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ADHD Stimming Explained: Why It Occurs and How to Manage It

From twirling a pencil to spinning in a chair, stimming is a unique language expressed by many who have ADHD. Uncover the hidden patterns of ADHD stimming in our expert guide. 
Written by
Jeff Sounalath
Mental Health Therapist, MS, LPC, LCDC, NCC

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Stimming is a term that might seem foreign to some, yet it's a familiar comfort to many individuals with ADHD. These repetitive behaviors are physical responses to internal states, expressed as an outlet to focus, stay calm, or release excess energy, among other reasons. 

This guide will explore the nuances of ADHD stimming and how these behaviors impact the daily lives of individuals who experience them. We'll also explain the different types of stimming and what might trigger them, ensuring you leave with a fresh perspective on this often misunderstood topic. 

What Is ADHD Stimming? 

Stimming, or self-stimulatory behavior, is an umbrella term for repetitive movements, noises, or similar habits that someone expresses to regulate their sensory inputs or emotions. These habits are often performed subconsciously and can range from tapping and fidgeting to more elaborate behaviors, depending on the type and severity of the person's ADHD diagnosis.  

Stimming behaviors can be challenging to pinpoint since there's no single cause or explanation. Still, they usually manifest as some sort of response to manage and cope with situations amplified by ADHD. 

ADHD Stimming vs. Regular Fidgeting

It's normal for people who haven't been diagnosed with ADHD to exhibit stimming behvaior, like repeatedly shaking a leg while seated, which is commonly known as fidgeting. However, ADHD stimming is usually more intense and occurs frequently, usually whenever the person needs to alleviate stress, increase focus, or manage sensory overload. 

Stimming can also interfere with daily functionality and could potentially be harmful, such as if someone constantly grinds their teeth or picks their skin. While ordinary fidgeting and stimulatory behaviors aren't exclusive to ADHD, they might be precursors and call for an official evaluation to rule out or confirm the condition. 

Stimming in ADHD vs. Autism Spectrum Disorder 

Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are both neurodevelopmental conditions that can cause similar behaviors, including impulsivity, inattention, and stimming.

However, autism stimming is one of the requirements of the ASD diagnostic criteria, meaning the patient must show this symptom to get diagnosed, unlike the case for ADHD. The "stims" themselves and the causes behind them can also vary, whether to express excitement, grapple with boredom, or relieve stress brought on by the mental disorders. 

Types of ADHD Stimming Behaviors

Stimming in ADHD can manifest in various forms, each associated with different sensory experiences. Some people with ADHD may exhibit several stimming behaviors, while others only show one. Common types of ADHD stimming include the following: 

  • Visual/Sight: Visual stimming involves habits related to sight, such as interacting with and staring at spinning objects, switching lights on and off, or drawing.  
  • Verbal/Auditory: Verbal stimming is characterized by actions that produce sound or involve listening to repetitive noises. These behaviors include humming, singing, or frequently clearing one's throat. 
  • Tactile: Tactile stimming involves touch, such as picking at the skin, hair twirling, or fidgeting with textured objects. 
  • Vestibular: Vestibular stimming relates to balance and spatial orientation. Rocking in a chair, tiptoeing, and head-tilting are typical vestibular behaviors. 

While these are the main types of stimming, ADHD can cause other stimming behaviors. For example, overeating or repeatedly sniffing a specific scent can also be interpreted as stimming if used as a coping mechanism. And since ADHD stims aren't always intentional, the person displaying these behaviors might not realize unless someone else observes them. 

Professional Insight

Other signs of ADHD Stimming behaviors can present as a need for mental stimulation. One way this type of stimming can occur is by working on several tasks at once, constantly bouncing from task-to-task for short periods of time.

What Causes ADHD Stimming?

ADHD stimming can result from various internal and external factors, including negative emotions, work environments, responsibilities, and more. There's no universal cause for ADHD stimming other than the neurological differences associated with the condition, as ADHD directly impacts hyperactivity, inattention/impulsiveness, or a combination. Depending on the individual, the following scenarios have the potential to trigger stimming behaviors: 

Sensory Overstimulation

Bright lights, loud noises, crowded environments, or any kind of stimulation that overwhelms the senses might cause someone to stim. ADHD often amplifies sensory inputs and makes them feel more intense than normal, leading to behaviors that help filter and manage these inputs. 

For example, someone with ADHD who feels nervous in large crowds might pace more than normal or bite their nails. Others might click their tongues or continuously brush their hair back. Avoiding overstimulatory environments is the best way to prevent harmful stimming behaviors, but if this isn't feasible, experimenting with various strategies, like carrying a stress ball, might provide a source of relief. 

Emotional Distress

In addition to intensifying sensory inputs, ADHD can amplify specific emotions, whether that’s anxiety, excitement, stress, or something else. Anyone with ADHD who struggles with processing emotions might subconsciously turn to stimming as a way to regulate how they feel, such as twirling their thumbs after receiving troubling news. Conversely, someone experiencing intense joy might bob their head to show excitement or feel the urge to hum their favorite song. 

If emotional distress causes uncontrollable stimulatory behaviors, practicing mindfulness, engaging in physical activity, or using grounding techniques may reduce the need for stimming and help maintain emotional balance. 

Professional Insight

Some grounding techniques to slow down your body and/or mind include box breathing, imagery, and the 5 senses techniques. These can ease the mind if your thoughts are racing a mile a minute, or calm your body down if you feel yourself getting tense, feeling like your heart rate is increasing, or tension headaches.

Boredom and Disinterest

On the other hand, the absence of stimulation, intellectually or sensory-wise, often prompts stimming in some people with ADHD. This type of stimming aims to create a self-supplied stream of engagement that counters the dullness of their environment, such as doodling during a lecture or rearranging objects on a desk.  

Strategies to overcome these triggers include:

  • Balancing responsibilities with stimulating tasks.
  • Altering routines to try new activities.
  • Ensuring instances of inactivity are balanced with engaging challenges.

By proactively addressing the conditions that lead to boredom-induced stimming, individuals can redirect their energy to productive efforts. 

Excitement and Energy Release

High levels of excitement and the need to release excess energy can manifest as stimming. For instance, someone with hyperactive ADHD might struggle with sitting still and frequently move around when they're supposed to be seated. Such behaviors are often subconscious attempts to manage surging adrenaline and enthusiasm, also known as "happy stimming." 

However, rather than suppressing this energy, channeling it into structured, physical activities can provide a healthy outlet, like walking, stretching, or practicing yoga. Additionally, incorporating routine physical exercises might help prevent this type of stimming, allowing the body and mind to release pent-up energy naturally. 

Habitual Behavior

It's entirely possible stimming can just be an acquired habit due to repetition. The Children's Hospital of Philadelphia has observed that people on the autism spectrum sometimes stim because it's enjoyable, not because it helps them self-regulate, and gradually adopted the behavior as a routine habit. It's also plausible that some people with ADHD stim for the same reason, regardless of their environment or internal states. 

Professional Insight

Many adults with ADHD-like symptoms often gravitate towards hobbies that allows for them to either let out their energy daily, or allows them to keep their mind and body stimulated at appropriate times. Examples of each would be activities such as going to the gym or running every morning to better regulate their hyperactive urges, or by doing things like knitting/crocheting during situations that require sustained attention.

Should You Be Concerned If You Stim? 

Stimming in itself is a natural response and doesn't have to be viewed as negative, especially if it helps you regulate emotions, calm the senses, or improve focus, and some mindfulness techniques involve stimming deliberately. That said, your stimming behavior's severity and impact can warrant concern. 

If stimming disrupts daily functioning, interferes with social interactions, or causes physical harm, evaluating the behavior more closely is important. Additionally, ADHD stimming that intensifies under stress or becomes a predominant focus over other activities might signal a need for professional help. 

It's particularly crucial to observe whether the stimming behaviors escalate or if they're used exclusively as a helpful, innocuous coping strategy. Above all, recognizing your self-stimulatory behaviors and their overall impacts is crucial, as many people don't even realize they engage in stimming. 

How to Manage Stimming Behaviors

Once you identify your routine ADHD stimming patterns, you can determine if intervention is necessary. While you might be able to address negative self-stimulatory behaviors independently, some situations call for a professional's help, especially if stimming causes physical harm. Here are various strategies to manage ADHD stimming: 

Recognize and Avoid Triggers

Whenever you stim, try to record when and where it happens, as well as your feelings, situation, and anything notable on your mind. For example, if you find yourself stimming in social interactions but not when you're on your own, take note of that.

You may also want to ask a trusted friend or family member about their observations regarding your stimming, as they may point out behaviors you weren’t even aware of. Over time, you should try to identify the scenarios that typically cause you to stim, which can take several days, if not weeks. 

Keeping track of your self-stimulatory behaviors in a daily journal is one of the most effective ways to gain awareness of your condition. Once you clearly understand what causes it, you can consider what accommodations will lessen stimming occurrences, such as wearing noise-canceling headphones in distracting environments. 

It's important to get a diagnosis for ADHD and we offer online options for that. Getting an online ADHD diagnosis can help you better understand and manage your triggers, oftentimes awareness is an important first step in addressing behavior that causes issues in your day-to-day.

Create a Focus-Friendly Environment

After you know what triggers your ADHD stimming behaviors, you should prioritize creating an environment that allows you to work and focus at your best. Blocking out external noise is one example, but for other situations, you want to embrace strategies that reduce the unconscious pull toward stimming behaviors. 

One such strategy is the Pomodoro Technique for time management, which alternates focused work sessions with brief periods of rest. Typically, this involves 25 minutes of full engagement followed by a 5-minute break. After four intervals or two hours, take a longer break, up to 30 minutes. This strategy is particularly beneficial if you find it challenging to sustain focus for long periods and routinely encounter stress-induced stimming. 

Outside of your physical environment, committing to regular physical activity can support your cognitive function and act as a natural stimulant for the brain, potentially reducing the need for stimming. Similarly, any kind of therapeutic practice, like meditation or deep-breathing exercises, can offer a tranquil break for an overactive mind. 

Professional Insight

Practicing mindfulness and incorporating small chunks of time into your daily routine can be beneficial if you have ADHD symptoms that make you feel like you are on “autopilot” or just going through the motions of your daily routine without really being present. 

Seek Medical Guidance

In some cases, you may need to consult a medical professional to overcome harmful and unrelenting stimulatory behaviors. ADHD stimming that causes physical injury, such as biting at gums and breaking skin, especially warrants medical guidance. Likewise, if stimming becomes too overwhelming or distracting in your daily life, it might be time to find support. Stimming is often coupled with other ADHD symptoms such as ADHD paralysis and ADHD hyperfixation.

With a team of seasoned medical experts in ADHD, ADHDAdvisor.org is an excellent online resource for holistic ADHD treatment, offering a blend of medication management, behavioral therapy, and success coaching tailored to address stimming behavior at its core. Here's how these treatments can help manage self-stimulatory ADHD behaviors: 

Medication Management

Medication plays a crucial role in managing ADHD symptoms for many, including stimming. Stimulant medications are commonly prescribed for ADHD and may help increase dopamine levels, which in turn can reduce the need for self-stimulating behaviors. ADHDAdvisor.org doesn't prescribe stimulants, but our team can offer effective non-stimulant alternatives to address your behavioral patterns.  

Moreover, we'll work with you every step of the way to ensure you find the proper medication and dosage. If you're still not seeing an improvement, we can connect you with another in-person specialist who can further assist with prescribing stimulants, though few patients need to go this route. 

Therapy and Success Coaching

Therapy is another effective medical strategy to manage ADHD, notably cognitive behavioral therapy (CBT) for adults. CBT can help you understand your stimming triggers and work to repair any long-term complications caused by living with ADHD. Behavioral therapy can also provide tools for enhanced emotional regulation, potentially reducing the frequency and intensity of stimming behaviors. 

In addition to therapy, ADHDAdvisor.org offers a unique ADHD treatment in the form of success coaching. Our coaches have vast experience helping individuals develop strategies to reach their goals, such as building a budget, making an ADHD-friendly daily schedule, or devising plans to avoid self-stimulatory triggers. 

Regardless of which treatment option(s) works best for you, ADHDAdvisor.org will always ensure it meets your personal needs and aligns with your expectations. 

Final Thoughts

While stimming behaviors are a relatively common aspect of ADHD, they're still as diverse as the people who experience them. Understanding the complexities of these behaviors is crucial in managing them, but it's important to remember that stimming doesn't always have to be a bad thing, depending on how it affects your life and ability to function. 

However, if you're concerned with personal ADHD stimming, the path to improvement starts with support. We encourage you to take ADHDAdvisor.org's brief diagnostic online ADHD quiz and schedule an appointment with one of our clinicians, the first step toward a more focused and balanced life. 

Professional Insight:

Many individuals believe that medication management or therapy for ADHD is a lifetime commitment, which isn’t necessarily always true. Just like how your life can be tumultuous, with very high highs and equally low lows, so can your need to maintain focus and concentration for long periods of time. 

For example, a student may no longer need to take medication once they graduate school and start working, or a first time mom may no longer need medication after her child becomes more independent. Sometimes routines and healthy habits one has developed over the years is enough once the stressor is taken out, thus allowing for the possibility of no longer needing medication management

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