Tic Disorders (Tourette’s Disorder)
Tics are sudden, involuntary, recurring motor movements or vocalizations. They can feel like an irresistible urge, yet they can be suppressed for varying lengths of time. The tension from experiencing an urge feels similar to an increasing amount of tension or bodily need, like the sensations before a sneeze or scratching an itch. Individuals may emit tics singularly or in multiples, and tics are separated by periods of time of non-tic behaviors, which can last for several hours. Tics can be exacerbated during stress.
Tics can be simple or complex. Simple motor tics include eye blinking and facial grimacing. Complex motor tics include jumping, holding unusual postures, and making hand gestures. Simple vocal tics are meaningless sounds, such as sniffing or clearing one’s throat. Complex vocal tics involve more developed speech and language. Complex vocal tics include spontaneously saying single words or phrases; sudden, meaningless changes in pitch or volume when talking; repeating one’s own sounds or words; repeating the last sounds or words that one hears.
Tourette’s Disorder involves multiple motor tics and at least one vocal tic. They may occur simultaneously or at different periods of time during the course of the disorder. Tics occur several times during a day and reoccur for a period of more than one year. For about half of individuals with Tourette’s, the first symptom is a single tic, usually eye blinking. For others, multiple symptoms may begin simultaneously. Coprolalia is a form of Tourette’s in which an individual utters complex motor tics that are obscenities, and this affects less than 10% of individuals with Tourette’s.
Children are generally more affected than adults, beginning as early as age 2. Typically, the onset of Tourette’s Disorder occurs during childhood or early adolescence. The duration of Tourette’s may be lifelong, with periods of time when symptoms remit. The severity, frequency, and disruptiveness of symptoms often diminishes during later adolescence and adulthood, and for some, the symptoms may completely disappear during adulthood. For others, however, symptoms worsen during adulthood. Males are 3 to 5 times more likely to develop Tourette’s than females.