Is social media responsible for recent outbreaks of teenagers developing tics? The Doctors investigate.
Senior investigative producer Leslie Marcus shares mental health professionals around the globe have documented outbreaks of Tourette’s-like behavior after watching tic content on TikTok and some specialists say the mysterious eruption of tics might be a mass psychogenic illness. This occurs when people in a group begin to feel sick at the same time, without any physical or environmental reason. She shares tic videos on the platform have billions of views and many users say when they watch videos about tics, it triggers unexplained movements and sounds in them.
A rise in teen girls developing “tic-like” behaviours could be linked to TikTok, along with an increase in anxiety and depression, resulting in symptoms similar to Tourette’s syndrome, doctors say.
In a study entitled “Rapid Onset Functional Tic-Like Behaviour in Young Females During the COVID-19 Pandemic,” published in the August issue of the journal Movement Disorders, researchers said when they began interviewing patients, many reported that the behaviours began after watching videos on platforms like TikTok and Youtube “showing persons allegedly having Tourette’s syndrome.”
“However, many of these videos show movement and vocalizations not typically present in Tourette’s syndrome, including predominantly complex, variable and often continuous movements and elaborated and variable swearing and offensive phrases,” the study’s authors wrote.
Neurologist Dr. Jen McVige, who has dealt with similar past unexplained tics among groups, says a mass psychogenic illness is usually contained in a small area like a school or workplace, but because social media is everywhere, she worries about how far it may spread.
“How do you control the situation when it is so widespread?” she asks, explaining she has treated patients who seemingly develop tics overnight in a way that differs from Tourette’s and tic disorder. She says for some people when they see a tic video, the content can compel them to mimic the movement or make similar sounds. She explains after more than a year of being disconnected, this may be a way for some teens to establish connections with others online.
Psychiatrist Dr. Ish Major also says the rise in tics could be linked to a teen’s tendency for modeling behavior and attention-seeking behavior.
Researchers from pediatric hospitals around the world found that referrals for tic-like behaviours “experienced a dramatic increase” during the pandemic, “almost exclusively” in girls aged 12 to 25, according to the study.
Since March 2020, referrals in the Canada, the U.S., the U.K., Germany and Australia have reached 20 to 35 per cent from one to two per cent prior.
The study notes that the videos, which are posted by young people all over the world and have millions of views, but are not verified by experts, may “trigger tic-like behaviours in susceptible individuals.”
The study used data from 290 registry participants from a Calgary tic disorder clinic that was collected between 2012 and June 30, 2021 to describe the symptoms and demographic characteristics of the youth affected in this global phenomenon.
When the data was analyzed, 270 patients were found to have a primary tic disorder and 20 patients were found to have rapid onset “functional tic-like behaviours” or FTLBs.
Of the 20 patients with FTLBs, 17 had no history of previous tics, whereas three had mild simple tics earlier in childhood that were never detected.
The rapid onset of the FTLBs all occurred in all participants during the pandemic period (after March 1, 2020) and all endorsed exposure to influencers on social media, mainly TikTok, with tics or Tourette’s syndrome.
The patients with FTLBs exhibited symptoms ranging from repetition of random words such as “knock knock,” or repetition of curse words, or obscene, offensive or derogatory statements, the study said. Others had complex hand and arm movements like clapping, pointing or throwing objects, and some exhibited behaviour where they would hit or bang parts of their body, other people or objects.
Those with FTLBs were more likely to be female and have anxiety or a major depressive disorder diagnosis, but most have no definite history of previous tics. Those with FTLBs typically escalated in frequency and severity over a period of hours to days, prompting emergency room visits and even hospitalization, the study said.
The study notes that this phenomenon is a “noticeable departure” from the usual demographic and natural history of Tourette’s syndrome, which disproportionately affects boys with onset occurring between the ages four to seven.
“Global availability and increased usage of social media, particularly during the coronavirus disease 2019 pandemic, coupled with great social interest in the stage of Tourette’s syndrome, might lead to maladaptive gains further intensifying symptoms in susceptible individuals,” the study’s authors wrote.
Researchers posit that the pandemic has been a major source of stress and anxiety for people globally, resulting in increased mental health symptoms and demand for mental health services, with “increased social isolation and widespread utilization of social media” likely factors in a relevant portion of the patients reporting FTLBs.
“External factors like watching popular social media personalities’ videos portraying tics or tic-like behaviours may have instilled a belief that ‘tics’ may catalyze peer acceptance or even popularity,” the study says. “This exposure to tics or tic-like behaviors is a plausible trigger for the behavior.”
While social media exposure was reported in all of the patients with FTLBs at the Calgary clinic, that was not the case for every patient at the other global centres, which is why researchers are calling for a more in-depth study of the link between social media and the onset of symptoms and their severity in youth.
The Doctors are joined by Alex, who says her tics intensified during the pandemic and began with a slight twitch in her lip. A few weeks later, Alex says she began developing head-shaking and other motor tics. She says her tics have been occurring for more than a year and she has been evaluated by her psychiatrist.
Dr. McVige urges parents to make sure they stay connected with their teens and to plan individual personal time with each child. She says parents should ask their kids what they are viewing online, what might be bothering them, and how they are feeling. The neurologist also suggests looking at their device history, how much time they spend online, and to create limits on device use. She says it is okay for parents to “respect their child’s privacy to an extent” in order to ensure they are safe online.
TikTok did not respond to our request for comment.