(TS) is a disorder of the nervous system that causes involuntary and repetitive movements or vocalizations called tics. These tics can be hugely disruptive in the life of the patient, making it difficult to maintain relationships in some cases or take on certain types of employment or activities.
A spectrum disorder, not all who are diagnosed with Tourette syndrome will experience the same symptoms or intensity of symptoms. Whether mild, moderate or severe, the disorder can be extremely difficult for patients to manage, and professional treatment is recommended.
Unfortunately, the existence of an issue like Tourette syndrome may increase the likelihood that a patient will turn to alcohol or drugs for escape or relief from the frustration and/or depression that often co-exists with the disorder.
When substance use and abuse become a regular habit, an addiction can develop and the patient risks experiencing all the problems associated with substance abuse, including:
- Exacerbation of symptoms of underlying mental health issues, including TS
- Medical emergencies while under the influence, including overdoses or accidents
- Long-term medical problems caused by ongoing drug use
- Increased risk for other mental health symptoms depending upon the drug of choice
- Legal problems caused by crimes committed to maintain drug abuse, purchasing or selling illegal drugs, and behaviors while under the influence
- Financial struggles caused by an increased inability to find or maintain employment
- Social problems, including divorce, loss of positive friendships and lack of family support
If you are, or your loved one is, diagnosed with Tourette syndrome and struggling with drug or alcohol abuse as well, Dual Diagnosis treatment can help. Contact us today for more information.
Tourette Syndrome: Facts and Figures
According to the National Institute of Neurological Disorders and Stroke, the following is true about Tourette syndrome and those who struggle with the disorder:
- The disorder dates back to 1885 when it was first defined by the French neurologist, Dr. Georges Gilles de la Tourette.
- Symptoms often manifest first during childhood between the ages of 3 and 9.
- Men are three to four times more likely to struggle with TS than women.
- All ethnic groups are equally hit by the disorder.
- About 200,000 Americans are diagnosed with severe Tourette syndrome.
- An estimated 1 in 100 Americans exhibit lesser symptoms of TS.
- Excitement or stress can worsen tics.
- Tourette syndrome is a chronic condition, but improvement in symptoms can occur over time.
- Medication and therapeutic intervention are recommended for optimum improvement.
One of the major characteristics of Tourette syndrome is the presence of tics, or uncontrollable movements or sounds expressed by patients with the disease. They can be simple or complex and may include:
- Blinking rapidly
- Throat clearing
- Repeating words
- Blurting out certain words
- Coprolalia (blurting out swear words; only occurs in 15 percent of those diagnosed with TS)
- Echolalia (repeating words or phrases said by others)
- Twitching or moving limbs in a jerking movement
- Spinning, jumping, kicking or hopping
- Shrugging shoulders
Some tics can be harmful to the patient (e.g., punching themself in the face). Others are prefaced by a premonitory urge or characterized by a sensation or feeling that it is about to happen. Some patients report the urge or need to repeat the tic multiple times before they can rest. Others find that hearing or seeing someone say or do their tic behavior may trigger the patient’s urge to follow suit (e.g., seeing someone skip or hop may make them feel compelled to do the same if that is their tic behavior) or certain sensations like feeling constricted or uncomfortable may trigger the tic as well.
Additionally, though tics are diminished during sleep, they do not stop completely, which is why many patients report sleep disruption issues.
Common Co-occurring Disorders with Tourette Syndrome
An estimated 79 percent of Tourette syndrome patients diagnosed in childhood are living with co-occurring disorders. These can include one or more of the following:
- Attention deficit hyperactivity disorder (ADHD): 64 percent
- Substance abuse
- Behavioral issues: 43 percent
- Obsessive-compulsive disorder (OCD)
- Sleep disruption
- Anxiety: 40 percent
- Depression: 36 percent
- Learning disabilities: 28 percent
Tourette Syndrome Co-occurring with Drug and Alcohol Abuse
Treatment can assist Tourette syndrome patients in learning how to mitigate the disruption caused by their tics. According to the Centers for Disease Control (CDC), there are a number of options, and an integrated treatment program that provides patients with everything they need to heal is recommended.
Treatment services can include any combination of the following as per the needs of the patient:
- Behavioral therapy. Often, patients try to mask their tics or suppress the urge until they feel safe to complete the tic. Unfortunately, many describe a buildup of stress that may occur as a result that can cause involuntary and/or more intense expressions of the tic. Learning how to manage tics properly can not only diminish the frequency of tics but also decrease their severity and impact as well. Habit reversal, or replacement of the tic with another behavior, and Comprehensive Behavioral Intervention for Tics (CBIT) are all effective behavioral therapies for TS patients that focus on this goal.
- Medication. Most patients will not require medication because their tics are nonintrusive in their lives; however, for those who find it difficult to function, medication may be helpful. A class of meds called neuroleptics is often used for the treatment of TS. These drugs may be able to assist the patient in suppressing their tics. Often, haloperidol and pimozide are used for this purpose. Unfortunately, there may be side effects with these medications and/or they may not work as well as hoped, which means that they are not always an option for all patients.
- Family education. The support of family members cannot be understated when it comes to treatment. Learning more about the disorder as well as how to help their loved one manage symptoms can be hugely beneficial.
Self-Medicating with Drugs and Alcohol
Why do many Tourette syndrome patients develop a substance abuse problem? Drug and alcohol abuse can become an issue for TS patients when they develop issues of anxiety, depression, or frustration due to their inability to control their symptoms and/or the effect they have on their lives.
Drinking and using drugs may initially provide an escape from these feelings, but over time, this habit can create a host of problems of its own and can turn into a devastating and debilitating addiction that requires treatment as well.
Dual Diagnosis Treatment
When a Tourette syndrome patient is diagnosed with a co-occurring disorder, it is important that they undergo a rehabilitation program that not only provides them with treatment for tics associated with TS but that also offers care to address the problems associated with other disorders as well. It is not effective to treat one disorder and then treat the other; rather, patients must address all of their disorders simultaneously in treatment in order to make lasting progress in both areas.
Some options to look for in a treatment program when Dual Diagnoses including Tourette syndrome are present should include:
- Evaluation. The issues associated with Tourette syndrome can change due to certain co-occurring disorders, like substance abuse. A thorough evaluation can serve to identify all the issues that are problematic to the patient (including substance abuse, learning disabilities, ADHD and more) in order to create an effective treatment plan defined by directed therapeutic intervention.
- Personalized treatment plan. Each TS patient is different not only in their experience of symptoms but in co-occurring issues as well. For this reason, no two treatment plans for TS should be the same and choices in care should be made based on the patient’s individual needs.
- Medications. In addition to the medications that may be used to help mitigate the severity of tics, patients who struggle with depression, OCD or addiction may be prescribed medication to help them manage specific issues related to these disorders as well.
- Medical care. Some patients may require medical care and monitoring for physical ailments that are co-occurring, including detox if one of the co-occurring disorders is addiction.
- Traditional therapies. In addition to the therapies listed above that are effective in treating TS, there will be therapies that have been demonstrated to be effective in the treatment of co-occurring disorders as well. Personal therapy, group therapy, and other traditional options are also recommended.
- Alternative therapies. Well-rounded treatment for Dual Diagnoses often includes sports and adventure therapies, dance therapy, art therapy, animal-assisted therapies and other options that aid the patient in overcoming issues that are blocking their growth in recovery.
- Holistic care. Decreasing stress and learning how to manage frustration can be beneficial in treatment for TS and other disorders. Yoga, meditation, nutritional therapy, herbs and supplements, and more may be helpful.
- Aftercare help. Continued care after treatment can help to support the patient and their family as they adjust to life in recovery. Alumni groups, 12-Step meetings, continued therapy and more are recommended.
A Brighter Future Can Start Today
Contact us at the phone number listed above to have your loved one matched to a Dual Diagnosis rehab that can help them address Tourette syndrome and co-occurring mental health or substance use disorders. Call now to get started.
David W. Newton is a board certified pharmacist and also has been a board member for boards of examiners for the National Association of Boards of Pharmacy since 1983. His areas of expertise are primarily pharmaceuticals as well as cannabinoids. You can read an article about his expertise in CBD on the National Library of Medicine.