Handling tics may vary depending on types, intensity and ability of patients to deal with symptoms.
Relevant information and support is very often sufficient for many adults with mild form of TS;
as is the case with children, whose symptoms are relatively mild. Diagnosis, explaining to parents and children the nature of the disorder, providing information about support groups as well as informing teachers are usually sufficient means to manage it.
When it comes to patients with more significant symptoms, such as ADHD, acts of self-harm/ aggression or OCD, the treatment is more diverse and ranges from psychotherapy to behavioural therapy.
Psychotherapy and behavioural therapy
The main objective of psychotherapy is to teach people how to manage TS in day to day life.
Behavioural therapy plays a role in treating patients with simple tics (both motor and vocal) and obsessive-compulsive behaviour. It can also be employed as supplement to pharmacological therapy and use with patients, who suffer extreme side effects or for whom medication does not bring desired effect.
There are the following techniques in behavioural therapy:
Habit Reversal Therapy, which involves the person identifying their tics in detail. Then the person is asked to choose the tic which bothers them most and repeat it constantly with a rest sessions, which ultimately means that the patient gets tired from making this particular tic and tehrefore it will not occur as often as it used to;
Instrumental Learning, based on the thesis that the behaviour is controlled by the effects. Positive strengthening is used in order for a patient to suppress tics or swap them for different behaviour;
Relaxation Training, used to reduce the stress that a person with tic disorders experiences. This is included in therapy because of the idea that having stress makes a person less able to control their tics. The most common relaxation training involves deep breathing combined with progressively tensing and relaxing the muscle groups in your body.
As mentioned previously, many people with TS do not require pharmacological treatment. Nevertheless, when the symptoms and tics prevents them from being able to function, the medications are introduced, enabling to bring down intensity of tics and related behaviour.
Unfortunately, there is no one medication that would work for all the cases of TS, and none of the existing medication can fully eliminate tics. Moreover, medications imply high probability of side effects, thus clinicians need to work closely with patients and their families when deciding about drug treatments, especially to balance potential risks and benefits.
Neuroleptics and antidepressants are mainly prescribed to those with TS (more detailed information regarding prescribed medications can be found in M.M.Robertson, S. Baron-Cohen TouretteSyndrome, Oxford University Press, 1998, pp. 42-45). The research has shown that most prescribed medications from the above-mentioned groups can bring down the intensity of symptoms. Nevertheless, there is high probability of side effects, such as: muscles stiffness, problems with concentration, limits to cognitive functions, insomnia, dryness in the mouth, headache and dizziness, loss of appetite, tiredness and sleeplessness.
EEG Biofeedback method
EEG Biofeedback method has been also used as ‘a borderline between pharmacotherapy and psychotherapy. It creates an opportunity to regulate functions of the brain (...), it changes bioelectric neural network in the brain and has no specific scopes of activity’ (M. Pakszys, EEG BiofeedbackMethod in Treatment of Tourette Syndrome [materials from the Association's Annual General Meeting, 5 June 2004], p.3).
Some of the researchers (S. Rogers, Finding triggers for tics) link tics with particular foods. They claim that the products such as alcohol, caffeine, chocolate, some dairy products, conservatives and food colourants, sweets, fizzy drinks, sweeteners, sweetcorn, orange juice, wheat and yeast-based products can intensify occurrence of tics.
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