- Hi everyone! My name is Dr. Shirag Shemmassian,
admissions expert and founder
of Shemmassian Academic Consulting.
Usually on this channel, I answer commonly asked questions
and share strategies to help you
get into your dream program.
But today, I want to talk about something
that's personally meaningful to me:
life with Tourette syndrome.
If you've been watching the channel,
you may have noticed my repetitive facial movements
or tics and some of you have even correctly identified
Tourette syndrome as the cause of these tics.
In this video, I'm going to share my story
about living with Tourette syndrome
and answer some questions I frequently receive
about my experience with Tourette's.
So, what is Tourette syndrome?
Tourette syndrome is a neurological disorder
characterized by repetitive, stereotyped,
and involuntary movements and vocalizations called tics.
Some examples of motor tics include
making facial grimaces,
blinking a certain way, shrugging your shoulders,
twisting your wrists, and moving your neck.
Examples of vocal tics include making a sound
or repeating a word or phrase.
Yup! Yup!
Like I mentioned earlier, for something
to be classified as a tic, it has to be repetitive,
meaning it happens over and over again;
it has to be stereotyped, meaning it happens
in the same way each time; and it has to be involuntary,
meaning that it's uncontrollable.
Now, people with Tourette syndrome can suppress their tics,
but only for a short period, like a few seconds.
While a lot of people tic, a Tourette syndrome diagnosis
is made only when a person has exhibited two distinct
motor tics and one vocal tic at some point,
though not necessarily at the same time.
Moreover, the tics have to be present for at least one year
and before age 18.
A key point here is that while
everyone with Tourette syndrome
has tics, not everyone with tics has Tourette syndrome,
because they've failed to meet
the remaining diagnostic criteria.
When was I diagnosed with Tourette syndrome?
I was diagnosed with Tourette syndrome
around ages eight to nine, which is quite common.
However, I started exhibiting tics around age seven.
My parents even recall me clearing my throat
more than other kids as an infant,
so there might have been earlier signs.
Unfortunately, I had to see a number
of physicians before my condition was correctly diagnosed.
My pediatrician thought it was a much more serious condition
and referred me to an adult neurologist
who called it a bad habit.
Finally a pediatric neurologist identified
it as Tourette syndrome within a minute
or two of speaking with and observing me.
Not knowing why I was ticking was very scary
for my parents and me.
Despite a bunch of people telling me
it was just a bad habit, I couldn't stop.
We wondered if my tics would get worse--
they did for a while--and whether my health was at risk.
Receiving the correct diagnosis and learning
that my health was not compromised in any way
was a huge relief for all of us.
Is Tourette syndrome a mental illness?
Tourette syndrome is not exactly
a mental or psychiatric illness.
It's more correctly classified as a movement disorder
or a neurological disorder.
A big part of the misconception
about Tourette syndrome being a mental illness
comes from the following two points.
Number one, Tourette syndrome
is often diagnosed by a psychiatrist.
However, it can also be diagnosed by a psychologist,
neurologist, or a pediatrician.
Second, Tourette syndrome is largely misunderstood
by the public.
It's also taken a long time for the disorder
to be understood by the medical
and mental health communities,
even if there's still a lot to uncover.
Historically, when a condition has largely
been a mystery, it's been misclassified
as a mental illness.
What causes Tourette syndrome?
The exact cause of Tourette syndrome is unknown.
However, scientists have found genetic (or inherited)
and environmental links. More specifically,
there are genetic combinations that lead
to the abnormal development of certain brain areas
like the basal ganglia and frontal cortex,
which also have atypical connections to one another.
In addition, disturbances in certain neurotransmitter
systems like dopamine and serotonin lead
to communication problems between nerve cells
otherwise known as neurons.
Collectively, these abnormalities lead
to an uncomfortable feeling in a body part,
known as a premonitory urge, that the person
with Tourette syndrome gets rid of by ticking.
Because the person feels better,
the ticking is negatively reinforced, making
it more likely to happen over and over again.
Abnormalities in some of the brain areas
and neurotransmitter systems that have been linked
to Tourette syndrome are also seen
in other mental health conditions,
which is why Tourette syndrome is frequently comorbid
with other disorders like ADHD and OCD.
Why don't I curse?
A common misconception about people with Tourette syndrome
is that they all curse.
But in fact, involuntary swearing, or coprolalia,
only occurs in about 10% of people diagnosed
with Tourette syndrome.
Personally, I have never experienced coprolalia.
And while I no longer experience vocal tics,
I had brief periods during my youth
when I gently cleared my throat [clears throat],
or made a slightly high-pitched sound like [sound].
But that hasn't stopped tons of people
from asking me how I could have Tourette syndrome
if I don't curse.
A few years ago a supermarket cashier
asked me if I was okay after observing my facial tics.
When I told him that I was fine
and that my tics are due to Tourette syndrome,
he jokingly put his arms up and said,
"Whoa! Don't cuss me out now!"
My wife who was standing next
to me wasn't too happy about it,
but I let it roll off my back.
I've pretty much heard it all before.
So what is it like living with Tourette syndrome?
During elementary and middle school,
I used to tic much more intensely,
which led to a lot more stares and teasing
than I receive today.
In addition, a number of teachers called
me out in front of class for "faking my condition"
and even told me I would amount to little
which was incredibly embarrassing and hurtful.
An interesting fact about Tourette syndrome,
and this is certainly the case for me,
is that tics can often be suppressed
for longer periods when the person
is involved in a highly engaging focused activity
like playing basketball or playing video games.
My tics have become much less uncomfortable over time
and they bother me little today.
I know when I'm about to tic and usually
let it happen anyway.
I've also had Tourette syndrome for so long
that I don't really remember life before it.
Frankly, the biggest issue for me has not been
the tics themselves, but rather
the negative social feedback.
People often ask if I'm okay or think
I'm somehow less capable.
This used to bring me down, but I now see
it as a blessing since I get to educate
folks about Tourette syndrome.
I'm in a fortunate position where my tics
have always been mild to moderate
and never crossed over into the severe end of the spectrum.
There are some individuals with Tourette syndrome
with much more impairing symptoms, whose lives,
I imagine, have been impacted much more negatively
by the condition.
Is there a cure for Tourette syndrome?
There is no cure for Tourette syndrome,
but there are many treatment options available,
including medication and psychotherapy.
A specific type of therapy,
known as habit reversal training,
or HRT, is especially effective for reducing tics.
When I was younger, I tried taking
a few different medications.
Some were more helpful than others in reducing tics,
but the negative side effects of the most helpful ones,
like serious weight gain, weren't worth it to me.
Of course, everyone with Tourette syndrome
has to decide whether medication is right for them
based on their symptom severity,
level of impairment, and so on.
But therapies like HRT don't really
come with negative side effects
and are worth a shot.
How can you support someone who has Tourette syndrome?
While I can only speak for myself, I have observed
that many people with Tourette syndrome
are willing to discuss how their condition impacts
them and to otherwise educate others.
Moreover, people with Tourette syndrome
really just want to be treated like everyone else
instead of a weirdo or outcast.
My advice is to be curious and ask people
with Tourette syndrome what their experience is like.
But otherwise, interact with members
of the Tourette syndrome community
as you would with anyone else.
We have the same hopes, fears, and dreams.
I hope you found this video valuable.
If you have any questions about Tourette syndrome
or my experience with it, please leave them
in the comments below and I'll respond soon.
And of course, if you have any questions
about admissions,
you can leave those in the comments as well.
I'd be glad to answer them. Take care!