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Do You People With OCD Stim?

Alicia continuously bounces her knee – up and down, up and down. Observers may think that Alicia is just being “fidgety.” But the truth is more complex than that. Alicia is not just being “fidgety,” she is stimming. Alicia’s leg movement is involuntary. In fact, she is rarely aware that she is doing it. Bouncing her knee helps relieve her stress and anxiety. It also arises when she becomes upset, tired, and overwhelmed. 

It is common to mistake Alicia’s knee movements as being “antsy,” and although it does pop up when she is anxious, “antsy” does not completely explain what is happening with her. Still, to the general public, the bouncing leg is simply an “annoyance.” Harsh people will see Alicia’s knee going up and down, and will exasperatedly say, “Stop bouncing your knee! It is driving me insane!” 

While more compassionate people will simply place a hand on her knee – as a sign of support, and an indiscrete way to help her become more aware of what she is doing. So, no, Alicia is not just being “fidgety,” she has obsessive-compulsive disorder (OCD) and is stimming to relieve her stress and anxiety. 

On the surface, stimming may look like a voluntary or deliberate behavior – without a clear purpose. But the truth is stimming does have a clear purpose. Why do people stim? To communicate with others, self-soothe, and/or relieve stress and anxiety. For many people, stimming feels good.

If you would like to learn more about stimming and if it is connected to OCD, keep reading because you will learn what stimming is, if you may have it, and how it can be treated.

Content

What is OCD?

Obsessive-compulsive disorder (OCD) is an anxiety condition that involves non-stop, unwanted, intrusive, and repetitive thoughts, urges, fears, doubts, negative emotions, mental images, etc., and/or compulsive behaviors (i.e., rituals and routines). Left unaddressed, OCD can damage relationships, your self-esteem and your self-confidence. 

OCD can also affect your work performance (productivity and quality), and lead to debt (from a lack of steady employment). Your life becomes consumed with obsessions and compulsions until you are a shell of the person you could be – without OCD. However, with the right OCD treatment, you can go out to live a life free of OCD and stimming behaviors.  

What Is Stimming?

Stimming is the abbreviation for “self-stimulation.” 

Most, if not all people, engage in self-stimulation or “deliberate stimming” from time to time. It is normal and healthy. “Stimming” is the body’s way of “calming down” and/or relieving stress and anxiety. Think back to a time when you had to pitch an idea to your co-workers. How did it feel? In other words, were you nervous, scared, or anxious? 

If so, what did you do to relieve your stress and anxiety? Bounce your knee, play with your hair, tap your fingers on a desk or table, whistle, play with your smartphone, scribble or doodle, etc. Were you aware or unaware that you were engaging in the behavior? 

If you were unaware that you were engaging in the behavior, you were engaging in “unintentional stimming,” but if you were aware that you were doing it, you were engaging in “deliberate stimming.” What about while you were waiting to see a doctor? How did you ease your nerves? Well, if waiting to see the doctor was stressful or triggering for you; the same concept applies. 

Perhaps, you repeatedly flipped through a waiting room magazine to distract yourself or maybe you bounced your knee up and down. Or, perhaps, you repeated mantras or phrases in your mind or continuously scrolled through social media pages to help you become less fearful and nervous about seeing the doctor. 

Understand, however that although stimming resembles fidgeting, it is not the same thing. “Fidgeting” implies that the behavior is voluntary or deliberate while “stimming” implies that the behavior is uncontrollable, unacceptable, intense, and/or repetitive. 

Knee bouncing and other “stims” are used to cope with emotionally distressing thoughts, urges, mental images, feelings, traumatic or upsetting experiences or events, doubts, stress, depression, and anxiety. 

Stimming reduces these negative thoughts and feelings. Thus, people with obsessive-compulsive disorder (OCD), social anxiety, post-traumatic stress disorder (PTSD), attention-deficit hyperactivity disorder (ADHD), schizophrenia, and autism spectrum disorder (ASD) “stim” to help them cope with and function in overwhelming thoughts, feelings, and situations. 

Also, understand that knee bouncing is not the only way to stim. Stimming behaviors can also involve picking at one’s ears or hair, clapping one’s hands, walking in circles, mumbling to one’s self, flexing various body parts, beating one’s chest with his or her fists, making noises, etc. 

And, while stimming is typically characterized as “repetitive movements, it can also involve staring at stimuli, such as a spinning ceiling fan, or blinking lights, or making random sounds, like humming sounds or whistling noises. 

Autism is strongly linked to stimming, in fact, this behavior is one of the main symptoms of autism, listed in the DSM-5. Autism-related stimming is not only obvious but also socially unacceptable or taboo, in many cases. These behaviors may include hand-flapping, clapping, repetitively rocking back and forth, blowing spit bubbles, staring at spinning or flashing objects for long periods, and/or repeating the same sound or phrase over and over again.

Note: Stims can change over time, and may occur in “spurts.” Stimming can also help you stay calm. In other words, stimming can stop you from becoming overstimulated by sensory input. For instance, if you start to feel overwhelmed, you may automatically start stimming to relieve the pressure. As a result, you can stay calm even in stressful situations.

Why Do People Stim?

People stim to reduce their anxiety and stress and “balance” their moods. Stimming helps with sensory processing, while also releasing emotional tension and energy. Thereby, stimming is a coping mechanism that acts like a natural stress-reliever similar to blogging, practicing yoga and/or mindfulness meditation, working out (exercising), writing poetry, and talking to and spending time with friends and family. 

Understand, however, that emotional tension does not just involve sadness, distress, anger, fear, or doubt; it can also involve happiness, jubilance, or excitement, such as cheering when your favorite football or basketball team wins, or when someone blows out the candles at his or her birthday party.

Happiness and excitement can also trigger stimming behaviors. For instance, when daydreaming about something that brings you joy, or something like your favorite song comes on the radio. In this scenario, you may start stimming or jumping up and down, screaming, and/or vigorously clapping to show your happiness and excitement that your song is being played. Usually, when this type of activity occurs, it involves a burst of energy. 

Stimming not only helps people with OCD, PTSD, schizophrenia, or autism with sensory processing issues but also helps them cope in stressful social situations.

Does Stimming Feel Good?

Yes, apparently, stimming does feel good to many, if not most people with anxiety conditions, like OCD and PTSD, and those with other mental health conditions, like schizophrenia, depression, ADHD, and autism.

The exact reason why stimming feels good is unknown, however, it is believed that engaging in stimming behaviors can help to trigger neurotransmitters (chemical messengers in the brain), serotonin and dopamine, the “happy hormones).” Serotonin and dopamine also “balance” your mood and “regulate” your emotions. 

Glutamate is also a neurotransmitter that is linked to self-stimulatory behaviors. Some people report feeling like real worms are crawling on the surface of their skin. However, before experiencing the “creepy crawly” feelings of worms crawling on their skin, people, who stim, may be overcome by a sudden rush of dread, sadness, fear, or doubt so strong that it knocks the wind out of them. 

Stimming provides these individuals with relief and gratification. It is this gratification (pleasure) that reinforces the behavior (stimming), creating a cycle of stress and anxiety – stimming (to relieve the emotional distress). This is similar to how rituals and routines reinforce obsessions, creating an OCD cycle.

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Is Stimming a Socially-Acceptable Behavior?

Although it is out of the hands of people who do, it is not generally considered a socially-acceptable behavior. In fact, it is somewhat controversial. 

In the past, people, who stimmed were encouraged to “unlearn” or “shun” the behavior. Therapy and medication were the “go-to” ways to “rid oneself” of stim behaviors. Nowadays, most therapists recognize “stimming” as a sign or symptom of another condition, like OCD or autism, and/or as a way to reduce tension and expend nervous energy. 

These mental health specialists have adopted the motto, “If it is not broken, leave it alone.” In other words, if stimming is not dangerous or harmful and provides relief, do not restrict or stop it. According to experts, the medications (i.e., SSRIs, SNRIs, tricyclic antidepressants, MAOIs, and antipsychotics) used to control stimming behaviors, may actually make the stimming worse.

So, the preferred way to treat stimming behaviors is with therapy, which in the case of OCD is OCD therapy (i.e., cognitive-behavioral therapy (CBT), exposure response prevention (ERP) therapy, and/or acceptance and commitment therapy (ACT)), when necessary. The good news is people are increasingly becoming more aware of stimming – what it is, what causes it, what condition(s) it is linked to, how it is diagnosed, and how it is treated. 

And, although, this is cause for celebration, the belief that stimming is just a form of “deliberate fidgeting” or that it involves attention-seeking behaviors that should be “performed” in private or not “performed at all, is especially discouraging. Thus, stimming remains a controversial issue. A 2019 study found that people, who stim, often feel angry, emotionally distressed, confused, irritated, hostile, anxious, depressed, dismissed or belittled, and/or ashamed when asked to stop stimming.

People, who stim, are considered neurodivergent, meaning that these individuals have an atypical or different way of learning, processing information, and communicating with others. People, who learn, process information, and communicate like the majority of people are referred to as neurotypical. Neurodivergent stimmers tend to feel that neurotypical people judge and belittle stimming because they do not understand it. As a result, people, who stim, face social challenges, leading to an inability to communicate effectively and function well in social circles, and society, in general.

Many people, who stim, learn early on to “mask,” or hide this behavior. This may look like emotional detachment or self-isolation, but it is not. It is fear, shame, and guilt. Because stimming is not socially acceptable, people, who engage in this behavior, become embarrassed by the behaviors, causing them to hide them from others. In other words, people, who stim, are often extremely afraid of being “shunned,” “judged,” or “criticized” because of their behaviors.

Although changing one’s stimming behaviors may be the optimal choice in certain situations, it is still important to examine and address the root cause of the stimming. Changing one’s actions does not help identify why someone is stimming. And, even though, most people may not think people, who stim, are communicating – they are. 

So, when these individuals are restricted from stimming or told to stop stimming, their “voices” are taken away. They no longer have “voices” or an “outlet” to share their experiences. They also no longer have coping mechanisms, which heightens their risk of self-harm and suicidal behaviors.

Is Stimming Harmful?

It can be, depending on the stimming behavior. 

Some stimming behaviors cause bruises, bumps, cuts, and/or raw skin on various parts of the body. It is imperative to get help if stimming leads to pain, wounds, and/or injuries. The only way you can stop stim-related pain and injuries is to seek help for your condition, for instance, OCD, PTSD, ASD, schizophrenia, etc. 

The goal of treatment is to help you develop healthier coping mechanisms and strategies. If you have an arsenal of healthy coping skills and mechanisms, you will no longer feel compelled to turn to self-harm behaviors to deal with the stress in your life. 

If you are afraid of stimming in public, carry a medical card that explains your condition, details your symptoms, and clearly communicates your needs, so the people around you, including close friends and loved ones, are aware of what you are dealing with. If you feel pressured not to stim in public, create a “safe space” at home, where you can safely and comfortably engage in stimming. If you live with other people, for instance, a partner or spouse and/or a child, explain to them how stimming is beneficial for your mental health.

According to a 2018 study, stimming is considered both a coping and a communication strategy. Researching “stimming” can help you learn more about what could be triggering these behaviors. Fortunately, there are therapy groups that can provide you with some much-needed support, while you identify your triggers. 

You can also find support, information, a platform to share your experiences, and advice or tips on stimming-based social media sites. Support groups, forums, and social media sites or groups can make you feel more accepted and less alone. Still, if the stimming behaviors are causing you physical pain, it is important to contact a doctor asap!

Some forms of OCD involve compulsions (rituals or routines). Other forms of OCD involve tic-like behaviors or compulsions. OCD can also involve stimming (self-stimulation). OCD-sufferers, who stim, tend to exhibit the following behaviors – jumping up and down, flapping their hands, swaying from side to side, rocking back and forth, walking in circles, pacing, spinning around, bouncing their knees, shaking their legs, rapidly blinking their eyes, humming, mumbling, etc. 

People with autism, OCD, PTSD, schizophrenia, etc., tend to stim as a way to cope with sensory-processing issues (the ability to accurately process stimuli or sights, sounds, textures, smells, etc.) and relieve stress and anxiety. Like autism, OCD, and other mental health conditions, often involve compulsive or compulsion-like behaviors (i.e., rituals and routines) like repeating mantras or phrases, repeatedly counting, checking, or organizing things, etc. 

And, like autism and other mental health conditions (i.e., schizophrenia), people with OCD tend to become “fixated” on people and/or things. These individuals are unable to stop the intrusive thoughts, fears, urges, doubts, mental images, and emotions (obsessions) even though they are unwanted and involuntary. Some OCD sufferers also suffer from compulsions (repetitive behaviors). People, who stim, are also unable to stop their behaviors (resembling OCD compulsions). Stims are also repetitive, like OCD compulsions. 

If stimming is one of your OCD symptoms, you probably start stimming because you are nervous or anxious about something and want to stop the intrusive thoughts, fears, urges (to run away), emotions, mental images, etc.

An example would be someone, who is extremely nervous about contracting COVID or monkeypox so much so that he or she not only refuses to leave the house, but also begins stimming (i.e., pulling at his or her hair, rocking back-and-forth, or pacing around the house) when intrusive thoughts about getting sick and dying from COVID or monkeypox enters his or her mind.

How is Stimming Treated When You Have OCD?

Understand stimming does not always require treatment and management. And, stimming behaviors may be resolved by treating the primary condition – i.e., OCD. In other words, the stimming should lessen or cease altogether once your OCD is under control or properly managed. In this case, the stimming is a symptom of OCD – not a standalone condition. Thus, it is up to you and your OCD therapist to determine the right treatment approach for your type of OCD

If the stimming is severely disrupting your life or causing you physical pain and injuries, your therapist may decide to focus on that aspect of your OCD first. An example of something that would warrant more intense OCD treatment would be picking at your skin until it bleeds or pulling your hair out until you have noticeable bald spots. 

On the flip side, your therapist may not spend much on your stimming behaviors, if the behaviors are not adversely affecting your life. If it is your child who is struggling with OCD-induced stimming, avoid punishing, scolding, or criticizing him or her because it will only worsen his or her OCD symptoms and trigger more intense bouts of stimming.

Overall, OCD-induced stimming is treated like any other type of OCD – with medications like antidepressants (i.e., SSRIs), antipsychotics, etc., and/or OCD therapies (i.e., cognitive-behavioral therapy (CBT), acceptance and commitment therapy (ACT), exposure and/or response prevention (ERP) therapy). 

Natural remedies, mindfulness meditation, CBD, vitamins and minerals, support groups, forums, apps, hypnotherapy/hypnosis, OCD books and workbooks, tracking your sensory triggers, journaling, applied behavioral analysis (ABA), fidget spinners or stress balls, lifestyle changes (i.e., healthy foods, plenty of sleep, and regular exercise), and self-help tools, like Impulse Therapy, can be used alone or combined with your OCD treatment plan.

Impulse therapy is an online OCD treatment program that can help you address your OCD symptoms (including stimming) in as little as 8 weeks. This program offers an online OCD assessment and tons of expert content and services that can help you get your life back on track! At the end of the day, you must be your own advocate. It is the only way you will receive the OCD help you need to stop the obsessions and compulsions.

References

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Author

DR. R. Y. Langham

Dr. R. Y. Langham has a B.A. in English, an M.M.F.T in Marriage and Family Therapy (Psychology), and a Ph.D. in Family Psychology. She is currently a medical, health & wellness contributor, copywriter, and psychological consultant

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