Last June, researchers from Texas Children’s Hospital and Baylor College of Medicine documented six unusual cases in the journal Movement Disorders. The subjects were teenage girls between 13 and 16 who had started having “abrupt-onset tic-like movements.”
The tics were puzzling because Tourette’s syndrome and other tic disorders — characterized by involuntary and repeated movements or sounds — are far more common among boys and tend to first appear in early childhood with small movements; the girls’ movements, though, were large, accompanied by vocalizations and had other unique traits. Among them: The girls all described having watched TikTok videos of tics before their symptoms began, suggesting the potential spread of a social contagion.
Indeed, the C.D.C. last month reported a pronounced increase in similar tics based on evidence from a source never before used to assess specific mental-health conditions among the nation’s children: emergency-room data. For girls ages 12 to 17, the proportion of visits to the E.R. for tics nearly tripled during the pandemic as of January 2022. Visits also doubled for eating disorders, and there were increases related to anxiety, trauma and stress and obsessive-compulsive disorders.
These findings, particularly the rise in what have been called TikTok tics, have received considerable media coverage. But “equally striking,” says the lead author, Lakshmi Radhakrishnan, a health scientist at the C.D.C., is the marked but less widely discussed decrease in mental-health visits by adolescent boys.
Why do girls appear to be struggling? Are boys faring better? Or are their problems more likely to be overlooked?
The numbers can’t answer questions like these. “No single, comprehensive surveillance system for children’s mental health in the United States exists,” the C.D.C. noted in a supplementary report. The current surveys that keep tabs on various aspects of mental health in children are too slow to capture swift changes amid a national crisis. And though rapid surveys have evaluated the pandemic’s impact on the mental health of adults, fewer have considered how children are doing. “A lot of times kids aren’t the first in line,” says Daniel Dickstein, the associate chief and director of research at McLean Hospital’s child and adolescent psychiatry division. And, he points out, if more children were getting adequate mental-health care earlier, fewer would end up in the E.R., a venue that is not set up for ongoing treatment of psychiatric conditions.
Emergency-room data has been monitored for almost two decades by the C.D.C. as part of a response to 9/11 and a congressional mandate to track health measures in the event of disease outbreaks or other public-health emergencies. Though mental-health data from the E.R. has not been a specific focus for the C.D.C. over the years, it has now enabled the agency to produce a report that is meant, Radhakrishnan says, to raise awareness among parents, physicians and mental-health organizations.
This is especially important for emerging conditions in order to reduce misdiagnoses. For the tics many adolescent girls are having, for example, “we would want to treat looking at anxiety and depression,” says John Piacentini, an expert in tic disorders and director of the Child Anxiety Resilience Education Support Center at the University of California, Los Angeles.
Those conditions can increase the vulnerability of children to developing tics and eating disorders. Hence doctors should use great care in prescribing medications for tics because Tourette’s syndrome and other movement disorders — and kids can have more than one — often involve different neurological pathways.
Joshua Bassett Opens Up About Struggling With Mental Health
Joshua Bassett’s career has catapulted in the last few years, the journey for the High School Musical: The Musical: The Series star has been fraught with hardship.
In January 2021, Joshua was thrust into the spotlight after Olivia Rodrigo released her smash single, “Driver’s License.” Although the two never confirmed or even publicly commented on their relationship, fans immediately believed that it was inspired by their breakup and the alleged love triangle between Joshua, Olivia, and actress Sabrina Carpenter. As a result, Joshua received death threats and hate messages online.
Shortly after “Driver’s License” dropped, Joshua was rushed to the hospital and was diagnosed with septic shock and near-heart failure. It’s a timeline of events that seriously impacted his mental health, which he opened up about in a new interview with People.
“In this last year a lot of my biggest fears came true,” he told the outlet. “But in that, I found that I’ll always be OK, if not better off.”
The actor and musician shared that after his single “Lie Lie Lie” was released and he underwent emergency surgery, he felt “even more depressed and stressed” and “had a panic attack every single day.”
Joshua also further opened up about the sexual abuse he endured as a child and a teenager, which he first shared in December 2021 after the release of his three songs, “Crisis,” “Secret,” and “Set Me Free.” He explained that he only first started to process his trauma last year, and that therapy, yoga, and meditation have been his best coping mechanisms.
“What I realized recently is that the reason why I haven’t been able to process so much of it is because I went into pure shock,” Joshua told People. “I’m still very much in the middle of the whole process, and I think it is a lifelong thing, but I’m learning to peel back the layers.”
With his public platform, Joshua aims to continue talking about his experience in order to help people going through similar struggles. “It really bothers me that people said, ‘Why didn’t you do anything about it?’ When you go into freeze mode, you literally shut down. If I, a person with a platform, got treated like that, what would happen to a person in a small town? I won’t shut up about this until we’re far past that,” he shared.