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TICS IN AN ADULT
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TICS IN AN ADULT

I am 51 years old.  I have had tics on and off since I was about 13.  I also have Bipolar Disorder.  I am very FRUSTRATED because I can control my very Bothersome tics at work but I cannot control them at home.  Do you have any suggestions that might help me?

Thank you.
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Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

It sounds like you have been suffering from tics since you were around 13. While I can not recommend a particular treatment for you, I will try to provide  you with some information.

Tics are of several types. They are movements of vocalizations that are associated with an urge that is only briefly suppressable.  They can be simple motor tics, such as blinking of the eyes or shrugging of the shoulders, or they can be complex motor tics, resembling a purposeful movement. Tics can also be vocal, such as grunting or verbalizing. Tics can occur in isolation or they may occur as part of Tourette's syndrome. In order for Tourette's to be diagnosed, there must be both motor and vocal tics that occur for over 1 year and start before the age of 18, and are not attributable to other causes.

The treatment of tics, whether in isolation, or as part of Tourette's, involves one of several medications. These include medications that block dopamine, the chemical in the brain thought to contribute to the occurrence of tics. The important thing to remember is that unless tics are socially disabling, causing discomfort for the person who has them or impairing function, they do not necessarily have to be treated. Any medication has side effects, and treatment should therefore be weighed against no treatment at all. In very severe cases of Tourette's in young people, there is a surgery called deep brain stimulation which can be tried, but this is still new and under research.

TIcs increase in times of stress and can also be seasonal, worsening during particular times of the year. Avoiding stress and treating underlying psychiatric problems such as anxiety, or in your case bipolar disorder, may help the tics.

Sometimes, certain movements a person has may resemble tics but in fact the movements may be something else, such as a complex habit or what is called a stereotypy. I suggest you see a neurologist, and you may benefit from evaluation by a movement disorder specialist. He/she can evaluate you and confirm the diagnosis of tics and whether or not you have Tourette's. Together, you can decide whether or not treatment of your tics is indicated.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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