What’s A Tic? Part 3 — Treatment & Management

What Are Tics

There are multiple forms of treatment and management for individuals with tics:

  1. Medication – I’ve never needed medication myself, but for some people, medication is what really helps them get their lives back on track when the tics are too much to handle, and there’s nothing shameful about it.
  2. Diet – While I don’t believe diet will cure true Tourettes, I know that my tics get a lot worse when I don’t eat healthy food. The way I see it, your brain will only function as well as the fuel you put into it.
  3. Exercise – Because many tics are often related to anxiety, exercise is a great way to both lower anxiety and lower tics. After really strenuous workouts, I can often go 10 to 15 minutes where I don’t even feel the need to tic. (Heaven!)
  4. Behavioral Therapy – According to Tourettes Action in the UK’s article, “Behavior therapies and Tourette Syndrome,” behavior  therapy is being used to help some individuals with tics by helping them learn to be mindful of what their brains and bodies are doing.
  5. Deep Brain Stimulation – This is the type of treatment talked about in the video clip posted above, only used for the most severe cases, as it’s still considered experimental.

One of the most important parts of treating and managing tics is simply the diagnosis. Once you know you’re dealing with tics, it can be easier to pinpoint and manage with the help of a primary care manager, family, and friends. It’s also important to remember that a diagnosis of a disorder with tics isn’t the end of the world; we must remember that under the tics is still the individual, and that person is a beautiful creation of God who’s simply struggling with the burdens of life like the rest of us.

Do you have any information on tics that you’d like to share? What about questions? I’d love to hear your comments and questions, so please post them in the Comment Box below. Also, don’t forget that if you sign up for my weekly newsletter, you’ll get extra resources on neurological disorders, as well as a gift in thanks for signing up. Thanks for reading!

UPCOMING WEBINAR: February 25 on Sensory Issues at Home & at School

THIS WEEK’S WEBINAR

Making Sense of Sensory Issues – How to manage heightened senses at home and in the classroom

February 25, 2015

Presented by Dr. Michelle Miller, Psy.D., a New York State-licensed clinical psychologist who works at Therapy West, a group practice in Manhattan, and as post-doctoral fellow in the Tourette’s Syndrome Clinic at Rutgers University in Piscataway, N.J.

Over the years, parents and teachers have been increasingly attending to childrens’ sensory-related struggles; however, understanding and supporting sensory problems still remains unclear for so many people who work with children. Research also has suggested that 1 in 6 children are significantly impacted by sensory issues, further highlighting the need for this area to be addressed. This webinar is aimed at exploring what sensory issues are, how they look in different children and adults, and what can be done — both at home and at school — to help children with sensory issues thrive.

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UPCOMING WEBINAR: January 21 on Habit Reversal Therapy

THIS WEEK’S WEBINAR

Creative Applications of Exposure Therapy and Habit Reversal Therapy

January 21, 2015

Presented by Dr. Joelle Beecher-McGovern, a clinical psychotherapist at the Child & Adolescent OCD, Tic, Trich & Anxiety Group (COTTAGe) in the Department of Psychiatry at the University of Pennsylvania School of Medicine.

Cognitive-behavioral therapy has strong experiential support for a number of psychiatric disorders among children and adolescents. It includes several treatment modalities, including exposure therapy for pediatric anxiety and habit reversal training for tic disorders and trichotillomania. Despite the strong evidence for these treatments, they can be difficult for children and families to implement for a number of reasons, including logistical barriers, motivation issues and difficulties with follow-through in out-of-session work.

In this presentation, Dr. Hilary Dingfelder will briefly describe these treatment modalities and discuss some of the practical issues associated with implementing these treatments with children and adolescents. Dr. Dingfelder will then discuss some creative applications of these strategies to enhance these treatments for children and adolescents. Examples of areas that will be covered include:

  1. How technology can be used to supplement treatment (e.g., using the smart phone to monitor progress or supplement exposures)
  2. How to strengthen reward plans to improvement motivation
  3. Creative ways to enhance exposures with young children (e.g., through the use of games and puppets).

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Understanding depression in children

As a child or teen, did it bother you when people would comment “these are the best years of your life”?

For many children, this blanket statement is a stark contradiction from the reality they know. A bulk of people experience a childhood or adolescence that is not always filled with rosy or positive experiences.

Once considered impossible, today’s experts are aware that even young children sometimes suffer from depression. As a parent, it’s hard to acknowledge that your child might be suffering from this ailment. If you feel that a child is suffering from depression it’s important to understand the facts, signs, symptoms, and pointers to help a child cope.

Childhood Depression

The American Academy of Child and Adolescent Psychiatry now estimates that typically one in 20 children or teens are depressed. This is shocking when you consider that within every classroom is a high probability that at least one child in attendance is suffering from depression.

Depression is a real medical condition and should be treated accordingly. Many parents feel there is a stigma attached to a child if it is suspected that she suffers from depression. Unfortunately, this is an illness that they can’t just “snap out of” and requires attention.

“Depression is no more a result of ‘bad parenting’ than is diabetes or cancer,” says Dr. David Fassler, co-author of “Help Me, I’m Sad”: Recognizing, Treating and Preventing Childhood and Adolescent Depression. “All are real illnesses that require careful evaluation. The good news is that we can help most children and adolescents.”

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UPCOMING WEBINAR: November 12 on getting kids motivated for school

THIS WEEK’S WEBINAR

Getting Kids Motivated for School: Strategies to foster your child/teen’s motivation to achieve in school

November 12, 2014

Presented by Dr. Graham Hartke, is a licensed psychologist in private practice in Roseland, N.J.

As our schools continue to increase curriculum, testing, and workload standards, many kids and teens are struggling to stay motivated in school. These are students who do not like school, struggle to complete homework, procrastinate often, have slipping grades, are bored, say they “don’t care about school”, avoid school work, get in trouble, are disorganized, and/or feel disconnected from classroom learning.

This webinar focuses on strategies parents and educators can use to increase student motivation to succeed in school. Strategies will address the causes of low motivation, learning difficulties, improving the homework process, improving organization, and reducing procrastination.

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OTHER UPCOMING WEBINARS

 

Bullying & Vulnerable Populations

November 19, 2014

Presented by Nadia Ansary, Ph.D.

More information about this webinar »

Monsters, Robbers & Nightmares, Oh My! Simple Ways to Improve Your Child’s Sleep

December 3, 2014

Presented by Courtney Weiner, Ph.D.

More information about this webinar »

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List of all NJCTS webinars, including October 29 on mental health in the African-American community

THIS WEEK’S WEBINAR

Mental Health Stigma in the African-American Community

October 29, 2014

Presented by Dr. Christine Adkins-Hutchison, Associate Director of the Office of Counseling and Disability Services at Kean University in Union, N.J.

Asking for help of any kind can be difficult. Seeking psychological services can be even more challenging. For many in the African American community, acknowledging the need for help and pursuing assistance in many forms, especially in the form of counseling, can feel next to impossible.

This webinar will discuss the stigma regarding help-seeking and mental health issues that persists in this ethnic community. How to recognize the need for support, and ways to encourage help-seeking in this population also will be considered.

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OTHER UPCOMING WEBINARS

Getting Kids Motivated for School

November 12, 2014

Presented by Graham Hartke, Psy.D.

More information about this webinar »

Bullying & Vulnerable Populations

November 19, 2014

Presented by Nadia Ansary, Ph.D.

More information about this webinar »

Monsters, Robbers & Nightmares, Oh My! Simple Ways to Improve Your Child’s Sleep

December 3, 2014

Presented by Courtney Weiner, Ph.D.

More information about this webinar »

Continue reading

List of all NJCTS webinars, including October 8 on Tourette in the Asian community

THIS WEEK’S WEBINAR

Mental Health Issues in Today’s Asian-American Community

October 8, 2014

Presented by Dr. Andrew J. Lee

Dr. Lee designed this webinar to provide participants information about the stigma surrounding mental health issues in Asian and Asian-American communities, some cultural factors contributing to this stigma and some suggestions as to how to talk with Asians about mental health issues.

Dr. Lee will cover Asian cultural values that may contribute to the stigma associated with seeking out mental health services, the model minority myth and the negative implications of this myth, the role of ethnic identity and acculturation, and what can be helpful to know in speaking with this ethnic population about mental health issues.

Dr. Andrew J. Lee is the Director of the Office of Counseling and Disability Services, which includes both the Kean Counseling Center and the Kean Office of Disability Services, at Kean University.

REGISTER FOR THIS WEBINAR »

OTHER UPCOMING WEBINARS

Bullying & Vulnerable Populations

November 19, 2014

Presented by Nadia Ansary, Ph.D.

More information about this webinar »

Monsters, Robbers & Nightmares, Oh My! Simple Ways to Improve Your Child’s Sleep

December 3, 2014

Presented by Courtney Weiner, Ph.D.

More information about this webinar »

Continue reading

List of all NJCTS webinars, including October 1 on trade secrets of a Tourette doc

THIS WEEK’S WEBINAR

Trade Secrets of a Tourette Syndrome Doctor

October 1, 2014

Presented by Tolga Taneli, MD

Would you like to learn some great tips on speaking with your child’s doctors?  How about getting them all to collaborate with each other about your child?  Did you ever wonder about the drug approval process?  Learn about this and more in this webinar!

REGISTER FOR THIS WEBINAR »

OTHER UPCOMING WEBINARS

Mental Health Issues? Asians have those? Understanding the stigma surrounding mental health for Asian and Asian Americans

October 8, 2014

Presented by Dr. Andrew J. Lee

More information about this webinar »

Bullying & Vulnerable Populations

November 19, 2014

Presented by Nadia Ansary, Ph.D.

More information about this webinar »

Monsters, Robbers & Nightmares, Oh My! Simple Ways to Improve Your Child’s Sleep

December 3, 2014

Presented by Courtney Weiner, Ph.D.

More information about this webinar »

Continue reading

List of all NJCTS webinars, including September 17 on getting kids motivated for school

THIS WEEK’S WEBINAR

Getting Kids Motivated for School

September 17, 2014

Presented by Graham Hartke, Psy.D.

As our schools continue to increase curriculum, testing, and workload standards, many kids and teens are struggling to stay motivated in school. These are students who do not like school, struggle to complete homework, procrastinate often, have slipping grades, are bored, say they “don’t care about school,” avoid school work, get in trouble, are disorganized and/or feel disconnected from classroom learning.

This webinar will focus on strategies parents and educators can use to increase student motivation to succeed in school. Strategies will address the causes of low motivation, learning difficulties, improving the homework process, improving organization, and reducing procrastination.

REGISTER FOR THIS WEBINAR »

Continue reading

Deep Brain Stimulation, Part 3: Who’s a good fit for DBS?

The use of brain surgery to treat Tourette Syndrome receives a lot of media attention. This three-part blog series from the Tourette Syndrome Foundation of Canada (TSFC) will give you up-to-date information about this treatment approach. Part 1 explained how the surgery works and how it might negatively affect someone with TS. Part 2 discussed new data on the long-term impact of DBS.

DBS model

According to a recent article published in the Journal of Movement Disorders, there are nine or more important considerations made regarding the suitability of a candidate for Deep Brain Stimulation or DBS:

  1. Tics result in severe distress, self-injury, incapacitation, and/or disruption of quality of life.
  2. The patient is over age 25 (except in exceptional cases).
  3. Medication (usually at least three different types) has been tried and has failed.
  4. Patient hasn’t undergone treatment for any associated conditions or other medical condition(s) during the previous 6 months.
  5. Botox injections have been considered, if possible.
  6. Any psychiatric disorders, including anxiety, depression and bipolar disorder, have been treated and stabilized.
  7. Patient has undergone screening for possible cognitive dysfunction and dementia.
  8. An expert, such as a psychiatrist or neurologist, diagnosed the TS.
  9. Patients were informed about the behavioral therapy treatment approach.

According to a several DBS experts, having a team of professionals from different fields who have experience with movement disorders is also critical. This team might include: a psychiatrist, neurologist, neurosurgeon, neuropsychologist, and in some cases, a social worker, occupational or physical therapist, and speech therapist. Experts recommend that this team meet to discuss the results of imaging (e.g. Magnetic Resonance Imaging). This model is similar to an approach used in cancer treatment (medical oncology boards).

Lastly, it’s important to remember that DBS is time-intensive. A commitment to give a lot of time—not just due to the procedure itself, but also because of the pre- and post- operative workups—is important to strengthen the chances for success. Consider that on average, a patient may need to return for device re-programming 4-8 times in the first six months! In short, DSB treatment is still far from being over once the person undergoes the actually surgery.

Overall, while DBS for TS is promising in certain cases, it is still a work in progress. Some patients who undergo the procedure may not benefit significantly. On the bright side, as research on DBS continues (countless DBS studies were published this year alone), medical professionals will come to better understand who with TS might benefit from DBS.

Source:

“Deep Brain Stimulation for TS” by Okun & Ward et al. Published in A Family’s Guide to Tourette Syndrome. Walkup, Mink & McNaught(eds.), Bloomington IN: iUniverse, 2012.