The difference between simple and complex tics

Tics can be simple or complex.

This doesn’t necessarily refer to the severity of the tic, or how often they occur.

It comes down to how many muscles are being used in the process, with some focus on duration and if there are thoughts involved in the movements and/or sounds.

The definitions

Mayo Clinic defines simple and complex tics as:

Simple tics. These sudden, brief and repetitive tics involve a limited number of muscle groups.

Complex tics. These distinct, coordinated patterns of movements involve several muscle groups.

Simple tics

Some examples of simple motor tics are blinking, head nodding and shoulder shrugging.

Something that involves short, sudden movements in any area of the body.

Simple vocal tics are similar, but with sound. Whistling, humming and grunting are common simple tics.

Complex tics

Complex movements involve more muscle groups.

Complex motor tics may involve bending down to touch the floor. It could be to move the eyes, nose and mouth at the same time, or punch another body part.

These tics typically last longer, are more noticeable and can be more harmful and tiring.

Complex tics can be an infusion of simple tics

Two or more simple tics can occur at the same, and may be considered a complex tic.

For example, a person may feel the need to nod the head and make a humming sound at the same time.

This combination of one simple motor and vocal tic could be classed as a complex movement if the pre-sensory urges manifested at the same time, or feel like they came from the same urge.

For some, the tic may only feel satisfactory if both tics are carried out simultaneously.

Tics may involve obsessional thoughts

Obsessional thinking can cause tic-like symptoms, and many people with Tourette and tic disorders have OCD or OCD-like behaviours.

Tics can be used to ‘correct‘ or ‘reverse‘ an intrusive thought, such as saying ‘Heaven’ when thinking about Hell.

Tics can also involve a ‘phantom‘ or ‘fake‘ tic.

For example, if a person dislikes odd numbers, having three urges to tic in a row can be unsettling. Doing a fourth identical ‘fake’ tic can relieve anxiety associated with obsessional behaviours.

A term that may better explain these behaviour is Tourettic-OCD, also known as ‘Just Right OCD‘.

The difference between simple and complex tics can be blurry

Tics can vary wildly, and the definition of simple and complex tics can be blurry.

Tics can manifest for a number of reasons, mainly as a sensory urge. Tic-like behaviours can be closely associated with anxiety and OCD.

Documenting how tics occur and the sensations felt before a tic can help specialists with a diagnosis.

Sources: Tourette Syndrome Overview