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the FAQs about
Tourette Syndrome

1.3 - Cause and Treatment

I have repeatedly stated that TS is a neurological condition. This raises the question of treatment. Since I would prefer to let the specialists speak, I will only make a few remarks here:

It is not all that obvious that TS needs to be treated; in fact, it is not self-evident that it is a "disease" at all. Most of the tics are irksome and considered "symptoms" mostly because they are culturally considered strange. In the majority of cases tics do not interfere with everyday life. If one thinks about it logically, what is "wrong" or "abnormal" about unprovokedly clicking your tongue?

Secondly, one can briefly say that TS is caused by a special kind of overactivity in the brain. Current theories point to an overabundance or overactivity of dopamine, a chemical used to transmit neurological messages in the brain. Tics can be viewed as a normal way for the brain to "let off steam" under these circumstances.

In ADD, there seems to be a shortage of dopamine in other, "higher" parts of the brain. These parts of the brain seem to be involved in suppressing unimportant impulses in favour of those which need attention.

There are drugs such as Haloperidol which counteract dopamine activity and these can cause a marked decrease of tics, compulsions and the like.

Thinking of Tourette Syndrome as a disease has many subtle implications I wish to deny. For example, skin cancer is a disease, therefore, every time a doctor sees a melanome he feels convinced that it should be cut out. By the same reasoning, if tics are taken to be "symptoms" of a disease, you would feel that you should give medication to reduce them, and that less tics means the patient is beter off.

By extension, it could even be implied that a Touretter who prefers not to have his tics "treated," or worse, who enjoys some of them, is denying his "illness" as a "defence mechanism."

I personally believe every Touretter should decide to which extent the tics interfere with his or her life and base any decision to seek medical help on that. We are, however, not on altruistic crusades to suffer for the sake of Tourette Tolerance, so by all means go for medication if you want to.

Nobody but a Touretter can really say, about himself, what is "disease," what is Tourette Syndrome, and what is just plain personality.


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