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Showing posts with label OCD. Show all posts
Showing posts with label OCD. Show all posts

Friday, May 31, 2013

Tourette Syndrome Awareness Month: Let's Talk Co-Morbids

I have mentioned co-morbids several times in the past, and I thought it was time to explain more about what co-morbids are and how they affect those with Tourette Syndrome.  Co-morbids are other medical conditions (neurological, psychological, or behavioral) that can appear alongside a main condition, such as Tourette Syndrome.  You might see a person with TS state that they have TS+, a term used to generalize the diagnosis of TS with co-morbids.  Knowing more about co-morbids can help us to gain a better understanding of how much those with TS struggle to overcome just to function on a daily basis.

There are several types of co-morbids that can exist for those with TS.  Below are a few examples.  Please keep in mind that there could be more conditions not described here.

Obsessive-Compulsive Disorder: Intrusive thoughts, ritualized behavior, OCD related anxiety

Anxiety Disorders: Generalized anxiety disorder, panic disorder, and other non-OCD related anxiety

Mood Disorders: Disorders such as bi-polar and depression

Attention Deficit Disorder:  ADD or ADHD

Autism Spectrum Disorders:  Asperger's and other forms of autism

Rage Attacks:  These can also be known as 'meltdowns' or 'storms'

Sensory Disorders:  Sensory Processing Disorder and Sensory Integration Disorder

P.A.N.D.A.S.:  TS+ symptoms that can be related to infections such as strep

Sleep Disorders:  For example, insomnia

Other Learning Disorders:  Dyslexia, dysgraphia, discalculia, and more

Tuesday, August 7, 2012

Dermatophagia and Trichophagia

 One of the things that Monster Man has been dealing with for a very long time (since well before his diagnosis) is biting his own fingers.  It started out with nail-biting and progressed into chewing on the skin around his nails. I cannot remember the last time that I actually had to clip Monster Man's fingernails because he's bit them down so short for so long.  

At first, we didn't realize that this was in any way, shape, or form related to Tourette Syndrome.  A few months after his diagnosis, I started noticing that other parents were talking about how they fight the chewing by using things such as chewelry (jewelry that can be chewed on).  With all the posts I was seeing online in the Tourettes groups that I am on, I came to realize that chewing of skin (whether it be on the fingers, the toes, or wherever), as well as the chewing of hair, is very common in the TS world.

I finally discovered today that there are actually names for the chewing of skin and hair.  Those that chew on their skin most likely suffer from dermatophagia, while those that chew on their hair most likely suffer from trichophagia.  Both conditions are not part of Tourette Syndrome itself, but are actually part of a TS comorbid... Obsessive Compulsive Disorder.  

In my reading on dermatophagia, I came to realize that it is something I've always struggled with myself.  I have always chewed the inside of my mouth, often leaving sores on the inside of my cheek and on the inside of my lip.  As a kid, I tried to control it either by chewing on pencils or chewing gum.  I ended up with TMJ in middle school, and I had to cut back on the gum chewing.  I've been chewing the inside of my mouth off and on ever since.

I still haven't found something to help Monster Man compensate for the need to chew his fingers.  We've tried multiple times, unsuccessfully, to at least limit how much he chews on his fingers. He often chews on them until they bleed or scab, and we're concerned about the possibility of infection if he doesn't start controlling how much he chews.  We're hoping something will come to us soon, but at least we know now what we're really dealing with. 

Tuesday, May 22, 2012

Comorbid Conditions & Tourette Syndrome

Today is day 8 of Tourette Syndrome Awareness Month, which (as I've stated in a previous post) runs from May 15 to June 15.  I want to take the opportunity today to share a little about comorbid conditions.  I've used the term many times in the past, yet I've still received a lot of question about the term "comorbid".  It seems that what throws most people off is the word "morbid", which is most commonly thought of as "gruesome" or "unwholesomely gloomy".  Dictionary.com gives four definitions for the word "morbid", including the two more common definitions I just mentioned.  However, it can also mean "affected by, caused by, causting, or characteristic of disease" or "pertaining to diseased parts".  In the case of co-morbid conditions, it would be more the "affected by,..." definition.

Comorbid condition of Tourette Syndrome can include Obsessive Compulsive Disorder (OCD), Attention Deficit Hyperactivity Disorder (ADHD), bipolar, depression, anxiety, and rage. They can also include learning disorders, such as dyslexia and dysgraphia.  In many cases, these comorbid conditions are actually harder on the individual with TS than the actual tics are.

It is important to remember that these can appear together but do not always.  Some people may have one or two comorbids with their TS, some may have none, some may have many.  Like the difference in tics, it seems that you can have a room full of ticcers and not see a completely matching list of comorbids between two individuals.  It is also important to realize that just because a child exhibits one of the comorbids, it doesn't mean that the child has Tourette Syndrome.  A child with ADHD could just have ADHD.  A child with OCD could just have OCD.  These are all conditions that can occur on their own or along with other conditions.

Wednesday, March 21, 2012

Gotta wonder

Knowing that Tourette Syndrome can be hereditary, it's hard to look at Angel Baby and Little Man without wondering if they, too, might have Tourette Syndrome like Monster Man does.  What makes us wonder even more is the fact that we know that both Angel Baby and Little Man have issues that can be comorbid with Tourettes.

Angel Baby, like Monster Man, is starting to go through puberty - a time that can increase the symptoms of TS.  While she has always had sensory issues (she and I both have a lot of problems with certain textures and sounds) and some problems with anxiety, we've started to realize that some of her other behaviors are actually tics.  She has recently started chewing on the inside of her lip more often, too, and she recently sang in a school competition while chewing her lip throughout the entire song.  She has always had a tendency to have temper tantrums, as well, and never outgrew it as she got older despite our best efforts to curve this behavior.  Things we previously had related to other health issues she's experienced are now being looked at in a new light, and it's hard not to think that she could have TS like her brother.

Little Man is much younger (5 1/2 years younger than Monster Man), so we don't see a pattern of behaviors changing for him like they have with his brother and sister.  We have, however, had to accept that he has OCD.  We kind of joked around about it before, laughing at how picky he was about how the velcro on his shoes was lined up or commenting on the way that he'd sort his M&M's by color before eating them, even when he was too little to know his colors.  Grocery shopping used to be a challenge if Little Man was with me; he'd straighten all the shelves within his reach while I was picking items off other shelves.  A trashcan lid that was out of place or a bottle of ketchup not standing in the right direction in the refrigerator could lead to a major meltdown if he wasn't given the opportunity to correct the situation immediately.  He's recently started having to have his shoes just perfect - not too loose, not too tight, and the velcro or shoelaces have to be done perfectly as well.  Last week, he decided to wear sandals (with 3 velcro straps per shoe!) and he spent over 15 minutes getting his shoes to feel and look right before I finally convinced him to just get on with our day (to which he actually started crying because I wouldn't let him finish his task!).  The only complaint his teacher has about him is that he can't seem to speed up his schoolwork because he takes so long trying to get each line of each letter perfect.

OCD, anxiety, tantrums that could equate to rage... They can all be comorbids to the tics of Tourette Syndrome.  It's so hard not to wonder if we're seeing signs of things to come with our other two children.

Monday, May 16, 2011

Tourette Syndrome Awareness Month

May 15 through June 15 is officially designated as Tourette Syndrome Awareness Month.  This is a month made to help bring awareness to others about an obstacle so many people around the world live with on a daily basis.  They are challenged with tics, many of which can make life hard to live with.  They face a life full of challenges that are both physical and emotional.  Their brains take control of their bodies, and they have little control over the actions their bodies are taking at the hands of their overly active brains.  Each day, those with Tourette Syndrome battle with their brains, fighting to take control over the desire to blink excessively, shake their heads, repeat words, and so much more.

The most common thing I've heard as a parent of a child with Tourette Syndrome is one simple question.  "He's not going to start cussing is he?"  (BTW- the proper term for the use of obscenities and slurs is coprolalia).  It sounds innocent enough, but it really shows just how misunderstood Tourette Syndrome is.  I recently encountered someone who suggested that Tourette Syndrome had a spiritual link because "it almost always is accompanied by swearing".  It made me realize just how wrong people often are in how they view this condition.  According to the Tourette Syndrome Association website, "cursing, uttering obscenities, and ethnic slurs are manifested by fewer than 15% of people with TS."  Somehow 15% doesn't sound like "almost always" to me.  And the truth is, the majority of those I've talked to that either have TS or have family members with TS are Christians with a strong sense of faith and a very good connection to God.  Tourette Syndrome affects people of all religions, just as it affects people of all races, genders, and even income levels.  Tourette Syndrome doesn't discriminate.  It doesn't select those who are less spiritual than others.


As I've mentioned, those with Tourette Syndrome are faced with a number of challenges.  Tourette Syndrome often coexists with disorders such as Obsessive Compulsive Disorder (OCD), anxiety, Attention Deficit Disorder (ADD), Attention Deficit Hyperactivity Disorder (ADHD), Sensory Processing Disorder (SPD), Sensory Integration Disorder (SID), insomnia, bipolar, depression, or any number of other behavioral, learning, or sleeping disorders.  As if these challenges are not enough, many people who live with Tourette Syndrome are faced with the reactions of those who do not understand the condition.  There are the countless stares, the snide remarks, and the bullies.  Sometimes, there are even those who deal with family members who, for lack of understanding or out of embarrassment, make nasty comments or even go to the point of emotional abuse rather than giving support, comfort, and love.  The home and the family should be a comfort zone for those with TS, but sadly this isn't always the case.


While there are those with Tourette Syndrome who would rather hide their condition from those around them, there are many more who long for acceptance and understanding.  Please take the time, during Tourette Syndrome Awareness Month and the rest of the year, to find out more about TS and the lives of those living with it.  Should you have any questions about Tourette Syndrome, please check out the links along the side of this blog or feel free to ask me any questions that I might be able to help you with. 



Friday, May 13, 2011

A mixture of emotions

The past couple of weeks have been pretty tough.  Monster Man is alternating between episodes of rage and episodes of extreme clingy-ness.  One minute, he's in full rage mode, yelling and throwing things over what seems to us as no big deal (like asking him to clean his room, help unload the dishwasher, or even brush his teeth).  The next minute, he's practically attached to my hip, begging for forgiveness for having been in an episode of rage previously.  No matter how many times I tell him that it's okay, that I understand he is having a hard time controlling his emotions, he still apologizes.  And then he apologizes for apologizing.  And sometimes he apologizes for apologizing for apologizing...

I'm beginning to think that he's living in a constant fear of hurting someone's feelings.  While he's having an episode, he tells us how much he hates us and how much he thinks we hate him.  He says things that he doesn't mean to say, throws things at us, even occasionally tries to hit us.  He also tries hurting himself, smacking himself in the face most of the time, but he tried to slam an aluminum pot into his foot the other day and a few days prior had tried to jump over the railing to the stairs.  It's so hard seeing him struggling like that and knowing that there is very little that I can do to make it all better with the exception of reassuring him and continuing to show him how much I love him.

The medicine that I've been giving him continues to help with the rage, though I'm trying to limit when I give it to him so that he doesn't build a resistance to it.  I try to give it to him only before softball games or other times when I know he lets himself get worked up, or at times when he's already starting to show signs that his emotions are getting out of control and we have to go somewhere.  If we're staying home, I try to just let him work through the emotions.  If we don't have to be somewhere, then we stay home when he's having a bad day.  It's hard on Angel Baby and Little Man to know that we are choosing to cancel outings that aren't needed when he's at his worst, but I can't take the risk of taking him out somewhere (especially when it is just me and the kids) and trying to keep him under control while keeping an eye on the other two as well.  We're getting through this bit-by-bit, and I'm hopeful that we'll still be able to do a lot of the fun things we do together each summer.

In the midst of all of this, my husband and I are starting to worry that Little Man might be following in his brother's footsteps.  While Little Man does not have any noticeable tics just yet, he has always had a bit of an OCD side to him (he has to have certain things placed in the perfect position or he'll do what he has to do to get it right).  He doesn't have anxiety issues, but he is most definitely starting to show signs of having some rage issues.  My husband and I see the changes in Little Man's temper and often question whether it is just a stage or if it is signs of things to come.  I guess only time will tell.

Friday, March 4, 2011

Anxiety leads to lying

Wednesday was Angel Baby's birthday.  While I was out running errands that day, I stopped at McDonald's and bought myself a Happy meal for lunch.  I threw the toy in Angel Baby's seat, knowing she'd find it when we left for church that evening.  Instead, Monster Man was the first to enter the van.  He gave Angel Baby the toy, insisting that he'd found it at school and had brought it home to give to her as a present.  Since I didn't want to encourage any lying, I told him that he knew that wasn't the truth and that I knew where it had come from.  Even as I explained what the toy was and where it had come from, he kept insisting that he was telling the truth.  He started crying, saying that no one ever believes him anymore and that it's almost like we don't love him anymore.  How are we supposed to believe the things that we know for certain are lies?


It took almost 10 minutes for him to finally calm down and to admit that he'd found the toy in the car.  Since he and Angel Baby had been arguing earlier, he explained that he'd given it to and come up with the story in hopes that it would make her like him again.  


It was kind of scary, though, when it first happened.  He didn't show his usual signs that he was lying.  He looked me straight in the eyes and didn't even blink, rather than looking away and getting tears in his eyes (the tears came afterward).  It was almost like he'd begun to believe his story as he was telling it.  No matter how much I tried to calm him down, he just became more and more agitated that I didn't believe his story.


When I got home that evening, I immediately got online to ask the members of the National Tourette Syndrome Association's Facebook Page if they'd had any experience with anything like this.  Many reported both lying and stealing being part of their compulsive side of their anxiety/OCD.  One said that her child would lie like that in her continued efforts to be a people-pleaser.  Again, it was related to the anxiety.  Monster Man has always been the people-pleaser type, too, so I wouldn't be surprised if his lying stemmed from similar anxiety.  


The members of the group gave me some great advice on handling it, recommending that I talk to him individually about it (rather than in front of even his siblings) so that he wouldn't get embarrassed.  The embarrassment tends to make the anxiety and the situation as a whole a lot worse.  Next time, I'll be better prepared.  

Wednesday, January 12, 2011

Clingy-ness, I love you, and I'm sorry

Monster Man has always been a bit clingy to me. The clingy-ness comes in spurts, getting progressively worse, then better, then worse again. He's always loved to be by my side when he isn't playing a video game, reading a book, or drawing. If I'm sitting by him when he's playing a video game, there are even times when he practically sits on top of me. We just figured he was a cuddly kind of boy, one who loved to hug and to spend time with me. There are times that the clinging seems to resemble separation anxiety, but we can usually work past it when it gets that bad. He also likes to say "I love you" a lot more than the other kids. Again, we just figured it was part of how loving he is. It never occurred to us that this isn't normal, that this might be part of something bigger.

I learned yesterday that this is actually part of his Tourette Syndrome. It seems to be more of the OCD side, if I'm reading right. It appears that many kids with TS seem to fear that something might happen to their parents, to the point that some call their parents, text them, etc multiple times a day just to say "I love you". Though he doesn't call me or text me, he does seem to feel the need to say it multiple times a day, even multiple times in an hour. He can be in one room and I'll be in another, and he'll yell "Mommy" from where he is. As soon as I ask what he needs, he'll just answer with "I love you." To me, there seems to be many worse problems to have than to have a child that loves you, but it does tend to be a problem when the clingy-ness gets to be a little disruptive to my classwork, his homework, and getting other things done.

Another part of his OCD and TS that I hadn't realized was part of the big picture was how often he apologizes. It broke my heart before to realize how much he was apologizing, since I thought that he must constantly think he is doing wrong. I thought that he might be a little depressed thinking that he was this person that needed to apologize for everything. He apologizes for every little thing sometimes, including apologizing for apologizing. Sometimes he apologizes for his "I love you"s because he thinks it's an inconvenience (I've told him that, while there are times that I need him to be quiet - like when I'm taking a test for school - I don't mind him saying "I love you", and that there is never a need to apologize for loving anyone). This need to apologize also seems to come in spurts, but I never realized that the need to apologize was part of his TS and OCD until I read about this yesterday, right along with the information on the clinging and the need to say "I love you".

I must say that I am a bit relieved to find out that his need to apologize is all part of what he is already dealing with. It is much easier to think about than the depression that I had previously thought might be to blame.

Friday, January 7, 2011

In thinking back

I've been thinking back a little, trying to remember when Monster Man really started showing signs of his TS and OCD. Though the majority of the signs didn't show themselves until the past couple of years, I have to wonder if maybe the anxiety started much earlier than I realized.

Monster Man didn't learn how to swim until this past summer. I didn't think too much of it, though I did notice that his troubles were due to fear once he realized that he was actually swimming without support. Before this summer, he'd make it about three feet before his feet would drop below the water and he would start to sink. I remember when he was younger, even when he was tall enough to touch in the shallow end, he'd start crying that he was drowning if I wasn't holding on to him. I thought he was just nervous and overreacting, and I kept reassuring him; we even quit going to the pool for quite some time just to give him a break from trying to teach him to swim. Now that I look back at it, knowing what he is experiencing with his anxiety/OCD, I have to wonder if this was an early sign of things to come.

Tuesday, January 4, 2011

You never really know

You never really know when a new tic or a new fear will start up. It seems like they come out of nowhere. It's weird how something that you have done just about every day of your life can suddenly turn into something that makes you nervous or at least uncomfortable.

Earlier today, I took Angel Baby, Monster Man, and Little Man to the store with me. Little Man sat in his usual seat directly behind me and Angel Baby sat in the other captain's seat beside him. Monster Man chose to sit on the rear bench seat, directly behind Little Man. I was driving down the road, less than five minutes from the house, when Monster Man suddenly informed me that he needed to change seats. I had to stop to let him move over directly behind Angel Baby. His reason for the switch, as told in a very nervous tone, was that he was "uncomfortable" and that sitting on that side of the van is "kind of freaky". Evidently, he suddenly realized that the cars on the other side of the road were closer to him than he thought, and he suddenly became afraid that one might cross over the yellow line and hit the van, injuring him. Once we got to the store, he also informed me that he was "kind of scared" when crossing the parking lot, afraid someone might come flying into the parking lot and hit one of us.

I can't even begin to imagine what it must be like to be in his shoes, constantly afraid that something bad might happen.

Monday, January 3, 2011

Obsessive Compulsive

From what I've been reading about Tourette Syndrome through both the TSA website and from the National Tourette Syndrome Association facebook page, I've discovered that Monster Man's anxiety issues aren't just anxiety. In fact, they are labeled as a form of OCD. With TS, people who have obsessive compulsive disorder tend to dwell on fear of disasters. It's more a fear of the uncontrollable, rather than a fear of what could happen if you don't do things a certain way (which is the more common form of OCD in patients without TS). This really explains a lot about his anxiety. I mentioned previously about his fear of a hurricane coming up the mountain and his fear about roller coasters coming off the tracks or displayed rockets falling over on top of him. From what I've been reading, this is actually more OCD than just general anxiety.

Monster Man's fears seem to be a big problem sometimes. They seemed to develop overnight, and they've really hit him hard. I was really worried at first that he was alone in these fears, and that something more was really wrong. It is a relief to me to know that this is just a part of his TS, and that so many others with TS are going through the same thing.