What causes tics: symptoms, diagnosis and therapy

What causes tics? They're usually associated with a specific syndrome called Tourette's Syndrome. It's a mental disorder that's generally diagnosed in young children and manifests itself in childhood. Generally, these symptoms are motor in nature and can be varied; vocal symptoms are also discussed.

External reference: Wikipedia: Tourette syndrome

Is there a specific, quantifiable timeframe for these problems to appear? Yes, once they appear in a child, they typically last at least a year. During this year, the disorder tends to recur frequently, and there's usually a period of acquiescence lasting about three months during which the disorder doesn't recur. If we had to define these disorders, how could we best classify them?

Definition and types of tics

When we talk about these problems, it's best to define them as movements that are characterized by suddenness and tend to recur over time. Vocal symptoms are usually linked to a variety of muscle segments present in the individual.

For related psychological mechanisms, see Freudian slip.

Can we define them unambiguously, or are there specific classifications we should base our decisions on? There are specific classifications; let's see which ones:

They may be simple, in which case the involuntary movement affects only one muscle group;

They may be complex, in which case they involve multiple muscle groups. The individual experiences them more slowly and they last longer.

Diagnostic Manual and Classification of the Disorder

Based on the diagnostic manual, these disorders are further divided into four specific categories:

We might have a patient with Tourette syndrome;

We might have a patient with a permanent motor or vocal disorder;

We might have a patient with a transitory disorder;

It could be an unspecified disorder.

Diagnostic Criteria

What are the diagnostic criteria for diagnosing this type of disorder? Let's look at the parameters that must be considered:

The first parameter is related to the presence of a vocal disorder;

The second parameter is related to the duration of the problem;

The third parameter is related to the onset of the disorder;

The fourth parameter is based on the principle of exclusion. After a series of careful investigations, other medical variables that could cause this disorder were ruled out.

According to the Manual of Medical Disorders, this type of specific disorder must appear in the individual before the age of 18. To be diagnosed with a syndrome like Tourette's, the patient must have a medical history of single or multiple motor problems and vocal problems.

Intensity of the Phenomenon

These problems can obviously have periods of greater acquiescence (the problem is present but rarely manifests itself), or, conversely, they can manifest themselves more intensely and more pronouncedly. When does this happen? Let's look at it together:

A person experiencing a particularly stressful period may see their problem increase;

A person experiencing a period of personal calm may experience an increase in their manifestations;

Conversely, a person performing an activity that requires a certain level of attention, focused attention helps reduce their presence.

Let's talk about Tourette syndrome

What is the age at which this syndrome can manifest? Generally, the disorder appears around the age of five. There is then a period in which the problems tend to worsen, between the ages of eight and twelve. During adolescence, the problem usually gradually stabilizes and then diminishes in intensity after the age of 18.

However, it is also important to note that all young people who suffer from Tourette syndrome also have a series of other problems, which we will now define:

They may have aggressive behaviors;

They may be individuals with a fairly high level of impulsivity;

They may be individuals with anxiety disorders;

They may be individuals with family problems.

Therapeutic Approaches

What therapeutic approaches are available to treat these problems? There are various techniques, from traditional ones to more modern ones:

The most traditional treatment for tics involves having the patient repeat these movements for about 30 minutes, followed by breaks. However, the therapeutic value of this technique is now minimal.

The technique called Habit Reversal is one of the most studied and applied. It is based on the premise of providing the patient with a high level of awareness of their problems, so as to create counter-responses that will replace the incorrect ones.

Better understanding the problem, understanding its dynamics, and recognizing when it is about to manifest helps the patient achieve a greater level of awareness. How does the patient effectively combat these problems? The patient learns responses that, over time, allow them to combat the problem until the need to bring it up disappears.

Along with this technique, an important part is careful monitoring, which the patient can implement through a diary. This will help identify the situations throughout the day that trigger this pathological mechanism.

Another very useful approach involves manipulating those events and situations in which these issues tend not to emerge for a long time.

If the patient is anxious, or perhaps experiencing a very difficult time, characterized by highly emotionally stressful events that create the ideal conditions for these problems to manifest, specific techniques will be needed to reduce the patient's stress and anxiety levels. What techniques can be used to achieve this? Let's look at them together:

Relaxation techniques and stress management

The patient can be taught to breathe in a way that relaxes their body and mind;

The patient can be taught a progressive muscle training program.

There is also a specific technique that assumes there is a close correlation between the patient's perception of the impending problem and the problem itself. So, how must this connection be broken? The patient is frequently exposed to the feeling that the problem is about to manifest, but must force themselves to resist the onset of the tic by tolerating the unpleasant sensation that accompanies its onset.