to] and fear associated with movements, and help the person continue to participate in the activities that matter to them,” says Rush.

Here are seven tactics you can use to reduce anxiety.

1. Try Slow Belly Breathing With a Longer Exhale

1. Place one hand on your abdomen and allow the breath to move gently into your belly, letting your stomach and hand rise as you inhale (versus inhaling into the chest).
2. Breathe in comfortably through the nose for about three to four seconds.
3. Exhale slowly through pursed lips, as if you’re breathing through a straw, for about four to five seconds.
4. Repeat for 30 to 60 seconds.

“Aim for breathing that feels slower and easier, not the deepest breath possible,” says Rush. “Overly deep or rapid breathing can sometimes increase lightheadedness or anxiety.”

2. Use Grounding to Shift Attention

Mental grounding techniques include using your imagination. “Positive imagery involves closing your eyes and imagining a calming scene, which can help calm the body, have our mind and body focus on the present moment, and reduce focus on the TD movements, all of which can reduce anxiety,” says Molly (Mary) Conlon, MD, an attending psychiatrist who helps oversee the outpatient program for individuals with early psychosis at Northwell Health’s Zucker Hillside Hospital in Glen Oaks, New York.

“For instance, you name one thing you smell, one thing you can feel or touch, one thing you see, one thing you hear, and one thing you can taste,” says Conlon. Often, people discover that one sense helps calm them more than others, she says.

Conlon suggests:

• Listening to soothing music
• Touching something with a soft texture
• Using a fidget or squishy toy
• Smelling something relaxing, like lavender
• Tasting something, like a piece of chocolate

Once you find your most calming grounding techniques, you can make sure they're available to you to use if your anxiety spikes, says Conlon.

3. Distract Yourself

“Distraction sometimes gets a bad reputation, but purposeful engagement can be very helpful,” says Rush. “We are trying to remind the brain that the movements do not require constant monitoring.”

Conlon and Rush recommend these helpful diversions.

• Listening to music or a podcast
• Doing a puzzle
• Gardening
• Cooking
• Drawing
• Knitting
• Playing a game
• Talking with a friend
• Taking a walk
• Doing yoga poses

4. Try to Relax Your Muscles

“This allows your body to release tension that can be a result of anxiety, and [it can] help the body to relax, in addition to taking away the focus on the TD,” says Conlon.

5. Repeat Factual Statements to Cope

Anxiety can create catastrophic thoughts fast, says Rush. You may think, “Everyone is looking at me,” “I have to make this stop,” or “I can’t handle this happening here,” she says.

• “I notice the movement, [but] I don’t have to fight it.”
• “My body is doing something uncomfortable, but I can still continue what I’m doing.”
• “I don’t know what other people are thinking, and I don’t need to figure it out.”
• “This is uncomfortable, not an emergency.”

“This allows [for the] opportunity to replace a threat-based interpretation with something more realistic and useful,” says Rush.

6. Create an Anxiety Action Plan

“For example, someone standing in a checkout line could quietly press their feet into the floor, slowly exhale for six seconds and identify three things they see around them,” says Rush. “[Or] someone at a restaurant might excuse themselves to the restroom, splash cool water on their hands, take several slow breaths and remind themselves, ‘I can go back to dinner when I’m ready.’”

The goal of these plans is to settle the anxiety enough to be able to stay in a situation or activity, rather than automatically leaving when anxiety shows up, says Rush. “Repeated avoidance can … strengthen the sense that public situations are unsafe or unmanageable.”

7. Lean on Your Support Circle

Conlon and Rush recommend building support with these tips.

• Find a virtual support group for tardive dyskinesia through the National Organization for Tardive Dyskinesia.
• Ask your family members and friends to respond to your movements calmly or ignore them.
• Ask your provider about psychotherapy treatments like cognitive behavioral therapy (CBT), to help you develop additional coping skills.