Dual Diagnosis: Tourette’s Syndrome And Addiction
Have you ever met someone with Tourette’s Syndrome (TS)? If you have, you may have noticed some uncommon characteristics, but in truth, it is more likely you may have not even known that a person had TS. That is because many people do not experience severe symptoms, called tics, past adolescence.
Even if people do not exhibit symptoms, more people have the syndrome than you may even realize: U.S. Census data from 2010 showed more than 300,000 children (ages 5 to 17) with TS, according to Tourette Association Of America.
Tourette’s Syndrome: What Is It?
In long terms, TS is a neurological disorder that influences the nerves and vocal activities, resulting in “repetitive, stereotyped, involuntary movements and vocalizations called tics,” according to the National Institute Of Neurological Disorders And Stroke.
While symptoms tend to appear in early childhood, and to peak in teen years, some people with the syndrome do experience symptoms into adulthood. In other words, TS can be a chronic condition, but tics may improve starting from early adolescence into adulthood.
TS does not discriminate in scope; it impacts people of all social classes and racial groups. Men are more likely to experience this than women. Since TS is now also classified as a Tic Disorder, an individual has to display at least two motor tics and one vocal tic for at least a year, in order to qualify for this diagnosis.
Unfortunately, those affected by the syndrome may also experience co-occurring conditions or disorders, including ADHD and OCD. For children, this may mean disinhibition, or an inability to restrain behavior. For adults or teens, this could also mean substance abuse disorders.
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Symptoms Of Tourette’s Syndrome
Tics are classified into two groups: simple and complex. Simple tics are characterized by sudden, brief, and repetitive movements. Examples of simple motor tics are as follows:
- Arm jerking
- Eye blinking
- Facial grimacing
- Head bobbing or jerking
- Neck stretching
- Shoulder shrugging
Simple vocalized tics may include barking, grunting, hooting, repetitive throat clearing, shouting, and sniffing. Complex tics, in contrast, are more distinct. A person exhibiting complex motor tics may engage in hopping, jumping, twirling, or may have, for example, facial grimacing in combination with a head twist and shoulder shrug. Complex vocal tics may involve words or phrases in addition to the simple vocal tics—these may not be recognizable, but will continually happen, appearing outside the context of the conversation.
In a rare percentage of persons with TS (10-15%, according to the Tourette Association of America), complex tics may also include inappropriate use of words, or coprolalia, such as swearing, cursing, ethnic or racial slurs, or other offensive words or phrases. The most disabling of the complex motor tics involve dramatic involuntary movements, which may seem purposeful, such as punching oneself in the face. Faced with such hardships, TS can often be coupled with other disorders, which may include substance use disorders.
As a person seeks to contend with TS, and the subsequent sense of being “out of control,” they may seek to temper these feelings or any shame or embarrassment that they attribute to their behavior, with drugs or alcohol. Tourette Syndrome is not something you should be ashamed about, and most importantly, self-medicating these feelings, in this way, can be very dangerous, as it can result in addiction.
Addiction: Who It Affects
One of the most important things to remember about substance abuse (and subsequent addiction) is that there is no single factor that can predict who will struggle with addiction. A number of things may contribute to the risk of substance abuse. Some of these may include genetic factors or environmental factors. Lastly, a person may experience increased vulnerability if they have certain diseases or disorders.
Of further concern, critical developmental stages, influenced by genetic and environmental factors in a person’s life, may heighten an individual’s risk for substance abuse. For teens, especially, this poses a high potential for addiction. In regards to this, The National Council On Alcoholism And Drug Dependence (NCADD) aptly states, “Although taking drugs at any age can lead to addiction, the earlier that drug use begins, the more likely it will progress into more serious abuse. Because areas in their brains that govern decision making, judgment, and self-control are still developing, adolescents may be especially prone to risk-taking behaviors…”
Recovering from substance abuse is difficult because drugs can change the brain, which makes quitting a harsh process. Withdrawal symptoms may occur for persons attempting recovery, some of which may be severe. Lessened self-control presents further challenges for persons touched by substance abuse—someone who has experienced repeated substance abuse may find it difficult, to nearly impossible to resist urges to continue use. Due to the tendency of people struggling in the face of substance abuse, it is common to relapse. Therefore, treatment should be ongoing, especially for those with co-occurring disorders or illnesses.
Dual Diagnosis: Finding The Right Treatment
As with any dual diagnosis, finding treatment for Tourette Syndrome and addiction can be a delicate process—but not an impossible one. The first step is to get a proper diagnosis for each disorder. Each person with TS has a unique case, a unique set of tics specific to him or her.
For some, tics may cause problems with everyday functions, and for those who wish to seek treatment, there are several types available. It is important to remember that TS does not have a cure, however, treatments are available that can significantly help a person gain control over this disorder. Some treatment types are behavioral therapy and medication.
A few types of treatment therapies are:
- Deep brain stimulation (DBS)
- Behavior modification (Comprehensive Behavior Intervention For Tics, or CBIT)
- Speech therapy
Medications may work to help reduce tics, but not to completely eliminate them. People seeking medication as a form of treatment may experience side effects as a result, but these can be managed. For instance, the person taking the medication would (with medical supervision) slowly decrease dosage when side effects occur.
With behavioral treatment, a person with TS focuses on training the body to move in response to tic urges. This replaces the predisposed, involuntary movements with new, carefully conditioned voluntary responses.
In treating addiction, medication and behavioral therapies may also be useful methods, but, as with TS, finding the most effective treatment will be dependent on the person, as well as substance abuse. Alcohol addiction may be treated quite differently than opioid addiction, for example. A person with both TS and addiction must carefully select treatment methods that target symptoms of the syndrome and also aid in recovery from addiction.
Get Help With Treatment
Finding treatment for one diagnosis may seem like a daunting task, and finding treatment for two may feel impossible. However, you are not alone in your quest for help with treatment—either for TS or addiction. Thousands struggle with TS and with substance abuse, and not everyone is getting the help to recover.
However, the good news is that there are many options available for treatment. Contact us today to reach a team trained to listen, and ready to aid you in finding treatment that is right for you.Article Sources
National Institute Of Neurological Disorders And Stroke - http://www.ninds.nih.gov/disorders/tourette/detail_tourette.htm
Tourette Association Of America - https://www.tourette.org/resources/overview/tools-for-educators/managing-classroom-ts-child/disinhibition/
Tourette Association Of America - https://www.tourette.org/about-tourette/overview/treatment/
Tourette Association Of America - https://www.tourette.org/about-tourette/overview/
Tourette Association Of America - https://www.tourette.org/about-tourette/overview/what-is-tourette/#1461071540102-3476eee2-5ae4