TikTok Tics?: Explanation and Treatment for a Mysterious Modern Illness

Written by William Benson, Psy.D. | Staff Psychologist

Since around the beginning of the COVID-19 pandemic, you may have been hearing about mysterious cases of teenagers, mostly girls, spontaneously developing tics after watching videos on online platforms such as TikTok.  In fact, it’s become a phenomenon of many such teens recording their own tics on videos, and then others have watched and developed these involuntary movements and vocalizations as well. 

What’s going on?  Why is this happening?  Let me try to give you a clear explanation and ideas about what to do if you are affected.

Essentially, the vast majority of people who develop tics after watching online videos of others with tics are experiencing neurological symptoms that are caused by psychological phenomena.  They do not have a chronic tic disorder (such as Tourette’s) or another type of neurological condition that can cause involuntary movements.  Nor are their symptoms caused by anything specific to screens or videos, other than how this technology makes the images of others’ movements and telling of their stories so easily available and capable of being shared widely and rapidly.

Not New 

This most recent case is not the first time that such a phenomenon has occurred, although this is likely the largest scale on which these things have happened.  New Yorkers may remember in 2011 when 20 high schoolers (nearly all female) in Le Roy, NY, mysteriously experienced similar twitching behaviors all around the same time.  Although those identified were evaluated and the school was tested for chemical or biological contaminants, there was no external explanation found for these behaviors.

Scientists and health experts refer to these symptoms as functional tic-like behaviors (FTLB), functional tics, or psychogenic tics.  Essentially, in medical lingo, functional means that something is psychological in its origin, rather than directly related to an identifiable physical cause, such as an injury, infection, or altered neurological process.

At times, multiple people who know or come in contact with each other experience such functional symptoms around the same time.  This phenomenon is called a “Mass Psychogenic Illness,” and was sometimes referred to historically as “mass hysteria.”  The symptoms can be tic-like behaviors but can also be a wide variety of other things.  For example, you may also have heard in the news over the last couple of years about Havana Syndrome, in which American diplomats have developed mysterious medical problems, such as memory and hearing loss and nausea.  While the first people who began experiencing these problems, diplomats working in Havana, Cuba, may have been exposed to harmful chemicals or radiation, it is thought that the majority of people were not exposed but instead were suffering from a functional neurological disorder.

While mass psychogenic illness can result in many types of symptoms, functional tic like behaviors (FTLB) are some of the most commonly reported.  As was the case in Le Roy, NY, and with the current global TikTok-related cases, sufferers are commonly adolescents and, in particular, adolescent girls.  We do not know why girls seem to be more susceptible than boys.

Why now?

While this phenomenon has been seen before, the scale that we are seeing now is vast.  This is global, affecting hundreds if not thousands of people.  There are likely several reasons for that.  For one, we know have this technology where people can access these brief videos so easily and are in the practice of watching sometimes hundreds of videos in a day, due to their length and the way that services like TikTok suggest videos to users based on ones they’ve viewed before.  In addition, due to the COVID-19 pandemic, people have spent even more time in front of screens, watching and also being captured on camera.  We’ve also been experiencing increased stress, anxiety, isolation, and sickness due to COVID. All of these factors likely made people more susceptible.

What can be done?

Fortunately, since this phenomenon is not new, we already know of effective interventions for those who have experienced a sudden onset of tic-like behaviors.  In fact, a key first component of treatment for FTLB is education.  Understanding what this is, knowing that it isn’t a sign of serious life-threatening health conditions, and that it is likely temporarily, can greatly reduce anxiety and may by itself lead to a reduction in the behaviors and impairments. 

A second step is to identify triggers.  When and where do tics tend to happen?  How does the person react and what are the responses of others?  Reducing contact with these triggers and avoiding giving too much attention to the behaviors often helps.  Especially in our current climate, people may turn to videos of others’ FTLB or record their own to show others, in attempts to connect or find answers.  These reactions may exacerbate tics.  While it can be validating to talk with people who’ve experienced similar phenomena, it is not necessary, and may be counterproductive, to show your own FTLB and watch others’ or to talk in-depth about the specific behaviors you experience, as this in itself may trigger episodes of FTLB.

Additionally, identifying sources of stress and treating anxiety or depression, which can often co-occur with FTLB, may be indicated.  Identifying coping skills, problem solving, learning relaxation strategies, and modifying negative thoughts associated with these conditions can also lead to decreases in tic-like phenomena.  Lastly, treatments developed specifically for tic disorders, such as Habit Reversal Training (HRT) and Comprehensive Behavioral Intervention for Tics (CBIT) may also help to reduce FTLB.

If you or a loved one has had tic-like episodes, it was almost certainly a scary and confusing experience.  However, I hope it’s helpful to know that this is an explainable and treatable phenomenon.  Speak with your doctor and ask about whether what you’ve experienced may be FTLB.  Consider reaching out to a healthcare professional, such as a therapist or psychologist, with training or expertise in this area.

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