Aidan could feel it. He was in the middle of an exam and didn't want to make a scene, so he tried to control it. But it was no use. The stress of the exam was getting to him, and the longer he held in his tic, the more he could feel it building up inside him. Finally he had no choice but to let it out. It wasn't as bad as he anticipated — his shoulders jerked slightly and no one seemed to notice.

Aidan has transient tic disorder, a temporary condition that affects up to 25% of people before the age of 18. Sometimes a person will have one kind of tic — like a shoulder shrug — that lasts for a while and then goes away. But then he or she may develop another type of tic, such as a nose twitch.

What's a Tic?

A tic is a sudden, repetitive movement or sound that can be difficult to control. Tics that involve movements are called motor tics and those that are sounds are called vocal tics. Tics can be either simple or complex:

• Simple motor tics involve a single muscle group.
• Complex motor tics usually involve more than one muscle group.
• Complex vocal tics involve more meaningful speech (such as words) than simple vocal tics.
• Complex motor tics aren't as rapid as simple motor tics and can even look like the person is performing the tic on purpose.

Shoulder shrugging is one of the most common simple motor tics; others include:

• nose wrinkling
• head twitching
• eye blinking
• lip biting
• facial grimacing
• repetitive or obsessive touching
• kicking
• jumping

Common vocal tics include:

• coughing
• throat clearing
• grunting
• sniffing
• barking
• hissing

Transient vs. Chronic Tics

It's perfectly normal to worry that a tic may never go away. Fortunately, that's not usually the case. Most tics are temporary and are known as transient tics. They tend to not last more than 3 months at a time.

In rarer instances people have tics that persist for an extended period of time. This is known as chronic tic disorder. These tics last for more than a year. Chronic tics can be either motor or vocal, but not both together.

The Doc's Diagnosis

Tics can sometimes be diagnosed at a regular checkup after the doctor asks a bunch of questions. No specific test can diagnose tics, but sometimes doctors will run tests to rule out other conditions that might have symptoms similar to tics.

The Embarrassment Factor

Many times, people don't see themselves having a tic — they're not walking around with a huge mirror at all times! So it's only natural that they may think that their tic is the worst tic ever. Of course it isn't, but it's still a concern for many people with tics. And these exaggerated thoughts can cause unnecessary feelings of embarrassment or angst, and actually make the tic worse.

Nobody wants to make tics worse, but is there any way to make them better? While you can't cure tics, you can take some easy steps to lessen their impact:

• Don't focus on it. If you know you have a tic, forget about it. Concentrating on it just makes it worse.
• Avoid stress-filled situations as much as you can — stress only makes tics worse. So get your work done early and avoid the stress that comes with procrastination and last-minute studying.
• A tic? What tic? If a friend of yours has a tic, don't call attention to it. Chances are your friend knows the tic is there. Pointing it out only makes the person think about it more.
• Get enough sleep. Being tired can makes tics worse. So make sure to get a full night's rest!
• Let it out! Holding back a tic can just turn it into a ticking bomb, waiting to explode. Have you ever felt a cough coming on and tried to avoid it? Didn't work out so well, did it? Chances are it was much worse. Tics are very similar.

In certain cases, tics are bad enough to interfere with someone's daily life and medication may be prescribed.

Don't let a little tic dictate who you are or how you act. Learning to live with and not pay attention to the tic will make you stronger down the road.

Reviewed by: Harry S. Abram, MD
Date reviewed: September 2010