Doctors have reported a rise in cases of tic-like behavior—tics, noises, and twitches—in teenage girls during the pandemic. These symptoms are common with Tourette’s syndrome, which is typically more prevalent in boys than girls.  Medical experts from the US, Australia, Canada, and the UK investigated the phenomenon and found one common factor between the patients—the teenage girls had an interest in watching TikTok videos from influencers who said they have Tourette’s syndrome. 

A Closer Look at the Studies

One study, published in the journal Movement Disorders, revealed that referrals to Tourette’s syndrome centers for tic-like behaviors soared during the pandemic, particularly among girls and young women aged 12 to 25. Since March 2020, referrals in the US, Canada, the UK, Germany, and Australia rose from 1 to 2% to 20 to 35%. The researchers wrote that they’ve seen a “similarity between the tics or tic-like behaviors shown on social media and the tic-like behaviors of this group of patients.” Doctors at Rush University Medical Center in Chicago, Illinois, looked at TikTok videos with the hashtags “tic,” “Tourette” and “tourettes.” In their study, published in Movement Disorders Clinical Practice, they wrote that people are copying the behaviors they see in the videos in what they describe as “an example of mass sociogenic illness.” They also called it “a pandemic within a pandemic.” Caroline E. Olvera, MD, a neurologist at Rush University, says their investigation began when a large number of girls in their late teens came to their movement disorders clinic with an abrupt onset of tics and abnormal movements, beginning in early 2021.  “Tourette’s syndrome typical starts when children are 6-7 years old, is more common in men and only happens suddenly in less than 5% of cases,” Dr. Olvera explains. But this was very different than what the doctors were seeing.  Some patients and children of other physicians in the practice began to mention tics were popular on TikTok, so Dr. Olvera joined TikTok and confirmed this was the case, with the hashtags #tics and #tourettes garnering billions of views.

The Rise of ‘TikTok Tics’

Since research focusing on what health information is available on social media is still limited, Dr. Olvera felt it was important to take an in-depth look at what her patients may be exposed to online.  “Social media may influence their behavior, but also it is important to see how certain neurological illnesses are portrayed,” she says. “These TikTok tics may be all the information people are seeing about Tourette’s syndrome, when these tics are incredibly different than what we have historically seen.” The Rush researchers found that many of the most popular influencers known for their tic videos had the same tics. “These tics looked like what we were seeing in our own patients and the majority of them were late teen girls,” says Dr. Olvera.  While a typical Tourette’s syndrome tic is blinking or small facial movements or sounds, the TikTok tics Dr. Olvera observed are different. “They are severe, causing injury and the inability to even do a simple task like baking,” Dr. Olvera explains. “Uncontrolled swearing is a very common tic on TikTok but is usually only seen in less than 15% of Tourette’s patients.” Dr. Olvera and her colleagues believe that the majority of the TikTok tics are caused by something called a functional neurological disorder (FND), although she acknowledges that some of the TikTok influencers may just have an atypical form of Tourette’s syndrome. “It is likely that these tics are a combination of many different etiologies, and it is complex and nuanced, which has to an extent been lost in the recent media stories about these influencers,” she says. 

Functional Neurological Disorder

FND is a neurological condition where there is a “misfire” between the brain and the body, often producing weakness, numbness or movements that are not normal. The tests that are run by doctors in those with these illnesses don’t show an identifiable reason for these abnormalities in the brain or nervous system. “FND is especially sensitive to and triggered by stressors as well as anxiety, depression, and other mood problems,” Dr. Olvera says. “The COVID-19 pandemic has been a global and unprecedented stressor and may have helped to trigger this disorder in many of these teens.”  Linda Charmaraman, PhD, a senior research scientist who studies the link between social media use and teens’ wellbeing at the Wellesley Centers for Women, thinks there may be another explanation for the phenomenon. “There may be a particular vulnerability in youth who are drawn to videos that depict Tourette’s syndrome,” she says. “Perhaps they are searching for an online community who will understand what they go through.” As Dr. Charmaraman points out, there’s a chance these phenomena may be coincidental, and more studies need to be carried out in order to understand the associations. Additionally, try to resist overreacting, and focus on helping your kids maintain a normal routine. Speak to your child’s pediatrician if you have any concerns about their health.