Tics

Types of tics

There are many types of tic. Some affect body movement (motor tics) and others result in a sound (vocal or phonic tics).

Examples of tics include:

• blinking, wrinkling the nose or grimacing
• jerking or banging the head
• clicking the fingers
• touching other people or things
• coughing, grunting or sniffing
• repeating a sound or phrase – in a few cases, this may be something obscene or offensive

Tics can happen randomly and they may be associated with something such as:

• stress
• anxiety
• tiredness
• excitement
• happiness

They tend to get worse if they're talked about or focused on.

They often start with an unpleasant sensation that builds up in the body until relieved by the tic – known as an urge – although they can sometimes be partly suppressed.

When to see your GP

Tics aren't usually serious and they don't damage the brain. You don't always need to see your GP if they're mild and not causing problems. Sometimes they can disappear as quickly as they appear.

See your GP if you're concerned about your or your child's tics, you need support or advice, or the tics:

• occur very regularly, or become more frequent or severe
• cause emotional or social problems, such as embarrassment, bullying or social isolation
• cause pain or discomfort (some tics can cause the person to accidentally hurt themselves)
• interfere with daily activities, school or work 
• are accompanied by other worrying moods or behaviours, such as anger, depression or self-harm

Your GP should be able to diagnose a tic from a description of it and, if possible, seeing it. Recording a short video can be helpful, but be careful not to draw too much attention to the tic while filming as this can make it worse.

Treatments for tics

Treatment isn't always needed if a tic is mild and isn't causing any other problems. Self-help tips, such as avoiding stress or tiredness, are often very helpful for most people.

If a tic is more severe and is affecting everyday activities, therapies that aim to reduce how often tics occur may be recommended.

The main therapies for tics are:

• habit reversal therapy – this aims to help you or your child learn intentional movements that "compete" with tics, so the tic can't happen at the same time
• exposure with response prevention (ERP) – this aims to help you or your child get used to the unpleasant sensations that are often felt just before a tic, which can stop the tic occurring

There are also medicines that can help reduce tics. These may be used alongside psychological therapies or after trying these therapies unsuccessfully. 

How long tics last for

In most cases, tics will improve significantly over time or stop completely. Sometimes they may just last a few months, but often they tend to come and go over several years.

They tend to be at their most severe from around eight years of age until the teenage years, and usually start to improve after puberty.

Research suggests that of those affected:

• one in three to four people won't have any tics by the time they're an adult
• one in three people will only have mild tics as an adult
• one in three people will have more severe tics as an adult

Causes of tics

It's not clear what causes tics. They're thought to be due to changes in the parts of the brain that control movement. They often seem to run in families, and there's likely to be a genetic cause in many cases. They also often occur alongside other conditions, such as:

• attention deficit hyperactivity disorder (ADHD)
• obsessive-compulsive disorder (OCD)

Tics can sometimes be triggered by:

• taking illegal drugs, such as cocaine or amphetamines
• serious health conditions such as cerebral palsy or Huntington's disease

• Tics

More useful links

• How to use your health services