ADHD

ADHD is the most commonly co-occurring condition with Tourette Syndrome (TS) with around 20 – 30% of children with ADHD also having a tic disorder.
 

People with ADHD will have difficulty with paying attention, are much more energetic than others, and are unable to control certain impulses.
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ADHD is also diagnosed around the same age as TS and has a higher prevalence in boys.
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ADHD is caused by the movement and ‘braking’ systems in the individual's brain maturing more slowly.
As with TS, not every child with ADHD will carry their symptoms through to adulthood.
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Symptoms mostly start in childhood. The key thing to remember is that someone with ADHD is not behaving badly on purpose. The area in their brain which is responsible for self-control takes longer to mature than in children who don’t have ADHD.

Symptoms can range from mild to challenging. Symptoms can be specific to certain environments like home or school.​

 

ADHD may include, difficulty sitting still, constant fidgeting, moving, talking, making noises, low patience threshold, for example, they may find it hard to wait in a queue or listen, this can also result in them interrupting others. They may also say and do things without thinking through the consequences due to their immature impulse regulations.Types of ADHD & some examples of their characteristics:Hyperactivity: noisy in play, fidgety, struggle to stay seated, always on the go, excessive talking.Impulsivity: difficulty waiting their turn, interrupts conversations, shouts out answers before the question is completed.Inattention: forgetful, poor organisation, distracted, loses things, appears to not listen, avoids tasks that require lots of attention, fails to complete tasks, makes careless mistakes.

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OCD

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Someone with OCD will experience recurrent obsessions and/or compulsions that are severe enough to affect everyday life. These obsessions are usually anxiety-driven. The symptoms of OCD are obsessions and compulsions. Obsessions are uncontrollable thoughts, images, impulses, worries, fears, or doubts. They are often intrusive (cause disruption and annoyance), unwanted, and can be frightening for the person experiencing them. People with OCD will often know that these thoughts are irrational, but this doesn’t mean they can control them.

 

The most common obsessional thoughts are worrying about the safety of others or worrying that everything needs to be arranged symmetrically so that it is ‘just right’.

 

Compulsions are purposeful behaviours and actions that are performed in an attempt to relieve the anxiety caused by obsessional thoughts. Often the behaviour is carried out according to certain rules or will be performed as a ritual.The relief provided by compulsions is only temporary and often reinforces the original obsession. Common compulsions include checking, counting, and touching.

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OCD & Tourette's

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 It is thought that approximately one-third of individuals with TS experience recurrent obsessive-compulsive symptoms. (Khalifa and von Knorring 2005; Leckman et al. 1997)It can be difficult to tell the difference between a compulsion and a compulsive tic.

 

A compulsion is typically behaviour that is carried out in an attempt to relieve the anxiety that is caused by an intrusive or obsessional thought. A compulsive tic is more associated with a physical sensation and needs to be performed to relieve the urge sensation.

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The condition affects both children and adults and it is estimated that as many as 12 in every 1,000 people are affected by OCD in the UK.

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Tourettetic OCD

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TOCD usually manifests as pure compulsions and rituals and does not have the fear element that something bad will happen if the ritual isn't completed.These rituals are preceded by a physical sensation rather than an anxiety-based thought. 

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TOCD is rarer than OCD and the OCD treatment pathway CBT, is usually ineffective with TOCD.

The treatment pathway for TOCD is the same as Tic intervention. These conditions are separate conditions but they can look virtually the same. It's important to establish which 'version' you have as treatment options vary. In classic OCD an individual may experience intrusive thoughts and anxiety that precede a compulsion. You may feel that something bad may happen if the ritual/compulsion isn't completed. Ie: you or someone will come to harm.  

 

The treatment pathway for OCD is Cognitive Behaviour Intervention (CBT) Both forms of OCD can be physically disabling and emotionally distressing, these rituals in both conditions can take hours, resulting in lateness to school, work, meetings, socialising, and even going to bed.For some individuals with TOCD these rituals cause them the most distress from their condition.