During the COVID-19 lockdown a number of teenagers suddenly developed tic-like movements or vocalisations. In contrast to standard tic disorders, these people had not experienced tics earlier in life and it affected teenage girls more than boys. The tics were atypical with more verbal tics, repetition of swear words and other obscene phrases, and self-injurious behaviour than is seen in Tourette’s syndrome.
It turned out that videos of tic-like movements or vocalisations were being shared on the social media platforms (such as TikTok) during lockdown. These tics were mimicked by young viewers. It’s not that social media causes tics but watching others tic – whether on TikTok or in real life – can prompt more tics.
Sudden onset of tics in a teenager are hardly ever caused by Tourette’s. Usually, they are “functional tics”. Functional tics are different from Tourette’s tics. Tourette’s is a developmental disorder that begins gradually in early childhood. It is more common in boys. Functional tics typically start rapidly and are much more common in girls.
The assumption that tics are due to social media and TikTok is too simplistic. In many cases, functional tics are the result of a complex mix of stress, anxiety, depression and social isolation. The rates of depression and anxiety in teenagers were rising before the pandemic, and have only gotten worse.
Functional tics are potentially distressing or disabling for those affected. Management focuses on understanding the what’s wrong and retraining the brain. Cognitive behavioural techniques can be helpful. Managing any underlying anxiety or mood disorders is also important. Prof Jon Stone, expert in functional neurological disorders explains functional tics here.
