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Tourette syndrome (TS) is a condition of the central nervous system that causes an individual to have tics. These tics manifest as uncontrollable twitches, sudden movements or sounds, such as grunts. The disease was first identified in the early 19th century by the French neurologist Georges Gilles de la Tourette. Tourette’s mental health impact ranges from psychological distress to social impairments. Understanding how TS affects individual mental well-being is essential for providing comprehensive care and support. The following article explores the impact of tic disorders on mental health, related illnesses and how to manage them effectively.
Understanding Tourette Syndrome
Studies show less than 1% of the population has TS. The condition usually appears in young children between the ages of 4 and 6 and starts with facial tics, such as constant blinking or squinting. An individual with TS typically has multiple motor tics and at least one vocal tic. Many times, tics improve over time, and sometimes, the condition disappears entirely before adulthood.
Symptoms of Tourette Syndrome
There are two types of tics commonly associated with TS: motor tics and vocal tics. Motor tics include involuntary body movements, such as grimacing, head jerks, shrugging, blinking and arm or leg jerks. Vocal tics may include random noises, such as clicking or constant throat clearing. More complex noises include involuntarily saying inappropriate words or phrases, also known as coprolalia. This phenomenon occurs in only 10% to 15% of all TS cases.
Causes of Tourette Syndrome
The exact cause of TS remains unknown. However, research shows genetics may play an important factor, as may the development of the cerebellum, the part of the brain that controls body movements. Other risk factors associated with the development of TS include smoking during pregnancy, low birth weight, bacterial infections and complications during childbirth.
In some cases, individuals may learn how to control their tics, but it can prove to be difficult. Tics can also get worse in stressful situations and improve when a person is relaxed and calm.
How Tourette Syndrome Is Diagnosed
TS requires a diagnosis from your primary care provider. While there are no diagnostic tests for TS, your physician will ask a series of questions to discover how often the tics take place and if they happen daily. Other considerations include the age of the patient and additional medical conditions.
How Tourette Syndrome Correlates to Mental Health
Individuals diagnosed with TS often have an additional mental health diagnosis or behavioral condition, including:
- Attention deficit hyperactivity disorder (ADHD). ADHD is one of the most common mental health conditions prevalent in individuals with TS. Approximately 52% of children with ADHD have also been diagnosed with TS. Impulsive behaviors, lack of attention and hyperactivity often accompany tics.
- Obsessive-compulsive disorder. OCD, which includes obsessive thoughts and compulsive behaviors, commonly accompanies TS. The symptoms of both overlap, which increases the importance of addressing both conditions during treatment.
- Anxiety. Individuals with TS often feel self-conscious and stressed when trying to manage symptoms. This may lead to an anxiety disorder, including social anxiety or a generalized anxiety disorder.
- Depression. Along with anxiety, depression commonly accompanies TS and can affect the overall quality of life of an individual coping with the condition.
Tourette’s Mental Health Impact
Tourette’s mental health impact is significant due to the chronic nature of the condition and the challenges a person faces when coping with tics. They can be widespread, depending on the severity of the condition and any underlying diagnoses:
- Psychological problems. Frequent or severe tics may cause embarrassment, frustration and anxiety, particularly in a classroom or social setting where a young person or individual may feel judged. Coping with these sudden movements and outbursts can contribute to feelings of low self-esteem and poor self-confidence.
- Regulating emotions. Individuals with TS may have difficulties managing their emotions, which can lead to mood swings and increased irritability.
- Managing relationships. The social stigma that comes with vocal and physical tics may lead to bullying and feelings of isolation. As a result, some individuals with TS may avoid social situations, withdraw from friends and family and have a hard time making friends.
- Cognitive difficulties. Tics may make it harder for an individual to concentrate or pay attention. The lack of attention span can lead to poor performance at work or in school and feelings of inadequacy or failure.
- Quality of life. The combined mental health effects, such as continued embarrassment, mood swings, feelings of failure and lack of socialization, can have an effect on the overall quality of life for an individual with TS.
Managing Tourette Syndrome and Associated Mental Health Conditions
The treatment of TS, especially when additional mental health concerns present themselves, requires a multidisciplinary approach that’s personalized to an individual’s specific needs. Tourette syndrome therapy will address both the TS symptoms and any associated health concerns.
- Comprehensive behavioral intervention for tics (CBIT). CBIT includes learning about tics and how they work. This includes discovering the triggers of tics and avoiding or reducing these situations. Individuals may work with an experienced therapist to discover skills that decrease the occurrence of tics, for example, putting their hands on their knees.
- Medications. The types of medications used in the treatment of TS depend on an individual’s underlying conditions. For example, when ADHD is the underlying condition, Ritalin or Adderall may be prescribed. For those with depression, clonidine or guanfacine may be prescribed.
- Collaborative care. Treatments for multiple conditions may require collaborative care between a mental health professional and an individual’s primary care physician.
A diagnosis of multiple mental health conditions increases the importance of a comprehensive assessment and combined medical and psychological treatment approaches. By understanding how neurological disorders and mental health conditions play on one another, health care providers can provide better support for those with TS.
Getting Help at FHE Health
If you or someone you love struggles with TS and another mental health condition, you can get the help you need. Contact FHE Health to speak to one of our counselors and get started on the path to recovery.
