Tourette syndrome (TS) is a tic disorder. For diagnosis, patients must exhibit at least two motor and one vocal tic over at least a year. Tics are compelling, repetitive movements or vocalizations carried out with no context. Although TS is a relatively common condition, there’s a lot of misinformation swirling around. Here is a look at five common myths.
People with TS run around screaming random obscenities.
The vocal tics seen in TS come in tons of different types. There are simple vocal tics (like hooting, grunting, or shouting) as well as complex vocal tics (repeating words to yourself or someone else or using vulgar words). Coprolalia, a vocal tic comprised of inappropriate language like racial slurs or profanity, only occurs in less than 15% percent of people with TS. Some sources suggest the forbiddenness of such words makes them more compelling as a tic—it certainly makes them more memorable. Nonetheless, coprolalia is not as characteristically descriptive of TS as is commonly believed.
People with TS just have no self control.
TS isn’t a choice. It’s a neuropsychiatric disorder. Although the exact cause of TS is unknown, it is a fact that it has to do with the brain. Abnormalities in specific parts of the brain and neurotransmitters that carry signals to them (dopamine, norepinephrine, and serotonin, specifically) all play a role. Think about what it feels like when you have to sneeze, TS is similar to that: there’s a sense of discomfort called a “promontory urge” in the body, followed by an overwhelming and compelling need to perform or recite a tic.
People with TS aren’t normal.
That’s largely dependent on what you consider normal. TS isn’t detrimental to learning or behavior—although it does co-occur frequently with behavioral and learning disorders as well as other psychiatric issues like attention deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder (OCD). Furthermore, depression and anxiety are not uncommon secondary symptoms that result from feelings of isolation and a lack of control. But this doesn’t mean people with TS aren’t like everyone else. They don’t have a mental deficit; they aren’t contagious. And they can still be surgeons or athletes or movie stars or anything else they want to be when they grow up.
People with TS have more trouble as they age.
Perhaps this misconception started because of vocal tics like echolalia (repeating others) or palilalia (repeating one’s self) which often appear in other disorders, from the autism spectrum disorders to degenerative diseases like Alzheimer’s. In any case, the onset of TS usually begins around age 6 or 7 (more commonly in male children than female). Around adolescence, it tends to start getting worse. Perhaps this is due to hormonal changes of puberty or the fact that the brain is beginning to lose plasticity, or simply because of the heightened anxiety present in almost every teenager. But many people find their TS gets better as they age into adulthood. Sometimes, it even goes away all together.
People with TS need medication.
That’s true, some people may find that tics are self-injurious or interfere with everyday life and functioning and require one of the different types of medication that can be helpful for TS. But some people only experience a few mild ticks that don’t need treatment at all. Other people with TS find that psychotherapy (particularly behavioral cognitive therapy which teaches alternative means of behavior to gain control) can be very effective at managing TS without any medication at all.