Acadia Touch Points Blog

Acadia Hospital Child and Adolescent Psychiatrist Julie Balaban, MD

Tourette Syndrome (TS) is something that is both very simple and very complex all at the same time. It is simple in that it is easily defined: A neurologic (brain-based) disorder that causes both motor and vocal tics that last for at least a year.

TS is complicated because although we know a lot more about it than we used to, there are still many unanswered questions; because the diagnosis can be missed; because it can affect many other aspects of mental health and life; and because there is no cure.

TS affects boys more than girls, and is seen in all ethnic groups. It is estimated to affect anywhere from 1% to 4% of the population of the United States.

A tic is an involunatary muscle contraction that leads to a certain movement or sound. Tics can be simple (noises like throat-clearing, sniffing; muscle movements like blinking, shoulder shrugging) or complex (repeating words or phrases; purposeful movements like twirling or scratching one’s head). Tics can come and go, and tend to change over time. Someone can have only a motor or only a vocal tic, but if they have had both at some point in their life, and the tics have lasted over a period of more than a year, they are then said to have Tourette Syndrome.

People with tics are often unaware that they have these movements or noises, until others point it out. While the tics are involuntary, they can sometimes be temporarily suppressed or controlled. They tend to be worse at times of anxiety or excitement, and better when things are relaxed, or when the person is engaged in a focused activity.

People with TS have the normal range of IQs, but often have learning disabilities or challenges associated with the Syndrome. They may also be more impulsive or emotional, leading to possible behavior problems at home or in school. In addition, the tics can be stressful or annoying to those around the person, which can lead to embarrassment and social isolation.

TS can also be associated with other psychiatric diagnoses, such as Obsessive Compulsive Disorder and Attention Deficit Disorder. These three disorders are thought to be genetically linked in some families, with various members having one, two or all three of the diagnoses. Typically the Attention Deficit Disorder gets diagnosed first (by age seven or so), then the tics come on sometime before puberty, and OCD typically develops either also around age 10, or in young adulthood.

There is no cure for tics or TS, but there are some excellent treatments. Tics do not always need to be treated, as they are not harmful in and of themselves. In addition, after adolescence they tend to improve and get milder, sometimes going away entirely on their own. Often just having the diagnosis, some education and support is all that is needed. For those with impairing tics or other associated symptoms, medications and specific forms of Cognitive Behavioral Therapy can help almost everyone. 

National Tourettes Syndrome Association

Click here to register for a free Tourette educational program on May 16