Some people who have tics stemming from conditions such as Tourette Syndrome, PANS or PANDAS have the ability to temporarily hold in their tics, this is known as Tic Suppression.
Some people may think 'if you can hold in your tics, then does that mean that you can control them?'. The answer to this question is no, because although we may be able to temporarily stop our tics from showing, the underlying urge to tic and the misfired signals from the brain are still there. We are just masking it and bottling it all up. This causes the suppressed tics to accumulate, which is why many people report that tic suppression makes them worse.
Suppression can cause symptoms to appear differently in different environments. Someone may tic frequently at home as they are letting their tics out freely, but may not appear to tic much at school as they are suppressing their tics.
Tic Suppression is Different From Tic Redirection and it is Different From Managing Tics and Reducing Them in Healthy Ways:
Tic suppression is where tics are forcefully held in without anything to help manage them, they build up and accumulate.
Tic redirection is where another action replaces a specific tic, a competing response is sometimes done to stop a harmful tic from occurring, the tic is either blocked or done in a different way, so that the urge is still satisfied but so that the tic doesn't cause harm. People may learn to redirect tics that cause injury or a lot of distress, if they have the ability to redirect.
Tic redirection for some people is a healthy way to manage tics, but there are also other ways to manage tics, such as medication and the elimination of triggering factors. These aren't the same as forceful suppression, as something is done to reduce the tics in the first place so that they may not need to be suppressed as much - the brain may not misfire as many signals with certain methods so this isn't bottling the tics up, but genuinely reducing them.
The Rebound Effect:
Many people with tics report that they experience an explosion of more severe tics after suppressing. This is known as the rebound effect. This explosion of more intense tics after suppression can be dangerous, as these severe tics may be destructive towards the person's surroundings and their own body and this can lead to injuries. Many people report that they experience tic attacks triggered by tic suppression. Tic attacks are episodes of tics which are more intense than a person's usual level of ticcing, tic attacks from the outside may resemble seizures or dystonia, a person's whole body may contort, jerk, and spasm.
Rage attacks are another symptom which people in the community sometimes report as being triggered by tic suppression. People have also reported that tic suppression has led to an increase in OCD symptoms and a decline in mental wellbeing in their case.
What Does Tic Suppression Feel Like?
When people suppress their tics, the premonitory urge (sensation that comes before a tic) may get stronger and stronger. It accumulates until it becomes physically intolerable. This is why some people say that tic suppression is painful for them and hurts.
It may feel like a buildup of pressure inside of someone or an uncomfortable sensation on someone's skin or inside a certain part of their body.
Many people report that when they are suppressing tics, they may not be able to focus on much else except not ticcing. It can take up the majority of someone's mental focus, so the person may be unable to perform as well as usual in school or in the workplace. Many people also report that tic suppression makes them extremely tired and tense.
Many people suppress their tics without even realizing they are doing it. This can happen in environments where a person has an underlying fear of being judged, bullied, or being seen as 'different'. Some people subconsciously suppress tics for their own safety in these situations, but it still isn't without risk as this can still lead to unhealthy consequences.
Unlearning Tic Suppression:
Some people feel that people with tics should 'learn to suppress', but many people already subconsciously suppress, at the detriment to their own wellbeing. This is why many people try to unlearn tic suppression. People try to tic freely after so long of repeatedly suppressing tics. This is so that people can experience better wellbeing, less tension in their body, and less negative consequences from suppressing the tics.
Our instinct to try and suppress our tics may be ingrained from early on in our tic journey, so unlearning suppression and doing what we feel is best for us can take time.
How Encouraging Someone To Suppress Their Tics Can Harm The Person's Self-Esteem:
When we are taught to hide or mask something which our bodies make us do automatically, we get the sense that our differences are 'bad'. We may feel a sense of shame for something we cannot control, as we have been taught to feel that way. We may feel ashamed for having neurologically misfired signals. Some people naturally cannot suppress their tics much, and this is okay, but when these people are encouraged to suppress their tics, they may feel as if they are 'weak' or 'lack self-discipline' or are being a 'rebel' when they experience their tics. This is extremely saddening.
Feeling like we have to suppress our tics can hinder our development of self-acceptance, and seeing as some people have tics all of their life, it's better to learn self-acceptance earlier than later.
From a poll I did on my Instagram Story, I gathered the following statistics.
For the question "Do you think tic suppression is unhealthy?"
120 people said yes.
8 people said no.
For the question "Do you find that tic suppression makes your tics worse?"
96% of respondents answered 'yes'
4% answered 'no'.
It was requested that only people with tics answer this question.
124 people responded.
For the question "Do you think it is bad for people to be encouraged to suppress tics?"
93% of people answered 'yes'
7% answered 'no'.
It was requested that only people with tics answer this question.
131 people responded to this question.
A Parent's Perspective:
"Suppression therapy seems to be more for the people around the person with tics and not to actually help the person who has tics." - Parent of an adult daughter with severe tics, which get worse with suppression.
Perspectives from Ticcers:
"I first started ticcing around 8 years old, I lived with my anti-medicine dad who punished me for my tics. School was my only safe place. Soon enough I began to get picked on by both students and teachers (I live in a small town where there is little to no understanding of Tourette’s). I began to suppress my tics all the time, holding them in until it was time to go to bed and I could tic freely. This led to severe rage attacks in which I would hurt myself and those around me. I smashed things, threatened people and so much more. As is the case with many children who have rage attacks connected to Tourette’s I felt like something else just took over me, I couldn’t control it no matter how hard I tried. Now I am officially diagnosed with Tourette’s and my life is so much better. I no longer live with my dad or go to school so I am not being punished for my tics. I feel safer and my mental health is overall better. Suppressing does nothing but harm for people with tics and Tourette’s, and those “professionals” who suggest otherwise need to listen to the people who experience the pain that suppression causes." - From spirited._.sunflower (Instagram Name).
Hi! I'm writing about tic suppression. I started having tics when I was about 9 years old, and by the age of 11 I was a master of suppressing them, to the point where 8 years later some friends of mine never even noticed I have tics in the first place... all this thanks to my parents, who would yell at me or punish me when I ticced... what they did to me still damages me, to the point where I don't know what my usual tics would be like since I suppress all the time and then have explosions once I'm by myself... I don't even know what NOT suppressing looks like, but everyday I'm trying to learn to let myself go in order not to feel tired all the time. - Anonymous
I personally feel that when I “let go” and tic without restriction, that my tics actually get worse. I’m not sure if it’s because I’m just letting go finally, or if it’s because they tend to make my muscles exhausted which is a feeling, and when I feel something in a muscle like soreness or pain or that burn from ticcing over and over my mind focuses on it more and I’ll tic more.
When I resist ticcing, that doesn’t happen.
That said, I don’t think that tic suppression should be encouraged for anyone that has their tics exacerbated by doing so, or for the sake of anything or anyone other than the peace of mind of the person with the tics.
I won’t suppress my tics for others to not be annoyed. I’ll suppress them so my neck and hands don’t hurt after a few minutes. - Anonymous
When I suppress tics it “transforms” in force.
It’s so much that it has torn my muscles, and gave me bloodshot eyes. Migraines come if I suppress too much, and I can only wait for it to go away.
Even though you can’t see it, I'm 100% rigid when I suppress, and if you touch me I'm rock hard.
Maybe it lasts 5 to 10 seconds, but at the end of the day it’s horrible. - Anonymous
I always try not to suppress, I tic loud and proud as I have no shame in having a condition. I tic freely in public as thankfully I am not self-conscious about my tics. When I was in classes in secondary school I could only suppress my tics for a few seconds at most, usually by holding my breath. The urge to tic was extremely strong. When I was in primary school I would subconsciously suppress my tics, I would suppress them without realizing. This meant that when I got home it felt as if my body was filled with pressure and it exploded out as violent rage attacks. When I was younger and had self-injury tics, the urge to tic when suppressing was more uncomfortable than the injuries my tics would give me.
Most of the time now I do not suppress as I know it makes me worse and is unhealthy for me, but I do still suppress when doing certain tasks, despite it being unhealthy. During this time my vocal tics often come out as writing tics instead, which is inconvenient as I write all over myself. After suppressing, my tics explode and I have an episode of very complex tics where my tics interact with the environment, are destructive, and can injure me. These explosions are less likely to happen when I do not suppress. - Romy
"I haven't been diagnosed but I've had tics for over five years. It's always seemed a little easier for me to suppress than other people with Tourette's so I keep my tics to myself because it's simpler than the questions and looks I know I'll get as a Christian girl yelling the f word or even just ticcing in general. So in my tangible, not-online life no one knows I have Tourette's. When I'm with others at home or I'm in public (I'm homeschooled) I suppress until I'm alone and try to let them out then. I told someone I knew once with whom I mostly talked online with and they were my best friend for a while, but they left without notice or goodbye.
I have friends but none of us really talk about any deep personal problems. My parents are the people I spend the most time with I guess they're pretty great as far as married people goes, but in our house, there's never been much of telling each other our problems, or even really apologizing or crying. The only person who sometimes cries in front of the rest of us is my mom but when she does it's mostly over something random and not very deep so there's not much consolation from my dad. It's like it's every man for himself.
They've told us in years past that we can tell them anything but I still *don't* trust them because of the way no one in the family trusts each other with their problems even though there's only four of us. I know they love me but there's some things they just don't do right.
A while back mom was talking in front of the rest of the household about how I wash my hands so much and want everything to be beyond sterile when it comes to handling meat (raw meat is my fiend) and other things I deem unclean. But the way she said it was like it was something comical and annoying someone who wasn't in the room listening to her had done. Then her and my brother talked about some of the clean freak things I'd done and were laughing about it. Then my mom brought up the "oh it's like she has OCD" card which made everyone laugh. I of course DO have OCD of several different types but they haven't noticed (through all of my anxiety over meat and making sure it's done and food poisoning and hand washing, etc that they have seen with their own eyes) and apparently aren't worried. Which seems a little odd because practically everyone in our family has had anxiety and panic attacks so anxiety is pretty respected and since OCD and anxiety work together you would think they would get it.
But when I first noticed my tics I just didn't tell them because I was scared and didn't want to have anything wrong with me and hid them because I was scared of them myself. Now I go back and forth between being afraid they won't get it, to being afraid to show weakness (comes with the whole no one in the family shares their "weaknesses" very much thing), and just not wanting to stress my parents out more than they already always are. I'm just worried that as I graduate and get a job I won't be able to hold it together anymore and I'll explode. You might be wondering "Well what the heck is your plan if you're not telling them? Hiding forever?" Not really. I plan on telling them some day but when I'm not a dependent having to live with them if they take it wrong. I'm graduating highschool this year so I guess I'll see if I hold it together soon.
The reason I'm saying all this is not for attention certainly not for advice because if you have the guts to tell people, by all means love your best life and shine that awareness light. I'm just writing this to be understood and to hopefully help others along the way. If anyone is going through a similar weird, lonely journey like this, I want you to know that even if you have no one present who understands, I do. At least one person out there knows and cares even though they don't know you. Even though it is beyond lonely some days and seems to much to take, you can get up and keep going until you find or make a time to let the world know. Just don't give up." - Anonymous
Disclaimer: I am NOT a medical professional, this is NOT to be used as a substitute for diagnosis or treatment from a qualified physician, this is to be used for educational purposes only. For medical advice, please see a medical practitioner. I do NOT claim to treat, cure or mitigate any condition.