WEBVTT - How Tourette Syndrome Works 0:00:00.280 --> 0:00:02.840 Brought to you by the reinvented two thousand twelve camera. 0:00:03.160 --> 0:00:07.520 It's ready. Are you welcome to stuff you should know 0:00:08.160 --> 0:00:16.439 from House Stuff Works dot Com. Hey, and welcome to 0:00:16.480 --> 0:00:19.960 the podcast. I'm Josh Clark. There's Charles w Chuck Bryant 0:00:20.040 --> 0:00:22.880 doing a little dance. You always give me away, Yeah, 0:00:23.000 --> 0:00:25.079 to do secret things for you, and then you immediately 0:00:25.120 --> 0:00:28.200 say what I'm doing? Yeah, Hey, Chuck just rubbed his butt. 0:00:28.520 --> 0:00:31.639 I didn't know that they were secret just from me. Yeah, 0:00:31.640 --> 0:00:33.600 it's all It's my little gift. I had no idea. 0:00:33.680 --> 0:00:35.920 Thanks to that Friday dude. It's so good to be 0:00:35.960 --> 0:00:39.280 recording on a Friday. Beautiful. Ow, it's like eighty degrees. 0:00:40.080 --> 0:00:43.160 We have a window so we can see the beauty, 0:00:43.880 --> 0:00:47.560 or we can actually see the ugly building. The construction 0:00:47.640 --> 0:00:51.000 and the office is well underway. We've been inhaling volatile 0:00:51.120 --> 0:00:54.840 organic compounds all week. It's out of hand. Actually, it's 0:00:55.160 --> 0:00:58.640 everywhere I turned, their desk that shouldn't be there, and 0:00:58.960 --> 0:01:01.480 cube walls stacked up. Yeah, it's weird. I can't believe 0:01:01.520 --> 0:01:04.399 we're not working at home through this whole thing. It's 0:01:04.480 --> 0:01:06.560 quite an idea, Bryant, is that a complaint? I don't 0:01:06.560 --> 0:01:08.720 want to come across his complaining. You're fine. I'm glad 0:01:08.720 --> 0:01:10.399 to have a job. We don't have a sponsor. It 0:01:10.440 --> 0:01:15.640 doesn't matter, Chuck. Yes, have you ever seen a Tourette's 0:01:15.640 --> 0:01:21.840 guy on YouTube? Uh? No, you haven't. He's this guy. 0:01:22.000 --> 0:01:25.640 He's a hefty guy with a glasses and a mustache 0:01:25.959 --> 0:01:30.840 and um, often a neck brace, and he has a 0:01:30.959 --> 0:01:36.039 foul mouth and anger problem. Uh. He's fond of using 0:01:36.200 --> 0:01:39.440 Bob sagg It as an expletive. He goes Bob sag It. 0:01:40.080 --> 0:01:42.360 It's funny because Bob Saget is a very foul mouth. 0:01:42.840 --> 0:01:47.000 He is surprisingly that in itself is almost a curse word. 0:01:47.960 --> 0:01:51.880 Um he Uh. He's taken a lot of heat because 0:01:51.960 --> 0:01:56.160 he's very abusive towards his family members. Um I I 0:01:56.680 --> 0:01:59.800 can't imagine that. You haven't. He says just the craziest stuff. 0:02:00.560 --> 0:02:04.280 And also, uh, the stuff he's saying is is in 0:02:04.400 --> 0:02:09.880 response oftentimes to what like questions other people ask or whatever. 0:02:09.919 --> 0:02:11.840 So really comes off as just a jerk. So I 0:02:11.880 --> 0:02:14.000 went on Snopes to find out if the guy actually 0:02:14.040 --> 0:02:18.120 has Turette's. He does. Actually he had, he was diagnosed 0:02:18.120 --> 0:02:22.640 with Tourette's, but his family admits on the Feeling Guilty 0:02:22.680 --> 0:02:27.560 page UM that, uh, he does have anger and alcohol 0:02:27.639 --> 0:02:31.800 issues that exacerbate things. Okay, so he may just be 0:02:31.840 --> 0:02:35.920 a jerk as well, It's possible, Yeah, but he has 0:02:36.000 --> 0:02:41.120 raised awareness. One could say of Turette's syndrome tourette syndrome. 0:02:41.440 --> 0:02:44.280 Tourette's going to be a problem throughout this whole podcast. 0:02:44.320 --> 0:02:47.840 There is no s. It is Turette syndrome. Yeah, unless 0:02:47.880 --> 0:02:51.600 you're just calling it Turette's without the syndrome, then it 0:02:51.600 --> 0:02:54.520 has an apostrophe s. The reason why is because it 0:02:54.600 --> 0:02:59.040 belongs to a French physician, correct, Chuck kom Yes, his 0:02:59.160 --> 0:03:02.000 name was de la Tourette is how I'm going to 0:03:02.040 --> 0:03:05.639 pronounce it in my faux French. And he was a 0:03:05.720 --> 0:03:08.960 physician in France in the eighteen hundreds. And he did 0:03:09.000 --> 0:03:13.520 not Actually he was not the first person to UM 0:03:13.720 --> 0:03:18.480 to report about Turette's. That was Jean Marc Gaspars. It yes, 0:03:18.680 --> 0:03:22.519 very nice, and he described the symptoms of a lady, 0:03:22.680 --> 0:03:27.519 a noble woman named Marquis de Dampia. I am impressed 0:03:27.560 --> 0:03:30.520 with you, chucking. She was elderly and she had it 0:03:30.560 --> 0:03:33.639 sounds like she had Turette's and uh, he described them 0:03:33.639 --> 0:03:37.520 as a tick illness. And then later on is when 0:03:37.920 --> 0:03:41.480 Tourette himself published the Study of Nervous Affliction, when he 0:03:42.080 --> 0:03:44.600 tracted nine people in a French hospital, and then it 0:03:44.680 --> 0:03:49.080 officially became Tourette, right, it became the syndrome de Turette. 0:03:49.400 --> 0:03:51.760 That's right. We sound like we could collude at any 0:03:51.800 --> 0:03:56.880 moment um, so that that's where the the syndrome gets 0:03:56.920 --> 0:04:00.640 its name, right indeed. Uh. And since then, well, I 0:04:00.680 --> 0:04:04.920 guess since the nineteenth century to I'd say the mid 0:04:04.960 --> 0:04:11.480 twentieth century, it was basically like holy cow, Tourette syndrome. Yeah. Uh. 0:04:11.520 --> 0:04:14.480 And then in the later twentieth century we started to 0:04:14.480 --> 0:04:17.880 get a slightly better handle on what was going on 0:04:18.440 --> 0:04:23.280 with Tourette sufferers. Um, but we still don't entirely know 0:04:23.640 --> 0:04:26.800 what what's going on there. We we suspect that it 0:04:26.880 --> 0:04:32.479 has a genetic basis because um, they haven't tracted to 0:04:32.520 --> 0:04:35.600 the gene but they believe that there's a or they've 0:04:35.640 --> 0:04:39.520 noticed that parents with Tourette's have a fifty chance of 0:04:39.520 --> 0:04:42.680 passing on to their kids, which is pretty strongly in 0:04:42.720 --> 0:04:45.160 favor of genetics. Yeah, we also know and this. I 0:04:45.200 --> 0:04:48.240 found it very interesting. I didn't know this that you 0:04:48.400 --> 0:04:53.800 always have the onset of turette Tourette's, right, it's just 0:04:53.880 --> 0:04:58.400 difficult before the age of eighteen. Yeah. Usually it starts 0:04:58.440 --> 0:05:02.839 around seven peaks from eight to twelve, and then the 0:05:02.920 --> 0:05:06.400 ticks start to decrease steadily after that. Boys get them 0:05:06.440 --> 0:05:09.800 more than girls. Yep. I think there are four times 0:05:09.800 --> 0:05:12.160 likely or three to four times likely to to have 0:05:12.240 --> 0:05:15.080 Tourette's girls are and you can have tourettess and not 0:05:15.080 --> 0:05:18.359 notice it too. Yeah. I did not have visible ticks. 0:05:18.400 --> 0:05:20.720 It's just in the gene is in your body. If 0:05:20.720 --> 0:05:24.359 it is indeed a gene. Let's let's stop beating around 0:05:24.360 --> 0:05:28.480 the bush, shall we. Let let us talk about cop 0:05:28.600 --> 0:05:33.240 ro lalia. Very nice, thank you, right, that is what 0:05:33.320 --> 0:05:36.039 you were. What most people think of Tourette's is the 0:05:36.080 --> 0:05:38.039 old joke, O, hey, that guy's got Turette's. If somebody 0:05:38.120 --> 0:05:43.360 yells an obscenity, right, A vocal tick. It's a complex 0:05:43.440 --> 0:05:46.720 vocal tick, very complex. There's a simple vocal tick, which 0:05:46.920 --> 0:05:49.560 might be like a grunt or clearing your throat or 0:05:49.600 --> 0:05:52.560 something like that. A complex vocal tick is is a 0:05:52.600 --> 0:05:57.279 symptom of Tourette syndrome, where you are stringing words together 0:05:58.000 --> 0:06:00.800 or even just saying a word would would be a 0:06:00.839 --> 0:06:05.880 complex vocal tick. But specifically with coper lalia copper lalia, 0:06:06.600 --> 0:06:11.320 I don't know, um. These these words aren't uttered often 0:06:11.560 --> 0:06:15.600 within a social or emotional context, meaning that you know, 0:06:15.640 --> 0:06:20.320 you're not there's it's quiet in the auditorium when the 0:06:20.400 --> 0:06:23.360 kid blurts it out, you know, um, and it's an 0:06:23.360 --> 0:06:28.440 obscenity there they blurt obscenities or reference to genitalia or um, 0:06:28.560 --> 0:06:36.560 bodily functions or sexual acts. Yeah, um, that right. The 0:06:36.560 --> 0:06:39.279 thing is, though, is UM. A lot of people who 0:06:39.360 --> 0:06:44.840 age uh and have copper lalia um learned to they 0:06:44.920 --> 0:06:47.880 learn tricks like they might mutter it a little more, 0:06:48.320 --> 0:06:52.200 They might mask their mouth with their hands. Um, they 0:06:52.320 --> 0:06:55.160 might say just the first letter two of the word like, 0:06:56.880 --> 0:07:00.160 and that is enough for a lot of people who 0:07:00.160 --> 0:07:04.760 suffer suffered from this this affliction or have the symptom um. 0:07:04.800 --> 0:07:07.360 But in other cases it's so extreme that you can't 0:07:07.360 --> 0:07:11.000 say anything but that word that comes out. And what 0:07:11.080 --> 0:07:16.440 I've read is it's akin to wanting to um sneeze, 0:07:16.800 --> 0:07:21.120 but say sneezing is socially unacceptable. So you have to cough, 0:07:21.920 --> 0:07:24.520 but that doesn't satisfy the urge to sneeze, and eventually 0:07:24.520 --> 0:07:26.480 you're gonna have to sneeze. Do you know what I 0:07:26.480 --> 0:07:29.160 would do? I would just turn around and look at 0:07:29.160 --> 0:07:32.920 the guy behind me every time. You're like, whoa dude? Right, Yeah, 0:07:32.960 --> 0:07:35.720 that's your deal. Well, apparently also there's a kind of 0:07:35.800 --> 0:07:41.679 um sub suffering of copper lalia where um people blurred 0:07:41.680 --> 0:07:45.000 out like racial and ethnic slurs in the company of 0:07:45.160 --> 0:07:49.600 people who would take offense to that. But the researchers 0:07:49.640 --> 0:07:52.040 point out, although I'm not entirely certain that they have 0:07:52.080 --> 0:07:54.280 a true handle on this, they point out that this 0:07:54.320 --> 0:07:58.760 doesn't necessarily indicate, you know, the thoughts of a person 0:07:59.480 --> 0:08:03.120 who has copper Lawiyah. It's just this is what they're 0:08:03.160 --> 0:08:05.240 what's in their mind right then, or what they're saying 0:08:05.360 --> 0:08:08.280 or what's coming out. Yeah, well that's uh. That is 0:08:08.640 --> 0:08:11.080 can be a symptom of turettes, but it's only in 0:08:11.600 --> 0:08:15.400 less than fifteen percent of sufferers, So the common thing 0:08:15.440 --> 0:08:18.200 that most people think of, it's actually very uncommon, right, 0:08:18.240 --> 0:08:20.080 And like you said, a lot of people have such 0:08:20.120 --> 0:08:23.360 mild symptoms you wouldn't even notice it. Like I could 0:08:23.360 --> 0:08:26.120 have Turette syndrome Chuck a very mild case and you 0:08:26.160 --> 0:08:31.520 wouldn't know. I know. Well, they say stat wise one 0:08:31.520 --> 0:08:35.080 and a hundred people suffer from a mild form, which 0:08:35.120 --> 0:08:36.960 is a lot more than I would have thought, and 0:08:37.040 --> 0:08:41.320 about two hundred thousand Americans. It's just Americans have the 0:08:41.320 --> 0:08:44.960 most severe forms. So that's that's definitely a little more 0:08:45.000 --> 0:08:47.760 common than you would think. And it is um pain cultural, 0:08:47.880 --> 0:08:50.920 but it's not found in equal amounts in every culture, 0:08:51.280 --> 0:08:55.319 which kind of undermines the genetic basis idea a little bit, 0:08:55.720 --> 0:09:00.000 because there's a lot more Turette sufferers in in UM 0:09:00.000 --> 0:09:03.680 the US than in Japan. Interesting, I wonder past something 0:09:03.720 --> 0:09:07.800 to do with our culture. We're a foul mouth culture. 0:09:07.880 --> 0:09:12.440 Maybe right, we're and we're very nervous. I think the 0:09:12.480 --> 0:09:14.560 Cold War did it to us well. And they do 0:09:14.640 --> 0:09:17.839 say that anxiety sometimes can increase the amount of tecks 0:09:18.160 --> 0:09:20.000 and relaxation. That's one of the things I'll try and 0:09:20.040 --> 0:09:22.720 get you do is relax yourself with like breathing techniques, 0:09:23.360 --> 0:09:25.760 so that that could have some credibility. We'll get to that, 0:09:25.880 --> 0:09:29.840 Dr Clark, Thank you. Dr bryant Um. Whether or not 0:09:29.880 --> 0:09:32.080 it has a genetic basis, and by the way, if 0:09:32.120 --> 0:09:34.680 it does, will know for certain within five to ten years, 0:09:34.720 --> 0:09:37.720 because I'm gonna understand every single gene in the human 0:09:37.760 --> 0:09:41.439 genome within that time. I think it is very scary, 0:09:41.559 --> 0:09:45.040 all the ramifications. That's a podcast in itself. Yes it is. 0:09:45.120 --> 0:09:49.360 Look for that one two thousand and eleven. Um whether 0:09:49.480 --> 0:09:51.920 or not it has a genetic basis, they have kind 0:09:51.960 --> 0:09:55.079 of and by they, I mean people who are involved 0:09:55.120 --> 0:09:59.720 intoret research have the government have no although they do 0:10:00.200 --> 0:10:04.000 some to the National Institutes of Health. Yeah. Yeah, Um, 0:10:04.160 --> 0:10:07.240 they've kind of narrowed down some regions of the brain 0:10:07.320 --> 0:10:11.760 that are likely candidates for, um, the underlying mechanism of 0:10:11.840 --> 0:10:14.080 Tourette syndrome. Right, Yeah, I thought this was a little weak. 0:10:14.679 --> 0:10:17.400 I did too, and I didn't like the word pinpointed. Yeah, 0:10:17.400 --> 0:10:19.800 because I mean they picked the thalamus, the basil, ganglia, 0:10:19.880 --> 0:10:22.959 and the frontal cortex, and it's kind of like those 0:10:22.960 --> 0:10:25.880 are the three things that control like your motor functions. 0:10:25.880 --> 0:10:27.200 Are like, well, I must have something to do with 0:10:27.240 --> 0:10:30.640 that then, or you're from a cortex which is in 0:10:30.720 --> 0:10:35.920 charge of controlling the motor activity of speech, including speech. 0:10:36.400 --> 0:10:38.079 So it seems like I don't know, those are the 0:10:38.120 --> 0:10:41.240 obvious parts of the brain, right, Like nobody didn't even 0:10:41.240 --> 0:10:44.440 real research. That's not true, of course, but you know, 0:10:44.520 --> 0:10:46.520 they're just like, it's probably this part of the brain. 0:10:46.600 --> 0:10:48.400 But like, we know enough about the brain. If someone 0:10:48.440 --> 0:10:50.400 were to have sat us down beforehand and said, pick 0:10:50.440 --> 0:10:53.000 out the three parts that may be responsible, I probably 0:10:53.000 --> 0:10:54.920 would have picked out those three. I would have said, 0:10:54.920 --> 0:10:59.600 frontal cortex. Sure. Sure. Um. The problem is, Chuck, is 0:10:59.600 --> 0:11:02.319 not only do we not know that much about the brain, 0:11:03.000 --> 0:11:07.280 Humanity in general and science specifically doesn't have that great 0:11:07.360 --> 0:11:10.360 of a grasp on the brain. But and we'll say 0:11:10.400 --> 0:11:14.640 it again too, but um, it looks like the likeliest 0:11:14.679 --> 0:11:18.760 candidate is not necessarily a brain region. But uh, these 0:11:18.840 --> 0:11:24.800 brain regions working or malfunctioning in conjunction because of a 0:11:24.800 --> 0:11:28.840 an excess of the narrow transmitter dopamine misfiring transmitters. That's 0:11:28.880 --> 0:11:31.640 always the case. And again, the reason why they think 0:11:31.679 --> 0:11:34.960 that this is possible is not because they have any 0:11:35.000 --> 0:11:37.960 hard scientific evidence that this is the case. They've just 0:11:38.120 --> 0:11:42.360 noticed that in Parkinson's patients, which are the opposite of 0:11:42.640 --> 0:11:45.960 um Turette's patients in a lot of ways. Um, they 0:11:46.440 --> 0:11:52.120 move much more slowly, unsteadily um and their motor function 0:11:52.200 --> 0:11:55.600 seems to be impaired, it's decreased, and they've found that 0:11:55.640 --> 0:12:00.199 there is a lack of dopamine in Parkinson's pay and 0:12:00.280 --> 0:12:03.040 so they're like, well, then it's probably just means that 0:12:03.080 --> 0:12:07.080 there's an excess of you know, turette pace, because that's 0:12:07.360 --> 0:12:10.680 the universe. Is that cut and dry, right, That's what 0:12:10.720 --> 0:12:12.679 I think? Yeah, me too, But like we said, it's 0:12:12.679 --> 0:12:14.920 the brain, and it's just such a crap shoot when 0:12:14.920 --> 0:12:17.480 you're dealing with the brain. Do you just don't know? 0:12:17.600 --> 0:12:20.800 They're doing their best? Though? Should we talk about symptoms? Yeah, 0:12:20.920 --> 0:12:27.200 let's while we already covered the obscenity bursting coupla very nice. 0:12:28.040 --> 0:12:31.120 He took the queue, and that is the rare symptom. 0:12:31.320 --> 0:12:34.360 More commonly, what you're gonna see is like eye blinking, 0:12:34.679 --> 0:12:39.920 throat clearing, shoulder shrugging. I knew a guy facial grimaces, 0:12:40.000 --> 0:12:42.360 that this friend of mine in high school had tourettes, 0:12:42.400 --> 0:12:45.760 and I didn't even know it until, you know, recently, 0:12:45.760 --> 0:12:48.120 when I was researching. I was like, oh, that guy 0:12:48.120 --> 0:12:51.320 Andy had tourettes because he would go like uh like 0:12:53.080 --> 0:12:55.160 and like blank and turn his head and like make 0:12:55.200 --> 0:12:57.200 a little gutural sound like that. Well, yes, then he 0:12:57.240 --> 0:12:59.800 would have turetts because you said that he had a 0:13:00.000 --> 0:13:03.120 motor tick and a vocal tick, right, yes, So if 0:13:03.120 --> 0:13:06.440 he just had you know, the shoulder shrugging um or 0:13:06.679 --> 0:13:10.080 eye blinking or twitching just that, he would have had 0:13:10.200 --> 0:13:13.280 a chronic motor tick disorder. Or if he just made 0:13:13.320 --> 0:13:17.400 the guttural sounds, he probably would have had chronic votal 0:13:17.520 --> 0:13:22.199 vocal motor tick. It's tough when you get out, isn't it. Yeah. Uh, well, 0:13:22.240 --> 0:13:23.880 since we're here, we might as well go ahead and say, 0:13:23.880 --> 0:13:26.080 and I didn't realize this either, that there are all 0:13:26.120 --> 0:13:29.720 these very specific classifications. So if you if you're being 0:13:29.720 --> 0:13:32.440 diagnosed with turettes, they rule out a lot of other 0:13:32.480 --> 0:13:35.280 things first, and then once they've ruled out all the 0:13:35.280 --> 0:13:38.400 all the other stuff, they go, okay, have you what 0:13:38.520 --> 0:13:40.800 kind of ticks do you have? How often do you 0:13:40.840 --> 0:13:42.840 have them? When did you start getting them? Because it's 0:13:42.880 --> 0:13:45.840 got to be before eighteen. You have to have multiple 0:13:45.880 --> 0:13:49.720 motor ticks and at least one vocal tick, and both 0:13:49.760 --> 0:13:52.360 of those have to happen within one year, and within 0:13:52.440 --> 0:13:55.480 that year you cannot go three months without a tick 0:13:55.880 --> 0:13:58.120 and still be diagnosed with turettes. I didn't know was 0:13:58.160 --> 0:14:01.240 that specific. I didn't either, but it's in all of 0:14:01.280 --> 0:14:06.080 It's based on observation obviously. Um. But if you have 0:14:06.160 --> 0:14:12.479 something else, turette falls under a the umbrella movement disorders. Right. Um. 0:14:12.559 --> 0:14:17.120 So there's all these different kind of sister sibling disorders 0:14:17.160 --> 0:14:20.560 that that could be, uh, that could be diagnosed rather 0:14:20.600 --> 0:14:24.480 than turette. It's kind of like tourette is a milange 0:14:24.680 --> 0:14:29.760 of movement disorders or motor disorders. Very nice, Thank you 0:14:29.880 --> 0:14:32.640 very much for back to the French. Right exactly, So, Chuck, 0:14:32.680 --> 0:14:37.680 I jumped ahead a little bit, didn't I. Um, there 0:14:37.680 --> 0:14:42.720 are some other really interesting tidbits about Tourette's that I 0:14:42.800 --> 0:14:46.520 was unaware of. Like, um, normally they start out higher 0:14:46.600 --> 0:14:49.760 up in the body and then as the patient ages, 0:14:50.120 --> 0:14:52.560 they the ticks move further down. Yeah. I thought that 0:14:52.600 --> 0:14:54.800 was interesting. So you might you might start out with 0:14:55.000 --> 0:15:01.360 um or shoulders shrugging or neck tensing or something like that. Right, 0:15:01.400 --> 0:15:03.360 And I should say, by the way, since this is 0:15:03.400 --> 0:15:05.400 in a video podcast, you can't see it, but every 0:15:05.400 --> 0:15:09.080 time Chuck or I describe some sort of tick, we 0:15:09.400 --> 0:15:12.240 try it out ourselves. It kind of feels it's almost involuntary, 0:15:12.640 --> 0:15:14.920 it is. And then uh, from there, it can work 0:15:15.040 --> 0:15:17.680 its way down to the arms and hands, like clenching 0:15:17.720 --> 0:15:20.920 your fists, that kind of thing, and then eventually down 0:15:20.920 --> 0:15:22.840 to your feet, so you might stomp your feet really loud, 0:15:22.920 --> 0:15:26.240 or you might have an a hitch in your giddy 0:15:26.320 --> 0:15:30.240 up as they say. Who says that, the Tourette researchers 0:15:30.280 --> 0:15:34.520 Walter Brennan Old Westerns. And then ultimately chucky can move 0:15:34.560 --> 0:15:38.760 into the respiratory and alimentary systems. So a tick can 0:15:38.800 --> 0:15:43.040 manifest as a hiccup or whistling or belching or throat 0:15:43.080 --> 0:15:45.320 clearing or something like that. So it makes the cycle 0:15:45.520 --> 0:15:49.800 over time. It doesn't necessarily, but it can. And once 0:15:49.800 --> 0:15:53.000 it starts moving, brother, it's tough to bring back to 0:15:53.080 --> 0:15:57.680 its original position. Yeah, what what happens is there's an urge. 0:15:57.760 --> 0:16:01.720 They all um suffers disc this build up. They feel 0:16:01.880 --> 0:16:03.880 it's like building up in their body, like this urge 0:16:03.960 --> 0:16:07.560 to do it, and then that that is satisfied by 0:16:07.640 --> 0:16:10.480 the tick, whatever that tick is. And sometimes you can, 0:16:10.520 --> 0:16:12.040 you know, learn to control that a little bit. But 0:16:12.080 --> 0:16:15.760 they say that you're just kind of putting up the uh, 0:16:16.280 --> 0:16:18.440 the wall, which will be broken at some point, so 0:16:18.480 --> 0:16:20.960 your tick will be even worse later on in the day. 0:16:21.040 --> 0:16:22.480 It's like, if you're in a business meeting and you're 0:16:22.520 --> 0:16:24.280 holding it back and holding it back, you might get 0:16:24.280 --> 0:16:25.840 out of the business meeting and have like a really 0:16:25.880 --> 0:16:28.640 bad tick or something, which is you know, I guess 0:16:28.640 --> 0:16:31.280 it's good if you can control it, but you gotta 0:16:31.280 --> 0:16:32.920 know when to let it loose to well. Yeah, and 0:16:32.960 --> 0:16:35.680 I imagine that that kind of comes with living with Tourette, 0:16:35.800 --> 0:16:38.920 Like you realize, Okay, I'm gonna have a really big 0:16:38.960 --> 0:16:41.720 tick after this business meeting, but if I can hold 0:16:41.720 --> 0:16:44.960 it during the meeting, then I'm probably better off. Or 0:16:45.320 --> 0:16:47.080 you know, if you're alone, I'm sure you just let 0:16:47.120 --> 0:16:50.920 the ticks fly right. Um. And also I was reading 0:16:51.000 --> 0:16:54.000 about a uh The New York Times has a lot 0:16:54.080 --> 0:16:58.920 of question and answer blogs about Turette syndrome, really interesting stuff. 0:16:59.120 --> 0:17:04.040 One guy said that he uses um his Turette's as 0:17:04.080 --> 0:17:08.960 a jerk meter or a jerk sensor, so like he's 0:17:09.000 --> 0:17:13.199 found that people who people react very differently, but they 0:17:13.240 --> 0:17:16.520 can kind of be lumped into two categories. One people 0:17:16.560 --> 0:17:19.400 who can look past it and be friends with you 0:17:19.920 --> 0:17:23.359 and the other category are people who just can't. And 0:17:23.400 --> 0:17:28.520 apparently people who are um not down with turettes are 0:17:28.960 --> 0:17:35.040 kind of uh sure, I mean in what way other 0:17:35.080 --> 0:17:36.719 than the fact that they're kind of jerks for not 0:17:37.040 --> 0:17:41.080 being understanding. I think that's enough, don't you. I mean, 0:17:41.480 --> 0:17:44.000 this is something that I don't I don't even know 0:17:44.040 --> 0:17:47.760 that you could say Turette syndrome is misunderstood and are 0:17:48.160 --> 0:17:51.720 I think the greatest misunderstanding is thinking that all Turette 0:17:51.760 --> 0:17:54.880 sufferers have copper lalia. But other than that, I mean, 0:17:54.960 --> 0:17:58.160 it's not like this is some hidden mystery that that 0:17:58.440 --> 0:18:01.160 everyone walking the planet had hasn't hurt about just because 0:18:01.160 --> 0:18:05.719 it's so fascinating and it doesn't have any um attendant 0:18:05.800 --> 0:18:10.119 like physical problems associated with it. It's completely based on 0:18:10.240 --> 0:18:14.080 brain function, you know. And although there's not like you know, uh, 0:18:14.320 --> 0:18:18.240 you're not wheelchair bound when you have Tourette syndrome. There 0:18:18.280 --> 0:18:24.679 are other um, I guess, behavioral problems or disorders that 0:18:24.920 --> 0:18:28.200 usually accompany or can very frequently right, Yeah, O C 0:18:28.560 --> 0:18:31.439 obsessive compulsive disorder and a d h D, which is 0:18:32.280 --> 0:18:38.639 adult attention deficit hyperactivity disorder. Yes, thank you for filling 0:18:38.640 --> 0:18:41.720 in the blanks there, um, and they're they're not always linked, 0:18:41.720 --> 0:18:45.639 but UM, a lot of times they are like a child. 0:18:45.680 --> 0:18:48.800 If if you've been diagnosed with Tourettes and you're a kid, 0:18:49.200 --> 0:18:51.800 many times will be diagnosed with O c D or 0:18:51.840 --> 0:18:55.120 a d h D afterward. And um, not only that, 0:18:55.200 --> 0:18:58.520 but sometimes you can have disorders as a result of Tourette's, 0:18:58.560 --> 0:19:02.560 like a sleeping disorder or learn disorder because of the 0:19:02.560 --> 0:19:08.720 Turette's and they they I know that of Tourette's suffers 0:19:08.760 --> 0:19:12.040 have a d h D, which is a pretty strong link. 0:19:12.119 --> 0:19:13.919 But I also wonder if some of it has to 0:19:13.960 --> 0:19:17.840 do with misdiagnosis. The one that UM I kind of 0:19:17.880 --> 0:19:22.760 bought into was the O c D UM Tourette link. Yeah, 0:19:22.760 --> 0:19:25.480 you're twenty times more likely to have O c D 0:19:25.840 --> 0:19:28.080 or symptoms of O c D if you have Tourette's. Yeah, 0:19:28.119 --> 0:19:31.040 and pretty high parents um who have O c D 0:19:31.480 --> 0:19:35.040 are have a higher likelihood of having kids with Tourette syndrome. 0:19:35.680 --> 0:19:39.040 So there's a there's a little something there, something linking 0:19:39.080 --> 0:19:43.280 them or something something. Uh So, Josh, let's say one 0:19:43.280 --> 0:19:45.840 of us has turette and we want to try and 0:19:46.080 --> 0:19:48.439 rein it in some what can we do? Do you 0:19:48.480 --> 0:19:51.800 mean treatments? What what are my options? Well? I think 0:19:52.160 --> 0:19:59.120 probably the gentlest um option is behavior modification. Behavioral therapy, yeah, Josh, 0:19:59.200 --> 0:20:01.960 And habit reversal therapy is one of the behavioral therapy, 0:20:02.040 --> 0:20:04.639 so we'll use a lot of times. It's got five components, 0:20:04.640 --> 0:20:08.520 but the main key there is the competing response. So 0:20:08.680 --> 0:20:12.200 if you feel a tick coming on, uh, and oftentimes 0:20:12.200 --> 0:20:14.760 you'll do the competing response is sort of linked to 0:20:14.800 --> 0:20:16.320 what your ticket is. So if you have like a 0:20:16.680 --> 0:20:19.080 a shoulder thing and you feel a tick coming on, 0:20:19.160 --> 0:20:22.119 you will like really relax your shoulders or roll your 0:20:22.119 --> 0:20:25.000 shoulders and like roll your neck around or something to 0:20:25.040 --> 0:20:27.200 try and like fight back the tick. Right, you want 0:20:27.200 --> 0:20:31.440 to use the same muscles to create the opposite movement though, Right, 0:20:31.680 --> 0:20:35.000 it's kind of like when your earbug chords are kind 0:20:35.000 --> 0:20:39.199 of bent, right, you have to bend them back the 0:20:39.240 --> 0:20:41.240 other way for a while to get back to the middle. 0:20:41.440 --> 0:20:43.760 It's just like that. Yeah, I can't believe me to 0:20:43.800 --> 0:20:47.920 think that. Thanks for that, Chucky. What I don't understand though, 0:20:47.960 --> 0:20:49.640 is it I mean, it makes sense in one way, 0:20:49.680 --> 0:20:52.000 but if you're always going to be doing that competing response, 0:20:52.359 --> 0:20:54.280 what's the difference. Now, The point is that you're not 0:20:54.400 --> 0:20:57.640 always doing the competing response, just like your earbug cord 0:20:57.760 --> 0:21:00.640 is not going to always be twisted the other. You're 0:21:00.680 --> 0:21:04.360 just working it out from being twisted one way for 0:21:04.400 --> 0:21:09.440 so long, so eventually eventually able to eradicate the ticks. Okay, Yeah, 0:21:09.720 --> 0:21:11.480 I thought it was just to keep from doing the ticket, 0:21:11.480 --> 0:21:14.800 and I think, well, what's the difference. You know, I 0:21:14.840 --> 0:21:17.440 think that it's to eventually get to the point where 0:21:17.480 --> 0:21:23.000 you're not having those ticks any longer. Um. There's also regular, 0:21:23.240 --> 0:21:28.080 straight up, good old cognitive behavioral therapy, which mainly focuses 0:21:28.280 --> 0:21:34.959 on UM relaxation techniques, UM, identifying and dealing with stressors because, 0:21:35.000 --> 0:21:38.359 like you said, UM Tourette's syndrome is often set off 0:21:38.400 --> 0:21:46.680 by UH emotions, stress right, UM, and drugs. There's drugs. Drugs. 0:21:46.840 --> 0:21:49.639 You want to this These are tough, man, This is dicey, 0:21:49.640 --> 0:21:53.480 and I think that these are generally UM reserve for 0:21:53.600 --> 0:21:57.840 people with UH Tourette syndrome that really interferes with their 0:21:57.920 --> 0:22:00.679 daily life. Yeah, if you can't get it through behavior 0:22:00.760 --> 0:22:03.400 modification and it's more than a nuisance, then you might 0:22:03.400 --> 0:22:06.840 want to look into something like an antipsychotic Josh, Yeah, 0:22:07.040 --> 0:22:10.560 like pema's eyed or hell a parrot al or something. Yeah, 0:22:11.400 --> 0:22:14.080 these are rough. Well, that's a deal. That's why doctors 0:22:14.080 --> 0:22:16.320 don't throw you on these meds if you have turetts 0:22:16.359 --> 0:22:20.440 like immediately, because they can bring along some side effects 0:22:20.520 --> 0:22:27.399 like men growing breasts, men growing breast, drooling, restlessness, sexual dysfunction, 0:22:27.520 --> 0:22:30.320 and seizures. Yeah. So in a lot of ways, the 0:22:31.359 --> 0:22:33.920 cure can be worse than the disease when you're using 0:22:33.960 --> 0:22:39.040 anti psychotics, tight turetts and UM. Since it occurs in 0:22:39.080 --> 0:22:41.520 conjunction with a d h D or O c D, 0:22:41.720 --> 0:22:44.000 a lot of times the doctor will just piggyback the 0:22:44.000 --> 0:22:47.840 turette treatment onto treatment of a d h D or 0:22:47.960 --> 0:22:50.440 O c D. Right, So, if you have O c 0:22:50.640 --> 0:22:53.880 D and Tourette syndrome UM, you're probably going to be 0:22:53.960 --> 0:22:58.720 prescribed to ssr I like Zoloft or prozac or something 0:22:59.320 --> 0:23:01.760 the p and then like riddling or something to treat 0:23:01.800 --> 0:23:06.720 a d h D may help alleviate the Tourette syndrome too. Yeah, 0:23:07.160 --> 0:23:10.200 but Josh, if all these don't work, then you've got 0:23:10.200 --> 0:23:13.600 a really really debilitating case of turettes and none of 0:23:13.600 --> 0:23:16.920 this stuff works. There is an experimental surgery taking place 0:23:17.000 --> 0:23:22.000 called deep brain stimulation where they connect electrodes two wires 0:23:22.040 --> 0:23:24.439 from a small battery pack in your chest. So it's 0:23:24.440 --> 0:23:26.800 sort of like a pacemaker for the brain, there's a 0:23:26.840 --> 0:23:28.800 good way to describe it. Yeah. And it prevents its 0:23:28.800 --> 0:23:33.560 supposedly prevents against the misfiring of neurons. Yeah, it blocks, 0:23:33.920 --> 0:23:37.480 it blocks the firing of the neurons. That crazy. And 0:23:37.520 --> 0:23:39.600 they're they're not using this widely now because it's really 0:23:39.600 --> 0:23:42.320 experimental at this point, but they do use it for Parkinson's. 0:23:42.440 --> 0:23:44.639 That's gonna be one of those treatments that in fifty 0:23:44.760 --> 0:23:48.160 or a hundred years looks just ridiculously primitive and barbaric. 0:23:48.760 --> 0:23:50.800 You know, I can't believe they suck up wires and 0:23:50.880 --> 0:23:53.960 block firing of neurons patient akers in the brain. Should 0:23:54.000 --> 0:23:57.679