Obsessive-compulsive disorder and tics

Obsessive-compulsive disorder (OCD) is marked by symptoms that can be disturbing and disruptive for affected individuals in their daily lives.

Sufferers are afflicted by obsessive thoughts, which cause distress. The obsessive thoughts are then accompanied by repeated behaviors that people with OCD feel compelled to enact. ^[1] These compulsive behaviors are typically performed to alleviate anxiety and provide comfort.

Tics are sudden, recurring, involuntary spasms which can take the form of both actions and words. ^[1] Whilst there is a correlation between OCD and tic disorders, such as Tourette’s disorder, it is not necessarily a causal one. ^[1] This is described in more detail below.

Can OCD cause tics?

Obsessive-compulsive disorder (OCD) and tic disorders are two distinct conditions, but they can sometimes coexist or occur together in individuals. While OCD does not directly cause tics, there are some overlapping features between the two mental health disorders.

OCD is characterized by intrusive and distressing thoughts (obsessions) that lead to repetitive behaviors or mental acts (compulsions) performed to alleviate anxiety or prevent feared outcomes.

Tics, on the other hand, are sudden, involuntary, repetitive movements or vocalizations. Tics can be motor (e.g., eye blinking, head jerking or jumping) or verbal (e.g., shouting, swearing, grunting or throat clearing).

However, some individuals with OCD may also experience tics as a comorbid condition. This co-occurrence is known as Tourettic OCD or, in certain studies, ‘tic-related OCD’. In these cases, individuals may exhibit both the characteristic obsessions and compulsions of OCD as well as tics. ^[2]

Previous studies show that people adjudged to have ‘tic-related OCD’ do not have increased OCD severity or worsened functioning than other people with OCD. ^[2] Data also indicates that tic-related OCD is highly hereditary and predisposed towards males. ^[2]

It’s important to note that the relationship between OCD and tics is complex and not fully understood, with more research required to establish definitive links. However, there is substantial evidence that OCD and tics overlap in ways which indicate a very close relationship. ^[1] Roughly 60% of Tourette’s disorder sufferers, a condition where a person exhibits repeated tics, show OCD symptoms and 50% of children with OCD demonstrate a history of tics. ^[1]

When to get help for OCD-related tic disorders

If you or someone you know is experiencing tic-like symptoms in association with OCD, it is essential to seek professional help. Here are some signs that indicate it may be time to seek assistance for OCD-related tic disorders:

1. Frequency and intensity of tics – If the tics frequently occur and have shown no signs of abating, it is time to seek help. Some children may outgrow tic However, seeking professional help is advisable irrespective of the age of the person in question.
2. Emotional distress – If tics are causing a person emotional distress, such as anxiety or low mood, seek professional guidance. The emotional burden of living with OCD-related tics can be overwhelming, and a mental health professional can help provide support.
3. Difficulty concentrating – If the tics are causing focus issues that disrupt school, work, relationships,or other areas of life, seek professional help.
4. Everyday life – If the tics are hindering daily activities, such as reading, writing, driving, or cooking, it is recommended to seek counsel.
5. Safety issues – If the tics pose a safety risk to either the individualor other people, it is crucial to seek immediate help. Some tics, both motor and verbal, can involve harmful or offensive behaviors which require addressing.

What treatments are available for OCD-related tic disorders

Effective treatment for OCD-related tic disorders involved a combination of methods, including therapies, medication and lifestyle changes. These include:

1. Cognitive-behavioral therapy
   
   CBT is a widely recognized as aneffective form of therapy for OCD and tic disorders. Specifically, Exposure and Response Prevention (ERP), which is a subtype of CBT often used in the treatment of OCD-related tic disorders. ^[1]

   ERP involves gradually exposing oneself to the situations or triggers that cause obsessions and tics while resisting the urge to engage in the accompanying compulsions. This therapy helps individuals develop healthier coping strategies and reduce the impact of tics on their quality of life.

2. Medication

   Medication can be helpful in managing OCD-related tic disorders. Selective Serotonin Reuptake Inhibitors (SSRIs) are commonly prescribed for OCD. Additionally, both standard neuroleptics, such as haloperidol and pimozide, and atypical neuroleptics, such as risperidone and olanzapine, can be used for treatment. ^[1]

   These medications may also help reduce tics in some cases. However, it’s important to work closely with a psychiatrist or healthcare provider to find the most suitable medication and dosage. Do not embark on any course of pharmacological treatment without consulting a trained doctor beforehand.

3. Stress Management and Lifestyle Modifications

   Stress can exacerbate tics and OCD symptoms. Engaging in stress management techniques, such as relaxation exercises, mindfulness, regular exercise, and maintaining a balanced lifestyle, can help reduce the frequency and intensity of tics.