Categories
Tic Disorders

Increase in Tic Disorders during the COVID-19 Pandemic

The COVID-19 pandemic and quarantine was a massive paradigm shift in how many people carried about their day to day lives. As with any large or small change to someone’s habits and routines, there is a level of stress associated with this. This stress alongside prolonged negative emotions such as loneliness and powerlessness drove the occurrence of the initial episodes of mental illnesses to occur in people or worsened them (Chatterjee & Chauhan, 2020). One section of the population where this trend was observed was children. More specifically, pediatricians and child mental health professionals in the United Kingdom noted an increase in tic symptoms in children and adolescents already diagnosed with tic disorders and an increase in presentations of sudden onset severe tics and “tic-like attacks” (Heyman, Liang, and Hedderly, 2021).

Tics are classified as “sudden, uncontrollable twitches, movements, or sounds that people do repeatedly”(CDC, 2021). There are currently three tic disorders that are included in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The three disorders are Tourette’s disorder, Chronic motor or vocal tic disorder, and Provisional tic disorder (DSM-5). One of the main factors that distinguishes the three disorders is the length of time that people have had tics, as well as the number of motor and/or vocal tics they perform (CDC, 2021). Tourette’s is the most involved diagnosis, as it is diagnosed in people who have two more motor tics and at least one vocal tic for at least a year. In comparison to the other two disorders, which vary in the length of time with symptoms and number of tics. 

Medical professionals postulate that tic-like attacks are primarily caused by underlying built-up anxiety in adolescents, but this cannot be used as a blanket explanation because previous studies have shown that the stress-tic relationship is not a linear one (NHS Choices, 2022). In one study that looked at a sample of children with co-occurring tic and anxiety disorders, the data suggested that tic frequencies may not change or change in implausible ways during acute periods of stress (Conelea et al., 2014). The main gripe with this study, though, comes in the form of the researchers not properly defining their definition of “acute”, as the quarantine was certainly not a 1 or 2 week event (2014). Therefore, anxiety may not be entirely the cause of tic disorders. 

The initial rise in tic-like symptoms during quarantine alarmed health care professionals in the United Kingdom, where this rising trend in tic disorders and tic-like attacks were observed, for three reasons. Firstly, the rate at which child mental health professionals received referrals for sudden tic-like attacks between 2020 and 2021 was double the rate in years prior (Heyman et al., 2021). Secondly, the onset of symptoms included a mix of both motor and vocal tics in adolescents, which is seen in individuals with Tourette’s. However, what has been generally seen in the past with non-Tourette’s tic disorders, is the normal onset of symptoms is mainly motor tics (Heyman et al., 2021). Thirdly, the main population of new adolescents who were affected by these sudden tic-like attacks were girls, a drastic contrast to the usual 4:1 ratio of tic-like symptoms present in boys as opposed to girls (Heyman et al., 2021). At the time the original study was conducted, the time frame between the onset of symptoms and the end of the study was less than a year, so the psychologists could not officially diagnose the new wave of people with new tic-like behavior with Tourette’s. Furthermore, when the adolescents were examined, there was no other neurological reason that could be found to explain the sudden onset of tic-like attacks, which coincided with the medical professionals believing the children developed some form of a tic disorder (Heyman et al., 2021).

The consensus belief held by the medical professionals involved in the care of these children, is that the children all had some form of underlying anxiety which could have unearthed their predisposition to tics and other neurodevelopmental impairments such as ADHD and autism (Heyman et al., 2021). Additionally, the sudden nature of the tic-like attacks, as opposed to a steady wind up of episodes, coincides with the sudden halt of their regular daily routines because of quarantine. Moreover, another confounding factor found by the professionals was the increased consumption of social media by these adolescents as a result of being stuck at home all day. More specifically, it is the consumption of content made by creators who have tic disorders, such as Tourette’s. Adolescents who presented with a sudden onset of tic-like attacks told medical professionals that posting videos and discussions about their symptoms to peers, gave the adolescents a sense of support and belonging (Heyman et al., 2021).  The medical professionals believe that as a result of this echo chamber of support, and a lack of proper therapeutic intervention, such as Cognitive Behavioral Intervention, the adolescents weren’t attempting to improve their tics. Cognitive Behavioral Intervention works to establish three things in people with tics: tics can improve and worsen on their own, tics are often done in response to a feeling or urge, and tics can be stopped, at the minimum for a short time (Cincinnati’s Children, 2021). Further research into this phenomenon is being heavily pushed by the medical professionals to try and definitely see a correlation between social media and an unintentional reinforcement of tic-like symptoms (Heyman et al., 2021).

Given the small sample size and the already non-consensual data on stress-tic relationships, there can be no definitive answer as to whether social media or pandemic anxiety played a role in the seemingly subsequent rise in tic-like attacks in children. However, it will definitely be something to keep an eye on for child mental health care professionals moving forward as the world returns to a state post-quarantine, but in the advent of social media’s continued growth. 

 

References

fancycrave1. 2015. “Hands Ipad Tablet – Free Photo on Pixabay.” Pixabay.com. June 25, 2015. https://pixabay.com/photos/hands-ipad-tablet-technology-820272/.

CDC. 2021. “Diagnosing Tic Disorders.” Centers for Disease Control and Prevention. April 15, 2021. https://www.cdc.gov/ncbddd/tourette/diagnosis.html#:~:text=Tics%20are%20sudden%20twitches%2C%20movements,make%20a%20grunting%20sound%20unwillingly.. 

Heyman, Isobel, Holan Liang, and Tammy Hedderly. 2021. “COVID-19 Related Increase in Childhood Tics and Tic-like Attacks.” Archives of Disease in Childhood 106 (5): 420–21. https://doi.org/10.1136/archdischild-2021-321748

Conelea, Christine A., Krishnapriya Ramanujam, Michael R. Walther, Jennifer B. Freeman, and Abbe M. Garcia. 2014. “Is There a Relationship between Tic Frequency and Physiological Arousal? Examination in a Sample of Children with Co-Occurring Tic and Anxiety Disorders.” Behavior Modification 38 (2): 217–34. https://doi.org/10.1177/0145445514528239

Chatterjee, Kaushik, and V.S. Chauhan. 2020. “Epidemics, Quarantine and Mental Health.” Medical Journal Armed Forces India 76 (2): 125–27. https://doi.org/10.1016/j.mjafi.2020.03.017.

NHS Choices. 2022. “Overview – Tics.” 2022. https://www.nhs.uk/conditions/tics/#:~:text=Tics%20can%20happen%20randomly%20and,talked%20about%20or%20focused%20on.. 

Cincinnati Children’s. “Cognitive Behavioral Intervention for Tics (CBIT).” 2021. Cincinnatichildrens.org. 2021. https://www.cincinnatichildrens.org/health/t/tic-intervention

Categories
Obsessive Compulsive Disorder Tic Disorders

Relations Between Tic Disorders and Obsessive-Compulsive Disorders

Unwanted urges and obsessions are burdensome because it likely interferes with daily life. These undesirable thoughts are associated with a lot of anxiety and distress over a specific event or action. Obsessive-Compulsive Disorder (OCD) is identified as intrusive and unwanted obsessions coupled with a compulsion or a sudden involuntary behavior. A tic disorder may often be characterized by motor or vocal. A vocal tic is when a person with the disorder will whistle, grunt, or repeat certain words. A motor tic is often exhibited through twitching, blinking, or nose scrunching. Obsessive-Compulsive Disorder and tic disorder can coexist, and the behaviors of each disorder can often overlap. 

There is a certain subtype of Obsessive-Compulsive Disorder, where many will identify as Tourettic Obsessive-Compulsive Disorder. This subtype is defined as extreme physical or psychological discomfort followed by a behavior that is carried out to relieve the discomfort. The difference between a tic and a behavior from Obsessive-Compulsive Disorder is very slight but can be correctly categorized by the intent. A tic can be characterized as a repetitive behavior that has no specific motive. Whereas a behavior from Obsessive-Compulsive Disorder is purposeful, and performed because it is believed to provide relief from discomfort. These distinctions are important especially in a clinical setting. It has been observed that when individuals with both these disorders seek treatment, they respond better when the treatment is catered to them rather than being treated for just one or the other. 

In a study led by Christine Conelea, it was proposed that children with tics in the Pediatric OCD Treatment Study II varied from those without tics. Therefore it is assumed that these children’s treatment responsiveness would differ because of a tic disorder. Youth between ages 7-17 with a primary diagnosis of Obsessive-Compulsive Disorder were included in this study. They were then divided into groups based on whether or not they had tics along with OCD or if they only had OCD without the presence of tics. This study used treatments like medication management, medication management plus instructions in cognitive behavioral therapy(CBT), or medication management plus full cognitive behavioral therapy. Throughout the treatment process people with tics terminated treatment early more often than people without tics did, however this was not reflective of how they responded to certain treatments. People with OCD and comorbid tics will benefit from cognitive behavioral therapy from someone with expertise in OCD and tic disorders. Tics are hypothesized to be facilitated by the feeling of relief when performing the behavior that alleviates discomfort. CBT aims to reduce the frequency of tics through exposure by purposely evoking more discomfort when that behavior is performed. 

The coexistence of both tic disorder and Obsessive-Compulsive Disorder does not suggest a higher degree of severity or a more intense expression of symptoms. Conelea’s study found that when comparing individuals with tic-related Obsessive Compulsive Disorder and individuals with only Obsessive-Compulsive Disorder, there was no significant difference in treatment responsiveness. Conelea’s study brings caution to making assumptions about people living with these disorders. 

 

References

Conelea, C. A., Walther, M. R., Freeman, J. B., Garcia, A. M., Sapyta, J., Khanna, M., & Franklin, M. (2014, December). Tic-related obsessive-compulsive disorder (OCD): Phenomenology and treatment outcome in the pediatric OCD treatment study II. Journal of the American Academy of Child and Adolescent Psychiatry. Retrieved October 16, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4254546/.

Marla Deibler, P. D. (2020, October 12). What is “just right” OCD and tic-like compulsions? Verywell Mind. Retrieved October 16, 2021, from https://www.verywellmind.com/just-right-ocd-2510668. 

Obsessive-compulsive disorder and TIC disorders. Duke Health. (n.d.). Retrieved October 16, 2021, from https://www.dukehealth.org/treatments/child-psychiatry/ocd-and-tic-disorders.

Tics, Tourette syndrome, and OCD. HealthyChildren.org. (n.d.). Retrieved October 16, 2021, from https://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Tics-Tourette-Syndrome-and-OCD.aspx.

Categories
Depression Tic Disorders

Depression and Tourette’s Syndrome

Depression is one of the most common mood disorders in the United States that affects all ages. There are several different kinds of depressive disorders including persistent depressive disorder, postpartum depression, psychotic depression, and seasonal affective disorder. Common signs and symptoms of all these forms of depression include feeling persistent sadness, hopelessness, and irritability. There is also a loss of interest and pleasure in hobbies, as well as restlessness, aches and pains, heachaches, cramps, digestive problems, difficulty sleeping, and difficulty concentrating. Not all people affected by depression experience the same symptoms, and some individuals may experience only a few of these symptoms while others experience multiple ( NIMH » Depression ). Causes behind depression may include changes within the brain, function and effect of neurotransmitters, and hormonal balance. Research has demonstrated that depression tends to be more common in individuals who have a family history of the mood disorder. Additionally, there can be multiple risk factors of depression including low self-esteem, traumatic or stressful events, family history of depression, having a past medical history of other mental health disorders, drug or alcohol abuse, serious to chronic physical illnesses, and certain medications’ side effects. Some prevention methods or treatments for depression can include healthy stress management strategies, medications such as antidepressants, and psychotherapy, all of which should be discussed beforehand with a medical professional (Depression (major depressive disorder) – Symptoms and causes). 

Tourette’s Syndrome is a neurodegenerative disorder that causes individuals to experience tics, which are sudden twitches, movements, or sounds that are done or made repetitively and can be difficult to voluntarily stop. Tics usually begin in children around the ages of five to ten, and the frequency and types of tics a person may experience could change a lot overtime. It has been commonly demonstrated that tics tend to decrease into adolescence and early adulthood, or may even completely disappear. Although a decline in tics in adulthood is common, some people may experience tics worsening into adulthood. Although there is no cure for Tourette’s syndrome, there are multiple methods to manage tics such as medication or behavioral therapy ( What is Tourette Syndrome? ). 

Many studies have found that there is an association between Tourette’s Syndrome and depression. One study had found that in a form of Tourette’s, Gilles de la Tourette’s syndrome (GTS), depression is common amongst these patients and is significantly associated with GTS patients, depending on factors such as tic severity, comorbidity with ADHD, and the presence of coexistent anxiety (Rizzo, Gulisano, Martino & Robertson, 2017). Another study had similar results, and found that screening for depression amongst patients with Tourette’s Syndrome was higher in adolescents, children, and adults with severe tics (Marwitz & Pringsheim, 2018). This association between Tourette’s syndrome and depression indicates that there is a need to emphasize the importance of routinely screening for depression amongst Tourette’s syndrome patients to implement appropriate screening. Additionally, it is important that patients with Tourette’s syndrome who have comorbidity of ADHD, anxiety, and severe tics, should receive proper care and treatment for these comorbidities and severe tics, so that the patient does not pose a greater threat of experiencing depression. Fortunately, such results from these two studies indicate that there is greater hope that future patients with Tourette’s syndrome will have better care that incorporates mental health. 

 

References

NIMH » Depression. (2021). Retrieved 13 April 2021, from https://www.nimh.nih.gov/health/topics/depression/index.shtml#part_145396

Depression (major depressive disorder) – Symptoms and causes. (2021).Mayo Clinic. Retrieved 13 April 2021, from https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007

What is Tourette Syndrome?.(2021). CDC. Retrieved 13 April 2021, from https://www.cdc.gov/ncbddd/tourette/facts.html

Marwitz, L., & Pringsheim, T. (2018). Clinical Utility of Screening for Anxiety and Depression in Children with Tourette Syndrome. Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l’Academie canadienne de psychiatrie de l’enfant et de l’adolescent, 27(1), 15–21.

Rizzo, R., Gulisano, M., Martino, D., & Robertson, M. (2017). Gilles de la Tourette Syndrome, Depression, Depressive Illness, and Correlates in a Child and Adolescent Population. Journal Of Child And Adolescent Psychopharmacology, 27(3), 243-249. doi: 10.1089/cap.2016.0120

Depression. (2018). [Image]. Retrieved from https://i0.wp.com/digitallyliterate.net/wp-content/uploads/2018/05/180510-depression-al-1509_8b5188e45e5aed500291d9c30689f57f.focal-1000×500.jpg?fit=1000%2C500&ssl=1

Categories
Tic Disorders

Tic Disorder in Media

There are three main types of tic disorder which are Tourette’s syndrome (TS), persistent (chronic) motor or vocal tic disorder, and provisional tic disorder. TS affects children who are younger than 18 years old and have at least two motor tics or 1 vocal tic that has been continuing for more than 1 year. Persistent motor or vocal tic disorder consists of motor or vocal tics that have been present for more than one year, but individuals cannot have both. Lastly, provisional tic disorder consists of motor and/or vocal tics that have been present for more than 1 year but do not meet the criteria for TS or persistent motor or vocal tic disorder. Tics are typically experienced from ages 5 to 7, increasing in frequency and severity between the ages of 8 to 12, but most people with TS experience improvements in late adolescence, and some become tic-free. However, a minority of individuals with TS continue to have frequent or severe tics into adulthood. The causes of tic disorder remain unknown. However, research has demonstrated that familial, genetic, environmental, and developmental factors may also be involved (What is Tourette ). Although there are no treatments available for tic disorder, there are therapies available to manage tics (Tics and Tourette Syndrome). 

A study seared international internet movie databases using the term “Tourette’s,” “Tourette’s Syndrome,” and “tics” to generate a list of all movies and television programs that had characters or scenes with TS or a person imitating TS. A total of 37 movies and TV shows were reviewed from 1976 to 2010, and although times and the media have changed since then, people still view these movies and shows. Most of the content viewed in the study misrepresented TS in multiple ways including characters being portrayed as having only autism spectrum disorder (ASD) instead of ASD with TS, coprolalia being overrepresented as a tic, as well as other examples (Calder-Sprackman, Sutherland and Doja, 2014).

Coprolalia is known as a vocal tic that specifically involves involuntary swearing and utterance of derogatory remarks. From the study it was found that of the characters imitating TS, 73% exhibited coprolalia, feeding into the misconception to viewers that it is the most common form of tic or symptom of TS. However, in reality, coprolalia is found in only 8.5% of individuals with TS. Additionally, when coprolalia was portrayed by actors, it was done so in a comedic manner. Combined with the comedic effect and overrepresentation of the media’s portrayal of coprolalia, a common negative and false stereotype of TS that may have been interpreted by viewers is TS as the “cursing disease” (Calder-Sprackman, Sutherland and Doja, 2014).

Another major misrepresentation in the media that was found in this study was that many characters who were portraying TS were made to have an “eccentric” appearance. However, in reality, children with TS do not appear physically different from others. The issue with falsely representing the appearance of individuals with TS lies in the fact that it inaccurately represents TS and promotes stigmatization towards individuals who have TS or other tic disorders (Calder-Sprackman, Sutherland and Doja, 2014). 

In recent times, new stereotypes can be created or old ones can be reinforced on social media platforms such as Tik Tok, Instagram, Facebook, and more. Therefore, it is absolutely essential to educate individuals about tic disorders and types of tics while destigmatizing stereotypes by eradicating desensitizing language or behaviors in scripts and other forms of media. Although the media can misrepresent TS and tic disorders, it can still be a useful tool for educating the public and representing those who have tics. For instance, it was found that some movies and TV shows such as South Park and Harvie Krumpet accurately portrayed tics as uncontrollable urges that can be suppressible in certain situations or worsened in stressful situations (Calder-Sprackman, Sutherland and Doja, 2014). This accurate depiction gives hope that the general public can become educated and less likely to promote stereotypes and misrepresentations to others. Thus, social media and other forms of media can be used in a positive way as well, and that is something our generation can look forward to.

 

References

Tourette Association of America. n.d. What is Tourette – Tourette Association of America. [online] Available at: <https://tourette.org/about-tourette/overview/what-is-tourette/#1461071540054-f0944fbc-3f2b>.

Cdc.gov. n.d. [online] Available at: <https://www.cdc.gov/ncbddd/tourette/documents/tics-and-tourette-fact-sheet-final.pdf> [Accessed 8 March 2021]. 

Calder-Sprackman, S., Sutherland, S. and Doja, A., 2014. The Portrayal of Tourette Syndrome in Film and Television. Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques, 41(2), pp.226-232.

Categories
Tic Disorders

Fine Motor Control and Tic Disorder

It is difficult enough for parents to receive phone calls from teachers that their child is “disruptive” or “disobedient” in class, but some parents may receive more concerning phone calls from their children’s teachers as they are told their child’s behavior may be a result of a neurodevelopmental condition.. In the case of children with tic disorder, this concern of disruptive behavior could be alarming and may point to a larger issue the child may be facing, over which they have no control over. In addition to facing the stereotypes of exhibiting disruptive behavior, many young children who have tic disorder are consequently discriminated against. According to the CDC, children with tic disorder, especially those who experience severe tics, are more likely to be bullied than children without tic disorder (Tourette Syndrome and Bullying).  

Tic disorder is a neurodevelopmental disorder that is characterized by repetitive and uncontrollable bodily movements, known as motor or vocal tics. The age of onset for most tic disorders in children spans from ages four to six. However, many of those who are affected by tic disorder see a great decline in their tics as they grow older (Leckman et al., 2014). This decline varies based on the different types of diagnosed tic disorders. Specifically, provisional tic disorder affects young children in their early school years, and the tics have a tendency to substantially diminish in less than one year. However, they may become worse under certain conditions including anxiety and fatigue. Children who experience chronic tics that may last a year or more are often diagnosed with Tourette’s syndrome, another severe tic disorder (Tic Disorders).  

Although more research on Tourette’s syndrome is needed, a few studies have shed light on the connections between fine motor movements and Tourette’s syndrome. A study examined the differences between fine motor skills in individuals with Tourette’s syndrome and individuals without it, and the results indicated that individuals with Tourette’s syndrome exhibited a lower performance in the categories of hand steadiness and aiming their right hands in comparison to individuals without Tourette’s syndrome. Results also demonstrated that right hand steadiness had a significantly lower performance than left hand steadiness in individuals with Tourette’s syndrome. Conclusions from the study indicated that this reduced control of fine motor skills in individuals with Tourette’s syndrome may be due to alterations in the subcortical and cortical components of one’s brain (Neuner et al., 2012). 

This evidence suggests that individuals with Tourette’s syndrome that engage in activities to improve their fine motor skills through their constant application may be able to limit the occurrence of their motor tics. In fact, older studies have concluded that by focusing concentration on improving these fine motor control skills and movements may be linked to a reduction in motor tics. Children and individuals can improve their fine motor control skills by playing musical instruments that require immense focus in exhibiting fine motor skills by plucking strings and pushing buttons. Other helpful activities include participating in dance or sports (Leckman et al., 2013). In fact, professional soccer players with tic disorder, David Beckham and Tim Howard, are some of the many talented people that have engaged in such activities that improve fine motor skills. 

Although much research regarding the connection between engaging in activities to improve fine motor skills and reduce motor tics is still needed, this finding provides hope for improving future treatments for tic disorder. For instance, current treatments for tic disorder include behavioral therapy to replace a tic with another behavior, like placing one’s hands on one’s knees, to prevent the tic from happening. Although there have not been any treatments created involving improving fine motor skills to reduce the occurrence of tics, increasing research within this area can eventually lead to the creation of such a treatment. Improvement of treatment in reducing tics will substantially help children focus better in classrooms.

 

References

American Academy of Child & Adolescent PsychiatryTic Disorders.(2017). Tic Disorders. https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Tic-Disorders-035.aspx 

Centers for Disease Control and Prevention. (2020, May 13th). Tourette’s Syndrome: Help stop bullying. https://www.cdc.gov/ncbddd/tourette/features/tourette-bullying.html 

Cottonbro, P.(2020). [Photo of a toddler playing a ukulele] [Photograph]. Pexels. https://www.pexels.com/photo/a-girl-holding-brown-ukulele-3662750/

Leckman, J.F., Bloch, M.H., Sukhodolsky, D.G., Scahill, L., & King, R.A.(2013) Phenomenology of tics and sensory urges: The self under siege. Tourette Syndrome Oxford: Oxford University Press,3–25. 

Leckman, J.F., King R.A., & Bloch, M.H. (2014) Clinical features of Tourette Syndrome and tic disorders. J Obsessive Compuls Relat Disord, 3(4), 372–379.doi:10.1016/j.jocrd.2014.03.004

Neuner, I., Arrubla, J., Ehlen, C., Janouschek, H., Nordt, C., & Fimm, B.(2012). Fine motor skills in adult Tourette patients are task-dependent. BMC Neurology, 12(120). doi:doi.org/10.1186/1471-2377-12-120

Categories
Tic Disorders

What is a Tic Disorder?

Envision yourself at the airport, about to catch your flight. Your father is getting scanned at security, when all of a sudden you start shouting “bomb” and “ I have a knife in my pocket.” You immediately explain your tics, so that everyone around you, especially the security guards with their huge guns, knows you are not actually a terrorist. After finally reaching the airplane, you start shouting again. You feel the stares, hear the snickering, and see faces filled with fear. Now you must explain yourself again, but this time over the intercom so that everyone in the vicinity can be reassured that they will not die today. This is not the first time this has happened and it surely will not be the last. For some with tic disorders, this is an everyday reality.

For many, tic disorders have caused much trouble early on in their childhood years; children with tics often face discrimination, reprimands, etc. Because the children and their classmates are unaware of the causes of their tic, they are often labeled as troublemakers, and subsequently bullied. This was the case for a child named Matthew who was bullied and ridiculed after being unable to hide his tics. “Then Matthew started jerking his head and shoulders and making little humming sounds. Sometimes, in school, the humming would get quite loud and the teacher would complain. Some of the children in his class began to tease him and call him mean names, like ‘Matthew the jerk’.

Miscommunication is often a central theme in the experiences of those with tic disorders. It is assumed that those with Tourette’s Syndrome only have a cursing tic and most people do not realize that this not as common as most people would think. People often perceive those with tic disorders as being disrespectful, believing that the tics are intentional and calculated. This is not the case, as those with tic disorders cannot control their tics. Suppressing the tics only worsens the condition, as the anxiety associated with repressing the tics oftentimes actually causes symptoms to flare up further. Some have even been told that they must be possessed, a prime example of how tic disorders are often misinterpreted.

Tic Disorders are neurobehavioral disorders, and the most common among them being Tourette Syndrome (TS). Tics are involuntary, sudden, non-rhythmic, repetitive movements or vocalizations. Motor tics include eye blinking, facial grimacing, head twitching, nose wrinkling, shoulder shrugging, tapping, etc. Vocals tics may be exhibited as barking, coughing, grunting, humming, sniffing, throat clearing, etc. Tics may either be simple or complex. Simple tics are brief and involve a single muscle group. Complex tics are lengthy and include a number of simple tics.

There are three types of tic disorders, including Tourette’s Syndrome. In order to be diagnosed with a tic disorder, one must have two or more motor and vocal tics that have lasted for at least a year. Tics should have occurred before the age of 18 and occur multiple times a day. For Persistent (Chronic) Tic Disorder, one must have one or more motor or vocal tics multiple times a day before the age of 18, but one cannot have both a motor and a vocal tic. Provisional (Transient) Tic Disorder, on the other hand, must have one or more motor or vocal tics before the age of 18, but must not be present for 12 months consecutively.

Although some people simply deal with their tics and accept it as part of their daily routine, others seek therapy. This may not be the case for all due to shame, embarrassment, lack of healthcare resources, etc. Habit reversal therapy may help those with disorders as well as counting tics. For habit reversal therapy, “A competing movement is done for three minutes after each tic and after each sensation that a tic is about to occur.” Comprehensive behavioral intervention for tics (CBIT) has also been proven to help, which includes “guidance for parents on what makes tics better or worse, relaxation techniques and strategies to reduce tic severity.”

Though some individuals have had their tics improve or disappear, many have not. Tic disorders do not stop an individual from living their life, but rather may be a barrier that they must overcome and learn to adjust their life to. Individuals with tic disorders are absolutely able to pursue their dreams and goals, and have historically made profound contributions to various fields. Amongst them are Samuel Jackson, who wrote the first English dictionary, and even David Beckham, a world-famous soccer player. For many, tic disorders have helped them to not only embrace themselves as they are, but have also taught them to appreciate and accept diversity within those around them.

References:

Fistell, Shane. “My Life With Tourette’s Syndrome.” The New York Times, The New York Times, 23 Nov. 2016, www.nytimes.com/2016/11/23/opinion/my-life-with-tourettes-syndrome.html.

“Matthew & His Tics – A Story for Young Children.” Tourette Association of America, www.tourette.org/resource/matthew-tics-story-young-children/.

“Tics and Tourette Syndrome | CHADD.” CHADD – The National Resource on ADHD, www.chadd.org/understanding-adhd/about-adhd/coexisting-conditions/tics-and-tourette-syndrome.aspx.

“Tourette Syndrome (TS).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 25 Apr. 2018, www.cdc.gov/ncbddd/tourette/diagnosis.html.

“Tics & Tourette Syndrome.” Chorea & Huntington’s Disease, www.movementdisorders.org/MDS/About/Movement-Disorder-Overviews/Tics–Tourette-Syndrome.htm.