What is Tourette syndrome?
Tourette syndrome (TS) is a neurological condition that causes tics: sudden, repeated movements or sounds that a person can’t fully control. To be diagnosed with Tourette syndrome, a person will have had both movement (motor) and vocal tics for more than a year, though not necessarily at the same time.
Tics usually start in childhood, typically between the ages of about 5 and 10. For many people they become milder in adulthood, but for others they continue throughout life. Tourette syndrome is thought to affect around 1 in 100 school-age children, and is more commonly diagnosed in boys.
It often occurs alongside other conditions, especially ADHD, obsessive-compulsive disorder (OCD), anxiety and autism. For some people these cause more day-to-day difficulty than the tics themselves.
About tics
Motor tics
- Blinking, eye rolling or grimacing
- Shrugging, head jerks or arm movements
- Touching objects or people
- More complex movements or sequences
Vocal tics
- Sniffing, grunting or throat clearing
- Whistling, coughing or other sounds
- Repeating words or phrases
- Rarely, words that are socially unacceptable
Only a small minority of people with Tourette syndrome have tics that involve swearing or offensive words (called coprolalia). It’s the best-known symptom thanks to TV and film, but it’s actually uncommon.
What affects tics
Tics change over time, often coming and going in waves. They tend to get worse with:
- stress and anxiety
- tiredness, including after long watches or disrupted sleep
- excitement
- being asked to stop, or being watched
Many people feel an uncomfortable urge before a tic, a bit like the feeling before a sneeze. Some can hold back their tics for a while, but this takes real effort and concentration, and the tics often return more strongly afterwards.
The most helpful thing you can do is usually nothing. Don’t comment on tics, don’t copy them, and never ask someone to stop.
Strengths
People with Tourette syndrome are as varied as anyone else. Many describe strong focus, creativity, quick thinking, resilience and empathy, often developed through managing their condition in a world that doesn’t always understand it.
Tourette syndrome at work and at sea
Most people with Tourette syndrome can do their job well. The biggest challenges usually come from other people’s reactions, not the tics themselves.
Follow their lead
Ask privately what, if anything, they would like colleagues to know. Some people prefer to explain their tics openly; others would rather nothing was said.
Reduce pressure
Stress and tiredness make tics worse. Predictable routines, adequate rest and calm communication help.
Allow breaks
A few minutes somewhere private to release tics can make the rest of the day easier.
Talk openly about safety-critical tasks
If any tics could matter for a particular task, have a practical, private conversation about what works. Many people know exactly how to manage their tics for specific jobs.
Challenge mockery
Copying or joking about tics is harassment. Make it clear it will not be tolerated.
See when someone tells you for how to respond if a crewmate shares their diagnosis.
Common myths
“Tourette syndrome means swearing.” Most people with Tourette syndrome don’t have swearing tics.
“They could stop if they wanted to.” No. Tics are involuntary. Suppressing them takes great effort and can’t be kept up for long.
“Tourette syndrome affects intelligence.” It doesn’t.
“It’s a childhood condition.” Tics often improve with age, but many adults continue to have them.