Nou Sopheamany: “I like to shrug my shoulders sometimes, but I think it’s kind of my habit and style. I don’t think it’s a tic or tourette.”
Nou Sopheamany has a habit of shrugging her shoulders on and off, unsure of what the reason is behind this constant behavior. Something she has had since she can remember, the tic luckily hasn’t affected her work as a nurse. Despite the need to shrug her shoulders three or four times an hour, she, like many Cambodians, sees it as a part of her everyday life, unlikely to ever discover the underlying cause or seek out information on a possible disorder.
What is Tourette syndrome?
According to the US’s National Institute of Neurological Disorder and Stroke (NINDS),Tourette syndrome is a neurological disorder identified by repetitive, stereotyped, involuntary movements and vocalizations which are called tics. This syndrome was coined in 1885 by Dr. Georges Gilles de la Tourette, a French neurologist, who later named the disease after himself.
Those diagnosed with Tourette syndrome (TS) will make strange sounds or movements which are uncontrollable like blinking your eyes constantly, shrugging your shoulders, repetitive throat-clearing, sniffing, grunting or blurting out unusual sounds or offensive words.
Research from the National Institutes of Health (NIH) shows that TS affects about 200,000 Americans in its most severe form, while as many as one in 100 are diagnosed with milder and less complex symptoms such as chronic motor or vocal tics.
What are the symptoms of Tourette syndrome?
According to a study from Mayo Clinic, an American non-profit academic medical center, TS is often noticed among children, aged from 2 to 15 years. Males are three or four times more likely to be affected than females. Tics, sudden body movement or sound, is divided into two groups with the same two levels:
- Motor tics: uncontrollable body movement or muscle movements
- Simple tics: shoulder shrugging,eye-blinking, nose twitching, mouth twitching or movements, etc.
- Complex tics: hopping, touching or smelling objects, repeating observed movement, bending, or twitching.
- Vocal tics: sudden sound or vocalizations
- Simple tics: grunting, throat clearing, barking,coughing.
- Complex tics: repeating their own or others words or phrases, using vulgar or curse words.
Additionally, tics can transform over time within various types in frequency and severity, especially during the transition from teenager to adult, or some even develop to have both vocal and motor tics. Unfortunately, tics will get worse with emotional changes like stress, illness, tiredness, excitement, and anxiety, and won’t go away even while sleeping.
Can Tourette’s Patients control their tics?
The National Health Service (NHS), the nationalised healthcare system in the UK, states that some people may be able to control their tics through concentration and practise, but just for a short period of time. Surprisingly, tics might be less noticeable during active situations like playing sports, reading books, singing, dancing, and other activities with high levels of concentration and activity. While it can be exhausting trying to control the tic, at the end of the day it will still be there, however.
What are the causes of TS?
Cause: A study from Mayo Clinic shows the cause of TS and other tic disorders still remain unidentified. While many experts and researcher are working to find the main root cause of it, they have only found the factors that increase the risk of having TS or another disorder:
- Family history: the risk of developing TS is high when there is a family history of tic disorders or TS.
- Sex: Males are three or four times more prone to have TS than females.
On the bright side,TS patients can also lead active lifestyles. However, Tourette syndrome will trigger behavioral and social challenges to your self-image and mental health. TS might lead to other challenges like sleeping disorders, depression, anxiety, learning disability, headaches, obsessive-compulsive disorder (OCD), or attention deficit hyperactivity disorder (ADHD).
How is it treated?
Sadly, there is no cure for TS yet. Patients can seek behavioral therapy and medication in order to cope with tics in their daily activities, as well as to reduce psychological and emotional problems.
Some children might develop tics, but only for a short period of time. While not all tics can be considered as TS, whenever a child shows unusual behavior, it’s important to identify the cause and refer to an expert or doctor.
What do Cambodian people think about Tourette syndrome?
After asking people about TS, only two out of ten Cambodians knew what it was. After Focus explained the symptoms of the disorder, more understood the syndrome, but they tended to describe it as a bad habit rather than acknowledge it as a disease.
Working as a nurse, Sopheamany admitted that she used to hear and see people with similar conditions like tics or TS in her everyday life, but is uncertain how to define what it is.
“I have seen people like twitching their eyes all the time or making some weird noise. I don’t know what it is, it’s not my area of study,but I think the resources for this information and service are scarce,” she said.
Dr. Todd Jungkuntz, a licensed clinical psychologist from Optimistic Counselling based in Cambodia, said the data on TS is absent in Cambodia compared to other diseases.
“The prevalence of Tourette’s is very low in the general population, around 1% or less, so I’m not sure how relevant the topic is for Cambodians, compared to things like autism, ADHD, PTSD, depression and anxiety disorders,” Todd explained.
With a great deal of experience treating anxiety and depression, stress, panic and adjustment disorders in his clinical practice for the past 20 years, Todd has not come across any clients with TS yet, including in Cambodia, although his clinic does offer services for tic disorders and TS.
However, from his observations, there are signs that tics and TS might exist in Cambodia.
“It is a tic disorder which often, but not always, includes verbal profanities and impulsive comments. But what is more common are the physical tics and movements (waving hands, motioning, gestures, etc.),” he said.
