A tic attack is an episode of intense, continuous, and overwhelming tics that can last from several minutes to hours. These episodes typically involve severe bouts of a person’s usual motor and vocal tics, sometimes combined with whole-body movements and shaking. While tic attacks are commonly associated with Tourette Syndrome, they are distinct from everyday tics due to their prolonged and disabling nature. Understanding how to respond to this temporary loss of physical control is important, as the right support can help reduce the duration and secondary injuries.
Immediate Steps for Physical Safety
The immediate priority when someone is experiencing a tic attack is to prevent self-injury without attempting to restrain their movements. The person’s movements during an attack can be violent, uncontrolled, and unpredictable, often involving flailing or thrashing. You should quickly assess the surrounding area and remove any potential hazards, such as sharp corners, hard furniture, or heavy objects that could be struck during the movements. This creates a safer zone where the person can move freely without causing themselves harm.
If the person is standing, gently guide or encourage them to sit or lie down on a soft surface, if they are able to follow simple direction. Placing a pillow, blanket, or soft garment near their head is important if they are hitting or jerking their head, which is a common and potentially injurious movement. Physically holding or restraining the person is counterproductive and can increase their distress, potentially worsening the tics. The goal is to provide passive protection from the environment rather than active suppression of the movements.
Ensure that the person has adequate personal space and is not being crowded by onlookers, which can exacerbate the feeling of panic and intensify the tics. If the attack is happening in a public area, the safest action is to move them to a quieter, more private location. This action minimizes the “audience effect,” which can increase self-consciousness and thus the frequency and severity of tics.
Communication and Reassurance Strategies
Maintaining a calm, neutral, and quiet demeanor is important when communicating with someone in the midst of a tic attack. The person experiencing the attack is often in a state of high anxiety, and any stress or agitation from a bystander can heighten their distress, leading to worse tics. Your presence should be reassuring, not alarming, and should convey a sense of control over the situation.
Use short, simple, and repetitive verbal phrases that affirm safety and support, such as, “You are safe,” or “I am here with you.” If you need to assess their needs or get information, use only simple yes or no questions, as complex inquiries can be overwhelming and impossible to answer due to vocal tics. Avoid drawing any attention to the tics themselves, as commentary or excessive focus can inadvertently reinforce the behavior and prolong the attack.
Validation of the person’s struggle is more helpful than attempts to minimize the event. If they are able to communicate, ask them directly what they need, as many individuals with tic disorders have personal coping strategies they prefer you to facilitate. Some people may request to be left alone to “ride it out,” while others may find that gentle physical contact, if they initiate it, can be grounding. Listening to their wishes is a deeply validating and supportive action.
Environmental Management During an Attack
Managing the surrounding environment can help reduce sensory input and promote de-escalation of the attack. Tics can be exacerbated by overwhelming external stimuli, so reducing this input can create a more soothing atmosphere. If possible, dim bright overhead lights or close blinds to lessen visual stimulation.
Reducing noise levels is another important step; turn off any televisions, music, or other loud devices, and ask any unnecessary individuals to leave the immediate area. Minimizing the number of people present helps to create a less stressful, more private setting. This quiet, low-stimulus environment allows the person to focus their attention inward.
If you know the person well, locate and offer any sensory tools or comfort items they typically use to manage anxiety or tics, such as weighted blankets or favorite fidget toys. These familiar objects can provide a grounding focus and help redirect attention away from the internal physical sensations that often precede and accompany a tic attack.
Recognizing When Emergency Medical Help is Needed
While most tic attacks resolve on their own, certain signs indicate the need for immediate medical intervention. Call emergency services if the person sustains a severe injury, such as a deep cut, a suspected fracture, or a head injury resulting in loss of consciousness. Any injury that would require medical attention under normal circumstances should be treated as an emergency.
Emergency services are also warranted if the person experiences difficulty breathing or a prolonged period of breath-holding that causes oxygen levels to drop. Furthermore, if the person loses consciousness, or if the movements involve sustained, generalized convulsive activity that does not resemble their typical tics, a medical evaluation is required to rule out an actual seizure. If the person expresses clear suicidal ideation or planning during the distress, this is a separate mental health emergency that requires immediate professional help.