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Since 2020, a record number of teens with dramatic and unusual displays of tics disorders exaggerated jerky movements, and verbal outbursts, have flooded into emergency departments and clinicians’ offices seeking immediate treatment. In many cases, the young patients had never been diagnosed with tic disorders, such as Tourette’s disorder.
Pringsheim and Dr. Davide Martino, movement specialists at the University of Calgary, saw a message in an online forum for the American Academy of Neurology.
“My practice has seen an unprecedented increase in young adolescent women with what appears to be acute explosive motor and vocal tics,” wrote a doctor in Kansas City, Missouri.
The Canadian neurologists had seen the same thing. Most of these new patients did not fit the mold of a typical case of Tourette syndrome, which generally affects boys and begins in early childhood.
Tourette’s tics tend to be simple movements — like blinking or coughing — and they wax and wane over time. In contrast, the new patients were often rushed to the emergency room with tics that had appeared seemingly overnight. They were relentless, elaborate movements, often accompanied by emotionally charged insults or funny phrases.
Tic disorders are linked to the brain and nervous system. Children with ADHD are more likely than other children to be diagnosed with tic disorders. Co-occurring conditions include obsessive-compulsive disorder, anxiety, depression, behavior problems, and learning or developmental disorders. Tic disorders typically occur more often in boys, according to the CDC.
Sometimes, children show behaviors that look like tics but are not typical, according to the CDC. For example, some children develop elaborate motor and vocal tic-like behaviors for the first time, with no reported history of tics. This can happen in groups of children, such as school classmates. Atypical tics tend to be more common among teenagers for underlying reasons that include anxiety, stress, and through exposure to social media posts.
At the heart of the rehabilitation program was a cognitive-behavioral approach that addressed the psychological root of the problem and helped children develop better ways to cope.
The patients needed to accept two things: that they did not have Tourette syndrome, and that their twitches were partly under their control. They had to want to get better.
For eight to 10 hours a week for six months, Patients met with a variety of specialists, including a speech therapist, a dietitian, and a psychiatrist. In therapy, the teenager discussed getting bullied at school, their growing stress over their gender, and how isolated they had become during the pandemic. They deleted TikTok and started on antidepressants.
“It was giving parents permission not to respond,” said Dr. Rachel Hnatowich, a psychiatrist at Alberta Children’s Hospital who helped treat Patients. Doing so, she said, would help take away the “meaning and power” of the illness.
Some experts blame social media, in part, for the recent increase in tic disorders among teens with underlying vulnerabilities, though the evidence is largely anecdotal. According to the journal Movement Disorders, new-onset tic-like behaviors have increased markedly among adolescents and young adults — and researchers say that many of these patients reported abrupt, uncontrollable, and sometimes severe behaviors after watching videos of people with movement disorders on TikTok and YouTube in particular.
Videos on TikTok with the hashtag #tourettes have recorded more than 4 billion views. Researchers believe this phenomenon could be an “example of behaviors, emotions, or conditions spreading spontaneously through a group,” the Journal reported.
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