Tic Disorders & Tourette Syndrome

What are tic disorders?

Tics are sudden, repetitive movements or sounds that a person makes without fully intending to. They can be quick and subtle - a blink, a throat-clearing - or more complex and noticeable.

Tic disorders include:

• Transient tic disorder - tics lasting less than a year, common in childhood
• Chronic motor or vocal tic disorder - persistent tics of one type
• Tourette syndrome - both motor and vocal tics present for over a year

Tic disorders in numbers

• Tourette syndrome affects approximately 1 in 100 children.2
• Transient tics are even more common - many children experience them without developing a chronic disorder.
• A study found that 72% of individuals with Tourette syndrome met the criteria for OCD or ADHD.1
• Adults with tic disorders report significant dissatisfaction with the diagnostic process and a lack of post-diagnostic support.3

Understanding tic disorders

Types of tics

Simple tics are brief and involve a single muscle group or sound: eye blinking, head jerking, sniffing, throat-clearing.

Complex tics involve coordinated movements or longer utterances: jumping, touching objects, repeating words or phrases, echolalia (repeating others’ words).

The premonitory urge

Many people with tics describe a premonitory urge - an uncomfortable physical sensation that builds before a tic, relieved only by performing it. It is sometimes compared to the urge to sneeze or scratch an itch.

Tics wax and wane

Tics are not constant. They change in frequency, type, and intensity over time. Stress, fatigue, excitement, and illness can all affect them. Some periods may be relatively tic-free; others may be intense.

Suppression

Many people can suppress their tics for a time - but this requires significant effort and often leads to a “rebound” of increased tics afterward. Suppression is exhausting and not a long-term solution.

Misconceptions

“Tourette’s means swearing.” Coprolalia (involuntary obscene language) affects only about 10-15% of people with Tourette’s. The vast majority of tics are non-obscene movements and sounds.

“Just stop it.” Tics are neurological. Telling someone to stop their tics is like telling someone to stop sneezing. Suppression is possible but costly.

“Tics are attention-seeking.” They are not. Most people with tics would prefer not to have them, particularly in social situations.

How tic disorders are diagnosed

Tic disorders are diagnosed clinically - through a detailed history and observation, rather than a specific test. Diagnosis is typically made by a neurologist, paediatrician, or psychiatrist.

The key criteria for Tourette syndrome are: both motor and vocal tics present for over a year, with onset before age 18.

It is important to assess for co-occurring conditions, particularly ADHD and OCD, as these often require their own support.

ORBIT - a new digital therapy

In 2025, NICE recommended ORBIT (Online Remote Behavioural Intervention for Tics) for NHS use. ORBIT is an online therapy for children and young people with chronic tic disorders, based on behavioural principles. It represents a significant step forward in accessible, evidence-based tic management.²

For guidance on navigating the diagnostic process, see our page on getting a diagnosis.

Tic disorders and mental health

The mental health impact of tic disorders is significant - and driven by both the condition itself and the social response to it.

Co-occurring conditions

The high rates of co-occurring ADHD and OCD mean that mental health support needs to be integrated, not siloed. Managing tics, attention, and obsessive-compulsive patterns simultaneously is complex and demanding.

Anxiety and depression

Many people with tic disorders experience anxiety - about when tics will happen, how others will react, and how to manage in social situations. Depression is also common, particularly when tics are poorly understood or unsupported.

Bullying and stigma

Tics are visible. This visibility invites scrutiny, comments, and - particularly in childhood - bullying. The social and emotional toll of having a condition that others can see and react to is profound.

The cost of suppression

The effort of suppressing tics in social or professional situations is a form of masking. It uses significant energy, increases anxiety, and often leads to a rebound of more intense tics in private.

Social withdrawal

Some people withdraw from social situations entirely to avoid the stress of managing tics around others. This isolation compounds mental health difficulties.

Living with tic disorders

Understanding your tics

Getting to know your own tic patterns - when they are more or less active, what triggers changes, how suppression affects you - is valuable self-knowledge.

Behavioural therapies

Evidence-based approaches include: - CBIT (Comprehensive Behavioural Intervention for Tics) - helps develop competing responses - ERP (Exposure and Response Prevention) - builds tolerance of the premonitory urge - ORBIT - now available through the NHS for children and young people²

Self-advocacy

Educating the people around you about tic disorders - at school, at work, in social settings - can reduce misunderstanding and create more supportive environments. You should not have to explain yourself, but sometimes it helps.

Connection

Getting support

Charities and organisations

• Tourettes Action - the UK’s leading tic disorder charity, offering information, support, and advocacy

Professional support

• Neurological or psychiatric referral for diagnosis and management
• Behavioural therapies (CBIT, ERP, ORBIT)
• Occupational therapy for daily functioning support

neurobetter resources

• Co-occurrence - tic disorders alongside ADHD and OCD
• Masking - the cost of suppression
• Getting a diagnosis - navigating assessment
• Our Local Services directory - find support near you