My previous post was titled “Triggers“, and talked about some of the things that exacerbate tics. I don’t know what the opposite of a trigger should be called. Dampener? Suppressant? Slacker-offer? How about abatements: things that abate or minimize tics. As with the triggers I can only discuss my own with any depth, but I’ll touch on those of others where I can.

The biggest one for me is being asleep. I don’t really think it’s fair to call this one an abatement since I don’t tic at all in my sleep. Not that I’m around to take notes, but my wife is an observant person and has told me many times that I don’t. Besides, if I had half the motor or vocal tics I normally do, she’d never be able to get to sleep, herself. Trust me, she would’ve told me. But I’ve heard of other people with TS who do tic in their sleep, so don’t take this as a given.

One abatement that seems to be common to almost everyone with TS is finding something that absorbs them completely. I find I tic less when flying kites, doing photography, and writing. Any guesses what my main hobbies are? I can also throw machining in there, but it doesn’t capture me as much as it used to. I do tend to tic when machining, just less so.

At this point you may be asking: if doing these things reduces the tics, can’t that be leveraged into a cure? As with the discussion on triggers, the answer is no. I still have TS when I’m doing these things. I just tic less.

Could it be leveraged into a treatment? You betcha! Give me a note from my doctor saying it’s cool for me to spend all my time flying kites, doing photography, and writing, and I’ll give you a big ol’ hug. But at some point someone is going to point out that I also need to do the dishes, do laundry, and go to work. Can’t play all the time.

Another good one is to remove as many triggers as possible. That one can be leveraged into… not exactly a treatment, but certainly a lifestyle. If I eliminated caffeine and music, and got rid of all the a-holes in my life who give me crap about my tics, I’d have fewer tics! I can’t say much about the caffeine and music since I refuse to give those up, but I have managed to surround myself with people who really don’t give a rat’s ass if I have tics. Best treatment ever!

Martial arts and meditation worked well for me in the past. I spent a couple of years studying Tae Kwon Do when I was in college. Those were some of the most tic-free years of my life. I never became very advanced at meditation, but it was an important part of our daily routine at the dojang. Meditation combined with the gross-motor exactitude of the forms worked wonders for my awareness of what my own body was doing. Regardless of whether you have TS, OCD, or any condition at all, I cannot recommend martial arts highly enough. The only reason I’m not still studying it is that I moved away and haven’t found another school to study at.

I’m not a practitioner of yoga, but I’ve been told by those who are that it’s as effective for controlling tics as martial arts. Makes sense since the mechanism is essentially the same. There are some good yoga schools here. I might take this up in the future.

There’s one other form of abatement that bears mentioning, but before launching into chemical abatement I need to point out that I’m not advocating anything I say past this point. A good bit of this falls under the category of self-medication. I’m not a big fan of self-medication because it’s such an uncontrolled process that pays so little attention to the long-term cumulative effects of whatever you’re ingesting.

But so is going to a psychiatrist who only considers pharmacological treatments. The ones I’ve met who fall into that category really didn’t seem to give a rat’s ass what the chemicals were doing so long as the Merck Manual said they could be used to treat TS. And long-term cumulative effects? The ones who prescribe crap blindly really don’t care. Steer clear.

A far better choice than either of these is to find a doctor who’s got a clue, listens to their patients, and does their homework. They’re worth their weight in gold, and are well worth the years it may take to find one. Just saying…

I’m mostly going into chemical abatement because the chemicals that can be used this way come up in social settings, so it helps to know how your tics will react to them. I already mentioned caffeine and coffee. Not a form of self-treatment. This makes my tics worse. But coffee is damn yummy.

Other stimulants fall into this camp, too. As a kid I was prescribed a CNS stimulant by a doctor who really didn’t have a clue what he was doing. This was before anyone knew I had TS. My tics spiked, and my mother brought me back. Considering TS had been on the medical books since the late 1800’s you’d think a doctor would do a little reading and say, “Hey! I think this kid might have TS!” Noooooo… Instead he told my mother I should be institutionalized. See why I have a problem with doctors who prescribe crap without doing their homework?! My mother took me home, discontinued the medication, and never went back. I’ve avoided CNS stimulants ever since.

Alcohol is a weird one. My tics typically get worse after the first drink and get better after the second. As inconsistent as that sounds it makes sense if you think about what the alcohol is actually doing. Like many people with TS I suppress my tics in public. I can’t make them disappear, but I can try to minimize their impact. I’ll turn aside to hide a motor tic. I’ll hold a hand up to my mouth to make a vocal tic appear more like a cough. I’ll try to suppress my vocals, knowing it may lead to an increase in motor tics. I can even hold them in to some degree, knowing I’ll have an outburst later.

But after one drink that level of control goes out the window. My ability to feel a tic coming falls apart, so I’m less able to conceal it with some other gesture. It becomes harder to hold down my vocal tics, so they become more frequent. And actually suppressing them? Ha! Good luck.

By the second one, though, the alcohol is having enough of an effect on my neurotransmitters to decrease the frequency and severity of the tics. But it also means I’ll have a headache the next day, which is not what you want when one of your tics is to jerk your head off to one side over and over. Guess you can see why I’m not a heavy drinker.

From what I’ve been told pot works wonders to reduce tics and has far fewer side-effects than, say, Haldol. I expect we’ll see a lot more research along these lines once legalization of medical marijuana becomes more prevalent and more studies can be done. I don’t really have any experience with it, though. Just not my thing.

I have no clue how tics respond to other drugs, but from that one experience with CNS stimulants I’m a little reluctant to find out. Brain chemistry is already such a delicate thing. Throw something out of whack enough for someone to have incessant motor and vocal tics, and that balance becomes far more important. I’m sure there are other things out there that would reduce my tics, but they really aren’t severe enough to warrant that kind of experimentation.

Sometimes it’s ok just to tic.

Hey! Fix me a coffee!




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