There has been a serious upsurge in the number of tics exhibited by teenagers in the past year. Experts suspect a connection between these involuntary movements and social media videos.
The Wall Street Journal last month published a report that drew attention to the fact that many of those who reported developing tics had been viewing videos by TikTok influencers with Tourette syndrome, which is characteristed by these movements.
The physical manifestation, researchers posit, is caused by a number of factors, from a response to COVID-19-created anxiety to a predisposition to tics exacerbated by social media content. UK peer-reviewed medical trade journal BMJ report ‘COVID-19 related increase in childhood tics and tic-like attacks’ explains, “it is was hypothesised that this unusual presentation is related to lockdown, change in usual structure and routine, social media related events/bullying and pandemic-related stress in vulnerable adolescents. Stress may be unmasking a tic predisposition in some, while in others compounding existing vulnerability to anxiety, for example, underlying neurodevelopmental or emotional difficulties to the point of becoming overwhelming.”
Gulf News reached out to TikTok for this story but at the time of publishing the company had not gotten back with clarification or comment.
What is a tic?
Dr Preeti Sahota, Consultant Neurophysician with Prime Hospital, explains: “A tic is described as a sudden, uncontrolled, rapid, non-rhythmic and recurrent movement or sound that a person makes with their body or mouth. The physical tics with the body involving motor movement are called motor tics while those involving sounds with the mouth are called vocal tics.
“Tics can be either simple or complex and may involve a combination of different movements or sounds. In the past, it was largely believed that tic disorders occurred due to emotional stress or traumas. However, experts now largely believe that tic disorders occur as a result of abnormalities in the brain, including imbalances of neurotransmitters. Functional brain imaging has shown that people with tic disorders often have abnormal brain activity in certain brain areas.”
When it comes to the Tourette syndrome, a tic may be caused by certain underlying factors. A study of 3,500 patients found that 60 per cent of patients with Tourette syndrome had attention-deficit/hyperactivity disorder and 27 per cent had obsessive-compulsive disorder (OCD), writes neurologist Dr Amber Stocco for the US-based Texas Children’s Hospital blog. An additional 32 per cent had obsessive compulsive behaviour, 23 per cent had a learning disorder and 15 per cent had a conduct disorder or oppositional defiant disorder (ODD). Boys were also more likely than girls to have comorbidities - meaning they were more likely to experience the presence of one or more disorders in addition to a primary disease. Tics can increase and decrease in severity (often described as waxing and waning) over time (days to weeks to months), she adds.
Everyone has a tic
Not all tics are caused by Tourette syndrome. “Nervous tics happen to many people at some point in their lives, especially when they are small children, typically around age of five or six, and peak in the preteen years, when they can get worse and they often decrease after that period. By age 18, the majority of kids will either have a significant improvement or a complete resolution in their tics. In some people it doesn’t, and can continue to happen throughout their lives, especially in times of stress, causing significant impairment to person inflicted and becomes tic disorder including Tourette syndrome,” explains Dr Sahota.
Is watching someone with a tic enough to trigger one in you?
Perhaps, respond the experts. According to a paper published in the US journal ‘Movement Disorders Clinical Practice’ in July, researchers who studied more than 3,000 TikTok videos produced by people who said they had Tourette's syndrome found that 19 of the 28 most popular content creators developed new tics after watching others’ videos. “We started to really notice it about a year into the pandemic and then through the summer months. We were seeing a lot of girls in their late teens for the very first time, which is abnormal — and they had developed the tics very abruptly — sometimes the week before we would see them in clinic, which is also an unusual situation,” Dr Olvera is quoted as saying by the ‘Everyday Health’ magazine website.
Nervous tics happen to many people at some point in their lives, especially when they are small children, typically around age of five or six, and peak in the preteen years, when they can get worse and they often decrease after that period. By age 18, the majority of kids will either have a significant improvement or a complete resolution in their tics.
Dr Sahota adds: “Over the course of 2020 and 2021, a number of doctors specialising in tic disorders have noted that more people, especially teenagers, are presenting with functional tics. These people may become more vulnerable to tics if they spend a lot of time watching someone with tics. Adoption of certain symptoms, behaviours or motor patterns following observation of other individuals displaying similar manifestations is called modelling and there is evidence that exposure to patterns of movements in such videos may serve as a model for others to unconsciously and involuntarily produce similar movements.” Today, the hashtag #tourettes on TikTok has more than 4.9 billion views.
“Tourette syndrome, however, cannot be precipitated by watching these videos. Stress and psychological factors are known triggers, but functional tics do involve the brain too. People with them cannot just ‘reach’ in to their own brain and switch them off,” warns Dr Sahota.
Cure for the tic
While some nervous disorders can be cured, for others it’s question of management. “There is no cure for a tic disorder. A holistic approach is the best way to manage tic disorders. It is always a good idea to look at diet, lifestyle, reduce stress levels, manage anxiety and get enough sleep. There is no medication which is specifically used for treating tic disorders. However, there are several types of medications that have shown benefit in reducing their severity and frequency including antipsychotics, antidepressants, neuroleptic drugs and certain hypertension medications. It is also very important to evaluate and treat underlying or co-existing other mental health disorders. Cognitive behavioural therapy is another option for treating tic disorders,” says Dr Sahota.
• Learning to recognise one’s distortions in thinking that are creating problems, and then to reevaluate them in light of reality.
• Gaining a better understanding of the behaviour and motivation of others.
• Using problem-solving skills to cope with difficult situations.
• Learning to develop a greater sense of confidence in one’s own abilities.
A tic is not uncommon
But before you panic about your child’s nervous jerky movements, consider this - in a typical school of 400 students, around 10 to 20 children will have tics of some sort. “As children mature, tics naturally improve and number of people with tics in a secondary school would be around 1 per cent. What separates a normal tic from a tic disorder is that, with a tic disorder, the tics cause significant impairment to the person inflicted and must not be from these external factors. Tic disorders can be a transient tic disorder, if a person presents with at least one motor or vocal tic lasting at least four weeks but does not last beyond a year. If a person has a single motor or vocal tic lasting more than a year, it is diagnosed as chronic tic disorder,” says Dr Sahota.
When should you see a doctor?
While a tic may not be unusual, it may be symptomatic of underlying issues. “Most children with persistent tic disorder have at least one comorbidity, commonly ADHD, anxiety obsessive-compulsive disorder, ADHD, sleep disorders and learning disabilities. Tics can also be associated with medical neurological conditions like stroke, head injury, infections or toxins. So, it helps to see a specialist for assessment for these comorbidities as well to receive education regarding the potential for these conditions to emerge as well as treatment options,” says Dr Sahota.
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