Using Behavioral Therapy
Identify the preemptive urge. Many people with tics have an "urge" before the tic onset, sort of like an itch that you need to scratch. In some way, the tic onset relieves that urge. If you can identify what happens right before you tic, you can take steps to suppress the tic. For instance, maybe you feel a certain tension in the area before the tic, and the tic relieves that tension. For example, tension in the throat may lead to a throat-clearing tic.
Pick a behavior to suppress the tic. Once you figure out when a tic is coming on, choose a behavior that will keep the tic from happening. For instance, if the tic is an arm fling, hold your arm tightly against your body. If the tic is clearing your throat, take slow, deep breaths. You'll need to become cognizant of the onset of tics, which is why identifying the preemptive urge is important. Then, you can practice the new behavior over and over, particularly when a tic is coming on to change the pattern.
Work with a behavioral therapist. While you may be able to work on behavioral tactics on your own, getting help from a behavioral therapist will likely be helpful. They can show you tricks that you may not think of on your own. They can also help you make lifestyle changes that can reduce the frequency or intensity of your tics.
Be patient. The behavior should stop the tic in the moment, but it also has long-term benefits. Behavioral therapists believe that over time, suppressing a tic can lessen its hold over you. In other words, suppressing the tic every time it happens may mean it appears less often.
Avoiding Triggers
Get enough sleep. If you're overly tired, your tics are likely to become worse. To get better sleep, set an alarm an hour before you need to go to sleep to remind you to start getting ready for bed. Turn off all electronics so you can start winding down, and make sure to minimize distractions, including light and extraneous sounds. Adults need 7-9 hours of sleep. 14 to 17 year-olds need 8-10 hours of sleep at night. 6 to 13 year-olds need 9-11 hours of sleep at night. 3 to 5 year-olds need 10-13 hours of sleep at night. 2-year-olds need 11-12 hours of sleep at night and 1-2 hours of naps. 1-year-olds need 10 hours of sleep at night and 4 hours of naps. Newborns need 14-17 hours of sleep.
Cut back on stress with exercise and support. Stress can make your tics worse, so cutting back on stress can help slow your tics. Try to get in at least 150 minutes of regular exercise a week to help reduce stress, such as swimming, jogging, or riding a bike. Make time for yourself when you're feeling stressed, and build a group of supportive friends who will listen to you and make you laugh when you're feeling down. It's also important to take control of issues in your life as they arise. If you tend to just worry about them instead of doing something, you raise your stress and anxiety level. However, by taking action, you'll reduce your stress level. Listen to calming music, color, or read a book when you feel stressed. You can also try things like yoga and meditation to reduce your stress levels.
Avoid smoking and drinking. Smoking and drinking can make it harder to control your tics. If you engage in these behaviors, do you best to quit. You can seek help from a therapist or addiction counselor, if necessary
Warn others about your tics. Of course, you don't need to walk up to strangers on the street and tell them you have a tic. However, it can be helpful to tell your close friends and family. Let them know about your condition so they can adjust their own reactions to your tics. Mention that high-stress situations can often make tics worse. Remember that your tics are nothing to be ashamed of! You have a medical condition, just like asthma, epilepsy, or diabetes.
Trying Medical Interventions
Ask about antipsychotics. The primary medications prescribed for tics are antipsychotics, including haloperidol, pimozide, and aripiprazole. In fact, these drugs are the only ones approved by the Federal Drug Administration (FDA) for the treatment of tics. Talk to your doctor to determine if these drugs are right for you. Discuss using these medications as short-term options while working on behavioral changes. These drugs may make you constipated, give you dry mouth, cause vision blurriness, and make you gain weight.
Talk about other medications. Even though only antipsychotics are approved to treat tics, many doctors turn to other medications to help with tics. Ask your doctor if one of these medications would be right for you. Once your tics are under control, speak to your doctor about reducing the dosage then fully stopping the medication. Two options are clonidine or guanfacine. These drugs are typically prescribed for high blood pressure, but they can help with both tics and ADHD. Another option is clonazepam, which is also used to treat anxiety. Tetrabenazine may help if you have a disease like Huntington's, though it can cause depression. Some people respond to topiramate, an epilepsy medication.
Discuss botulinum injections. With these injections, the doctor will inject botulinum (Botox) into the muscle. Sometimes, the botulinum will help relax the muscle, reducing the tic. However, this only targets small, specific areas, so it should be used a s a last resort.
Consider deep brain stimulation surgery. In very few cases, deep brain stimulation surgery may be an option. With this surgery, small electrodes are placed in your brain. The electrodes are then connected to a pulse generator in your chest. The generator sends out small electrical currents to help regulate your tics.
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