Tourette Syndrome Explained

Tourette Syndrome Explained

If you’ve heard of Tourette Syndrome (TS) but never met someone with the condition, then you might have a very specific picture in your mind. You might envision someone who spews out cuss words in the most inappropriate circumstances, twitching violently as they do. While someone with TS can certainly present this way, that’s not all that there is to the condition. Some people with TS don’t present that way at all. It’s important to understand the condition in more depth if you want to have compassion for anyone with this diagnosis (including, perhaps, yourself).

What is Tourette Syndrome?

Tourette Syndrome is a tic disorder. A tic is an irregular, repetitive movement of the voice and/or body that you don’t want to have but can’t stop. There are several different types of tic disorders, three of which are listed in the DSM (which is the manual to help diagnose mental health conditions). Tourette Syndrome is one of those three tic disorders.

There are two primary types of tics:

Motor Tics affect the body. For example, someone with a motor tic might blink, jerk around, snap their head or neck, shrug their shoulders, move their jaw, or touch things involuntarily. There are simple motor tics, which are sudden, short, and tend to use only one or a few muscle groups. There are also complex motor tics, such as hopping or gesturing, that utilize more muscles at once.
Vocal Tics, as the name suggests, are those that come from the throat. The stereotypical “cussing tic” is a vocal tic, although a person might repeat any word or phrase, not necessarily a swear word. Vocal tics also including clearing your throat, coughing, and making grunts. Sometimes these are called phonic tics.

Someone with Tourette Syndrome has both motor tics and vocal tics. If someone has had at least one vocal tic and two motor tics within 1+ years, then they may receive a TS diagnosis.

The Lifelong Course of Tourette Syndrome

People with TS typically start having tics when they are young, around the age of six or so. A head or neck tic is the most common first symptom. Symptoms tend to get worse, both in frequency and in severity, for several years to follow, peaking in the tween years.

As children age, they sometimes grow out of their tics completely. Alternatively, they may continue to have tics with reduced frequency and severity. By late adolescence, many of the worst TS symptoms subside. However, that’s not always the case. Adults can have severe TS, too.

Oftentimes, people with TS will find that their symptoms settle down as they age but re-emerge during specific situations. Tics tend to worsen with:

Anxiety/ stress
Excitement or times of high emotion
Fatigue
Illness
When temperatures get too hot or cold

In other words, when things aren’t going optimally and evenly, people with TS tend to have more tics.

There are different types of treatment for TS symptoms depending on the individual’s wants and needs. Treatment may include medication, Comprehensive Behavioral Intervention for Tics (CBIT), Cognitive Behavioral Therapy, and/or therapy for relaxation and developing coping skills.

Other Disorders that Occur with TS

Some people have Tourette Syndrome and do not have any other mental health issues. However, it is very common for people with TS to also have a second diagnosis. The most common co-existing conditions are:

ADHD
Anxiety including Social Anxiety
Autism Spectrum Disorders
Behavioral Challenges
Depression
Learning Disorders
OCD
Speech Disorders
Sleep Disorders

People with co-existing issues should work with a therapist who understands both TS and the additional conditions.

Dr. Jeffrey Levine a Hartford Therapist Licensed Psychologist with over 40 years of clinical experience. He specializes in treating adults in individual psychotherapy, with expertise in trauma focused hypnosis, energy transformational healing and Internal Family Systems.