Popular entertainment may have you believe that people with Tourette Syndrome do little more than have a physical tic and swear nonsensically all the time, but there’s a little more to the condition than that. Tourette Syndrome is part of a spectrum of conditions known as Tic Disorders. This spectrum includes Transient tic disorder and Chronic tic disorder. All of these disorders are typified with involuntary tics that vary in degree of severity and regularity.
There are two kinds of tics - physical and vocal - and both are roughly defined as short, sudden movements or sounds that occur during otherwise normal activity. These movements may be repetitive, such as rapidly blinking eyes, finger tapping or nose twitching. Physical tics can be further categorised into simple and complex.
Simple tics revolve around a single movement, such as eye blinking, neck stretching or twisting. Complex tics involve a number of movements in a sequence that remains constant whenever the tic occurs, such as reaching out to touch or stroke something repeatedly, kicking or punching with one arm or leg and then the other or complicated repeated hand gestures. Vocal tics can manifest in multiple ways, such as grunts, hoots and barks to nonsense words and yes, even uncontrolled swearing.
What is Tourette Syndrome?
Tourette Syndrome (TS) is the most severe of Tic Disorders and features both physical and vocal tics . Tourette Syndrome is sometimes classified as having unvoluntary physical or verbal tics. That’s not a spelling mistake. Tics are unvoluntary rather than involuntary , in that some sufferers of tics can suppress the need to tic for a while but the suppression grows increasingly uncomfortable until the pressure must be released with a tic.
The syndrome usually first presents between the ages of 2 and 21 and, while symptoms may decrease over time, it is a lifelong condition that may require medication or other treatments. Severity is usually broken into two broad categories, simple and complex, in reference to the type, frequency and degree of tics.
- Simple - Simple TS is the mildest form and features physical and vocal tics like blinking, shrugging, grimacing, nose twitches, grunts, howls and barks.
- Complex - Complex TS features much more detailed movement and vocalisations, such as jumping, spinning, touching or stroking. Some complex TS tics can be self injurious, with hitting, scratching and head banging being uncommon but observed. Long vocalisations such as repeated words and sounds or swearing (known as coprolalia) make up the bulk of complex vocal tics.
While Tourette Syndrome may be a developmental disorder, it has no effect on cognition and intelligence. Some people with Tourette’s may have learning difficulties associated with the condition - such as difficulty concentrating or focussing, difficulty reading, or lack of energy because of trouble sleeping - but most will intellectually develop normally.
What Causes Tourette Syndrome?
The syndrome is a neurodevelopmental disorder (a group of disorders that affects the development of the nervous system) and there is currently no consensus as to the root cause. Research points to a number of potential contributing factors including:
- Genetics - Children with a parent with Tourette Syndrome have a 50% chance of developing TS and males are three times more likely to develop the syndrome than females.
- Neurochemistry - Neurotransmitters like dopamine and serotonin appear to be metabolised differently in the brains of people with TS.
Tourette syndrome often appears in conjunction with other conditions, including ADHD (Attention Deficit Hyperactivity Disorder) , OCD (Obsessive Compulsive Disorders) and Dyslexia. The link between TS and ADHD is the strongest, with ADHD symptoms appearing in 35%-90% of children with TS , but this could be because ADHD is the most prevalent mental health issue diagnosed in children and often presents around the same time as Tourette Syndrome.
Diagnosing Tourette Syndrome
Diagnosis of Tourette Syndrome can be difficult and time consuming but involves observation of symptoms over time to determine if it is an intermittent tic disorder or Tourette’s. Additional testing may be required to determine if the tics are caused by illness, disease or medication.
If you wish to find a doctor for diagnosis , or book an appointment with a psychologist for help controlling stress or dealing with the pressure of living with TS, the easiest, most convenient and stress free way is to search and book with MyHealth1st.
Treatment for Tourette Syndrome
Tourette Syndrome may disappear over time or lessen with age, but by and large it is a lifelong condition. Treatment varies depending on the severity of the condition but can include both medication and therapy.
- Medication - The majority of people with Tourette Syndrome require no medication as their tics do not seriously impact normal functioning. Those with tics severe enough to impact function may require medication, but there is no one size fits all solution. TS medications can’t eliminate symptoms but can help control individual tics.
- Therapy - It’s important to state that Tourette Syndrome is not a mental health issue, but that doesn’t mean that psychotherapy can’t help people with TS. Many people with Tourette Syndrome suffer more frequent or prolonged tics when stressed or anxious, and therapy, including mindfulness training and relaxation techniques can help TS patients cope better. Therapy can also help people with Tourette’s better cope with the stress and social stigma that can come with the syndrome.
The Tourette Syndrome Association of Australia is one of the primary sources of information, resources and support for people with Tourette Syndrome.