Gotta love triggers – those events or conditions that knock on your brain’s door and ask your tics to come out and play. Everyone with TS has them, and for each person they’re different. So if you’re looking for a trigger-by-trigger, tic-by-tic playbook, I’m sorry to disappoint you. I can only share my own:
One that almost everyone with TS shares is being around other people with tics. (And you thought it was only yawns that were catching! See how good an analogy that is?) Worse yet is watching videos in which people tic. Life is unscripted and unedited. But videos? You can take a half hour of footage, edit down to only the juicy ticcy bits, stick it on Youtube, and make two minutes of concentrated tic-triggering hell.
And it’s not just your own tics that get triggered. You find yourself taking on other people’s tics. One of the funnier phenomena with TS is when someone posts a link to a TS awareness video in a support forum and asks, “Do any of you have any of these tics?” My stock response: “Well I do now! Thanks a lot!”
The most extreme example of this came when I went to the TSA National Conference many years ago. I got on the plane with a really mild set of tics I could more or less hide. I reached the conference hotel and found the entire place was booked and chock full of people with TS. There must have been over a thousand attendees at that conference, almost all of them with tics. When I left several days later I was about as subtle as one of those wind-up monkeys with cymbals. It took months for them to work their way out of my system so I could get back to normal.
Stress is another common trigger, which is why giving someone crap about having TS is such a pointless waste of time.
Me: >tic< >tic< >tic<
Them: “Stop it.”
Me: >tic< “I can’t.” >tic< >tic< >tic< >tic<
Them: “I said stop it!”
Me: >tic< >tic< >tic< “I really can’t!” >tic< >tic< >tic< >tic< >tic< >tic<
Them: “CUT IT THE @#$! OUT YOU FREAK!”
Me: >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic< >tic<
Get the picture? It’s like trying to put a fire out by dumping gasoline on it. The fire’s going to grow into a bigger fire, and the one dumping gasoline on it is just gonna look like an idiot.
Another one for me is caffeine. It’s a pretty common trigger, but not everyone reacts to it. For a variety of other health reasons I really try to limit my caffeine. Something about being in college and a doctor asking me, “You drink two pots a day?! Are you insane?!” These days I try to keep it to just a few cups. Yeah, it makes my tics worse. But you have no idea how much I like coffee.
Music is a big trigger for me. Not all music. Just some. I admit I get a little jealous when this topic makes the rounds on the support forums. I see posts saying, “Music soothes me,” and “When my tics are really bad I can lie down in my room, put on some music, and everything just calms down,” and I just think how lucky they are. Of course there’s nothing quite like driving home after work, having an awesome song come on the radio, and having my vocal tics hit full throttle. That’s reason enough to roll down the windows, crank it up, and let ’em rip!
But the worst, for me, ties back into my OCD. My guess is this relates to the stress trigger more than anything, but I’ve got a specific one that gets me every time: having all my exits cut off.
I realize I probably should’ve gone into OCD and how it keys into TS before launching into this topic, but I didn’t. So bear with me. Just like TS, OCD has its stereotypes and truisms. Not everyone with TS swears constantly, the way Hollywood would like you to believe, and not everyone with OCD can’t step on cracks, though that actually is one of mine. With classic stand-alone OCD these “gotta do”s or “can’t do”s are typically tied to some overwhelming feeling of danger, like having your family die a horrible death or knowing that you’re causing someone pain. With comorbid OCD in conjunction with TS, more often than not it’s tied to the feeling you get when you try to suppress your tics. When I step on a crack I don’t think anyone’s going to die as a result. I just know deep down in the core of my being that it’s WRONG. And that sets off the tics…
It’s funny how easy it is to handle cracks. Or not stepping on color divisions, which is more what it is in my case. When I’m in a cross-walk, my feet either have to be completely on the white stripes or completely on bare pavement. I can’t step so that my foot crosses that boundary. Not without feeling absolutely horrid, anyway. On bad days I have to have the same number of steps on each foot on the white stripes. It sounds like I’d have to walk around with this comical exaggerated care to pull off a stunt like that. But for the most part I can just lengthen or shorten my stride, step where I need to step, and move on. People I’m walking with rarely even notice.
But that whole thing about exits? Yeah, everyone notices that one. It’s dead-nuts simple to avoid stepping on a crack. But try going to a grocery store and not having someone block the aisle with a shopping cart, and then have someone else block the other end of the aisle with another shopping cart. Not challenge enough? Try Costco. Still not good enough for you? Try a festival. Or a dance club. Or a concert. Or any of the other myriad activities people do because they’re “fun”. And every time you lose your exits, you start ticcing and can’t stop.
“Come on! Let’s go out to the club. It’ll be fun!”
“Aaaaaah! Um… I’d love to, but I can’t. I already had an appointment to have pencils surgically inserted under all of my toenails. And you know that kind of opportunity doesn’t come up often! Have fun without me.”
Oh yeah. I was the life of the party in college. Maybe that’s why I drank so damn much coffee.
So why expose myself to any of them? Couldn’t I cure my TS by removing all these triggers from my life? In a word, no. I’d still have TS. I’d just have a slightly milder case without ever getting to do some things I really love, like drinking coffee and listening to good music.
Let me turn that around and ask you: Do you do anything that you know isn’t healthy, but you do it anyway because you like it? Having the occasional drink? Eating that ice cream? Staying up late, knowing full-well you have to get up at 5am the next morning? Trying that skateboard trick, knowing the first five times you did it you face-planted?
I hope your answer is yes. If we only did what was best for us, we’d all be nice little pre-programmed robots and wouldn’t have any fun at all. Sure, cutting out all risks to health, life, and limb is a good way to survive. But is it a good way to live?
You have to assess the risks and ask yourself, “Is it worth it?” For me, coffee’s worth it so long as I limit my intake. Clubbing? No chance in hell. Putting on some Avril Lavigne or The Smiths or soaking in the sound of Pink Floyd and ticcing to exhaustion?
You betcherass it’s worth it, tics and all.