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Five common misconceptions: Tics and OCD

With mainstream media's atrocious coverage of mental illness and movement disorders, it is no surprise that there are countless misconceptions that have permeated common belief. It is of paramount importance to correct and dispel these beliefs in order to put forth an accurate representation of what mental illness and how it manifests in extremely unique and individualized manners. In this post, I will examine some of the more common misconceptions surrounding OCD and Tic Disorders (TS/PTD) and how they are inaccurately deployed to undermine others' experiences.

1) "I mean, I barely even notice your tics. Aren't you exaggerating?"

In reality, many kids with Tics and OCD drain their energy during the school day, suppressing their tics and trying to ignore their compulsions; this can cause extremely uncomfortable tension in the muscles and alarming anxiety that can lead to extreme "tic explosions" or heightened compulsive behaviors at home. In addition, research heavily indicates that those with Tic Disorders experience the bulk of their symptoms in early adolescence (9-11 years old), and from the age of 13-14, the severity of their condition significantly decreases. Many, myself included, have even noticed a periodic absence of symptoms during the latter half of puberty or the disappearance of tics writ large. It might be that your friend struggled with it before you met. Or maybe they just recently worked with a neurologist to manage the physical symptoms. Nonetheless, the fact that you never "noticed" or "saw" your friend/peer tic does NOT mean you can assume they never experienced symptoms in the past; for many, the decrease of visible symptoms is something with which they've struggled and worked hard to achieve, and to make belittling comments is discouraging and disparaging to those seeking positive change in their lives.

For example, I had days in middle school where my neck tics caused inflammation so bad that I had to visit a chiropractor. Other days, my tics seemed to fade away and were the least of my worries. The waxing and waning of tics is something confusing and bewildering for many of us, and the last thing people who suffer(ed) with Tic Disorders need to hear is, "You have tics/TS, huh? How come I don't see them?" Something to think about is that you would never doubt anyone telling you that they have arthritis, for example. You would never ask them, "Well, how come I've never seen you in pain?" The same level of understanding should apply to mental illnesses.

2) "Wait, why don't you curse?"

This is perhaps the most frequent comment I've received. By now, you should understand that tics can manifest in a variety of ways. Just because you saw a Youtube video titled, "Tourette's Syndrome," and everyone blurted out obscenities in public, that does not mean everyone with Tourette's/Tics experiences the same slew of struggles. There are both motor and vocal tics, complex and simple. In fact, cursing tics are a rare facet of TS called corprolalia. When you do meet someone with corprolalia, it is absolutely imperative that you do not belittle or mock them in any shape or form. I'm sure you can imagine the suffering they have already endured; don't make it worse.

3) "Germaphobe" = OCD

This is a popular misunderstanding. An inclination to keep things clean and tidy does not mean you have OCD, nor does having OCD mean that you are obsessed with cleanliness. It is definitely the case that OCD patients can have obsessions such as an extreme fear of germs and contamination, or compulsions such as repeatedly washing hands or scrubbing. However, this representation fails to encapsulate the wide spectrum of the disorder. Symptoms manifest in a plethora of ways, and many of them are completely unrelated with hygiene.

4) "Wait, you have OCD? Why didn't I ever notice!"

Although there are times when OCD behavior is clearly noticeable, many OCD patients have learned to suppress their symptoms and manage them on a regular basis. Treatments like CBT (Cognitive Behavioral Therapy) and ERP (Exposure Response Prevention) have proven effective for many, but a decrease in perceived symptoms does NOT indicate that one has been "cured" of their illness. OCD is chronic for many, meaning that over time, symptoms can morph in both frequency and form. This can cause obsessions and compulsions to either become more or less eye-catching, depending on the scenario. Moreover, it is possible that these obsessions (the "O" in OCD) are rampant in the mind in the form of thoughts, fears, and anxiety. Since symptoms can appear differently for each person, you must refrain from openly vocalizing your doubts. "I can't see it" is NOT a justified reason to deny the lived experiences of someone with mental illnesses, and these remarks only exacerbate the already pervasive stigma surrounding these disorders. Instead, when someone opens up to you about something vulnerable like this, you should be empathetic and appreciate their honesty.

5) "C'mon, it's just a habit, right? I mean, just try to stop it, and calm down."

Dr. Ralph Ryback, Harvard professor and author of The Truisms of Wellness, articulates it best: "OCD isn’t a personality quirk—it’s a disease. If curing a chronic illness was as simple as just 'calming down,' no one in the world would be sick." This misguided thinking applies similarly to Tic Disorders, where many think one can simply "stop." In reality, mental illnesses like Tourette's and OCD involve neurological incapacitations with regards to neurotransmitters and brain regions such as the Basal ganglia.

I hope this post cleared up some questions you had about Tic Disorders and OCD. Please contact me at to share your experiences, tips, techniques, or even just say hello!

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