The mysterious case of the 'TikTok tics': Is social media making us sick? – Stuff

Strolling through a mall with her sibling, whiling away the time before school started, Bella Maxwell’s head suddenly snapped into her shoulder.
Though barely perceptible to her at the time, a week shy of her 16th birthday, things worsened throughout the day: she was saying things and her body was moving in ways she couldn’t stop or make sense of.
It happened “completely out of the blue”. One day, the Clevedon girl had “absolutely nothing”, the next she was “the loudest one in the classroom, not able to control it”. It was June 2020, not long after New Zealand exited its first Covid-19 lockdown.
That first tic was just the beginning for Maxwell, and countless other young women worldwide who developed similar involuntary behaviours during the pandemic, in what has colloquially come to be known as the “TikTok tics”.
* She woke up one day with severe Tourette Syndrome: Tic disorders skyrocket post Covid-19
* My Tourette’s diagnosis came in adulthood but has made sense of things retrospectively

At first glance, meowing nuns in the Middle Ages, fainting teenage girls in modern-day Melbourne, and the Salem witch trials appear to have little in common.
But over time, each came to be considered examples of mass psychogenic illness: known also as “mass hysteria” or mass sociogenic illness.
With these conditions, people in a social group develop similar, medically inexplicable, often bizarre symptoms. Some believe they have been exposed to something dangerous, such as a toxin, but investigations find none.
Now, it’s feared TikTok and other social media may be a perfect vehicle for psychogenic illnesses to spread.
Over the past two years, neurologists globally have seen increasing numbers of patients – particularly adolescent girls – displaying unusual, involuntary movements and vocalisations, akin to Tourette syndrome.
After ruling out other explanations, it’s been suggested tics in many of these teens seem related to TikTok videos – which garnered billions of views – from people who report having Tourette syndrome and other movement disorders.
Sociologist Robert Bartholomew, an honorary senior lecturer in the University of Auckland’s Department of Psychological Medicine, has devoted decades of his life to decoding bizarre behaviours, and unravelling hysteria and hoaxes.
But the suffering and symptoms caused by mass psychogenic illness is no hoax: it’s real, and there’s cause to believe social media is facilitating their transmission.
It’s an issue he and Maxwell delve into in a new Loading Docs documentary, called Believing is Seeing.
Bartholomew says there are two common types of mass psychogenic illness.
You may have heard of the placebo effect: where belief in a treatment produces a beneficial impact the treatment itself did not cause. It has an “evil twin” – the nocebo effect – which has the power to induce illness purely through suggestion or belief. An idea is enough to make you sick.
Often they’re linked to a perceived danger in air, water or food and triggered by a foul or unfamiliar odour. Symptoms are transient, benign and typically resolve within 24 hours.
Imagine being told you’ve just accidentally ingested rat poison. You might start getting stomach pains, or even vomit.
But the “TikTok tics” fall into a different group, Bartholomew says.
The second type arises from prolonged, extreme stress over time. Common motor symptoms include twitching, shaking, trouble walking, uncontrollable laughing and weeping, communication difficulties or trance states, that can take weeks or months to subside after the stress has been reduced or eliminated.
Such “outbreaks” are rare – Bartholomew has noted 3500 cases of mass psychogenic illness since 1556, just four in the US between 1900-1999 – but he’s seen a rise in the past two decades.
So why now? Why teenage girls? And why TikTok?
Professor in psychological medicine at the University of Auckland, Keith Petrie​, says the nocebo effect can be strongly transmitted by social information: the greater the reach, the greater the effect.
Before the social media age, mass psychogenic illness spread primarily via sight and sound in close-knit settings, such as school classrooms, offices and sometimes army barracks – typically after a recent social stress, or “dramatic” episode witnessed by a lot of people.
“Now, your mobile phone is an extension of your world. It’s limitless. [Mass psychogenic illness] can spread around the world in the blink of an eye,” Bartholomew says.
On social media, we’re primed to look at what other people are doing, which works in favour of the phenomenon spreading.
Covid-19 was a major stressor: people were in lockdown, many separated from their friends, spending their time online.
“They can go into their room, enter the world of social media, and see people ticcing,” he says.
“The main vector of spread is an idea: it just soaks up and amplifies anxiety of young, vulnerable girls.”
But there’s a potential protective factor with social media, Petrie says: there’s no immediate threat in the environment which is typically needed to set off a larger outbreak.
Historically, mass psychogenic illnesses affect women more than men.
The reasons are not entirely known, but both Bartholomew and Petrie say women are socialised to cope with stress differently than men. They’re more likely to discuss symptoms and seek medical attention than their male counterparts.
Though sub-conscious, it is real, Bartholomew says. These girls are not faking it: “they are victims, and they’re suffering.”
Paediatric neurologist Dr Hannah Jones​ says some features of these cases are unusual and atypical for tic disorders and Tourette syndrome.
Tic disorders commonly present at age 4-6, and occur in three boys for every girl. Meanwhile, these functional tic disorders in higher numbers over the past few years are in adolescents, and mostly females.
A high proportion of functional tic disorders (such as those being seen in young women) have an abrupt onset, different to typical tic disorders and Tourette syndrome.
Tourette’s Association of New Zealand hasn’t seen an influx of people experiencing these type of tics, but says no-one collects data to report how widely this is happening here.
Anecdotally, a paediatric neurologist tells the documentary he’d seen a fourfold increase in such cases.
Jones, who’d seen just two such patients over the past two years, thought they probably had increased, similar to what has been in New Zealand – but wasn’t sure to what degree.
Maxwell’s doctors concluded her tics were most likely triggered by stress and anxiety.
A “massive introvert”, Maxwell thrived in lockdown. Heading back to school, with new Covid-19 measures in place, was stressful.
Ticcing would physically wear her out, making her more vulnerable to more tics: “it was a cycle I couldn’t get out of”.
A neurologist told her it appeared she had a form of Tourette syndrome, but Maxwell doesn’t feel she has a formal diagnosis.
Spurred on to spread awareness of tics and anxiety, Maxwell herself turned to TikTok, sharing videos of her experience with tics while baking cookies with her mum, and doing challenges.
“I wanted to help people understand it, and be there to support others.”
Now 18, Maxwell has just finished her first year of a Bachelor of Visual Arts at Auckland University of Technology. Her tics aren’t as big as they used to be, “which I’m insanely grateful about”.
Maxwell doesn’t believe her tics were influenced by social media, and says she had seen just one or two videos before they emerged.
What’s important to her isn’t why the tics started, but that people understand it could happen to “anyone”.
“Whether it’s mass psychogenic illness, or just anxiety, not a lot of people know about tics,” Maxwell says, hopeful her story can help others “learn a bit more”.
So can social media really make us sick? Bartholomew says not only is it, but we’re all potential victims.
“The ‘TikTok tics’ have happened right under the noses of parents. The danger here is that, if this can happen to thousands of adolescent girls around the world through social media, what’s next?”
“We need to be paying attention, because there will be something else.”
Believing is Seeing is part of the Loading Docs 2022 collection. More Loading Docs titles are available to watch on Play Stuff, and
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