When it hits at the worst possible moment, that’s when the insecurities strike.
How can I hide this? Will people notice? What will they think?
What if it keeps up like this? How am I going to manage this? Will my life always be different? What can I do? Why is this happening? How do I stop it? Where in the world can –
Breathe. You can do this, and even when the persistent, involuntary, repetitive movements of Tardive Dyskinesia (TD) seem insurmountable, there are hacks you can try.
Are they guaranteed to work? Not at all, but they do represent a growing understanding of the neurological condition, and as medical and non-medical approaches to TD improve, you’re in a position to improve as well.
The next time your face, tongue, limbs, or trunk move without your approval, remember: other people have been here too.
Overall, 20-50 percent of people on long-term antipsychotics and other dopamine receptor-blocking medications experience TD, with an average prevalence of 25 percent for those specifically on antipsychotic medicines.
A conversation with your healthcare provider is the first step. Two medications classified as VMAT2 inhibitors are FDA-approved specifically to treat TD: valbenazine and deutetrabenazine. In clinical trials, both reduced abnormal movements better than placebo, and the benefit held up over a year of treatment. Experts typically recommend these medications when TD is moderate to severe. If no one has discussed them with you, it is reasonable to ask.
Want to make everyday life easier? Here are the top TD hacks and different ways to achieve each.
RELATED: “TD Changed How I Saw Myself—Here’s What Helped”
Lowering Your Cortisol Levels
Cortisol is commonly known as ‘the stress hormone,’ and when elevated in your body for long periods, it can negatively impact your health. Because stress is a well-documented trigger that can intensify TD symptoms, managing your stress load becomes paramount.
The good news is you don’t have to overturn your life overnight or engage in intense, hard-to-access practices.
Conscious Breathing
For starters, a little breathwork can help. Short sessions of deep breathing or simply being mindful – clearing your mind and listening to your breaths – can activate the parasympathetic nervous system, which, in turn, can reduce how ‘aroused’ or anxious you feel.
Because anxiety and tension can flood your nervous system with dopamine and adrenaline, your TD essentially goes into overdrive when you’re too stressed. Remember, TD is linked to a hypersensitivity to dopamine, so spiking even more dopamine can be problematic.
Not sure how to do deep breathing?
It’s actually quite simple. First, find a comfortable, quiet place, then sit in a chair with your feet flat on the floor. You can also lie down if you prefer. Make sure any tight clothing is loose around your waist, then close your eyes.
Once in position, place one hand on your belly, just below the ribs, and your other hand on your chest. Begin by exhaling completely. Breathe out through your mouth and empty your lungs as much as possible without being uncomfortable. Gently squeeze your belly to get out the remaining air.
Then, inhale deeply, breathing in slowly through the nose and allowing your belly to rise and expand like a balloon. Count to 4. You should feel the air filling the lower part of your lungs. Now, hold your breath for a count of 4 as well, or up to 7 once you’ve practiced this multiple times. Make sure your body is relaxed without strain.
Next comes the exhale.
Breathing out through your mouth (or nose), exhale for 4 to 8 seconds. Your exhale should be longer than your inhale, if possible. Gently pull your belly in to empty the lungs fully.
Once fully exhaled, take a break. Pause for several seconds, and repeat the cycle four to 10 times. Do this a few times a day if it helps (stop if you feel lightheaded).
In short, stress can make TD movements more noticeable, and relaxation can temporarily quiet them. That relief is short-lived rather than a cure, but still worth trying.
RELATED: 5 Movement Therapies That Can Help Manage Tardive Dyskinesia Symptoms
Intentional Exercise
It’s also important to get regular physical activity. In this case, gentle, consistent exercise is your best option over intense but short-lived efforts. The goal is not to necessarily work harder, but to work more consistently.
Do something you can sustain, like neighborhood walks, increasing distance over time, stretching on your floor or outside on a mat, or maybe even a little yoga, while watching a tutorial on YouTube.
Although research on physical activity in patients with TD is limited, several studies have indicated positive impacts when moderate exercise was combined with other treatment modalities. For instance, marginal to significant improvements in gait, stride length, facial twitches, and involuntary chewing were all observed, with some animal models showing that intense exercise actually worsened orofacial dyskinesia.
Optimized Sleep
Speaking of relaxation, don’t neglect sleep either. Sleep hygiene is critical because when we’re chronically sleep-deprived, this can lead to chemical imbalances throughout the body and brain. Because TD is greatly impacted by dopamine hypersensitivity, and because sleep deprivation is known to disrupt dopamine systems, prioritizing good rest is a must.
This is why creating a calm environment that is cool, routine, and stress-resistant is important for sleeping.
Keep your bedroom comfortable and very dark, and do your best to avoid all screens and stimulants within a couple of hours of bedtime.
If certain hobbies, like nature, music, or writing, help you drift off, definitely consider incorporating them. Given that research indicates symptoms are “more pronounced during periods of fatigue or stress,” it’s no wonder many people with TD report using muscle relaxants and sleeping medication to fall asleep and stay asleep.
An important caution: don’t start sleep aids or muscle relaxants on your own. Some sedating medicines have anticholinergic effects that can worsen TD. If sleep is a problem, check in with your healthcare provider before self-medicating.
With these strategies, you can reduce the vicious cycle where stress worsens movements, which in turn increases anxiety and adds more stress.
Talking Confidently About TD
You’re probably wondering how you can explain to people why you’re suddenly twitching or moving in ways that seem bizarre. If the thought of ‘being caught’ makes you avoid activities you once loved, you’re not at the end of the road.
In fact, you’re just starting your journey.
Because TD often affects orofacial muscles, leading to challenges with speech, eating, and visible movements, there’s no shame in feeling embarrassed. However, it doesn’t have to remain this way. With some strategic ‘hacks,’ you can feel more comfortable, be more confident, and improve your challenges over time.
Proactive Disclosure
If the thought of social interactions or unexpected events gets you nervous, it can be helpful to plan something simple to say if symptoms arise. A short, prepared phrase like “I have a neurological condition that causes involuntary movements” is sometimes all it takes.
You may even clarify by adding, “It’s not related to anything else,” to help further reduce awkwardness and shift back to the focus of the conversation.
The research appears promising. Some studies have indicated that merely having a positive attitude about mental health disclosures can predict a better quality of life after 6 weeks. While the factors are uncertain, this may be due to increased social support and less self-isolation.
Speech Therapy
You may not want to initially, but working with a speech-language pathologist can help significantly in some cases, especially with orofacial dyskinesias.
Your therapist will typically employ the following techniques: paced speech, breathing support, and compensatory strategies. Together, these can help patients attain clearer communication and improved swallowing.
Adaptive Tech
Seeing as we’re living in a digital revolution of sorts, particularly with AI, it’s no surprise that cutting-edge technology is hotter than ever. So make it work for you!
You can use written notes, adapt text-to-speech apps, or simply learn gestures during high-stress moments. If you find yourself in a group setting, try to position yourself to minimize visual distraction. Or, if helpful, choose quieter environments for important discussions.
Many patient organizations and online communities, such as TalkAboutTD.com, can connect you with shared experiences and provide some of the tools, resources, and support you seek. Peer support, also, more generally, can help reduce feelings of isolation, depression, and loneliness, which can feel overwhelming in severe cases of TD.
Streamlining Routines
If you’ve ever gone to a grocery aisle and had no idea what you wanted because there were so many colors, brands, shapes, sizes, and everything else – you’re not alone.
But what happens when you constantly have to make choices, day in and day out, one after another in a seemingly endless haze? If this sounds like you, it could be decision fatigue, which is mental exhaustion that can lead to poorer choices, irrational behaviors, and impulsive thinking.
Fortunately, consistent routines can prevent such fatigue, instead creating stability and predictability.
Structured days may also support better medication adherence, symptom tracking, and overall disease management of health conditions in general.
Morning/Evening Anchors
One habit to begin today is starting your day with short movements, which can offset overnight stiffness and start the day off on a positive note. Although exercise has not been proven to reduce tardive dyskinesia movements directly, research in related movement disorders suggests regular physical activity is a consistent way to support balance, mobility, physical function, and quality of life.
Follow this up with your normal medication routine, then with light stretching and a balanced breakfast. To end it, you can conclude with wind-down activities such as leg elevation, journaling, or just relaxing.
Task Simplification
Decision fatigue is partially caused by too many tasks or tasks that are too complex. To address this head-on, consider breaking chores into smaller steps. For example, you can use adaptive utensils with larger grips for eating, or even Velcro clothing. Some patients have even found success with voice-activated devices to finish tasks.
If you’re running short of ideas, a specialized occupational therapist can recommend personalized tools, whether you’re on the grind at work or practicing some simple self-care at home. And speaking of self-care, you can better care for your TD by simplifying your symptom tracking as well.
For this, it doesn’t need to be complicated. Even a basic daily log of movements with recorded triggers – like diet or job stress – can help. At your next visit, just make sure to share any patterns with your neurologist or psychiatrist. This way, you can tweak your treatment if needed, which may include VMAT2 inhibitors and other adjustments.
Activity Segmentation
Proper rest cannot be overstated.
If your TD is often triggered by intense stress, whether physical or mental, you should attempt to alternate active periods with rest. It’s not as hard as you may think. Firstly, build in buffer time for tasks that TD might slow down, such as eating or writing.
Then, prioritize important activities when you feel your best.
Of course, one way to feel better overall is to ensure you’re adequately fueled. This is where nutrition and hydration come in. Eating regular, balanced meals may not sound like a ‘hack,’ but it’s certainly an easier way to support energy and avoid blood sugar fluctuations.
Aside from that, stay ahead of thirst by sipping hydrating beverages (preferably low in sugar) throughout the day. If you can do this and limit alcohol and nicotine, you’re well on your way to minimizing triggers.
Overall, the most effective approach to making life with TD easier is one that includes all three areas: constructive conversation, stress reduction, and efficient routines. Although many patients will report that TD symptoms remain, these lifestyle hacks can significantly improve daily functioning and emotional well-being in specific cases.
The bottom line: TD is treatable. Everyday strategies can make life easier, but they work best alongside medical care — not instead of it. Don’t let TD’s challenges overshadow your life. Make the commitment today and start on the path to better management and control.