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Transmissible Tics? TikTok Panics and the Newest "Social Contagion"

By Kyr Goyette

The headline of a September 2023 article from right-wing British news magazine The Spectator forcefully declares: “TikTok is giving our children Tourette’s.” It bears all the hallmarks of a clickbait headline, especially in the age of the internet: a threat against the health of the children, and the blame being leveled against the increasingly maligned social media app TikTok. What it doesn’t contain is an iota of truth.

Fear-mongering over what the newest social development is doing to “the youth” is nothing new: from the Satanic Panic of the 1970s to the recent assertions by authors like Abigail Shrier that transgender children are being convinced by their friends and the internet to transition, social trends that draw the ire of some interest group can generate a fervent backlash against the individuals or the sites that are seen as responsible for promoting them. When it comes to TikTok, the site has been blamed for pretty much every failure of Generations Z or Alpha, and has been the target of xenophobic rhetoric from all levels of American society—including the national government—because it is owned by a Chinese company. There have been examples of truly damaging trends propagated by social media sites, such as the “Tide Pod Challenge” that dared people to swallow laundry detergent packs several years ago and the more recent “Blackout Challenge,” which involves holding someone up by their neck until they pass out and has been linked to several deaths. But more often than not, blame is severely misplaced—particularly when it is assigned to individual creators on specific social media sites.

The aforementioned article levels blame against TikTok, and a particular creator who shared their experiences with Tourette’s, for an emerging medical phenomenon that has become increasingly widespread in the past five years. During the COVID-19 pandemic, a startlingly global trend began to emerge that concerned neurologists: increasing numbers of adolescents were presenting with what appeared to be a kind of “sudden-onset” Tourette’s syndrome. Tourette’s syndrome is a condition that causes tics, which are uncontrollable muscle twitches that can produce a variety of movements and vocalizations. Although the exact pathophysiology of Tourette’s is not known, it is generally established as a genetic condition modulated by environmental factors, and a key diagnostic criterion is a slow and gradual onset of tics starting at a young age. Although a number of these individuals who presented in the early months of the pandemic were initially diagnosed with Tourette’s syndrome, scientists quickly realized that the sudden, steep rise was not consistent with Tourette’s and determined instead that most of the individuals were suffering from functional tic disorders.

Functional tic disorders are distinguished from Tourette’s in that they generally appear later in life. The first tics that appear may be severe immediately instead of increasing gradually in severity, and functional tic disorders are believed to be a manifestation of individual psychological distress. Significantly, there is some indication that the onset of functional tic disorders may be associated with exposure to individuals with tics on social media: closer examination of the trend that initially seemed to start with the COVID-19 pandemic revealed that the uptick coincided with the rise in popularity of a particular TikTok influencer who regularly posted videos of their tics in June 2019—months before COVID-19 lockdowns went into effect and their devastating impacts on adolescent mental health became widely documented.

Regardless of the exact moment at which this trend emerged, COVID-19 almost certainly made it worse: social media use in the emotionally turbulent environment of the pandemic has been tied to a worsening of other psychological conditions, such as eating disorders, where exposure to other individuals with the same condition can occasionally have damaging effects. Studies overall have indicated that particularly adolescent mental health took a severe hit throughout lockdown periods, with pre-existing anxiety and depression worsening due in part to social isolation and restricted access to support networks; it follows that a similar combination of exposure and distress would have had a parallel effect on functional tic disorders. These cases contribute to an increasing body of evidence that suggests that social media may be a new vector via which mass psychogenic illnesses—more commonly known as mass hysteria—can spread. 

Since the 2012 incident where more than a dozen students at a high school in LeRoy, New York came down with a mystery illness associated with tics and seizures, scientists and doctors interested in mass psychogenic illnesses (MPIs) have commented on the role that social media and the internet at large may play in the transmission of MPIs, which were once thought to be limited to groups with close geographic proximity to one another. Recently, in southern Mexico in 2022, more than two hundred students across several schools fell ill in fainting episodes over several weeks. Investigations by health officials turned up no concrete answers, and it wasn’t until an expert in MPIs examined the case that a social media connection—a shared WhatsApp group chat—was discovered between some of the afflicted victims, suggesting that social media may have played a role.

So why, with this bevy of evidence connecting social media use to mass psychogenic illness and functional tic disorders, is the article title “TikTok is giving our children Tourette’s” both factually wrong and immensely damaging? First, as has already been established, Tourette’s syndrome and functional tic disorders are fundamentally different conditions: they have distinct differential diagnoses, different prognoses, and separate treatments. Moreover, those with Tourette’s syndrome have already historically dealt with an immense amount of stigma associated with their condition; the uncontrollable movements and vocalizations associated with it can make social encounters difficult. Individuals with Tourette’s, particularly children, hardly need additional stigma suggesting that their condition is somehow contagious. This article stokes stigma against Tourette’s and spreads potentially dangerous misinformation, as standard treatment for Tourette’s won’t help someone with a functional tic disorder.

Beyond that, blaming TikTok and social media at large is a cop-out when it comes to confronting the true causes of psychological distress in adolescents. Social media in this case acts in an amplificatory manner. It provides another avenue through which individuals can be exposed to tics, but exposure on its own doesn’t result in the development of functional tic disorders—if it did, the several million people who have watched certain popular videos of tics would all have some form of functional tic disorder. Moreover, the reason that individuals with Tourette’s and functional tic disorders are active on social media most of the time is to create communities for themselves and others with the same condition. The same social media sites that are blamed for “spreading” these conditions provide havens for those who may not have a similar in-person support network available. Likewise, the attribution of adolescent distress as a whole to social media is faulty for the same reasons: the studies mentioned earlier and others show that social media only exacerbates what is already present.

While reducing social media use may be valuable for those whose conditions are amplified by engagement, social media itself isn’t the problem. Those who think it is are either out of touch with the experiences of modern adolescence or are unwilling to confront the realities behind the current mental health crisis, and so instead choose what will make for a punchy headline.