Tics are rapid, repetitive, involuntary contractions of a group of muscles. Although they're rarely harmful, some tics can severely interfere with daily life.
Tics may occur as either:
- motor tics (bodily movements) – such as facial twitching or shrugging the shoulders
- phonic or vocal tics (sounds) – such as grunting, clearing the throat or sniffing
Tics can also be described as simple or complex.
Simple tics, such as blinking or coughing, tend to happen quickly and may not even be noticeable. Complex tics, such as facial grimacing or repeating a sound, tend to be slower and may appear intentional.
Read more about different types of tics.
When tics happen
Tics can start with a feeling of tension that builds up inside you (a premonitory urge). Some people also describe this as a hot, itchy or generally unpleasant sensation you want to get rid of.
The sensation increases if you try to prevent the tic. After you've made the movement or sound, you may feel a sense of relief until the need to tic begins again.
Tics usually stop during sleep, although they can sometimes persist. They also tend to be less frequent when you're deeply absorbed in an activity.
Stress and anxiety can often make tics worse. They can also be worse when you're tired, excited or self-conscious about your tic being noticed.
When to see your GP
You should visit your GP if you or your child develops a tic and they:
- occur regularly or become more frequent or severe
- are associated with emotional problems or physical discomfort
- 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 the movements and by observing them. Special tests aren't usually required. If possible, it can be helpful to record the movements on video to show your GP.
What causes tics?
It's not clear exactly what causes tics, although they're known to be related to the parts of the brain that control movement.
Tics often appear to run in families, so there may be a genetic reason why they develop. Less commonly, tics may be caused by other health conditions, such as:
Tics can also occur as a result of taking recreational drugs, such as cocaine or amphetamines, or when you stop taking drugs (as a withdrawal symptom).
Most tics start during childhood. People who have them experience periods when they're better and periods when they're worse. For many people, tics are only temporary and they tend to improve during the late teenage years or early adulthood.
If you have a mild tic, you may decide that treatment isn't necessary. However, a number of different options are available.
Behavioural therapies are often recommended as a first-choice treatment for tics. They include:
- Habit reversal therapy (HRT) – which aims to help you learn "responses" (other movements) that "compete" with tics, meaning the tic can't happen at the same time. HRT teaches you to use these competing responses when you get the feeling you need to tic, until the feeling goes away.
- Exposure with response prevention (ERP) – which aims to help you get used to the overwhelming unpleasant feelings that are often experienced just before a tic.
There are also a number of medicines that can improve tics in some people. Sometimes, medicine is also prescribed for associated symptoms that some people with tics report. These can include inattentiveness, hyperactivity or anxiety.
In particularly severe and rare adult cases, a type of surgery called deep brain stimulation may be used.
Read more about treating tics.
Although tics often improve over time, they can be associated with social problems or affect performance at school or work. This can have a significant impact on a person's quality of life.
If your child has a tic, it may be helpful to develop ways for them to explain their tics to other children who ask about them. This may help your child to deal with their tics and reduce any stress and anxiety they're feeling.
In some cases, someone with a tic may feel bullied, which can be difficult to cope with. Read the section on bullying for help if you're being bullied.
School and work
Tics can emerge as a problem when your child is under extra pressure – for example, when they're studying for exams. This type of stressful situation can make the tics seem worse, especially if they come and go.
If your child is finding work difficult, talk to their teacher about possible ways of dealing with it. For example, being allowed "time out" to leave the classroom if their tics are particularly bad and they need a break to help them concentrate more in class.
Similarly, if you have a tic that's making things difficult for you at work, speak to your employer to find out whether any additional help and support is available.
Tourette's syndrome is a condition where both motor and phonic tics are experienced over at least 12 months.
It's a relatively common condition in the UK, affecting around 1 in 100 children.
Read about Tourette's syndrome.
Page last reviewed: 22/01/2015
Next review due: 22/01/2017