Many of the best strategies work by reducing stress, a key aggravator of tardive dyskinesia. “Any movement disorder, including tardive dyskinesia, gets worse under stress,” says Burton Scott, MD, PhD, a neurologist and movement disorder specialist at Duke University School of Medicine in Durham, North Carolina. This could be due to the effects of an increased release of the brain chemical norepinephrine by your sympathetic nervous system — the famous fight-or-flight response, Dr. Scott says. The following strategies can help you reduce stress and maximize your ability to control your movements. But you should not stop an antipsychotic drug abruptly, as that can cause serious problems, he says. Work with your doctor on a plan to wean yourself off it.
2. Consider Taking Another Drug to Reduce Movements
Talk to your doctor about taking a type of medication called a vesicular monoamine transporter 2 inhibitor, two of which, Austedo (deutetrabenazine) and Ingrezza (valbenazine), are approved by the U.S. Food and Drug Administration for the treatment of tardive dyskinesia. “These medications can help suppress the abnormal movements and make them more tolerable, so that patients can get back to their normal,” says Scott.
3. Practice Stress-Reduction Techniques
Meditation is a proven stress reliever, possibly because it turns down the sympathetic nervous system’s responses to stressful situations. Another option is to sign up for a class in mindfulness-based stress reduction (many local health networks offer them). You may also find relief in your beliefs. “For some people, spiritual activities or reconnecting with their religion is a good thing,” says Scott.
4. Exercise Regularly
Get moving, and you will feel better — both physically and mentally. “Schedule daily walks in a pleasant place,” says Scott. Walking in a natural setting, rather than urban one, may have added benefits: A study published in Landscape and Urban Planning found that taking a 50-minute nature walk resulted in decreased anxiety and rumination, while preserving a positive mood. Swimming is another good source of aerobic exercise — or if you enjoy sports like tennis or basketball, look for opportunities to play regularly. “The rest of the world may not be as focused on the movement as the person thinks,” says Scott. Remind yourself that other people probably aren’t scrutinizing you as much as you think they are.
6. Empower Yourself With Information
Sometimes people feel better when they learn all they can about their condition, says Scott. Consult reliable sources, such as the National Institute of Neurological Disorders and Stroke, and talk to your healthcare provider about ongoing research, which can help you learn more about this disorder and possible treatments.
7. Join a Support Group
You can help yourself and others at the same time by leaning on each other for support. “If there’s a mental health support group or psychoeducation group somewhere that you have access to, that may be the most helpful thing,” says Karen E. Anderson, MD, a professor of psychiatry and neurology at Georgetown University in Washington, DC. “Often, your psychiatrist, psychologist, or social worker will be able to point you to local support groups or an online support group where you can learn more,” Dr. Anderson says.
8. Prioritize Good Sleep Hygiene
When you’re tired, it’s harder to control your movements. The solution: Practice healthy bedtime habits. “The best place to start is to get rid of screens in the evening,” says Anderson. “Phone screens, tablets, computers — the blue light from those can cause a lot of people to stay up much later than they should.” Blue light can suppress production of the sleep hormone melatonin, so give yourself a deadline at night and don’t look at any screens after that time. As much as possible, try to stick to a schedule of going to bed at about the same time each night and getting up at around the same time each morning.
9. Give Yourself a Break When You’re Nervous
“I always try to remind patients: If you’re in a stressful situation, like if you have to go to a family event or a big church or community event, your movements may get a little worse,” says Anderson. “That doesn’t mean you’re suddenly worse or that you’re relapsing — it just means that when you’re stressed, your movements are going to come out a little more.” Knowing that, and being able to show yourself compassion, can help.
10. Consider Reducing Your Caffeine Intake
Caffeinated beverages can make involuntary movements worse for some people, says Anderson. That doesn’t necessarily mean you have to give up your morning cup of coffee, but she suggests trying an experiment: Have one fewer caffeinated beverage per day, and cut out caffeine entirely after 5 p.m. If you notice an improvement in your movements, you might be sensitive to the effects of caffeine, and you might feel somewhat better if you consume a bit less.
11. Ask a Friend or Family Member How Much You Move
Sometimes people with tardive dyskinesia aren’t sure how much they’re moving, so if you feel comfortable doing so, ask someone you trust for feedback on your motions. Anderson suggests saying something like: “My doctor has told me that involuntary movements, particularly in my face but sometimes in my fingers and toes and the rest of my body, can be a side effect of my medication. Do you notice that I’m doing this? Does it look like I’m fidgeting or chewing gum when I’m not, or moving around a lot?” These kinds of conversations can help you assess your situation more objectively.
