Do I have Tourette's Syndrome?

March 23, 2008 9:08 AM

A friend thinks I may have Tourette's Syndrome. What should I do?

I have a couple of behaviors that I have never thought of as particularly unusual, but which a friend believes may indicate either Tourette's or a similar disorder. I believe she got this impression from watching a documentary about people with Tourette's, for what it's worth.

The things that she mentioned are a couple of my physical tics and the fact that I clear my throat frequently when nervous. The physical tics are minor but probably noticeable: muscles in my face twitch involuntarily, causing me to wink or blink or scrunch up my nose, and sometimes I shake my head slightly as though startled. None of these things happen all that often, and most of the time I don't notice them. I feel like I do it a lot more when I'm anxious or the center of attention, but it may be that that's just when I notice it. I do not have any involuntary vocal outbursts. I am female and in my mid-twenties, and have had these tics since childhood.

My question is twofold: is my friend right that these behaviors may indicate Tourette's or a similar disorder? And if she is right, does it matter? I have graduated from college. I have a good job and a good relationship, friends and an active social life, etc. I don't really feel like my twitching has interfered with my life in any perceptible way. What is there to be gained by a potential diagnosis? I would be extremely reluctant to take any medication for the tics alone, but could there be something else harmful going on in my brain that requires treatment? What should I do about this, if anything?

posted by anonymous to health & fitness (21 comments total)

After I saw a movie about Tourette's -- Twitch and Shout, I think -- I suddenly noticed that some of my friends seems to exhibit Tourette's-like symptoms. If your tics aren't bothering you or getting in the way of the things you want to do, then basically speaking you do not have a problem, whether you technically have Tourette's or not. There's an interesting mention in the Wikipedia article on Tourette's about how the diagnotic tool for mental disorders changed their outline of what Tourette's was in the most recent edition.

"DSM-IV included a requirement for "marked distress or significant impairment in social, occupational or other important areas of functioning", but this requirement was removed in the most recent update of the manual, in recognition that clinicians see patients who meet all the other criteria for Tourette's, but do not have distress or impairment"

Theoreticaly you might want to get it checked out to make sure there isn't another more serious problem causing your twitches (seizures, hypothyrhoidism), but like autism, Tourette's is a spectrum disorder and if it's not causing you trouble then it's not realy something you need to be freaked out about. Standard IANAD disclaimer here.
posted by jessamyn at 9:27 AM on March 23, 2008

Tell your friend to fuck off? :)

It sounds like you're just nervous.
posted by stereo at 9:38 AM on March 23, 2008 [1 favorite]

Ever heard of 'psychology student syndrome'? Sounds like your friend has a case of 'psych student syndrome by proxy'. Just because some of your behavior matches what she's seen in a documentary doesn't really mean much; I'd imagine ANY of us could flip through the DSM-IV and pick out a slew of disorders whose symptoms sounded alarmingly like things we do (as a psychology undergrad I think I "diagnosed" myself with 3-4 new disorders per semester - if even half of what I fretted about was even halfway true, I could have kept some lucky psychiatrist rolling in the dough throughout both our natural lives =P

If your friend's concerns plant a 'bug' in your brain to the point that you're genuinely concerned about whether or not you have Tourette's, I doubt there's any harm in seeing a professional just for peace of mind (after all, even if they want you to take medication it's entirely your choice as to whether or not you do - and from what you say, it sounds like odds are good they'll just tell you you're doing fine and not to sweat it, anyway). Otherwise, so long as your behavior isn't negatively affecting your life or causing you to do harm to other people, I'd say to just thank your friend for her concern and then go back about your regularly scheduled programming.
posted by zeph at 10:17 AM on March 23, 2008 [2 favorites]

Tell her you're worried she has Medical Student Syndrome, a common but potentially irritating and socially debillitating condition.

That said, if you really want to know, do a bit of research and bring it up with your doctor next time you have a check-up. Ask whether it would make sense in your case to bother getting diagnosed.
posted by bettafish at 10:17 AM on March 23, 2008

These tics of yours sound fairly normal. Everybody's got something. Your friend is not an expert, and (what sounds to me like) "Hey, I think you have Tourette's because it kind of annoys me when you clear your throat, so you should get that looked at" is hardly a relevant diagnosis. But even if you DO have TS, so what? It hasn't interrupted your life before now. There's no reason it ever should.

My dad has Tourette's, he's an awesome guy, and his tics have never gotten in his way. I'm the one who gets all defensive and crazy-eyed when I hear a TS joke. My dad, on the other hand, probably laughs his head off and retells those jokes to his buddies at work. In other words, it's only as big a deal as you make of it.
posted by katillathehun at 10:34 AM on March 23, 2008

Not a great deal to add really, but a wonderful little book, Passing for Normal: A Memoir of Compulsion by Amy Wilensky, will not only entertain and enlighten, but likely show you that you don't have Tourette's, and that it's not such a terrible thing if you do. I initially read it for the OCD coverage (and because a writer/teacher I respect gave me a copy) but she writes beautifully and really articulates what living with Tourette's is...
posted by dawson at 11:03 AM on March 23, 2008

An Australian friend of mine responds to this kind of thing by saying, "Sod off, you over-sophisticated wankers!"

Works for me.
posted by Class Goat at 11:23 AM on March 23, 2008

I'm currently being treated for Cervical Dystonia. At first, the docs were having a rough time diagnosing it and thought it might be a tic. I didn't buy that diagnosis for a second and sought to dodge it, so I looked it up. Well, turns out that the treatment for at tic is, usually, to do nothing. The only drugs they could give for it would be sedatives or something else that would muck about with the central nervous system in an incapacitating way. They figure letting the patient walk around with the tic is less problematic.

Moral of the story: Starve a cold, feed a fever and, as a rule, ignore a tic.
posted by Clay201 at 11:35 AM on March 23, 2008

You have some tics, and it doesn't matter. If your life is fine, you don't need to do anything. If your friend brings it up again you can say, "Maybe, but my winks and blinks don't bother me. If that ever changes, I'll look into it."
posted by wryly at 11:38 AM on March 23, 2008

Sometimes I reach down into the back of my shirt, above the neck line, and kind of rub myself on the back. Why? I think it's usually done after I tell a good joke, a pat on the back. Maybe I have tourettes. Nah, I don't. I'm just goofy in some ways. ;-)
posted by tcv at 12:09 PM on March 23, 2008

A good friend of mine has a son with Tourette's and it's made her quite aware of other people's tics. She has pointed out so many people around us with tics but has never suggested that any of them have Tourette's. It just means that lots of people have tics!

Tourette's is about much more than just tics, though that's the most obvious part. Thank your friend for her concern and move on.
posted by wallaby at 1:19 PM on March 23, 2008 [1 favorite]

Nthing telling the person to leave diagnosing to the doctors (IANAD, also). The defining quality of any mental illness in which normal behavior at some point shades into abnormal (ie, most of them, which are spectrum disorders and shakily defined anyway) is whether *you* think it's a problem and whether it interferes with work and/or love.

Tourette's is not a progressive disease so even if you did have it, it wouldn't be a problem if you didn't treat it. The treatment is symptomatic and not that effective for many people.
posted by Maias at 1:34 PM on March 23, 2008

You could very well have Tourette's - I do. My major symptoms are a number of facial and other tics that have changed and moved since I was about 12, combined with a vocalized tic (coughing) similar to your throat clearing. The majority of people with Tourette's Syndrome don't have the whole screaming of random swear words that people associate with it.

That said, I don't think it really matters much. Unless the tics are severely impairing your ability to live a normal life, there's not much they can do for you. The medications that are most likely to help tics have really nasty side effects that don't always subside when you stop taking the medication, so it's just not worth the risk for a few twitches.

So I would say just don't even worry about it. Unless of course you want an official diagnosis so you have an excuse to swear at people :)
posted by thejanna at 1:57 PM on March 23, 2008

A few thoughts from another person with diagnosed Tourette's:

There is no definitive test for Tourette's. There are physical differences in the brain (mostly the basal ganglia) that can only be identified by autopsy, after death. I've been given EEGs and been examined by plenty of psychologists and neurologists, and they were all hesitant to use the term Tourette Syndrome because there really is no way to tell the difference between a "nervous tic disorder" and full blown straight-from-Giles-de-la-Tourette TS.

If you go to a doctor, I doubt they'll give you a straight yes or no. If they were silly enough to prescribe medication for something that doesn't affect your life, expect nasty antipsychotics: Orap, Risperdal, Haldol. I've taken them all and in my opinion, they are a last resort, only to be used if you experience physical discomfort from tics or find them completely socially crippling.

You will never get any worse. There is nothing worse lurking in your brain. TS is linked with a few other psychological disorders (google "the tourette spectrum") such as OCD and ADHD. If you has TS, you would be statistically more likely to have other psychological disorders, but no more likely to have physical problems than anyone else. If you think you have any other conditions, ask your friend to watch a documentary on them. She should be more than happy to diagnose you.

There's really no way to someone with a few odd compulsions from those with Tourette's, and I'm certainly not a walking DSM-IV, but these are a few things I think are generally assumed to be present in someone with full-on TS:

Tics for more than a year.

Onset during childhood or teenage years.

Both motor and vocal tics.
posted by Juliet Banana at 2:57 PM on March 23, 2008 [1 favorite]

I think some people misunderstand what "I think you have Tourette's" means. "Tourette's" isn't a disease or anything -- it's just a combination of physical tics and at least one verbal tic that has onset before age 18. So yeah, you probably "have" Tourette's, at least in a mild way. But you already knew that, and have known it for years, you maybe just didn't name it that. So all this "psych student syndrome" or whatever is misguided; a diagnosis, per se, doesn't really mean much.

I have Tourette's. Many people in my family have various tic issues. Not a huge deal. If it hasn't bothered you before now, I wouldn't do anything. It's bothered me some, and I've looked into various treatments, but none of them worked and many had side effects. I've learned to live with it and it seems you have too. The only thing a diagnosis could help with would be if you did someday want medication for it, or if you wanted some sort of disability benefit (like extra time on school exams); since neither of those seems to be a goal, just keep living your life like you always have.
posted by SuperNova at 3:02 PM on March 23, 2008 [1 favorite]

On lack of preview, Juliet Banana's comment for the win.
posted by SuperNova at 3:02 PM on March 23, 2008

I have facial tics, with blinking and scrunching and muscles flickering. I also clear my throat a lot, not loudly but an annoying little clicking sound at the back of my throat. The reason? I have chronic low grade hayfever. My face itches all the time. The skin on my nose in particular, is crawling right now. My eyes water. My eyelids flicker. My muscles jump. I shake my head in a subconscious effort to make the itch go away. My throat is often phlegmy and I have post nasal drip (hence the compulsive throat clearing). All caused by dust allergies. If I take antihistamines (which I do most of the time these days) it goes away for the most part, but entering a dusty room will still set it all off. I had a lecturer once who was the same and we used to wink and blink and grimace away at each other every time I talked to him in his dusty office.

There are lots of reasons why you may wink or have tics or whatever. If you're itchy as well I'd suggest seeing a doctor for allergy tests, but I doubt this is the case from your question. Just because your friend saw a documentary about a specific disease doesn't mean you need to start worrying about something which previously wasn't an issue.

Now I need to go take my Telfast, the itchy nose indicates I forgot this morning.
posted by shelleycat at 3:46 PM on March 23, 2008

I had all your tics at one time or another and outgrew them all.
posted by 4ster at 4:38 PM on March 23, 2008

Not that it matters, but it's actually called Tourette Syndrome (no 's).
posted by Prawn at 5:15 PM on March 23, 2008

They've tried to take the "s" out of all syndromes: hence Down's is now Down etc.

Most people aren't following the "rule"-- so I don't know if it will actually stick.
posted by Maias at 5:55 PM on March 23, 2008

I interviewed for a secretarial position at a Tourette & Tics clinic a while back (still waiting to hear if I have the job) and sent a great deal of time talking to the doctor about the disorder. Apparently, many people have tics like what you're describing that aren't all that dramatic and don't intefere with their life in any signifigant way. Most people would be more likely to think that you have allergies than a tic. The meds that are used to treat tourette and tics have pretty intense side-effects and are more suitable for people with extreme tics (cropolalia, dramatic head jerks, grunts, etc.). If at any point you develop tics that are so dramatic that it interferes with your ability to function socially, then you might want to get treatment, but you've gotten this far in life without it causing you problems, there is no reason to do anything about it.
posted by echolalia67 at 10:31 PM on March 23, 2008