Can TikTok trigger 'tics' in teens? Here's what doctors said

Since the onset of the pandemic, specialists around the globe have seen a spike in young patients that have developed tics. And some have pointed to social media, particularly TikTok, as a factor. 

Exposure to videos of tics, sudden, repetitive involuntary movements or sounds, could be correlated to the "explosive" onset of tic-like behavior in young people, said Dr. Mohammed Aldosari, director of the Center for Pediatric Neurosciences at Cleveland Clinic. 

"What, usually, these TikTok or other social media videos do is they trigger those movements, maybe they are associated with the onset of these movements," Aldosari said, noting that some patients mimic what they've seen in videos.

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What have doctors seen?

Last August, doctors in the United States, Canada, Germany, Australia and the United Kingdom reported an increase of patients, mostly girls and women aged 12 to 25, who had suddenly developed physical and verbal "tic-like behaviors" since the onset of the pandemic.

The Centers for Disease Control and Prevention analyzed emergency room data and released a report in February that noted an increase in tics among teen girls during the pandemic. For girls between 12 to 17 years old, emergency room visits for tic disorders nearly tripled as of January. 

"Stress of the pandemic or exposure to severe tics, highlighted on social media platforms, might be associated with increases in visits with tics and tic-like behavior among adolescent females," the CDC said. 

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Can TikTok trigger tics?

Some researchers have described the sudden increase in tics as a "pandemic within a pandemic," noting that they are distinct from tics seen in people with Tourette syndrome.

But social media isn't all to blame and what specialists are seeing isn't new, said Dr. Julio Quezada, a pediatric neurologist at Children's Mercy Hospital in Kansas City, Missouri. 

"What we're seeing is an increase in what's known as tic-like phenomena, not tics," Quezada said. "There's been an increase that was more noticeable during the pandemic, but it's not a new thing. It's something that we've seen for a long time."

Patients without access to social media can also develop tic-like behaviors, while others who use TikTok and other platforms never develop tics or tic-like symptoms, said Joseph McGuire, a child psychologist at Johns Hopkins Children’s Center.

"The issue is a little bit more complex than just social media," McGuire said.

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How are tic-like behaviors different from Tourette syndrome?

Tourette syndrome is a nervous system disorder that causes people to have tics. The condition typically affects boys, and symptoms usually start in early childhood and peak during adolescence, when tics start to decrease in most cases.

"What has been happening more recently is these acute onsets of tic-like symptoms where these adolescents, who typically don't have a history of kind of tics, will suddenly onset with these really explosive, really impairing tics or movement or tic-like behaviors," McGuire said.

Most tics in people with Tourette syndrome tend to be subtle, whereas some videos on social media portray "dramatic movements" that highlight rare behaviors, said Dr. Keith Coffman, director of Children's Mercy Tourette Syndrome Center of Excellence. 

"Individuals will slap things, hit things," Coffman said. "When they vocalize, they'll vocalize words. They may have very long phrases of words, and many of the vocalizations in these videos have really high levels of utterances of profanity, which is exceptionally rare in individuals with Tourette."

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Are tic-like behaviors real?

The tic-like symptoms are real, and they are the brain's reaction to being overwhelmed with things like anxiety or stress, Aldosari said.

"They don't do it for attention," Aldosari said. "They need help as much as any other physical health disorder."

For Amanda Talty, president and CEO of the Tourette Association of America, the first question when someone displays tics or tic-like behavior shouldn't be about whether they are faking it.

"Your first question should be how do I get access to the nearest provider who will be qualified to identify what is happening," Talty said. "I think that that's the most important question and whether or not TikTok or social media consumption is causing this, in my mind, is a secondary question."

What can parents do?

Seek a professional. The Tourette Association of America provides resources and recommends certain hospitals and clinics. "If we diagnose it early on, and we treat it early on, there's good prognosis. The problem is when it's there for a long time," Quezada said.

Limit social media. Doctors suggested limiting exposure to social media videos of people displaying tics. "It's really being kind of aware of what's going on and thinking about practical solutions to support your son or your daughter for dealing with this really tough time," McGuire said.

Get the tic on video. "Tics are very variable. They can be there one week be gone another week," said Coffman. "Anytime we're seeing new patients and even established patients, we ask patients and families to get whatever they're seeing on video." 

Stay calm. "Don't jump to conclusions," Talty said. "Don't assume that you understand what's happening."