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COVID and the Increasing Severity of Tourette Syndrome

The COVID-19 pandemic has definitely caused a drastic decrease in social interactions, whether it may be in a school setting or in public. Initially, I thought that could be a beneficial break for kids across the world like me with Tourette’s Syndrome. Ever since the official start of the pandemic in March 2020, I have noticed a dramatic increase in the frequency and severity of my own tics. I remember thinking to myself How could this happen when I don’t have to worry about others noticing my behavior? I looked back on my recent experiences at school, remembering my struggles to control my head shaking in math class or my small but distinct noises in history, and I am surprised at how it has gotten worse in this pandemic.

Neurological conditions like Tourette Syndrome face a sense of social stigma especially with teenagers in a public setting; the feeling of being “caught” can create extreme embarrassment, something I would know. A review and synthesis of Tourette Syndrome suggests that kids devalue or alienate themselves as a direct result of this condition, which would make it seem as if staying inside more often would give these individuals more confidence and social acceptance (I would be extremely intrigued to see a more quantitative analysis about the stigma behind Tourette’s). However, studies and pediatricians have actually seen an “explosion of tics” since the onset of lockdown. According to an article about Tourette’s in the BMJ Journal, “child mental health practitioners have noticed an increase in tic symptoms,” as well as an escalation in severe tic attacks and cases, most unexpectedly noticeable in girls. The study also suggests that social media platforms such as TikTok play a large role in bringing light to disorders like Tourette’s. However, I have noticed that increasing attention to tics can actually increase symptoms, as it makes individuals think about it more often and the involuntary actions take over. It is possible that stress related incidents during this pandemic (e.g., closing of schools or increasing anxiety about college admissions) have also caused tics in children as well as some adults to become more severe.

What do you know? While doing a bit of research to understand if there was a valid correlation between the pandemic and an increase in tics, I came across a study about the effect of the COVID-19 lockdown in Italy on Tourette’s. And it comes with some interesting numbers. An online survey was sent out to parents of children with Tourette Syndrome around 4-6 weeks after the start of lockdown, and “over 67% of parents reported worsening of TS symptoms”. The study also found several other fascinating relationships with respect to online school, physical activity, and more. For one, they found an inverse relationship between the number of hours spent on school activities and the overall symptomatology (the group of symptoms characterized by a disorder) of an individual. I have definitely seen this in my own life, as the longer I’m busy with homework or classes, the less I usually tic since I tend to be distracted from those behaviors. Additionally, decreased time for sports or physical activity in general because of the lockdown has also shifted children away from spending time on a general well-being and towards social media, which, as we’ve already seen, can increase the severity of tics.

After reviewing all this information, a question comes to mind: Do social interactions actually improve the lives of individuals with Tourette Syndrome? It seemed like such a counter intuitive idea when I first pondered it but observing the drastic impact of the pandemic (not only on myself but others around the world) suggests getting out of the house does help. And the more I look back at my life in the last year, the more instances I can find where I distracted myself from my tics by having fun with my friends outside my house.

A modified version of this this blog post was originally published by the Tourette Association of America at https://tourette.org/the-increasing-severity-of-my-tourette-syndrome/

Sources

Stigma in youth with Tourette’s syndrome: a systematic review and synthesis

COVID-19 related increase in childhood tics and tic-like attacks

Adverse Mental Health Impact of the COVID-19 Lockdown in Individuals With Tourette Syndrome in Italy: An Online Survey

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