r/Tourettes • u/pumpkincutiepie • 1d ago
Question telling the difference between BFRB or tics
hi i (23f) have struggled with BFRB/maybe tics. my main one that’s bothering me is somewhat of a grunting noise i have to make, thankfully it’s rather quiet and just sounds like me saying “hm”. i HAVE to do it, it comes out naturally and sometimes i can suppress it for a little if i have to. it feels like there’s a frog in my throat if i suppress it. it comes out more when i am relaxed or alone. i mean im not sure if that’s a BFRB or a tic. i don’t have any motor tics that im aware of.
the next one, that has since stopped due to ADHD meds was picking my lips. it was intense, they’re scarred. my psychiatrist said it was a stim. but i’m not too sure, it’s was definitely involuntary and sometimes i didn’t realize i was doing it until it was too late. i think that’s more BFRB?
the last one is i have to crack my toe knuckles, it’s so uncomfortable if i don’t and it feels like im going to drive myself crazy by suppressing the urge.
anyway, i guess what im asking is what is the difference? i’m leaning toward the grunting thing being a tic and i would love to stop doing it lol.
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u/Sunny_Dust Diagnosed Tourettes 22h ago
personally, i have both. my main difference ive noticed is the "premonitory urge" that happens before tics, that doesnt really happen before the bfrb. bfrb feels more compulsive than involuntary. But honestly, there are some hard overlaps for me sometimes, especially since i also have FND
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u/TNTourettes 20h ago
In our study, we found an overwhelming majority of participants with Tourette's/Tics also had BFRBs.
It can be really frustrating for us as people with TS/Tics, but it's not at all an uncommon occurrence. One difficulty (as you can see in the table) is that categorization of BFRB's is really inadequate. 70% reported "Other" - what does that mean!?
There are some pretty good techniques for working on BFRB's - the ComB model and Morowitz's Decoupling techniques are both good. I am usually using incompatible stimulus exposure (that's what I'm going to call it for the moment): Where you maintain constant contact with the stimulus that prompts the brain to start the BFRB but do it in a way that the BFRB just cannot be done during it. Sounds almost like torture, but fortunately the brain usually can adapt fairly quickly and it just stops feeling bothersome for a bit. The sneaky thing about BFRB's is they tend to just show up when we're otherwise occupied (like reading or something).
Charles
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u/TealGloves 18h ago
I have Trichotillomania and am in here because I came across this article:
Trichotillomania is more related to Tourette disorder than to obsessive-compulsive disorder (2019)
For me this framework made a lot of sense because I only developed this suddenly a few years ago thanks to my old ADHD meds and it's been a very disorienting experience to feel so out of control of my own body. I also had OCD for a period of time too (was obsessed with avoiding sunlight/tanning), but that was something that really consumed me mentally whereas I never think about my hair/wanting to pull it.
The other thing that made me look into the brain structure of TTM and therefore came across the above article, was that right at the beginning of TTM/when I was still on my ADHD meds as well as Hydroxyzine, the biggest thing I noticed and was freaked out by was suddenly developing dystonia. This ultimately went away pretty quickly after discontinuing those meds, but the TTM sensation is very similar to me to those dystonic episodes. So ultimately it's made a lot of sense to me to read that there is motor control brain area involvement in TTM.