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Over the first year of the COVID pandemic, a wave of tic symptoms struck women age 12 to 25 around the world. Referrals to neurologists’ offices and clinics specializing in tic disorders skyrocketed, as hundreds more people than usual reported new tic behaviors. While these disorders are not unheard of, the sudden increase of tics in people who had never had them stunned doctors. Additionally, it was especially puzzling that this coincided with the beginning of the pandemic.
What are tic disorders?
Tics are repeated and uncontrollable movements or sounds that people make. These could be blinking, tilting the head, clicking the tongue, or blurting out words. You’ll likely recognize “Tourette Syndrome” as it is the most well known tic disorder. A “simple” tic is isolated to one area of the body while “complex” tics involve multiple body parts at once or in sequence.
People can’t stop themselves from doing these tics. They may be able to hold them back for a short time, but they always need to come out. Tics can come and go over time, and they usually get worse during stressful times.
What did these people have?
The young women in this sudden surge experienced the sudden start of tics that would appear in a matter of hours or days. The tics are complicated, including multiple different body parts with movements and sounds that form a regular sequence. Most people in this sudden surge had no previous history of tics. The new symptoms were incredibly distressing, and many of these people ended up in the emergency room.
New phenomenon vs Tourette Syndrome
Tourette Syndrome (TS) is a neurological disorder that starts in childhood, usually between the ages of 5 and 10. Boys are three times more likely to have TS than girls. The first tics begin gradually and are usually simple and often begin in the head and neck region. Complex tics usually don’t appear until simple tics have been present for at least several months. Tics in TS are usually most intense in the tween years and tend to peter out as kids progress through adolescence.
A common major misconception about TS is that these people will often blurt out offensive words or repeat things others say. Let’s be clear: Although these can rarely happen, they are not frequent symptoms and are not required for a diagnosis of TS.
With this in mind, it’s clear that the new symptoms that these women experienced are far different from those of TS. The age, gender prevalence, rate of onset, and types of tics all separate these two groups. People with these new tics were less able to suppress them compared to people with TS. Additionally, their co-occurring disorders were different. People with TS often also deal with ADHD and OCD, while those in this new group more frequently had anxiety and depression. So if this wave of diagnoses isn’t Tourette Syndrome, what is it?
Searching for a source
Here’s where this story takes an interesting turn. A large number of the young women who suffered these rapid onset tics reported viewing videos made by people with Tourette Syndrome on TikTok. Videos on this topic are wildly popular on the platform, collecting billions of views. Researchers from multiple different groups noticed that the new tics people had were often very similar to some of the most popular TikTok videos.
If this sounds unlikely, you might also need to remember the circumstances. This was the first year of the pandemic. Stuck in our homes, we become glued to our phones and TVs while constant anxiety took over our minds. People with new tics reported lots of family stress as a result of COVID lockdowns. They also felt a bunch of new academic pressure when they suddenly transitioned to virtual learning.
This stressful environment primed the viewers of TikTok tic videos for developing these new tics. It’s no surprise that women in this same age range (16 to 24) use social media more than any other group in the world. Even with all this context though, the whole situation still seems very strange to many observers. That’s because it’s part of a rare phenomenon called “mass sociogenic illness” (MSI).
Mass sociogenic illness
At different times called “mass hysteria” or “mass psychogenic illness,” MSI occurs when multiple people from the same group displaying similar, inexplicable symptoms. Symptoms tend to be troubling and sometimes very unusual, but they are almost always ultimately harmless. These come on quickly, yet they defy all medical examinations and tests. They go away just as fast when people are removed from the inciting source.
These rare but fascinating events are hardly new, either. In the past, these events happened in groups of people who spent a lot of time together, be it working, living, or in school. In 1962, dozens of workers at a textile mill suddenly began suffering from dizziness, nausea, vomiting, and bodily numbness. Many claimed bugs from a materials shipment had bitten them, but doctors found no evidence of that. Their symptoms abated after short stays home from work.
In 1965, sudden dizziness and fainting struck over 80 girls at a single school in England. Again, no explanation was found. Even during the Middle Ages, epidemics where hundreds of people would dance to exhaustion swept through Europe on multiple occasions. Now, in the modern area, media consumption is so integrated into our lives that it, too, can play a role in MSI.
Making sense of TikTok tics
Beyond this, we don’t know much more about what causes mass sociogenic illness. We know that victims already feel trapped in stressful situations and experience a great amount of pressure. MSI just demonstrates another way that emotional distress can come out in bodily ways. This wave of new tics stands out because its one of the first social media-induced episodes of mass sociogenic illness.