Witnessing a tic attack can be distressing and confusing, especially for those unfamiliar with the condition. These episodes involve severe, sustained, and overwhelming tics that require an immediate, informed, and calm response to ensure the person’s safety and provide support. This guide provides practical steps for bystanders to offer safe and non-judgmental assistance.
Recognizing and Defining a Tic Attack
A tic attack is a prolonged, intense, and physically exhausting bout of tics that can last from several minutes to hours. The movements are non-suppressible, continuous, and disabling, often involving intense muscle tensing, shaking, and whole-body writhing. These episodes are involuntary and represent a severe breakdown of the nervous system’s ability to manage tics, frequently linked to extreme anxiety or stress.
It is important to differentiate a tic attack from other medical events, such as an epileptic seizure or a panic attack. Unlike a seizure, the person usually remains conscious and is often acutely aware of the movements, which can increase distress. The movements involve complex motor and vocal patterns, unlike a standard panic attack. Recognizing that the person is overwhelmed by involuntary movements, rather than being in danger of losing consciousness, guides the appropriate response.
Immediate Physical Safety and Environmental Management
The primary goal during a tic attack is to prevent the individual from accidentally injuring themselves due to the forceful, involuntary movements. Quickly assess the immediate area and create a safe perimeter around the person. This involves clearing away any sharp, hard, or breakable objects that the person might strike with their limbs or head.
If the person is on the floor or lying down, gently place soft items like pillows or folded blankets around their head and thrashing limbs for padding. Avoid the impulse to physically restrain or hold the person down. Restraint can increase distress, potentially worsen the tics, and lead to muscle strain or injury. The movements are involuntary, and physical restraint should be avoided.
Only move the person if they are in immediate danger, such as being in the middle of a road. If movement is necessary, use gentle, supportive motions while minimizing physical contact, as touch can sometimes intensify the tics. If the person is thrashing, focus on redirecting the environment to them, such as sliding a mat underneath, rather than moving the person themselves.
In public spaces, the bystander can help manage the reaction of others by creating a physical barrier or gently asking onlookers to step back. Reducing the audience helps decrease the person’s stress and self-consciousness, which can sometimes shorten the attack. The focus remains entirely on the physical safety of the person experiencing the attack and minimizing external stressors.
Supportive Communication and De-escalation Strategies
While managing the physical environment, maintaining a calm and patient demeanor is important, as the bystander’s anxiety can be sensed and may heighten the person’s tics. Use a low, calm tone of voice and keep sentences short, clear, and simple. Recognize that the person’s ability to process complex information is diminished during the crisis. The goal is to be a steady, non-judgmental presence that signals safety.
Use simple, reassuring phrases that acknowledge their experience without demanding a response, such as, “I’m here,” or “You are safe.” Never instruct the person to stop the tics or question why they are occurring, as these movements are uncontrollable. Drawing attention to the tics can be counterproductive.
Offer choices using simple, closed-ended questions that require minimal effort to answer. For example, ask, “Do you need water?” or “Should I dim the lights?” instead of open-ended questions. Listen actively to any verbal requests, respecting their wishes about physical contact and support. If the person can communicate, ask if they have a preferred grounding technique or item, like a weighted blanket, that can help redirect their focus.
Post-Attack Care and Medical Intervention
Once the intense ticcing subsides, the individual will typically be left feeling utterly exhausted and disoriented, as the attack is a physically draining experience. Aftercare should focus on allowing the person time to rest and recover in a quiet, comfortable space. Offer water, electrolytes, or a light snack to replenish energy and manage any muscle soreness resulting from the intense movements.
Remain nearby for a period, as tics may continue at a less severe frequency, and the person may still need assistance or emotional support. Gently inquire about any pain or injury sustained during the episode. If the person is known to you, discreetly note the duration and severity of the attack for their future medical review.
Emergency medical services (911 or equivalent) should be called only under specific, serious circumstances. Seek immediate help if the person sustains a severe injury, such as a head trauma or a suspected broken bone. Intervention is also warranted if the person experiences prolonged unresponsiveness, a loss of consciousness after the tics stop, or if they are unable to breathe normally. Providing first responders with the context that the person has a tic disorder ensures appropriate care.