Tic disorders are conditions featuring sudden, non-rhythmic movements or vocalizations. A formal tic disorder diagnosis is determined by tic frequency, duration, and type.

Tics are non-rhythmic movements or vocalizations that happen suddenly and rapidly.

They’re considered involuntary, though some people experience a strong sense of discomfort before a tic (a “premonitory urge”) that can be used to predict or manage the behavior.

The exact causes of tics aren’t fully understood and likely involve complex relationships between genetics, the environment, and your physiology.

If tics negatively affect your ability to function in important areas of life, you may be living with a formal tic disorder.

Tic disorders are defined by diagnostic criteria set in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR).

The DSM-5-TR is an internationally used guidebook that provides standardization for diagnosing conditions causing impairment to your cognitive function or mental well-being.

Three main types of tic disorders are outlined in the DSM-5-TR:

  • Tourette syndrome: This syndrome consists of multiple motor tics and at least one vocal tic that have been present and persisted for more than 1 year since tic onset.
  • Persistent (chronic) motor or vocal tic disorder: A single or multiple motor or vocal tic has been present for at least 1 year since tic onset, but only one type of tic is experienced (motor tics or vocal tics only).
  • Provisional tic disorder: Single or multiple motor and/or vocal tics that have been present for less than 1 year and do not meet the criteria for other tic disorders.

When tics don’t align with set categories in the DSM-5-TR, they may be eligible for two other diagnoses:

  • Other specific tic disorder: Tics that are clinically significant or cause impairment in daily life but do not meet the full criteria for a specific tic disorder or neurodevelopmental disorder. This diagnosis is used when your doctor specifies why the tic presentation does not meet diagnostic criteria.
  • Unspecified tic disorder: Tics that are clinically significant or cause impairment in daily life but do not meet the full criteria for a specific tic disorder or neurodevelopmental disorder. This diagnosis is used when your doctor chooses not to specify the reason diagnostic criteria aren’t met or when there isn’t enough information to make a more definitive diagnosis.

Are all tics a part of a tic disorder?

Tics are not limited to tic disorders. You can experience tics in a variety of circumstances, including high-stress situations and during normal childhood development. Tics that are passing and don’t have a major impact on your life are known as “transient.”

It’s also possible to experience tics and tic-like behaviors as symptoms of other medical conditions, such as obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), and Wilson disease.

No universal cause of tics or tic disorders has been discovered.

Influencing factors differ between each person and can involve genetics, changes to the brain’s function and structure, and environmental factors like perinatal adverse events (such as premature birth, breech presentation, and maternal smoking).

For some people, tic disorders are secondary to other underlying medical conditions like thyroid disorders, neurodegenerative conditions, movement disorders, or autoimmune disorders.

Some tics can be brought on as a side effect of medication use.

You may be more likely to experience tics during times of elevated emotions. You might notice them more with stress or anxiety, for example, or when you’re excited or angry. Tics can also be triggered by fatigue, physical touch, or substances like caffeine.

Tics don’t have to have an obvious trigger, and many people can’t trace tics back to a specific cause.

Tics are non-rhythmic movements or vocalizations. They can be simple, involving only one part of the body, or they can be complex, involving multiple body parts and taking on distinct patterns of movement.

While tics are often unique and individual, certain presentations are common among people diagnosed with tic disorders.

Common vocalization tics include:

  • coughing
  • grunting
  • throat clearing
  • sniffing
  • barking
  • humming
  • repeating words (echolalia)
  • making high-pitched noises
  • mouth clicking or popping
  • uttering inappropriate words or phrases

Examples of common motor tics include:

  • hand or arm flapping
  • facial grimacing
  • leg jerking
  • blinking
  • head jerking
  • shoulder shrugging
  • fist clenching
  • stomping
  • tapping
  • body twisting
  • mimicking or repeating the movements (echopraxia)
  • hitting
  • hair pulling

Premonitory urges are a common feature of tic disorders, though they are not a symptom necessary for diagnosis. Premonitory urges, or the uncomfortable sensation preceding a tic, can involve sensations like tingling, itching, or aching.

Treatments for tic disorders include behavioral interventions, medication, and supportive therapies. Your comprehensive treatment plan is tailored to your specific needs and preferences and may involve:

  • Habit reversal training (HRT): Learning to recognize tic urges and replace the tic with a less impairing response.
  • Comprehensive behavioral intervention for tics (CBIT): A strategy that combines HRT with lifestyle changes to help reduce and manage tics.
  • Cognitive behavioral therapy (CBT): A psychotherapy framework that helps you identify, restructure, and cope with unhelpful ways of thinking and behaving.
  • Medications: Antipsychotics may help reduce severe tics, and other medications might be prescribed to manage symptoms of co-occurring conditions like ADHD.
  • Supportive therapies: When tics impair important areas of function, your doctor may recommend therapies like speech therapy or occupational therapy to help improve your day-to-day function and overall quality of life.

It’s not always possible to eliminate tics completely, but with treatment, you may be able to minimize how they affect your life.

Tic disorders feature non-rhythmic, involuntary movements or vocalizations that cause impairment in daily life. The tic disorder you’re diagnosed with depends on tic frequency, duration, and type.

It’s possible to experience tics in life without living with a formal tic disorder. Tics can appear during normal developmental stages, during times of stress, or as secondary symptoms in other medical conditions.

With treatment, tics can be managed and replaced with more beneficial responses.