tourette

If you have Tourette syndrome, you make unusual movements or sounds, called tics. You have little or no control over them. Common tics are throat-clearing and blinking. You may repeat words, spin, or, rarely, blurt out swear words.

Tourette syndrome is a disorder of the nervous system. It often occurs with other problems, such as:

• Attention deficit hyperactivity disorder (ADHD)
• Obsessive-compulsive disorder (OCD)
• Anxiety
• Depression

The cause of Tourette syndrome is unknown. It is more common in boys than girls. The tics usually start in childhood and may be worst in the early teens. Many people eventually outgrow them.

No treatment is needed unless the tics interfere with everyday life. Excitement or worry can make tics worse. Calm, focused activities may make them better. Medicines and talk therapy may also help.

NIH: National Institute of Neurological Disorders and Stroke

Movement disorders are neurologic conditions that cause problems with movement, such as:

• Increased movement that can be voluntary (intentional) or involuntary (unintended)
• Decreased or slow voluntary movement

There are many different movement disorders. Some of the more common types include:

• Ataxia, the loss of muscle coordination
• Dystonia, in which involuntary contractions of your muscles cause twisting and repetitive movements. The movements can be painful.
• Huntington's disease, an inherited disease that causes nerve cells in certain parts of the brain to waste away. This includes the nerve cells that help to control voluntary movement.
• Parkinson's disease, which is disorder that slowly gets worse over time. It causes tremors, slowness of movement, and trouble walking.
• Tourette syndrome, a condition which causes people to make sudden twitches, movements, or sounds (tics)
• Tremor and essential tremor, which cause involuntary trembling or shaking movements. The movements may be in one or more parts of your body.

Causes of movement disorders include:

• Genetics
• Infections
• Medicines
• Damage to the brain, spinal cord, or peripheral nerves
• Metabolic disorders
• Stroke and vascular diseases
• Toxins

Treatment varies by disorder. Medicines can cure some disorders. Others get better when an underlying disease is treated. Often, however, there is no cure. In that case, the goal of treatment is to improve symptoms and relieve pain.

Bullying is when a person or group repeatedly harms someone on purpose. It can be physical, social, and/or verbal. It is harmful to both the victims and the bullies, and it always involves:

• Aggressive behavior.
• A difference in power, meaning that the victim is weaker or is seen as weaker. For example, bullies may try to use physical strength, embarrassing information, or popularity to harm others.
• Repetition, meaning it happens more than once or that it probably will happen again

There are three types of bullying:

• Physical bullying involves hurting a person's body or belongings. Examples include hitting, kicking, and stealing or breaking someone's stuff.
• Social bullying (also called relational bullying) hurts someone's reputation or relationships. Some examples are spreading rumors, embarrassing someone in public, and making someone feel left out.
• Verbal bullying is saying or writing mean things, including name-calling, taunting, and threatening

Cyberbullying is bullying that happens through text messages or online. It could be through emails, social media, forums, or gaming. Some examples are:

• Posting rumors on social media
• Sharing embarrassing pictures or videos online
• Sharing someone else's private information online (doxing)
• Making threats against someone online
• Creating fake accounts and posting information to embarrass someone

Certain types of cyberbullying can be illegal. The laws on cyberbullying are different from state to state.

Cyberbullying is a type of bullying, but there are some differences between the two. Cyberbullying can be:

• Anonymous - people can hide their identities when they are online or using a cell phone
• Persistent - people can send messages instantly, at any time of the day or night
• Permanent - a lot of electronic communication is permanent and public, unless it's reported and removed. A bad online reputation can affect getting into college, getting a job, and other areas of life. This applies to the bully as well.
• Hard to notice - teachers and parents may not overhear or see cyberbullying taking place

Children are more likely to be bullied if they:

• Are seen as different from their peers, such as being overweight or underweight, dressing differently, or being of a different race/ethnicity
• Are seen as weak
• Have depression, anxiety, or low self-esteem
• Don't have many friends or are less popular
• Don't socialize well with others
• Have an intellectual or developmental disability

There are two types of children who are more likely to bully others:

• Children who are well-connected to peers, have social power, are overly worried about popularity, and like to be in charge of others
• Children who are more isolated from peers, may be depressed or anxious, have low self-esteem, are easily pressured by peers, and have trouble understanding other people's feelings

There are certain factors that make someone more likely to be a bully. They include:

• Being aggressive or easily frustrated
• Having trouble at home, such as violence or bullying in the home or having uninvolved parents
• Having trouble following rules
• Seeing violence positively
• Having friends who bully others

Bullying is a serious problem that causes harm. And it doesn't just hurt the person who is being bullied; it can also be harmful for the bullies and for any kids who witness the bullying.

Kids who are bullied can have problems at school and with their mental and physical health. They are at risk for:

• Depression, anxiety, and low self-esteem. These problems sometimes last into adulthood.
• Health complaints, including headaches and stomachaches
• Lower grades and test scores
• Missing and dropping out of school

Kids who bully others have a higher risk for substance use, problems in school, and violence later in life.

Kids who witness bullying are more likely to abuse drugs or alcohol and have mental health problems. They may also miss or skip school.

Often, kids who are being bullied don't report it. They may fear a backlash from the bully, or they may think that no one cares. Sometimes they feel too ashamed to talk about it. So it is important to know the signs of a bullying problem:

• Depression, loneliness, or anxiety
• Low self-esteem
• Headaches, stomachaches, or poor eating habits
• Disliking school, not wanting to go to school, or getting worse grades than before
• Self-destructive behaviors, such as running away from home, harming themselves, or talking about suicide
• Unexplained injuries
• Lost or destroyed clothing, books, electronics, or jewelry
• Trouble sleeping or frequent nightmares
• Sudden loss of friends or avoidance of social situations

To help a child who is being bullied, support the child and address the bullying behavior:

• Listen and focus on the child. Learn what's been going on and show you want to help.
• Assure the child that bullying is not his/her fault
• Know that kids who are bullied may struggle with talking about it. Consider referring them to a school counselor, psychologist, or other mental health service.
• Give advice about what to do. This may involve role-playing and thinking through how the child might react if the bullying occurs again.
• Work together to resolve the situation and protect the bullied child. The child, parents, and school or organization should be part of the solution.
• Follow up. Bullying may not end overnight. Make sure that the child knows that you are committed to making it stop.
• Make sure that the bully knows that his or her behavior is wrong and harms others
• Show kids that bullying is taken seriously. Make it clear to everyone that the bullying will not be tolerated.

Department of Health and Human Services

Obsessive-compulsive disorder (OCD) is a mental disorder in which you have thoughts (obsessions) and rituals (compulsions) over and over. They interfere with your life, but you cannot control or stop them.

The cause of obsessive-compulsive disorder (OCD) is unknown. Factors such as genetics, brain biology and chemistry, and your environment may play a role.

Obsessive-compulsive disorder (OCD) usually begins when you are a teen or young adult. Boys often develop OCD at a younger age than girls.

Risk factors for OCD include:

• Family history. People with a first-degree relative (such as a parent, sibling, or child) who has OCD are at higher risk. This is especially true if the relative developed OCD as a child or teen.
• Brain structure and functioning. Imaging studies have shown that people with OCD have differences in certain parts of the brain. Researchers need to do more studies to understand the connection between the brain differences and OCD.
• Childhood trauma, such as child abuse. Some studies have found a link between trauma in childhood and OCD. More research is needed to understand this relationship better.

In some cases, children may develop OCD or OCD symptoms following a streptococcal infection. This is called Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS).

People with OCD may have symptoms of obsessions, compulsions, or both:

• Obsessions are repeated thoughts, urges, or mental images that cause anxiety. They may involve things such as
  • Fear of germs or contamination
  • Fear of losing or misplacing something
  • Worries about harm coming towards yourself or others
  • Unwanted forbidden thoughts involving sex or religion
  • Aggressive thoughts towards yourself or others
  • Needing things lined up exactly or arranged in a particular, precise way
• Compulsions are behaviors that you feel like you need to do over and over to try to reduce your anxiety or stop the obsessive thoughts. Some common compulsions include
  • Excessive cleaning and/or handwashing
  • Repeatedly checking on things, such as whether the door is locked or the oven is off
  • Compulsive counting
  • Ordering and arranging things in a particular, precise way

Some people with OCD also have Tourette syndrome or another tic disorder. Tics are sudden twitches, movements, or sounds that people do over and over. People who have tics cannot stop their body from doing these things.

The first step is to talk with your health care provider about your symptoms. It's important to check whether a physical problem is causing your symptoms. So your provider will do a physical exam and will ask you about your medical history. If your symptoms do not seem to be caused by a physical problem, your provider may do an OCD test or may refer you to a mental health specialist for further evaluation or treatment.

Obsessive-compulsive disorder (OCD) can sometimes be hard to diagnose. Its symptoms are like those of other mental disorders, such as anxiety disorders. It is also possible to have both OCD and another mental disorder.

Not everyone who has obsessions or compulsions has OCD. Your symptoms would usually be considered OCD when you:

• Can't control your thoughts or behaviors, even when you know that they are excessive
• Spend at least 1 hour a day on these thoughts or behaviors
• Don't get pleasure when performing the behaviors. But doing them may briefly give you relief from the anxiety.
• Have significant problems in your daily life because of these thoughts or behaviors

The main treatments for obsessive-compulsive disorder (OCD) are cognitive behavioral therapy, medicines, or both:

• Cognitive behavioral therapy (CBT) is a type of psychotherapy. It teaches you different ways of thinking, behaving, and reacting to your obsessions and compulsions.
  • Exposure and Response Prevention (ERP) s a specific type of CBT. ERP involves gradually exposing you to your fears or obsessions. You learn healthy ways to deal with the anxiety they cause.
• Medicines for OCD include certain types of antidepressants. If those don't work for you, your provider may suggest taking some other type of psychiatric medicine.

If you have severe OCD that does not get better with these treatments, your provider may suggest a treatment called repetitive transcranial magnetic stimulation (rTMS). It is a brain stimulation procedure that uses magnetic waves. It can target specific brain areas associated with OCD.

NIH: National Institute of Mental Health

Stuttering is a speech disorder. It involves interruptions in the flow of speech. These interruptions are called disfluencies. They may involve:

• Repeating sounds, syllables, or words
• Stretching out a sound
• Suddenly stopping in the middle of a syllable or word

Sometimes, along with the stuttering, there may be nodding, rapid blinking, or trembling lips. The stuttering may be worse when you are stressed, excited, or tired.

Stuttering can be frustrating, because you know exactly what you want to say, but you have trouble saying it. It can make it difficult to communicate with people. This can cause problems with school, work, and relationships.

There are two main types of stuttering, and they have different causes:

• Developmental stuttering is the more common type. It starts in young children while they are still learning speech and language skills. Many children stutter when they first start talking. Most of them will outgrow it. But some continue to stutter, and the exact cause is unknown. There are differences in the brains of people who continue to stutter. Genetics may also play a role, since this type of stuttering can run in families.
• Neurogenic stuttering can happen after someone has a stroke, head trauma, or other type of brain injury. Because of the injury, the brain has trouble coordinating the different parts of the brain involved in speech.

Stuttering can affect anyone, but it is much more common in boys than girls. Younger children are most likely to stutter. About 75% of children who stutter will get better. For the rest, stuttering can continue their whole lives.

Stuttering is usually diagnosed by a speech-language pathologist. This is a health professional who is trained to test and treat people with voice, speech, and language disorders. If you or your child stutters, your regular health care provider may give you a referral to a speech-language pathologist. Or in some cases, a child's teacher may make a referral.

To make a diagnosis, the speech-language pathologist will:

• Look at the case history, such as when the stuttering was first noticed, how often it happens, and in what situations it happens
• Listen to you or your child speak and analyze the stuttering
• Evaluate you or your child's speech and language abilities, including the ability to understand and use language
• Ask about the impact of stuttering on you or your child's life
• Ask whether stuttering runs in the family
• For a child, consider how likely it is that he or she will outgrow it

There are different treatments that can help with stuttering. Some of these may help one person but not another. You need to work with the speech-language pathologist to figure out the best plan for you or your child.

The plan should take into account how long the stuttering has been going on and whether there are any other speech or language problems. For a child, the plan should also take into account your child's age and whether he or she is likely to outgrow the stuttering.

Younger children may not need therapy right away. Their parents and teachers can learn strategies to help the child practice speaking. That can help some children. As a parent, it's important to be calm and relaxed when your child is speaking. If your child feels pressured, it can make it harder for them to talk. The speech-language pathologist will probably want to evaluate your child regularly, to see whether treatment is needed.

Speech therapy can help children and adults minimize stuttering. Some techniques include:

• Speaking more slowly
• Controlling breathing
• Gradually working up from single-syllable responses to longer words and more complex sentences

For adults, self-help groups can help you find resources and support as you face the challenges of stuttering.

There are electronic devices to help with fluency, but more research is needed to see whether they really help over the long term. Some people have tried medicines that usually treat other health problems such as epilepsy, anxiety, or depression. But these medicines are not approved for stuttering, and they often have side effects.

NIH: National Institute on Deafness and Other Communication Disorders

The brain, spinal cord, and nerves make up the nervous system. Together they control all the workings of the body. When something goes wrong with a part of your nervous system, you can have trouble moving, speaking, swallowing, breathing, or learning. You can also have problems with your memory, senses, or mood.

There are more than 600 neurologic diseases. Major types include:

• Diseases caused by faulty genes, such as Huntington's disease and muscular dystrophy
• Problems with the way the nervous system develops, such as spina bifida
• Degenerative diseases, where nerve cells are damaged or die, such as Parkinson's disease and Alzheimer's disease
• Diseases of the blood vessels that supply the brain, such as stroke
• Injuries to the spinal cord and brain
• Seizure disorders, such as epilepsy
• Cancer, such as brain tumors
• infections, such as meningitis