We are often asked about different types of tics and how to treat them. Not “Tick” the bug that bites you while walking through wooded areas, but rather “tic” which is a sudden, repetitive, non-rhythmic motor movement or vocalization involving a specific muscle or a group of muscles. The biggest question we get regarding different types of tics and how to treat them is “Do we see people with Tourette’s syndrome and is that really bad compared to simple motor or vocal tics?” The answer to the first part is simple. Yes we specialize in treating many individuals with Tic disorders, including Tourette’s. As for the second part of the question the answer is: it depends. To better understand different types of tics and how to treat them it is important to define what are the different kinds of tics.
In general when considering when it comes to different types of tics and how to treat them, there are two kinds of tics. Motor Tics or Vocal Tics and these can occur alone or in combination with each other. Additionally, they can be simple or complex and thus we end up with Simple Vocal Tics, Simple Motor Tics, Complex Vocal Tics and Complex Motor Tics. Next we look at how often these tics occur. Transient Tics disappear within a year, but Chronic Tics can last for a year or more. When we put all this information together we end up with these basic categories of tics: Transient Tic Disorder, Chronic Motor or Vocal Tic Disorder, and Tourette’s Syndrome or Tourette’s disorder.
In considering different types of tics and how to treat them, now that we know about different kinds of tics we ask the next question: How frequent are the tics and how severe are they? With regard to different types of tics and how to treat them, it is important to keep in mind that an individual could be considered to have Tourette’s Syndrome if they had a mild constant sniffing sound (without having a cold or allergy, of course) and would also rub their nose to the point it would become red and irritated. This is so subtle that most people would think nothing of this. Let’s contrast this to someone who would make sudden high-pitched squealing sounds, every few seconds. This person could be heard far away and the sounds would be very penetrating, disturbing and distractible to all those around the person. They could even be subjected to ridicule, or even punished by a teacher, as happened to one of my child patients whose teacher thought he was doing it on purpose to distract the class. This is a Chronic Vocal Tic Disorder. So when it comes to different types of tics and how to treat them, clearly the person with Tourette’s in the example above may go unnoticed or be thought as having a chronic cold or allergies and thus receive no treatment. However, when it comes to different types of tics and how to treat them we would definitely want to help the child with the Chronic Vocal Tic Disorder. So, in essence, when it comes to different types of tics and how to treat them we treat for the comfort of the patient and that depends on how bad the tics impact their life. In considering different types of tics and how to treat them, the names we use to define the tics are merely classifications, not necessarily suggestive of the severity and discomfort they cause.
So when it comes to different types of tics and how to treat them, how do we treat these tics? When thinking of different types of tics and how to treat them the treatment of tics is a delicate balance and requires correct identification, not only of the presence of these tics, but any coexisting problems that can make them worse. Keep in mind that with different types of tics and how to treat them, people with tics may also have ADHD, Obsessive Compulsive Disorder, Anxiety, Bipolar Disorder, and the list goes on. With regards to different types of tics and how to treat them, all of these coexisting problems must be addressed when it comes to different types of tics and how to treat them. The reason is that each one of these, or their treatment can have an effect on tics. For instance when it comes to different types of tics and how to treat them, ADHD medications may make tics worse, but the anxiety and stress of untreated ADHD can also lead to Anxiety that also makes tics worse. When it comes to different types of tics and how to treat them people with tics, may have obsessive behaviors, which affect the tics and may co-occur with them. The medications for OCD or Anxiety (antidepressants called SSRI’s, for instance) could result in improvement of tics, albeit indirectly. However, depending on the individual, some may make them worse.
So with regard to different types of tics and how to treat them, once tics and any co-occurring problems are correctly identified we can begin treatment. This is far from a cookie-cutter approach and requires a mix of therapy and very likely medications. The final goal in different types of tics and how to treat them is to create an internal state of relaxation and calmness right down to the involuntary nervous system itself. With different types of tics and how to treat them, this is done in therapy by addressing any personal or environmental triggers that create stress and thereby amplify tics. With different types of tics and how to treat them, medications are used that “tone down” the nervous system so that the individual goes from a revved up state of “flight or fight” to a calm and relaxed state. In essence, imagine constantly feeling as if you were running for your life versus the relaxed state of lying on a quiet beach with the waves gently lapping on the shore. An individual with tic disorders that feels the first way will be having a lot of tics, but if that individual feels the second way there would be minimal if any noticeable tics. To achieve the ideal relaxed state could involve, personal therapy, relaxation and stress management, family therapy, etc. Medications include those that are also used to treat high blood pressure, which can result from what is called an “increase sympathetic tone”. By lowering this “sympathetic tone” the tics can be minimized or eliminated all together. Sometimes this isn’t enough and other medications called Neuroleptics are used. These medications act at the level of the brain to decrease tics in the body.
In conclusion, when we think of different types of tics and how to treat them it comes down a careful combination of science and art for different types of tics and how to treat them. For different types of tics and how to treat them, it first involves correctly identifying what is going on in the specific and unique individual you have in front of you. Then when it comes to different types of tics and how to treat them we tailor make a treatment that helps him or her get past the stranglehold the tics have on their life. No two persons are the same so their treatment won’t be either, but rest assured that with persistence and perseverance we would work to provide you significant relief from tics.
