What it is Like to Have a Tic

For individuals who do not have tics/Tourette syndrome (TS), it can be hard to imagine.  Here is an example intended as an approximate comparison to the experience of a tic:

Picture being in a silent library and developing an urge to cough: you give a little cough and feel better, but ten seconds later the urge returns and you give another little cough.  This happens again and again. Worrying about the attention you might be drawing – several fellow readers are glancing in your direction –  you attempt to delay the cough. While you delay, the urge increases. It becomes rather difficult to focus on the book you are reading. After delaying the cough as long as seems possible, a series of loud coughs escape. Now, almost everyone in the library seems to be looking up. Ten seconds later, the urge returns. You are now faced with the dilemma of frequently distracting others with soft coughing every ten seconds, occasionally distracting others with periodic loud coughing, or leaving the library. Having tics can be kind of like that.

Beyond this example, tics come in great variety (see List of Tics). Many individuals with tics are able to “fly under radar.” Their tics are minor – sometimes almost unnoticeable. More minor but noticeable tics can sometimes be passed off as insubstantial; an eyeblinking tic could be attributed to allergies, or body movements might be incorporated into a general tendency towards fidgeting. As the severity of different tics increase, the consequences can become more of a concern. Some tics involve tensing or shaking the same muscles throughout the day and can become painful; I have treated many handshaking tics with Habit Reversal Therapy, not because there is a concern about what others think, but because of the incessant neck pain from identical repetition of movement occurring throughout the day. Some tics are impossible to mask, including tics where speech is continually interrupted by puffs of air, or tics that create strange facial postures or whole body movements. On the more extreme end are tics that disrupt any and every social situation, such as loud shrieks or inappropriate words or gestures. The victims of such tics are on permanent display, always faced with the challenging decision of when to explain what is going on and to whom (see Learning to Live with Tics). Sometimes avoiding social situations seem like the best answer to this dilemma. Finding support for these challenges is key: whether through family, friends, self-education, tic-focused organizations, or counseling.