Strategies
Practical, evidence-informed techniques you can start using today. Click each strategy to see detailed guidance and tips.
At Home
At School
Guidance for working with teachers and navigating the school environment.
For Young People
Your body is not misbehaving, and you are not broken. This guide is for you.
Based on clinical guidance by Dr Inyang Takon, Consultant Paediatrician.
Why Tics Get Worse After School
"I have tics. They are not deliberate. The helpful thing is to carry on normally, offer the agreed option if I need it, and not draw attention to me."
What does it feel like inside?
The Premonitory Urge
Most teenagers describe a physical warning sensation right before a tic — a build-up of pressure, muscle tightness, an itch, or a 'fizzy' feeling. Doing the tic releases that pressure, just like scratching an itch.
Suppression & Rebound
You can hold tics back for a short time, but it requires huge mental energy. When you get home to your safe zone, that built-up pressure releases in an after-school rebound. This is completely normal and does not mean you are getting worse.
Waxing & Waning
Tics naturally rise and fall. You might have a busy month then a quiet one, or 'trade' one tic for another. They get louder when tired, stressed, or excited — and quieten during things you enjoy, like music, gaming, or sports.
Busting the big myths
Myth: Tourette Syndrome always means swearing out loud.
Fact: Involuntary swearing (coprolalia) is actually rare — it affects only 10–15% of people with Tourette's. Most have ordinary motor and vocal tics like neck jerks or throat clears.
Myth: 'If you can stop for 5 minutes, you can stop all day.'
Fact: Temporarily suppressing a tic takes effort and creates tension. You can hold your breath underwater for a minute, but that doesn't mean you can stop breathing!
Myth: Tics are caused by bad parenting, bad habits, or too much screen time.
Fact: Tics are biological and highly heritable. While stress or fatigue can turn up the 'volume' on tics, they are not caused by screens or poor discipline.
What about 'TikTok Tics' (Functional Symptoms)?
Since 2020, doctors have seen a rise in teenagers developing sudden complex movements after intense stress or watching online tic videos. These are called Functional Tic-Like Behaviours (FTLBs).
- Are they real? YES, 100%. They are involuntary and distressing.
- How are they different? Classic tics start gradually in early childhood; functional symptoms appear suddenly in teens with complex movements from day one.
- How are they managed? A digital break from tic content, managing stress, and support from a clinician helps the brain reset — standard tic medications don't work for these.
Your daily playbook
Your everyday approach
Notice
Spot patterns without blaming yourself. What makes the day harder or easier?
Ask
Tell someone you trust what is getting in the way: pain, tiredness, worry, schoolwork or friendships.
Adapt
Try a small change: a reset, sleep routine, enjoyable activity, movement or music.
Review
Ask: "Is this helping me take part?" Keep what works; change what does not.
When to ask for help & what treatments work
Most tics don't need medical treatment. Speak to a GP or Paediatrician if tics cause physical pain, stop you sleeping or concentrating, are linked to anxiety or low mood, or started very suddenly overnight.
Psychoeducation & Reassurance
Understanding your body is the most powerful first step.
Specialist Behavioural Therapy (CBIT / ERP)
First-line evidence-based therapy — a specialist helps you spot your premonitory urges and build competing physical responses.
Digital Apps (ORBIT)
NICE-recommended therapist-supported online ERP programs you can complete from home.
Medication
Reserved for severe or painful tics when therapy isn't enough, under strict specialist supervision.
Your choice, your words, your plan
You choose what to share, with whom and when. You do not have to explain your tics to a group. If someone teases, copies, films, or pressures you to disclose, ask a trusted adult — you do not have to manage it alone.
My reset signal
My trusted adult
What helps / what to avoid
"Your tics do not define who you are. They don't limit your intelligence, your talents, your friendships, or the incredible future you are building. You belong here exactly as you are."
— Dr Inyang Takon, Consultant Paediatrician
