• Patient Care & Health Information
  • Diseases & Conditions
  • Tourette syndrome

Tourette (too-RET) syndrome is a disorder that involves repetitive movements or unwanted sounds (tics) that can't be easily controlled. For instance, you might repeatedly blink your eyes, shrug your shoulders or blurt out unusual sounds or offensive words.

Tics typically show up between ages 2 and 15, with the average being around 6 years of age. Males are about three to four times more likely than females to develop Tourette syndrome.

Although there's no cure for Tourette syndrome, treatments are available. Many people with Tourette syndrome don't need treatment when symptoms aren't troublesome. Tics often lessen or become controlled after the teen years.

Products & Services

  • A Book: Mayo Clinic Family Health Book, 5th Edition
  • Newsletter: Mayo Clinic Health Letter — Digital Edition

Tics — sudden, brief, intermittent movements or sounds — are the hallmark sign of Tourette syndrome. They can range from mild to severe. Severe symptoms might significantly interfere with communication, daily functioning and quality of life.

Tics are classified 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.

Tics can also involve movement (motor tics) or sounds (vocal tics). Motor tics usually begin before vocal tics do. But the spectrum of tics that people experience is diverse.

In addition, tics can:

  • Vary in type, frequency and severity
  • Worsen if you're ill, stressed, anxious, tired or excited
  • Occur during sleep
  • Change over time
  • Worsen in the early teenage years and improve during the transition into adulthood

Before the onset of motor or vocal tics, you'll likely experience an uncomfortable bodily sensation (premonitory urge) such as an itch, a tingle or tension. Expression of the tic brings relief. With great effort, some people with Tourette syndrome can temporarily stop or hold back a tic.

When to see a doctor

See your child's pediatrician if you notice your child displaying involuntary movements or sounds.

Not all tics indicate Tourette syndrome. Many children develop tics that go away on their own after a few weeks or months. But whenever a child shows unusual behavior, it's important to identify the cause and rule out serious health problems.

There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form.

From Mayo Clinic to your inbox

Sign up for free and stay up to date on research advancements, health tips, current health topics, and expertise on managing health. Click here for an email preview.

Error Email field is required

Error Include a valid email address

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.

Thank you for subscribing!

You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox.

Sorry something went wrong with your subscription

Please, try again in a couple of minutes

The exact cause of Tourette syndrome isn't known. It's a complex disorder likely caused by a combination of inherited (genetic) and environmental factors. Chemicals in the brain that transmit nerve impulses (neurotransmitters), including dopamine and serotonin, might play a role.

Risk factors

Risk factors for Tourette syndrome include:

  • Family history. Having a family history of Tourette syndrome or other tic disorders might increase the risk of developing Tourette syndrome.
  • Sex. Males are about three to four times more likely than females to develop Tourette syndrome.

Complications

People with Tourette syndrome often lead healthy, active lives. However, Tourette syndrome frequently involves behavioral and social challenges that can harm your self-image.

Conditions often associated with Tourette syndrome include:

  • Attention-deficit/hyperactivity disorder (ADHD)
  • Obsessive-compulsive disorder (OCD)
  • Autism spectrum disorder
  • Learning disabilities
  • Sleep disorders
  • Anxiety disorders
  • Pain related to tics, especially headaches
  • Anger-management problems

Tourette syndrome care at Mayo Clinic

  • Jankovic J. Tourette syndrome. http://www.uptodate.com/home. Accessed Nov. 7, 2015.
  • Ferri FF. Tourette's syndrome. In: Ferri's Practical Guide: Fast Facts for Patient Care. 9th ed. Philadelphia, Pa.: Mosby Elsevier; 2014. http://www.clinicalkey.com. Accessed Nov. 7, 2015.
  • Hallett M. Tourette syndrome: Update. Brain & Development. 2015;37:651.
  • Zhang JG, et al. Long-term outcomes of globus pallidus internus deep brain stimulation in patients with Tourette syndrome. Mayo Clinic Proceedings. 2014;89:1506.
  • Gilbert DL, et al. Pharmacological treatment of Tourette syndrome. Journal of Obsessive-Compulsive and Related Disorders. 2014;3:407.
  • Swaiman K, et al., eds. Tics and Tourette's syndrome. In: Swaiman's Pediatric Neurology: Principles and Practice. 5th ed. Philadelphia, Pa.: Saunders Elsevier: 2012. http://www.clinicalkey.com. Accessed Nov. 8, 2015.
  • Shaw ZA, et al. Tics and Tourette syndrome. Psychiatric Clinics of North America. 2014;37:269.
  • Ganos C, et al. Tics and Tourette syndrome. Neurologic Clinics. 2015;33:115.
  • Ghosh D, et al. Sleep disorders in children with Tourette syndrome. Pediatric Neurology. 2014;51:31.
  • Brown AY. Allscripts EPSi. Mayo Clinic, Rochester, Minn. July 3, 2018.
  • Tourette syndrome fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/tourette/detail_tourette.htm. Accessed Nov. 8, 2015.

Associated Procedures

  • Botox injections
  • Cognitive behavioral therapy
  • Deep brain stimulation
  • Psychotherapy
  • Symptoms & causes
  • Diagnosis & treatment
  • Doctors & departments
  • Care at Mayo Clinic

Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.

  • Opportunities

Mayo Clinic Press

Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press .

  • Mayo Clinic on Incontinence - Mayo Clinic Press Mayo Clinic on Incontinence
  • The Essential Diabetes Book - Mayo Clinic Press The Essential Diabetes Book
  • Mayo Clinic on Hearing and Balance - Mayo Clinic Press Mayo Clinic on Hearing and Balance
  • FREE Mayo Clinic Diet Assessment - Mayo Clinic Press FREE Mayo Clinic Diet Assessment
  • Mayo Clinic Health Letter - FREE book - Mayo Clinic Press Mayo Clinic Health Letter - FREE book

Let’s celebrate our doctors!

Join us in celebrating and honoring Mayo Clinic physicians on March 30th for National Doctor’s Day.

U.S. flag

Tourette Syndrome

What is tourette syndrome.

Tourette syndrome (TS) is a neurological disorder that may cause sudden unwanted and uncontrolled rapid and repeated movements or vocal sounds called tics. TS is one of a group of disorders of the developing nervous system called tic disorders.

The motor (involving body movement) or vocal (involving sounds you make) tics of TS come and go over time, varying in type, frequency, location, and severity. If you have tics, you cannot stop your body from having them. The first symptoms usually occur between the ages of 5 and 10 years, generally in the head and neck area. These may progress to include the muscles in your torso, arms, and legs. Motor tics generally occur before the development of vocal tics. 

Tourette syndrome affects more boys than girls. Most people with TS experience their worst tic symptoms in their early teens, but tics typically lessen and become controlled by the late teens to early 20s. For some people, TS can be a chronic condition with symptoms that last into adulthood. In some cases, tics may worsen in adulthood. TS is not a degenerative condition (one that continues to get worse) and individuals with TS have a normal life expectancy.

Classification of tics and symptoms

If you have TS, you may experience simple or complex motor tics. They may range from very mild to severe, although most cases are mild.

Simple tics are sudden, brief, repetitive movements that involve a few muscle groups. They are more common than complex tics. Simple tics often precede complex tics.

Simple motor tics include:

  • Eye blinking and other eye movements
  • Facial grimacing
  • Shoulder shrugging
  • Head or shoulder jerking

Simple vocal tics include:

  • Repetitive throat clearing

Complex tics are distinct, coordinated patterns of movement involving several muscle groups in different parts of the body.

Complex motor tics   might include facial grimacing combined with a head twist and a shoulder shrug. Other complex motor tics may appear purposeful, including:

  • Sniffing or touching an object

Complex vocal tics   may include:

  • Repeating one's own words or phrases
  • Repeating others' words or phrases (echolalia)
  • Using vulgar, obscene, or swear words (coprolalia)

Some of the most dramatic and disabling tics may include motor movements that result in self-harm such as punching yourself in the face or vocal tics such as echolalia or swearing. Some tics are preceded by an urge or sensation in the affected muscle group (premonitory urge). You may feel like you have to complete a tic in a certain way or a certain number of times to relieve the urge or decrease the sensation.

Tic triggers

Your tics may worsen with excitement or anxiety and get better during calm, focused activities. Certain physical experiences can trigger or worsen tics; for example, tight collars may trigger neck tics. Hearing another person sniff or clear the throat may trigger similar sounds. Tics do not go away during light sleep but are often significantly diminished; they go away completely in deep sleep. 

Although the symptoms of TS are unwanted and unintentional (involuntary), some people can suppress or otherwise manage their tics to minimize their impact on functioning. However, people with TS often report a substantial buildup in tension when suppressing their tics to the point where they feel that the tic must be expressed (against their will). Tics in response to an environmental trigger can appear to be voluntary or purposeful but are not.

Disorders associated with TS

Like many other individuals with TS, you may experience additional co-occurring neurobehavioral problems (how the brain affects emotion, behavior, and learning) that often cause more impairment than the tics themselves. Although most people with TS experience a significant decline in motor and vocal tics in late adolescence and early adulthood, the associated neurobehavioral conditions may continue into adulthood.

The most common co-occurring conditions include:

  • Attention Deficit Hyperactivity Disorder (ADHD)—People with TS may have problems with concentration, hyperactivity, and impulsivity.
  • Obsessive Compulsive Disorder or Behaviors (OCD/OCB)—Unwanted thoughts, ideas, or sensations (obsessions) may make someone with TS feel the need to perform behaviors repeatedly or in a certain way (compulsions). Repetitive behaviors can include handwashing, checking things, and cleaning, and can significantly interfere with daily life.
  • Anxiety—People with TS, along with others, may have a fear, uneasiness, or apprehension about a situation or event that may have an uncertain ending.
  • Learning disabilities—Problems with reading, writing, and arithmetic that are not related to intelligence are seen in some individuals with TS.
  • Behavioral or conduct issues—Common issues include aggression, anger management problems, and problems adjusting emotionally and socially.
  • Problems falling or staying asleep—Sleep disturbances may include difficulty falling and staying asleep and excessive daytime sleepiness.
  • Social skills deficits and social functioning difficulties—People may have trouble with social skills and with maintaining social relationships.
  • Sensory processing issues—Some people with TS have difficulty organizing and responding to sensory information related to touch, taste, smells, sounds, or movement.

Educational Settings

Although students with TS often function well in the regular classroom, ADHD, learning disabilities, obsessive-compulsive symptoms, and frequent tics can greatly interfere with academic performance or social adjustment. After a comprehensive assessment, students should have access to an educational setting that meets their individual needs. Students may require tutoring, smaller or special classes, private study areas, exams outside the regular classroom, other individual performance accommodations, and in some cases special schools.

Who is more likely to get Tourette syndrome?

Most cases of TS involve the interaction of multiple gene variations and environmental factors.   

Although the cause of TS is unknown, current research points to abnormalities in:

  • Certain brain regions, including the basal ganglia, frontal lobes, and cortex
  • Circuits that connect these regions
  • Neurotransmitters (dopamine, serotonin, and norepinephrine) responsible for communication between nerve cells (neurons)

TS Inheritance

Changes (mutations) in one or more genes have been shown to be involved with TS. A small number of people with TS have mutations involving the SLITRK1 gene, which affects how neurons grow and connect with one another. Abnormalities in the NRXN1 and CNTN6 genes, which also regulate the normal formation of these nerve connections, also may play a role in TS. Scientists continue to look for other genes involved with TS. Although there may be a few genes with substantial effects, it is also possible that many genes with smaller effects and environmental factors may play a role in the development of TS. 

It is important to understand that genetic tendency may not necessarily result in TS; instead, it may express itself as a milder tic disorder or as obsessive-compulsive behaviors. It is also possible that children who inherit the gene abnormality will not develop any TS symptoms.

Genetic studies also suggest that some forms of ADHD and OCD are genetically related to TS, but there is less evidence for a genetic relationship between TS and other neurobehavioral problems that commonly co-occur with TS.

Gender also plays an important role in TS gene expression. At-risk males are more likely to have tics and at-risk females are more likely to have obsessive-compulsive symptoms.

Genetic counseling of people with TS should include a full review of all potentially hereditary conditions in the family.

How is Tourette syndrome diagnosed and treated?

Diagnosing TS

To diagnose TS, a doctor will ask if you have:

  • Presence of both motor and vocal tics that occur several times a day, every day or intermittently for at least 1 year
  • Onset of tics before age 18
  • Tics not caused by medications, other substances, or medical conditions

Common tics are often diagnosed by a primary care provider, pediatrician, or mental healthcare specialist. Atypical symptoms (different from classical symptoms) or atypical presentations (for example, symptoms that begin in adulthood) may require additional expertise for diagnosis.

There are no blood, laboratory, or imaging tests needed for diagnosis. In rare cases, neuroimaging studies, such as magnetic resonance imaging (MRI) or computerized tomography (CT), electroencephalogram (EEG) studies, or certain blood tests may be used to rule out other conditions that might be confused with TS. 

It may take some time to receive a formal diagnosis of TS. Families and physicians unfamiliar with the disorder might think mild and even moderate tic symptoms may be insignificant, a part of a developmental phase, or the result of another condition. For example, some parents may think that eye blinking is related to vision problems or that sniffing is related to seasonal allergies.

Treating TS

Currently, there is no cure for TS but treatments are available to help manage some symptoms. 

If tic symptoms are mild and do not cause impairment, you may not need treatment. If symptoms interfere with daily functioning, there are effective medications and other treatments. Some medications may have or cause side effects and should be carefully managed by your physician or healthcare provider.

Medications:

  • Medications that block dopamine (drugs that may be used to treat psychotic and non-psychotic disorders) are the most consistently useful medications to suppress tics (for example, haloperidol and pimozide).
  • Alpha-adrenergic agonists such as clonidine and guanfacine are used primarily for hypertension (high blood pressure) but are also used to treat tics. 
  • Stimulant medications such as methylphenidate and dextroamphetamine can lessen ADHD symptoms in people with TS without causing tics to become more severe. Some studies show the short-term use of these drugs can help children with TS who also have ADHD.
  • Antidepressants, specifically,   serotonin reuptake inhibitors (clomipramine, fluoxetine, fluvoxamine, paroxetine, and sertraline) can help some people control symptoms of depression, OCD, and anxiety.

Unfortunately, there is no one medication that is helpful to all people with TS, nor does any medication completely eliminate symptoms. 

Other therapies and treatments can include:

  • Behavioral treatments such as awareness training and competing response training can be used to reduce tics. A recent National Institutes of Health-funded, multi-center randomized control trial called Cognitive Behavioral Intervention for Tics (CBIT) showed that training to voluntarily move in response to a premonitory urge can reduce tic symptoms. Other behavioral therapies, such as biofeedback or supportive therapy, have not been shown to reduce tic symptoms. However, supportive therapy can help a person with TS better cope with the disorder and deal with the secondary social and emotional problems that can occur.
  • Psychotherapy can help individuals cope with the disorder and deal with accompanying problems or conditions, including ADHD, depression, anxiety, and OCD.

What are the latest updates on Tourette syndrome?

The National Institute of Neurological Disorders and Stroke ( NINDS ) and other components of the National Institutes of Health ( NIH )—such as the National Institute of Mental Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the National Institute on Drug Abuse, and the National Institute on Deafness and Other Communication Disorders—support research relevant to TS, either at NIH laboratories or through grants to major research institutions across the country.  

Another component of the Department of Health and Human Services, the Centers for Disease Control and Prevention (CDC), funds professional education programs as well as TS research.

Knowledge about TS comes from studies across numerous medical and scientific disciplines, including genetics, neuroimaging, neuropathology, clinical trials (medication and non-medication), epidemiology, neurophysiology, neuroimmunology, and descriptive/diagnostic clinical science.

  • Genetic studies—Currently, NIH-funded scientists are conducting a variety of large-scale genetic studies involving TS. Understanding the genetics of TS genes may strengthen clinical diagnosis, improve genetic counseling, lead toward a better understanding of its causes, and provide clues for more effective therapies.
  • Neurostimulation—NINDS-funded research is testing the effectiveness and safety of   deep brain stimulation (DBS) for treating tics and co-occurring conditions, such as obsessive-compulsive behaviors, in individuals with TS who do not respond well to medications and behavioral therapy. DBS uses a surgically implanted, battery-operated medical device to deliver electrical stimulation to specific areas in the brain that control movement, which blocks the abnormal nerve signals that cause symptoms.
  • Neuroimaging studies—Advances in imaging technology and an increase in trained scientists have led to an increasing use of novel and powerful techniques to identify brain regions, circuitry, and neurochemical factors important in TS and related conditions, such as ADHD and OCD.
  • Neuropathology (the study of nervous system diseases)—There has been an increase in the number and quality of donated brains from people with TS available for research. This increase, coupled with advances in neuropathological techniques, has led to initial findings with implications for neuroimaging studies and animal models of TS.
  • Clinical trials—Several clinical trials in TS recently have been completed or currently are underway. These include studies of stimulant treatment of ADHD in TS and behavioral treatments for reducing tic severity in children and adults. Smaller trials of novel approaches to treatment such as dopamine agonists and glutamatergic medications also show promise. Neurostimulation treatments mentioned above such as DBS and noninvasive transcranial magnetic stimulation in children and adults are also ongoing.
  • Epidemiology and clinical science—Careful epidemiological studies (those that track the pattern or incidence of a disease) now estimate the prevalence of TS to be substantially higher than previously thought, with a wider range of severity. Also, clinical studies are providing new findings regarding TS and co-existing conditions. These include subtyping studies of TS and OCD, an examination of the link between ADHD and learning problems in children with TS, and a new appreciation of sensory tics. One of the most important and controversial areas of TS science involves the relationship between TS and autoimmune brain injury associated with group A beta-hemolytic streptococcal infections or other infectious processes. There are many epidemiological and clinical investigations currently underway in this area.

You may find more information about research on TS by using  NIH RePORTER , a searchable database of current and past research projects supported by NIH and other federal agencies. RePORTER also includes links to publications and resources from these projects. 

How can I or my loved one help improve care for people with Tourette syndrome?

Consider participating in a clinical trial so clinicians and scientists can learn more about TS. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat, or prevent disease.

All types of volunteers are needed— those who are healthy or may have an illness or disease— of all different ages, sexes, races, and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them.

For information about participating in clinical research visit NIH Clinical Research Trials and You . Learn about clinical trials currently looking for people with TS at Clinicaltrials.gov , a searchable database of current and past federal and private clinical trials.

Where can I find more information about Tourette syndrome? Information may be available from the following resources: Centers for Disease Control and Prevention  (CDC) Child Neurology Foundation Phone:  888-417-3435 Tourette Association of America Phone:  888-486-8738

Learn about related topics

  • Attention Deficit Hyperactivity Disorder
  • Learning Disabilities
  • Get Help Now

What is Tourette

For someone i know, through my profession.

  • Find a Provider
  • Toolkits & Guides
  • Join Workshops & Events
  • Treatment & Therapy
  • Centers of Excellence
  • Advisory Boards
  • Join a Clinical Trial
  • Support the TAA
  • Mission & History
  • Strategic Plan FY2023-FY2028
  • Annual Report
  • Diversity, Equity & Inclusion
  • Board of Directors
  • Education Advisory Board
  • Medical Advisory Board
  • Scientific Advisory Board

Home » Tourette Syndrome: An Overview » What is Tourette

  • Medical Diagnosis
  • Newly Diagnosed
  • Co-Occurring Conditions
  • Find A Provider
  • Online Support Groups
  • Advocating for your Child
  • Bullying Issues
  • Individual Education Plans & 504 Accommodations
  • Testing & Evaluation
  • Legislation Affecting Education
  • Behavior Issues in Children with Tourette
  • Handling Classroom Behavior
  • National Education Conference
  • Stories That Inspire
  • Print a “I have TS Card”
  • Kids Corner
  • Stand Up for Tourette
  • Identifying Common Challenges
  • Youth Ambassador Program
  • Youth Ambassador Activity Report
  • Rising Leaders
  • Rising Leaders Activity Report
  • Print an “I Have TS” Card
  • Kids Tool Kit
  • I Have Tourette, but Tourette Doesn’t Have Me
  • Resource Directory
  • College & TS
  • Social Situations
  • That Darn Tic
  • Print an “I have TS” Card
  • Social Media
  • Military Service
  • Tourette Syndrome and the Workplace
  • Ticcing in Public
  • Later in Life
  • Brain Bank for Participants
  • ¿Qué es el síndrome de Tourette?
  • Síndrome de Tourette: preguntas frecuentes
  • Tics en público: 8 formas de manejarlos
  • Empleo: Como conseguir trabajo y conservarlo
  • El ST y beneficios
  • Envejevcer con ST
  • Planes de Educación Individualizados
  • Prevención del Acoso Escolar/Bullying: Estrategias Positivas
  • ¡LEVANTEMONOS PARA SINDROME DE TOURETTE!
  • Redes Sociales
  • El ST es más que los tics
  • Efectos sobre el Aprendizaje
  • Para los conductores de autobús
  • Intervención Global de Comportamiento para Tics (CBIT)
  • La Genética del Síndrome de Tourette
  • Preguntas Comunes Sobre el ST Y la Genética
  • Entendiendo la Coprolalia: Un Síntoma Malentendido
  • Listas de médicos y terapeutas
  • Contáctenos
  • Financial Stewardship
  • Corporate Partners
  • International Contacts
  • Find Local Support
  • Whistleblower Protection Policy
  • Conflict of Interest
  • Ways to Give/ Get Involved
  • Volunteer Opportunities
  • Volunteer Training Modules
  • Team Tourette
  • Public Policy
  • Youth Ambassadors Program
  • Youth Ambassadors Activity Report
  • Rising Leaders Program
  • Submit Your Story
  • Walks and Races
  • Annual Gala
  • Golf Outings
  • National Conference
  • Take Action
  • Public Policy Priorities
  • Congressional Tourette Syndrome Caucus
  • National Neurological Conditions Surveillance System
  • Discipline Disparities for Students with Disabilities and the Impact on Students with TS
  • CARE act for TS
  • Children’s Health Act
  • Social Security
  • Healthcare Reform Principles
  • Mental Health Parity
  • Genetic Information Nondiscrimination Act
  • Advocacy Coalitions
  • Legislative Process
  • CBIT Overview
  • CBIT for Patients
  • CBIT for Practitioners
  • Pharmacology
  • Speech Therapies and Pathologies
  • Deep Brain Stimulation
  • Deep Brain Stimulation (DBS) for Professionals
  • Medical Marijuana
  • Centers of Excellence Program Overview
  • Centers of Excellence Locations
  • Apply to be a Center of Excellence
  • Clinical Trials
  • Impact Survey
  • Grants & Fellowships
  • TAA Young Investigator Award
  • American Brain Foundation Partnership
  • Support for Research Consortia and Collaborative Research Projects
  • TAA Behavior Sciences Consortium
  • TAA Neuroimaging Consortium
  • TAA Grant Database
  • Brain Tissue Requests
  • Behavioral Therapy Institute
  • Provider Webinar Series
  • Find a Chapter or Support Group
  • Resource Tool Kits
  • Informational Webinars
  • Print an “I Have TS” Card
  • Explaining TS
  • ADHD and OCD/OCB
  • Executive Function Challenges
  • Disinhibition
  • Processing Disorder/Sensory Issues
  • Strategies and Techniques
  • Assistive Technology for Students
  • IEP & 504 Overview
  • Preparing for a School Meeting
  • Preparing an IEP Binder
  • Testing and Evaluation
  • Free & Appropriate Public Education (FAPE)
  • Americans with Disabilities Act (ADA)
  • Advocating for Your Child
  • Bullying Prevention & Strategies
  • Working with Your Child’s School
  • Local Support
  • Online Support
  • Comprehensive Family Guide
  • Standing up for Yourself: Explaining Tourette at School
  • ADHD and OCD/OCB in the Classroom
  • Assistive Technology
  • Children’s Guide to TS
  • I Have Tourette’s, But Tourette’s Doesn’t Have Me
  • Accommodations & Education Rights
  • Understanding Your Rights
  • Teen Summit
  • Workplace & TS
  • Workplace Accommodations and Disability Rights
  • Comprehensive Young Adult Guide
  • Rising Leaders Program (18-25)
  • Adult Webinar Series
  • Simplifying TS
  • Comprehensive Educator Guide
  • Request a Training
  • Behavior Therapy Institute
  • Schedule a CBIT Workshop
  • Schedule an Intro to TS
  • Schedule an Intro CBIT Workshop
  • Comprehensive Provider Guide
  • De-Escalation Techniques
  • High-Risk Encounters
  • Law Enforcement Tool Kit
  • TIC-CON 2023
  • Youth Ambassador Program (12-18)
  • Schedule a TS Workshop
  • Schedule a Classroom Training
  • Seminarios web

Tourette Syndrome is a neurodevelopmental disorder that affects children, adolescents and adults. The condition is characterized by sudden, involuntary movements and/or sounds called tics. Tics can range from mild/inconsequential to moderate and severe, and are disabling in some cases. 

Tourette Syndrome is one type of Tic Disorder. Tics are the primary symptoms of a group of childhood-onset neurological conditions known collectively as Tic Disorders and individually as Tourette Syndrome (TS), Persistent (Chronic) Motor or Vocal Tic Disorder, and Provisional Tic Disorder. These three Tic Disorders are named based on the types of tics present ( motor, vocal/phonic, or both ) and by the length of time that the tics have been present.

Below are the criteria that a doctor or other health care professional will use to diagnose TS or other Tic Disorders. There is no test to confirm the diagnosis of Tic Disorders, but in some cases, tests may be necessary to rule out other conditions.

Tourette Syndrome (TS), also known as Tourette’s Disorder:  1) At least 2 motor tics and at least 1 vocal (phonic) tic have been present, not necessarily at the same time. 2) Tics may wax and wane in frequency but have occurred for more than 1 year. 3) Tics started to appear before the age of 18. 4) Tics are not caused by the use of a substance or other medical condition.

Persistent (Chronic) Motor or Vocal Tic Disorder : Either motor tics OR vocal tics have been present for more than 1 year; cannot be both motor and vocal tics.

Provisional Tic Disorder : Motor and/or vocal tics have been present for less than 1 year, and have not met the criteria for TS, persistent (chronic) motor, or vocal tic disorder.

Motor tics are movements. Simple motor tics include but are not limited to: eye blinking, facial grimacing, jaw movements, head bobbing/jerking, shoulder shrugging, neck stretching, and arm jerking. Complex motor tics involve multiple muscle groups or combinations of movements and tend to be slower and more purposeful in appearance,(e.g., hopping, twirling, jumping).

Vocal/Phonic Tics

Vocal (phonic) tics produce a sound. Simple vocal tics include but are not limited to sniffing, throat clearing, grunting, hooting, and shouting. Complex vocal tics are words or phrases that may or may not be recognizable but that consistently occur out of context. In 10-15% of cases, the words may be inappropriate (i.e., swear words, ethnic slurs, or other socially unacceptable words or phrases). This type of vocal tic, called coprolalia, is often portrayed or mocked in the media as a common symptom of TS.

Tics typically emerge between the ages of 5 and 7 years, usually with a motor tic in the head or neck region. They tend to increase in frequency and severity between the ages of 8 and 12 years and can range from mild to severe. Most people with TS see improvements by late adolescence, with some becoming tic-free. A minority of people with TS continue to have persistent, severe tics into adulthood.

Tics can range from mild to severe and, in some cases, can be self-injurious and debilitating. Tics regularly change in type, frequency, and severity—sometimes for reasons unknown and sometimes in response to specific internal and external factors, including stress, anxiety, excitement, fatigue, and illness.

Tics occur in as many as 1 in 5 school-aged children at some time, but may not persist. TS and other Tic Disorders combined are estimated to occur in more than 1 in 50 school-aged children in the United States. TS occurs in 1 in 160 (0.6%) school-aged children, although it is estimated that 50% are going undiagnosed. The reported prevalence for those who have been diagnosed with Tourette is lower than the true number, most likely because tics often go unrecognized. TS affects all races, ethnic groups and ages, but is 3-4 times more common in boys than in girls.  There are no reliable prevalence estimates of TS and other Tic Disorders in adults. However, they are expected to be much lower than in children as tics tend to decline into late adolescence.

The causes of TS and other Tic Disorders remain unknown. These conditions tend to occur in families, and numerous studies have confirmed that genetics are involved. Environmental, developmental, or other factors may also contribute to these disorders but, at present, no specific agent or event has been identified. Researchers are continuing to search for the genes and other factors underlying the development of Tic Disorders.

People with TS often have other mental, behavioral, or developmental conditions that may be present prior to the onset of tics. While tics are the primary symptoms, these co-occurring conditions may cause more problems and can be more bothersome than the tics themselves.

Among people diagnosed with TS, it is estimated that 86% have been diagnosed with at least one of these additional conditions.  The most common co-occurring conditions include the following:

  • Attention Deficit/Hyperactivity Disorder (ADHD):   Problems with concentration, hyperactivity, and impulse control.
  • Obsessive Compulsive Disorder or Behaviors (OCD/OCB):    Repetitive, unwanted intrusive thoughts and/or repetitive behaviors. These thoughts lead to compulsions, which are unwanted behaviors that the individual feels he/she must perform repeatedly or in a certain way.
  • Behavioral or Conduct Issues:  Aggression, rage, oppositional defiance or socially inappropriate behaviors.
  • Anxiety:  Excessive worries or fearfulness, including excessive shyness and separation anxiety.
  • Learning Disability:  Reading, writing, mathematics, and/or information processing difficulties that are not related to intelligence.
  • Social Skills Deficits and Social Functioning:  Trouble developing social skills; maintaining social relationships with peers, family members, and other individuals; and acting in an age-appropriate manner.
  • Sensory Processing Issues:  Strong sensory preference and sensitivities related to sense of touch, sound, taste, smells, and movement that interfere throughout the day.
  • Sleep Disorders:  Trouble falling or staying asleep.

Tourette Syndrome is...

NHC logo

ACN Latitudes

What is Tourette Syndrome? – A Comprehensive Overview

What is Tourette Syndrome

By Sheila Rogers DeMare, MS , Director of the Association for Comprehensive NeuroTherapy

What is Tourette syndrome?

Tourette syndrome is a neurological disorder defined by repetitive, involuntary movements and vocalizations, called tics. The condition is named for Dr. Georges Gilles de la Tourette, who first described it in 1885. Chances are if you’d asked someone 30 years ago, “What is Tourette syndrome?” the person would not know what to say. Yet, because the incidence of this condition has skyrocketed over the last few decades, especially in western countries, and the since the media has been giving it more attention, it’s now much more recognized.

Once considered rare and unusual, Tourette syndrome is now considered “common.” Further, temporary or transient tics in childhood are “very common.”  Current Opinion in Neurology  (2003). The National Institute of Health estimates (2015) that in the USA 1 in 100 have a mild case of tics and 200,000 have a severe form of Tourette’s. However some research suggests these may be significant underestimates.

A study of schoolchildren in and around Rochester, New York in 2001 revealed that nearly 20% of students in elementary through high school had some level of tics. The rate among students in special education classes was 27%. A second study found mild to severe tics in 24% of a student population in Washington, DC.

Please Share on Pinterest

Symptoms of Tourette syndrome can negatively impact all areas of a person’s life. Tourette syndrome is usually diagnosed in childhood, but may begin later in life. Childhood tics often decrease after adolescence or early adulthood, while a smaller percentage must deal with the disorder into and through adulthood.

Preschool children can experience Tourette syndrome, as can the elderly. Males are three or four times more likely to receive the diagnosis than females, and all ethnic groups can be affected.

Although many millions of dollars have been spent in research over the past 40 years, the underlying causes of Tourette syndrome have not been clearly identified. Conventional medical efforts have focused on genetics, yet attempts to isolate the genes involved have failed to yield suitable treatments.

In this overview, symptoms of Tourette syndrome and related tic disorders are discussed along with diagnostic criteria, coexisting conditions, the role of the environment, social implications, and new directions for the Tourette community.

Table of Contents

Types of movement and vocalization tics in tourette syndrome.

  • Tourette syndrome: Two major oversights

Diagnosis and categories of tic disorders

  • Pitfalls of diagnosing tic disorders and Tourette syndrome with checklists

Conditions that often coexist with Tourette syndrome

Can tics in tourette syndrome be suppressed or self-controlled, the role of the environment in tourette syndrome.

  • Waxing and waning of symptoms
  • Inflammation, immune function, and allergy in tic disorders

Social and practical implications of Tourette syndrome

  • Treatment for Tourette syndrome: new directions

Please join our Stop Tics Today initiative

tourette syndrome family

Patterns and types of tics vary greatly among those dealing with Tourette syndrome and other tic disorders. The categories of tics listed below are used by physicians to make a diagnosis.

Tourette syndrome occurs on a spectrum. Many tic conditions are mild or short-lived, and the tics may be more of a nuisance than anything. At the other end of the spectrum vocal and/or motor tics can be highly disruptive, emotionally distressing, and even painful.

Some tic movements, such as sniffing, blinking, shoulder shrugs, and neck jerks, are termed  simple  and only involve one muscle group.  Complex  tics, on the other hand, involve movements that use multiple muscle groups with coordinated movement. Examples of complex tics are twirling or jumping while walking, imitating someone’s actions, and touching objects.

Tics can occur from head to foot. They can be as mild as an eye blink or severe enough to affect large muscles and knock someone from a chair.

A simple motor, or movement tic, can be severe in its expression; simple does not imply that the tic has less impact on an individual than a complex tic. Tics can also involve a need to touch others, or distressing self-injurious behaviors, such as slapping oneself, playing with sharp objects, or touching hot items.

Vocal tics may be barely noticeable, such as a light cough or hum. Yet, some are disruptive and embarrassing: a loud shout, yelp, squeal or scream, bark, repeating phrases just heard, or swearing—known as coprolalia. Fortunately, only a small percentage of people with Tourette’s experience coprolalia, although the media focuses on it.

People often feel a sensory urge to tic that has been described by some as similar to the need to scratch an itch. After ticcing there is usually a sensation of released tension. The ability to recognize a sensory urge to tic increases with age; children younger than ten years are thought to be much less aware of that urge.

Tic symptoms tend to come and go, within a given day or across weeks, days, and even years. The type of tic, intensity or severity, frequency, and area of the body affected can vary.  Please see our section on Waxing and waning of symptoms.

Most recently, the role of the immune system in Tourette’s and tics is being investigated including in pediatric autoimmune disorders, the most well known being PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections). Tics can occur as a reaction to a number of bacterial and viral infections, including Lyme disease.

Return to top

Tourette Syndrome: Two major oversights

what is tourist syndrome

Oversight #1: Ignoring environmental factors

Key advocacy groups and mainstream medicine have emphasized that Tourette’s is “genetic” and “mysterious,” and that there is little that patients or families can do to address symptoms beyond reducing stress and trying medications. Yet is well recognized that the prescribed medications can often have undesirable side effects, are not well safety tested for children, and may not be effective. This leaves those dealing with Tourette’s with few options.

Evidence gathered by the Association for Comprehensive NeuroTherapy (ACN) reports that the widely repeated “facts” that Tourette’s is primarily genetic and little can be done for symptoms is a harmful misunderstanding.

ACN has reported a connection between Tourette’s and environmental factors for more than 20 years. These factors include issues like diet; allergens such as dust, mold, pollens, and dander; exposure to commercially scented products and toxic chemicals; visual stimuli, heat and other sensory factors, bacterial and viral infections, and many more. These findings open new doors to the prevention and treatment of the disorder, yet research for Tourette’s has not explored these areas.

The role of genetics in all medical conditions is important. But the prevention and treatment of Tourette syndrome and related tic conditions needs to move beyond genetics. As the saying goes, “genetics loads the gun but the environment pulls the trigger.”

ACN has documented environmental triggers that have a significant impact on many in the Tourette community. Once the potential for these triggers is understood, patients and families have a better chance of intervening and controlling tics without, or with less, standard medication.

Oversight #2: Failure to identify subgroups and individual causes

Researchers and practitioners often approach Tourette’s as if everyone who meets the criteria for a diagnosis, based on a short checklist of symptoms, must have the same physical condition related to the symptoms.

Little research has been done to define biological subgroups for Tourette syndrome. Further, physicians typically do not go beyond making the diagnosis. They often assume it is a genetic problem and stop there.

A thorough physical exam that looks at nutritional status, immune/allergy issues, possible underlying infections, the health of the digestive tract, or hidden infection is rarely conducted.

It’s much like treating everyone who complains of chest pain and shortness of breath with the same approach, without investigating what may actually be causing the symptoms.

Please see “Pitfalls of diagnosing tic disorders and Tourette syndrome with checklists” in this article.

what is tourist syndrome

The information below on diagnosing tic disorders is provided by the  Center for Disease Control :

The American Psychiatric Association’s  Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition  ( DSM-5 ) is used by health professionals to help diagnose tic disorders.

Tics are sudden twitches, movements, or sounds that people do repeatedly. People who have tics cannot stop their body from doing these things. For example, a person with a motor tic might keep blinking over and over again. Or, a person with a vocal tic might make a grunting sound unwillingly.

Three tic disorders are included in the  DSM-5  and are described below:

  • Tourette’s disorder (also called Tourette Syndrome [TS])
  • Persistent (also called chronic) motor or vocal tic disorder
  • Provisional tic disorder

The tic disorders differ from each other in terms of the type of tic present (motor or vocal, or a combination of both), and how long the symptoms have been occurring. People with Tourette’s have both motor  and  vocal tics, and have had tic symptoms for at least 1 year. People with persistent motor or vocal tic disorders have either motor  or  vocal tics, and have had tic symptoms for at least 1 year.

People with provisional tic disorders can have motor or vocal tics, or both, but have had their symptoms less than 1 year.

The criteria for diagnosis have been updated with the recent publication of the 5 th  edition of the DSM. One change was to use the term ‘provisional’ tic disorder rather than ‘transient’ tic disorder for tics that started less than a year before diagnosis. (In DSM-IV, a diagnosis of Tourette syndrome or persistent tic disorder required that there was no tic-free period of 3 months or more in the year prior to diagnosis.  This is no longer required.)

The criteria presented below are in modified form to make them more accessible to the general public. They are listed for information purposes only and should not be used for self-diagnosis. If you are concerned about any of the symptoms listed, you should consult a trained health care provider with experience in diagnosing and treating tic disorders.

Tourette syndrome (TS)

For a person to be diagnosed with TS, he or she must:

  • Have two or more motor tics (for example, blinking or shrugging the shoulders)  and  at least one vocal tic (for example, humming, clearing the throat, or yelling out a word or phrase), although they might not always happen at the same time.
  • Have had tics for at least a year. The tics can occur many times a day (usually in bouts) nearly every day, or off and on.
  • Have tics that begin before he or she is 18 years of age.
  • Have symptoms that are not due to taking medicine or other drugs or due to having another medical condition (for example, seizures, Huntington disease, or postviral encephalitis).

Persistent (Chronic) Motor or Vocal Tic Disorder

For a person to be diagnosed with a persistent tic disorder, he or she must:

  • Have one or more motor tics (for example, blinking or shrugging the shoulders) or vocal tics (for example, humming, clearing the throat, or yelling out a word or phrase), but  not  both.
  • Have tics that occur many times a day nearly every day or on and off throughout a period of more than a year.
  • Have tics that start before he or she is 18 years of age.
  • have symptoms that are not due to taking medicine or other drugs, or due to having a medical condition that can cause tics (for example, seizures, Huntington disease, or postviral encephalitis).

Provisional Tic Disorder

For a person to be diagnosed with this disorder, he or she must:

  • Have one or more motor tics (for example, blinking or shrugging the shoulders) or vocal tics (for example, humming, clearing the throat, or yelling out a word or phrase).
  • Have been present for no longer than 12 months in a row.
  • have symptoms that are not due to taking medicine or other drugs, or due to having a medical condition that can cause tics (for example, Huntington disease or postviral encephalitis).
  • Not have been diagnosed with TS or persistent motor or vocal tic disorder.

Reference from CDC: American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA., American Psychiatric Association .

Pitfalls of diagnosing tic disorders and Tourette’s with checklists 

what is tourist syndrome

No laboratory or neurological examination is used to determine a diagnosis of Tourette syndrome. Typically, a professional takes a medical history along with a description of the pattern and nature of tics using the checklists described above. A diagnosis is made after excluding other conditions that could cause tics or symptoms similar to Tourette’s.

To some extent, having a label for a set of symptoms can be reassuring. People know they are not alone, and they feel they have a professional opinion on what they are dealing with. They can also learn what medications might be helpful.

But there is also a downside to providing diagnostic labels for tic disorders. They don’t give the full answer needed. Typically, once a diagnosis is given by a physician, and medication options are explored, that’s basically the end game. Neither the patient nor the doctor knows why someone has symptoms of Tourette’s.

Sadly, this diagnosis can last a lifetime without a comprehensive physical examination ever being conducted. Further, families and even children are often told “there is no cure” for people with the diagnosis of Tourette’s. Our organization points out that it is difficult to find a “cure” for someone when no efforts are made to discover the causes of the central nervous system imbalance—causes that could potentially be corrected.

In our book,  Natural Treatments for Tics and Tourette ‘ s” A Patient and Family Guide , a mother described how they moved beyond a diagnostic label of Tourette syndrome to using an approach that looked for causes of symptoms. Desperate for answers beyond drugs, she had taken her young son, who was having severe symptoms and had been diagnosed by a respected neurologist, to an integrative physician.

As the child stood in the clinic office with numerous tics on display, the doctor asked what the problem was. Mom explained that her boy had Tourette syndrome. He immediately dismissed the diagnosis, telling the mother, “That’s just a label. You need to understand that tics are the body’s way of letting you know that something is wrong. They are a symptom. They’re saying, ‘Something is wrong inside—won’t you fix it?’ The label isn’t important.”

This opened up a new thought process and approach for the family. The child was successfully treated for nutritional imbalances, chemical and food sensitivities, and allergies. They were taught how to avoid triggers that aggravated symptoms. For this particular youngster, these issues had been causing inflammation of the nervous system and brain, resulting in a variety of serious symptoms that fell under the “label” of Tourette syndrome.

Many other physicians, patients and families have had similar experiences of recovery with this type of integrative approach.

Until the medical community starts looking at  why  someone has tics and other symptoms associated with Tourette syndrome, biological subgroups among tic disorders will not be identified, and many patients will continue to suffer.

what is tourist syndrome

In the United States, approximately half of children with Tourette syndrome also have attention deficit disorder with hyperactivity (ADHD). Researchers estimate that more than half of those with Tourette’s have learning problems and/or obsessive-compulsive disorder. Anxiety and panic attacks, separation anxiety, and depression are also common.

Behavioral difficulties and mood swings are frequently reported, adding to the difficulty of targeting treatment. Trichotillomania (involuntary hair-pulling) occurs at higher than average rates among those with Tourette’s. Sleep problems, bedwetting, and numerous other complaints are also frequently reported. Research suggests that patients with Tourette’s have a nearly fourfold increased occurrence of migraine headache compared with the general population.

At times, dealing with these coexisting conditions can be as difficult for the patient and family as the tics themselves, if not more so.

Our organization (ACN Latitudes) encourages considering at all existing conditions and symptoms when developing a comprehensive approach to address tics. The percentage of overlap among different conditions is too high to be dismissed as a coincidence.

A physical examination related to the coexisting conditions can yield valuable clues to underlying causes of tics and Tourette syndrome. For example, if someone has chronic stomach or gastrointestinal complaints, headache, or bed-wetting along with tics, there is a good chance the symptoms are linked.

Rather than assuming these co-existing symptoms are occurring as a coincidence—or that they are happening because the person is upset about having tics and that is causing the other conditions (this has been suggested in the literature)—a physician should first look for related physical imbalances that tie the symptoms together and treat those issues.

tourette syndrome what it is

Tics are typically described as involuntary.  There’s often a feeling that a tic “has to be done” to relieve a sense of tension. Tics have sometimes been described as a sensory urge that must be acted on.

Yet, there’s a great deal of individuality in how tics are dealt with among people of all ages. Many people report being able to withhold, or postpone tics for short periods, but the tics are usually “released” in some fashion later. The ability to sense, or experience an urge to tic helps allow for this adjustment. Many people with tics become experts at disguising associated movements so they appear more natural. For example, a person might make a motion to brush hair out of the face in order to make a neck jerk seem intentional.

Considerable energy and attention are needed to withhold or disguise tics. Doing so can increase stress and result in physical and emotional fatigue. When children withhold tics during school, they may end up releasing them in an explosive and emotionally stressful manner at home.

For example, a student may try to focus on not ticcing in front of peers and manage to exercise some control. Yet later, the tics may “have to come out” and at this point the tics may be intensified. This release could occur in a more private location, such as in a restroom or hallway at school, or once home in a socially safe setting. There is no consensus, though, as to whether suppressed tics will truly intensify or “rebound” for a given individual.

Cognitive behavior therapy, a treatment approach that combines cognitive, or thinking techniques, with behavior therapy, is gaining in popularity. Given the strong connection between mental stress and tics, cognitive behavior therapy is a logical approach for treating tic disorders, and recent research supports its use. Habit reversal training is a related approach. Hypnosis has also been used with success in some individuals. Not everyone is a suitable candidate for these types of self-help approaches.

what is tourist syndrome

When we hear the word environment , the first things to pop in the mind may be things like recycling, pollution, or global-warming. But in medicine, the term refers to influences that go beyond genetics. These can range from things like maternal issues—like did Mom smoke or have a nutritional deficiency?—to what someone ate for breakfast, the perfume a teacher is wearing, mold in the basement, an emotional upset, medications being taken, or a new cat in the house.

And those are just a few examples of many, many factors that can fall under the heading of environmental influences.

Research confirms that environmental factors play a role in the development of Tourette syndrome. For example, two identical twins can have the same genetic predisposition for a tic disorder, but it is their lifestyles or experiences that determine how the genes for each twin are expressed.

“Tourette syndrome is a unique example of a medical condition in which genetic and environmental factors influence cerebral development and function to produce a complex neuropsychiatric disorder.” —Dr. Thomas Hyde, researcher

Physicians and families have reported an association between environmental factors and Tourette syndrome and related disorders for more than 20 years. Our organization has focused on collecting that information. See our popular book Tourette Syndrome: Stop Your Tics by Learning What Triggers Them

Unfortunately, scientific and medical communities have been shockingly slow to show interest in this area. Compared to many other medical conditions, research to document environmental factors in Tourette syndrome is glaring in its absence. By failing to study and promote the importance of environmental factors in Tourette’s, and by not informing physicians and families of the value in exploring a possible connection between the environment and personal symptoms, ACN Latitudes believes millions of people have suffered unnecessarily.

Waxing and waning of symptoms in Tourette syndrome

tourette sundrome doctor

One of the first things a patient or family dealing with tics hears from a professional, or reads in the literature, is the term “waxing and waning.” This refers to the fact that the types of tics often change over time, and the frequency and intensity of the tics tend to change also.

You may have heard the question, “What makes her tick?” The spelling is different, but that’s the issue! What makes a person tic? What accounts for the fact that symptoms are sometimes better and sometimes worse?

This roller coaster pattern of tic symptoms is actually encouraging because it means the body is capable of periods when tics are in relative remission. The goal should be to learn how to extend and improve those periods of remission and to prevent conditions that aggravate symptoms.

Several years ago, ACN surveyed patients and families with tics and Tourette syndrome to gain information on any nonconventional therapies they were using. The results were published: “Nutritional Supplements and Complementary/Alternative Medicine in Tourette Syndrome” ( Journal of Child Adolescent Psychopharmacology 2004;14:582–89).

In 2003, we launched a different survey online to get feedback on personal triggers for tics—factors that can initiate or increase tic symptoms. The survey, which was concluded in 2004, documents that something as simple and common as orange juice, flashing lights, or contact with chlorine can make someone’s tics worse. Each person is different, and triggers vary. More than 1700 people participated in our survey, and a first-ever comprehensive list of potential triggers was documented.

Natural Treatments for Tics and Tourette’s: A Family and Patient Guide  shares detailed information on numerous environmental factors determined by our survey that can trigger tics, and guidance is provided on how to address these issues.

Far more work is needed to further identify the role of the environment in tic disorders, from conception through daily life. In the meantime, the book  Stop Your Tics by Learning What Triggers Them   shares key factors families and physicians can consider when trying to unravel environmental causes for tics. Check out the list, and you will see there is a wide range of items.

The Association for Comprehensive Therapy urges people to “demystify” the concept of waxing and waning in tic disorders. When tics flare, rather than think, “Oh no, the @%&# tics are waxing again!” you should assume a cause and effect relationship. After all, cause and effect is the law of the universe. Was it something you ate, breathed, smelled, or touched? Was it stress? Excitement? A bacterial or viral infection? A parasite? Do you have a nutritional imbalance?

If you start sneezing, don’t you usually wonder what made you sneeze? If you get a stomach ache, don’t you ask yourself why? People should do the same things with tics flare up. Once there’s an understanding of how a variety of triggers may be playing a role in a tic disorder, including Tourette syndrome, efforts can be made to track down causes of specific symptoms.

Sometimes the cause will be easily identified. Other times professional help may be needed. And it is possible that in some cases the cause may remain undiscovered. But without looking for answers, without taking an investigative approach to waxing and waning, one misses a tremendous opportunity to improve symptoms.

The role of inflammation, immune function, and allergy in tic disorders

what is tourist syndrome

For decades, environmental physicians have promoted the concept of “brain allergy,” a condition in which the brain is the target organ for an allergic or immune response. The condition was well described by William H Philpott, MD, in his book  Brain Allergies,  first printed in 1980 and updated in 2000.

This concept has not traditionally been accepted by conventional medicine. Much of our organization’s work has involved collecting related data and raising awareness of the importance of the immune system and central nervous system allergic response in tic symptoms.

In recent years, scientists have made new discoveries linking the autoimmune/inflammatory process to the development of tic symptoms and the onset of obsessive-compulsive disorder following a  streptococcus  (strep throat) infection. This condition is referred to by the acronym PANDAS.

This comparatively recent discovery resulted from groundbreaking work by Susan Swedo, MD, of the National Institute of Mental Health, and her colleagues. The concept was extended to include other types of infection: Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). Presently, PANDAS/PANS is considered to be a separate category from classic tic disorders or Tourette syndrome. Whether this separate status will continue remains to be seen.

Dr. Swedo’s discovery has opened the door for research into the immune system as an important player in tic symptoms and obsessive compulsive disorder.

If you believe the tic disorder you are encountering might be a result of infection, or if symptoms developed in a dramatic and sudden manner, request that your physician consider this possibility. See our introductory booklet on this topic for more information.

In 2005, James Leckman, MD, and colleagues at Yale University School of Medicine completed research on tics and Tourette’s that documents the immune system’s inflammatory response and its involvement with tics. New research shows a possible connection between a maternal history of autoimmune disease the later development of Tourette’s in offspring, particularly males.

The need to define subsets among those who react to strep infection with neurological reactions also underscores the role of the immune system and tic disorders.

Inflammation in the digestive tract can directly affect brain and nerve function. Recent research into autism and ADHD focuses on the gut-brain connection. It is hoped that research for Tourette’s will soon follow suit.  See  Importance of Immune Imbalance and Autoimmunity in Nervous System Disorders  by Dr. Vijendra Singh.

tourette syndrome treatment a

Increased public awareness of Tourette’s in many parts of the world has helped remove some of the stigma associated with the condition. Yet life can be far from easy for those affected. The implications infiltrate relationships, classroom functioning, studies, behavior, physical activities, career, and leisure time. Physical reactions such as fatigue and pain in in the body from repeat or forceful ticcing can be very troublesome.

While IQ is not affected by Tourette’s, the condition poses special challenges at both the social and academic level. Many youngsters and even adults may withdraw from social situations due to embarrassment, or they avoid specific situations that they believe will trigger tics.  Students find it challenging to achieve at the rate they might if they did not have tics; they spend time and energy trying to modify tics or conceal them from classmates. Plus it’s naturally difficult to concentrate on work while physical tics result in movement the head, eyes, hands or entire body. In fact it’s remarkable that some high-achieving students with Tourette’s accomplish as much as they do. Vocal tics can make speaking in front of the class difficult. At other times, motor and vocal tics draw the attention of school staff and this can result in reprimands or discipline by those who do not understand the condition.

A study has shown that people dealing with Tourette’s experienced significantly more “victimization” than normal, yet many staff members were unaware that the students were being bullied or teased.

Suitable adaptations in a school setting, based on individual needs, can make a significant impact and pave the way for success that would not otherwise be possible. Families and school staff should be aware of the legal obligation for public schools to develop 504 plans and Individual Educational Plans in the USA; there are similar efforts in some other countries. The goal is to work with the school, family and student to maximize accommodations available to youngsters with Tourette’s, tic disorders and related conditions.

Treatment for Tourette syndrome: New directions 

what is tourist syndrome

The treatment of tics has undergone dramatic change during the last century. Initially, psychologic dysfunction was thought to be the cause of tic disorders; the focus was on counseling and psychotherapy. Then, in the 1960s, scientists found a medical, or biological basis, for the condition; clinicians began to prescribe medications to suppress tics, treating the brain and nervous system. Scientists determined that an abnormal metabolism of the neurotransmitter dopamine and/or serotonin could be involved.  This resulted in improved tic control, yet the medications for Tourette syndrome used then—and now—are strong, often untested in children, and may have serious side effects.

We will address the topic of treatment in a separate article. Briefly, medications to subdue tics fall into a few main categories. 1) Drugs such that block or deplete dopamine (a neurotransmitter) in the brain; 2) Central adrenergic inhibitor drugs that are usually prescribed for high blood pressure. 3) Botulinum toxin injections into the offending muscle(s). Other medications such as antidepressants that help to reduce symptoms of anxiety and obsessive compulsive disorder may be prescribed when the conditions overlap. Antipsychotics are also used by mainstream medicine.

Since subsets for people with tic disorders have yet to be identified, it is difficult to pinpoint which medications will be most effective and least harmful for a given person.  Due to the potential side effects and the lack of long-term studies on their use in children, many parents are reluctant to go this route unless absolutely necessary.

Biofeedback, cognitive behavior therapy, and hypnosis are being used by a small percentage of the Tourette population in an effort to help control tics without using medication. Others are using complementary or alternative medicine approaches, some of which are included below.

Findings by the tic community

Those wishing to avoid drugs to subdue tics have often turned to integrative approaches. Among many of those approaches: nutritional support; immune/allergy therapies; identifying and avoiding triggers for tics; dietary change; and testing for and treating biological imbalances.

Individual needs vary, and there is no single protocol that works for everyone. But positive results have been reported by many patients, families, and physicians, allowing them to avoid or reduce standard medications typically used to subdue tics and other Tourette symptoms.

We will be summarizing and give details on these efforts soon in a separate article. In the meantime we hope you will take advantage of material on our website www.Latitudes.org that focuses on new directions for neurological health.

We realize individual reports, whether from physicians or patients, do not take the place of comprehensive studies. However, new directions and research into new medical findings often begin with case discoveries.

Since there has been little interest by the medical community to pursue research into the integrative areas that families and physicians have been reporting helpful for Tourette’s, the public is left to decide whether to consider new directions that do not rely on typical drugs, or wait decades for research to catch up.

Hopefully in the near future when people ask “What is Tourette syndrome?” they will be told that a number of tic conditions fall under the umbrella of this commonly used label. Those specific conditions have yet to be defined. Yet, by taking a comprehensive integrative approach to uncovering the causes for the symptoms, many people can be treated safely and effectively without strong medications.

Please see our quick-start infographic:  14 Do’s and Don’t for the Treatment of Tourette syndrome

Sample reports sharing tips on reducing symptoms without standard drugs

  • Griff’s Dramatic Recovery from Tourette Syndrome Using an Allergy Approach
  • Nutritional Supplements for Tics and Tourette Syndrome
  • Rethinking Triggers for Tourette Syndrome
  • Tracking Down Triggers for Tourette Syndrome
  • Dealing with Tourettes or Tics? I Wrote this Just for You
  • What you Eat is What You Are
  • Surprising Answers that Helped Our Son’s Tics
  • My Advice to Parents on Diet and Tics

See other accounts on our site , physician articles, and  related research .

We hope you will join our efforts  to jump start the research into safer and more effective approaches to these conditions. Studies are so desperately needed.

Improving Identification of Tic Disorders

Improving Identification of Tic Disorders

  • Study: Functional tic-like behaviors among adolescent girls in Minnesota
  • Estimating the number of people with Tourette syndrome and persistent tic disorder in the United States
  • Data on Tourette syndrome for 2016-2019: Children’s mental health report
  • Bullying victimization and perpetration among US children with and without Tourette syndrome
  • Patterns of problems with school and relationships in children with ADHD and Tourette syndrome

Learn About Tourette Syndrome

Tourette Syndrome (TS) causes people to have “tics”. Tics are sudden twitches, movements, or sounds that people do repeatedly. People who have tics cannot stop their body from doing these things.

Children's Mental Disorders

Meet two families and hear about their experiences living with Attention-Deficit/Hyperactivity Disorder and Tourette Syndrome.

Watch the video

Stethoscope and book

Learn about how TS and other tic disorders are diagnosed.

Professional family therapist writing notes

Information about medication and behavioral therapy for tics.

School counselor talking with 9 year old girl

Learn how Comprehensive Behavioral Intervention for Tics (CBIT) teaches a person to become aware of their behavior and helps them change how they behave.

Exit Notification / Disclaimer Policy

  • The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website.
  • Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
  • You will be subject to the destination website's privacy policy when you follow the link.
  • CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.

Appointments: 1-888-884-BEAR (2327)

Children's National Hospital logo

Pediatric Tourette Syndrome

Key points about tourette syndrome in children.

  • Tourette syndrome is a neurological disorder. It affects more boys than girls.
  • The disease causes repeated tics. These are sudden, uncontrolled vocal sounds or muscle jerks.
  • Symptoms of Tourette syndrome often begin between ages 5 and 10.
  • Tourette syndrome can occur differently in boys and girls. Boys are more likely to have long-term (chronic) tics. Girls are more likely to have obsessive-compulsive disorder (OCD) .
  • Some children may not need treatment. A child with Tourette syndrome can usually function well at home and in a regular classroom. In some cases, a child may need special classes, psychotherapy or medicine.
  • A family with a history of Tourette syndrome should speak with a geneticist or a genetic counselor.

Appointments

Our team is standing by to schedule your child’s appointment.

Frequently Asked Questions

What is tourette syndrome in children.

Tourette syndrome is a neurological disorder. It is also called Tourette disorder. The disorder causes repeated tics. Tics are sudden, uncontrolled vocal sounds or muscle jerks. Symptoms of Tourette syndrome often start between ages 5 and 10. They usually start with mild, simple tics of the face, head or arms. Over time, a child may have different kinds of tics that may happen more often. They may also involve more parts of the body, such as the trunk or legs. And they may be more disruptive to daily life.

What causes Tourette syndrome in a child?

Most cases of Tourette syndrome are caused by genes. It is an autosomal dominant disorder. Autosomal means that the gene is not on a sex (X or Y) chromosome. Dominant means that only one copy of the gene is needed to have the condition. A parent with Tourette syndrome or the gene for Tourette syndrome has a one in two chance to pass the gene on to each child.

In up to one in 20 children with Tourette syndrome, the disorder is not caused by genes. Possible causes in these cases may be problems during pregnancy, low birth weight, head injury, carbon monoxide poisoning or inflammation of the brain (encephalitis).

Which children are at risk for Tourette syndrome?

Tourette syndrome affects more boys than girls.

What are the symptoms of Tourette syndrome in a child?

The most common symptoms are uncontrolled muscle movements. They may occur in the face, neck, shoulders, torso or hands. Examples include:

  • Head jerking
  • Nose-twitching
  • Repeated foot tapping, leg jerking, scratching or other movements

Complex tics include:

  • Sticking out the tongue or lip-smacking
  • Touching behaviors
  • Making rude gestures

Tourette syndrome also includes one or more vocal tics such as:

  • Grunting or moaning sounds
  • Tongue clicking
  • Saying rude things
  • Throat clearing, snorting, or coughing
  • Squeaking noises
  • Echoing sounds or phrases repeatedly

Tic behaviors change over time. They also vary in how often they occur.

Tourette syndrome can occur differently in boys and girls. Boys are more likely to have long-term (chronic) tics. Girls are more likely to have obsessive-compulsive disorder (OCD). This is an anxiety disorder. With OCD, a child has a repeated thought, fear, or worry (obsession) that they try to manage through a certain behavior (compulsion) to reduce the anxiety.

Not everyone with the gene will have symptoms of Tourette syndrome. If a parent passes the gene to a child, the child may not have any symptoms. If a daughter inherits the gene, there is a 7 in 10 chance that she will have at least one sign of Tourette syndrome. If a son inherits the gene, there is an almost sure chance (99%) that he will have at least one sign of Tourette syndrome.

The symptoms of Tourette syndrome can seem like other health conditions. Have your child see their healthcare provider for a diagnosis.

How is Tourette syndrome diagnosed in a child?

A child with Tourette syndrome is usually diagnosed around the age of 7. A primary care provider , pediatrician, child psychiatrist  or a mental healthcare provider may diagnose your child. The healthcare provider will ask about:

  • Your child’s symptoms and health history
  • Your family’s health history
  • Developmental problems

The healthcare provider will also:

  • Watch your child's behavior
  • Ask for a history of your child's behavior from teachers
  • Assess your child’s psychological, social and educational status

How is Tourette syndrome treated in a child?

Treatment will depend on your child’s symptoms, age and general health. It will also depend on how severe the condition is. Some children may not need treatment. A child with Tourette syndrome can usually function well at home and in a regular classroom.

In some cases, a child may need special classes, psychotherapy or medicine. These may be choices if:

  • Tics cause problems with daily function or school
  • Your child has a problem such as OCD or attention deficit/hyperactivity disorder (ADHD)
  • Your child has another emotional or learning problem

A treatment called comprehensive behavioral intervention for tics can help children deal with tics and reduce tics.

Your child may need medicines if they have related conditions such as ADHD, OCD or a mood disorder . Talk with your child’s healthcare providers about the risks, benefits and possible side effects of all medicines.

What are possible complications of Tourette syndrome in a child?

Many children who have Tourette syndrome also have attention problems. Some have trouble in school. But most have normal intelligence and don’t have a learning disability.

Other conditions commonly seen in children with Tourette syndrome include behavior problems, mood changes, social challenges and trouble sleeping.

How can I help prevent Tourette syndrome in my child?

Your healthcare provider may advise genetic counseling. You can discuss with a counselor the risk for Tourette syndrome in a future pregnancy.

How can I help my child live with Tourette syndrome?

Your child may need support and help with:

  • Self-esteem
  • Relationships with family and friends
  • Classroom participation

Develop a strong, positive relationship with your child's educational team. Depending on how severe the disorder is, they can both support your child in the classroom and also help with social situations. As your child gets older, pay attention to social media and possible issues with bullying. Seek professional counseling for your child and their siblings to help deal with the emotional impact of Tourette syndrome. Talk with your child’s healthcare provider and school staff about the best ways to support your child.

Tourette syndrome has no cure, and the condition is lifelong. It does not get worse over time. And some children see their tic symptoms decrease in their late teens and early 20s. People with Tourette syndrome also have a normal life expectancy. Tic symptoms tend to decrease with age, but ADHD, OCD, depression , generalized anxiety , panic attacks and mood swings can continue and cause ongoing problems in adult life.

When should I call my child’s healthcare provider?

Call the healthcare provider if your child has:

  • Symptoms that don’t get better, or get worse
  • New symptoms

two young girls smiling

Movement Disorders Treatment at Children's National Hospital

The Movement Disorders Program at Children’s National offers evaluation, diagnosis and treatment to more than 400 children each year with conditions that affect the speed, quality and ease of their movement. Discover more about the treatments we offer.

Girl Smiling and Clapping

Help Kids and Make a Difference

Invest in future cures for some of life's most devastating diseases. Give today to help more children grow up stronger.

PATIENT STORY

Elise's Story

what is tourist syndrome

Providers Who Treat Tourette Syndrome

Jeffrey Rabin

Jeffrey Philip Rabin, DO

  • Vice-Chair, Pediatric Rehabilitation Medicine
  • Pediatric Rehabilitation Specialist
  • Chronic Pain Specialist
  • Main Hospital
  • Montgomery County
  • Prince George's County
  • Howard County

Departments

  • Pediatric Stroke Program
  • Pediatric Pain Medicine
  • Physical Medicine and Rehabilitation

Laura Tochen

Laura Schiffman Tochen, MD

  • Co-Director, Myelin Disorders Program
  • Neurologist

Movement Disorders Program

  • Leukodystrophy and Myelin Disorders Program

Alonso Zea Vera

Alonso Gonzalo Zea Vera, MD

  • Pediatric Movement Disorder Specialist

Departments that Treat Tourette Syndrome

Young Girl Smiling with Arms Up

The Movement Disorders Program at Children's National Hospital offers evaluation, diagnosis and treatment to more than 400 children each year with conditions that affect the speed, quality and ease of their movement.

what is tourist syndrome

Psychology and Behavioral Health

In the Division of Psychology and Behavioral Health, our child psychologists and other mental health professionals work exclusively with children and teens, emphasizing patient and family-focused care.

Pre-teen girl practicing balance for her provider

Our pediatric neuroscience team is the largest in the country, allowing us to offer our vast experience to patients and families.

Rare Disease Day at NIH Logo

  • Browse by Disease

Tourette syndrome

  • About the Disease
  • Getting a Diagnosis
  • Resources and Support

Disease at a Glance

Find your community, participating in clinical studies, about tourette syndrome.

Many rare diseases have limited information. Currently, GARD aims to provide the following information for this disease:

  • Population Estimate: This section is currently in development.
  • Symptoms: This section is currently in development.
  • Cause: GARD does not currently have information about the cause of this disease.
  • Organizations: Patient organizations are available to help find a specialist, or advocacy and support for this specific disease.

When Do Symptoms of Tourette syndrome Begin?

This section is currently in development. 

Patient organizations can help patients and families connect. They build public awareness of the disease and are a driving force behind research to improve patients' lives. They may offer online and in-person resources to help people live well with their disease. Many collaborate with medical experts and researchers. Services of patient organizations differ, but may include:

  • Ways to connect to others and share personal stories
  • Easy-to-read information
  • Up-to-date treatment and research information
  • Patient registries
  • Lists of specialists or specialty centers
  • Financial aid and travel resources

what is tourist syndrome

Patient Organizations

6 Organizations

Organization Name

Who They Serve

Helpful Links

Tourette association of america, people with.

Tourette Syndrome

United States

Tourette Canada

Everylife foundation for rare diseases.

Rare Diseases

Genetic Alliance

Global genes, national organization for rare disorders.

Clinical studies are part of clinical research and play an important role in medical advances, including for rare diseases. Through clinical studies, researchers may ultimately uncover better ways to treat, prevent, diagnose, and understand human diseases.

what is tourist syndrome

What Are Clinical Studies?

Clinical studies are medical research involving people as participants. There are two main types of clinical studies:

  • Clinical trials determine if a new test or treatment for a disease is effective and safe by comparing groups receiving different tests/treatments.
  • Observational studies involve recording changes over time among a specific group of people in their natural settings.

Why Participate in Clinical Studies?

People participate in clinical trials for many reasons. People with a disease may participate to receive the newest possible treatment and additional care from clinical study staff as well as to help others living with the same or similar disease. Healthy volunteers may participate to help others and to contribute to moving science forward. To find the right clinical study we recommend you consult your doctors, other trusted medical professionals, and patient organizations. Additionally, you can use ClinicalTrials.gov to search for clinical studies by disease, terms, or location.

What if There Are No Available Clinical Studies?

ResearchMatch helps connect people interested in research studies  with researchers from top medical centers across the United States. Anyone from the U.S. can register with this free program funded by NIH. Researchers from participating institutions use the database to search for and invite patients or healthy volunteers who meet their study criteria to participate.

Join the All of Us Research Program!

The All of Us Research Program is inviting 1 million people from all backgrounds across the U.S. to help build one of the most diverse health databases in history. Researchers will use the data to learn how our biology, lifestyle, and environment affect health. This may one day help them find ways to treat and prevent diseases.

Learn about symptoms, cause, support, and research for a rare disease. 

Take steps toward getting a diagnosis by working with your doctor, finding the right specialists, and coordinating medical care.

Find resources for patients and caregivers that address the challenges of navigating life with a rare disease.

  • Reference: Access aggregated data from Orphanet at Orphadata . Orphanet is an online database of rare diseases and orphan drugs. Copyright, INSERM 1997.
  • Reference: OMIM is authored and edited at the McKusick-Nathans Institute of Genetic Medicine , Johns Hopkins University School of Medicine, under the direction of Dr. Ada Hamosh.
  • Reference: Human Phenotype Ontology Downloads  Kohler S, Gargano M. Matentzoglu N, et al., The Human Phenotype Ontology in 2021, Nucleic Acids Research, Volume 49, Issue D1, 8 January 2021, Pages D1207-D1217.
  • Reference: MedGen Data Downloads and FTP
  • Reference: MedLinePlus
  • Reference: Data from the Newborn Screening Code and Terminology Guide is available here. Downs SM, van Dyck PC, Rinaldo P, et al. Improving newborn screening laboratory test ordering and result reporting using health information exchange . J Am Med Inform Assoc. 2010 Jan-Feb; 17(1):13-8
  • The National Library of Medicine . (2023). Unified Medical Language System (UMLS) .
  • National Academies of Sciences, Engineering, and Medicine. (2015).  Improving Diagnosis in Health Care . Washington, DC: The National Academies Press.
  • U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2016).  Health Literacy Online: A Guide for Simplifying the User Experience .

Last Updated: February 2024

Academia.edu no longer supports Internet Explorer.

To browse Academia.edu and the wider internet faster and more securely, please take a few seconds to  upgrade your browser .

Enter the email address you signed up with and we'll email you a reset link.

  • We're Hiring!
  • Help Center

paper cover thumbnail

The tourist syndrome: an interview with Zygmunt Bauman

Profile image of Claudia Poletto

Related Papers

Jackie Feldman

Zygmunt Bauman wrote that whereas the modern problem was to construct an identity and keep it stable, the postmodern one was to avoid fixation and keep all options open. He characterises this shift from solid modernity to liquid postmodernity as the movement 'from pilgrim to tourist': the pilgrim follows a lifelong path through the desert of life. Along the road, sacrifices are made, pleasures foregone, byways ignored, immediate rewards forsaken, to achieve one's ultimate goal. In liquid modernity, the pilgrim is replaced by the tourist, the systematic seeker of diversity, pleasure and novelty. I argue that Bauman's image of the 'plodding pilgrim' does violence to the multiplicity of pilgrim experiences. I show how historical pilgrimage has involved risk-taking and serendipity, a suspension of social ties and routines as well as a desire for transcendence. Contemporary pilgrimage often includes a desire for intimacy, intense bodily experience, changed attitudes towards time and nature and the quest for self-transformation. Pilgrimage may forge alternative bonds of community and provide new ways of imagining futures. The pilgrim, far from being an icon for a frozen past, is a figure that embodies many aspects of contemporary mobility and identity.

what is tourist syndrome

Journal of Consumer Culture

Christopher A Howard

Based on a mobile ethnography of tourism and pilgrimage in the Himalayan region, this article interprets performances and imaginaries of Western travellers as a meta-commentary on late modern life. Being typically critical of consumer culture, Himalayan travellers often demonstrated positive yet naive appraisal and nostalgia for places and people perceived as non-modern, natural and authentic. Such eco-utopian imaginaries are consistent with media representations of the region and the wider discourse of reflexive modernity. While Himalayan journeys are often inspired and oriented by a search for authenticity and the seduction of difference, such valued ideals are contested by the same late capitalist conditions that make encounters with the Other and global mobility possible. Tourist consumers thus seek to capture authentic objects of desire before they are destroyed, while paradoxically contributing to their destruction in the process. At the same time, it is shown how the quest for authenticity exposes travellers to the possibility of other, less consuming and more sustainable forms of life.

Ruud Welten

For the first time in history, the majority of the global population can engage in leisure travel. Making contact with people from different cultures and different parts of the world has never been easier. To paraphrase Zygmunt Bauman: these days, the earth’s prosperous not only often act like, but essentially have become tourists. What, in a globalized world that is no longer merely a place to dwell but, rather, has all the features of a huge tourist resort, are the chances of survival for ethics? This article begins with a description of Bauman’s critical analysis of modern interna- tional tourism, followed by an investigation into the feasibility of formulating an ethics of mod- ern tourism using the age-old notion ‘cosmopolitanism’. Following the Stoics, Kantian cosmopol- itanism—Kant was the first to connect the notion with hospitality and physical travel—and, even- tually, the work of Levinas and Derrida, we will explore what, if anything, the term cosmopol- itanism can contribute to the quest for an ethics of tourism.

Crispin Thurlow

CITATION DETAILS: Jaworski, A. & Thurlow, C. (2010). Language and the imagined communities of tourism: A sociolinguistics of fleeting relationships. In N. Coupland (ed.), The Handbook of Language and Globalization (pp. 256-286). Oxford: Blackwell.

CITATION DETAILS: Heller, M., Jaworski, A. and Thurlow, C. (2014). Introduction: Sociolinguistics and tourism – mobilities, markets, multilingualism. Journal of Sociolinguistics, 18(4), 425-458.

Monica Heller , Adam Jaworski

Feminist Media Studies

Manoucheka Celeste, Ph.D.

Claudia Poletto

Adam Jaworski

RELATED PAPERS

Olivier Evrard

Paolo Parmeggiani

Mekonnen Tesfahuney

Bianca Freire-Medeiros

Tourist Studies

Ewa Mazierska

Kate Domingos

Maximiliano E. Korstanje

Neamatullah sharifi

Current Issues in Tourism

Birgit Abelsen

Paolo S H Favero

Simone Krüger Bridge

European Journal of Marketing

Angela Cruz

Michael O' Regan

Nature and Culture

Mark C J Stoddart

Jonas Larsen

National and European identities in the process of European integration

Goran Tomka

Andjela Popovic

Gender, Place & Culture

Jessica Jacobs

Dragica Tomka

Antonia Canosa, PhD

Thesis Eleven, vol. 70 no. 1, pp. 36-54

Vince Marotta

Crispin Thurlow , Adam Jaworski

Vytautas Michelkevicius

Anna Wojtynska

Tourist behaviour: A psychological perspective

Noel B. Salazar

NIKOLAS STASINOPOULOS

Migration Studies

ilse van liempt , Joris Schapendonk

kyle woosnam

Anjali Vats

Barb Brents

Simon Bradford

P. Jane Reas

  •   We're Hiring!
  •   Help Center
  • Find new research papers in:
  • Health Sciences
  • Earth Sciences
  • Cognitive Science
  • Mathematics
  • Computer Science
  • Academia ©2024

What is the Tourist Syndrome?

what is tourist syndrome

March 13, 2023

what is tourist syndrome

When traveling, you probably experience moments of awe, culture shock, and misunderstanding. Whether these moments happen in your own country or abroad, they can be very uncomfortable and even scary at times. For some, these experiences lead to serious psychiatric disorders. Tourist Syndrome is a term that refers to those who become disoriented, depressed, and sometimes even hospitalized when they visit certain destinations.

What is the Syndrome?

Tourist Syndrome is a set of symptoms that develops in people who travel to an unfamiliar place. Breathtaking TikTok videos and glamorous Instagram reels can lead to high expectations for a place, and when those expectations don’t meet the reality of the city, some tourists might experience real pain in their hearts and minds.

Paris, France, is a popular destination that attracts many visitors each year. It is known for its world-class art, museums, parks, and architecture.

But for some tourists, their experience of the French capital is not quite as magical as they expected it to be. Some suffer from a condition called “Paris Syndrome,” a disorder that causes them to feel dizzy, lose their sense of balance, become hallucinating, and even believe they are Louis XIV!

The condition is mainly associated with Japanese tourists and is so serious that an average of 12 Japanese tourists seek mental health help after every trip to France. But it’s also common for travelers from other countries to experience this strange phenomenon as well.

Stendhal Syndrome

Stendhal Syndrome, also known as Florence syndrome or aesthetic sickness, is a rare psychosomatic disorder that causes tachycardia, dizziness, fainting, sweating, disorientation, and confusion when someone looks at artwork with which they connect emotionally. Its named after the pseudonym of a French author who wrote about experiencing. It in 1817 when he visited the Basilica of Santa Croce in Florence.

Researchers explain that it could develop in people who are incredibly sensitive to art. have access to an abundance of it in one place. Visual and architectural arts are the most common culprits. But other items in a natural environment — like a gorgeous sunrise or breathtaking mountain view — could also cause it.

Graziella Magherini an Italian psychiatrist described the condition in 1979. After she saw a few patients who experienced similar symptoms after visiting Florence’s art museums and galleries. This condition has since spread across the world. With researchers noting that Paris syndrome and Jerusalem syndrome are related.

Jerusalem Syndromes

Jerusalem Syndrome is a serious mental illness that occurs in tourists visiting the Holy City. It was first reported by Israeli psychiatrists in 2000.

The symptoms usually start within a few days of arriving in the city. They often triggered by a fixation or idiosyncratic belief in the place. For example, they may have a deep religious connection to the land or believe they’re John the Baptist, Jesus, or Samson.

They may also become obsessed with cleanliness and purity. They will take countless baths and showers, wear white bed sheets or a toga, and cut their fingernails and toenails.

These manifestations can be a warning that they need to seek professional psychiatric treatment. And will likely result in an escalation of the symptoms leading to a psychotic episode. However if these patients are physically removed from the holy places in Jerusalem they will usually recover.

Paris Syndrome

Tourists often build up a city or country in their minds as the perfect getaway spot. Whether that is a beach vacation in the Maldives, an overwater bungalow in South Africa. Or getting lost among Paris’s streets. It is not uncommon to be disappointed by travel expectations that are too high.

A condition recognized by Japanese psychiatrist Hiroaki Ota in 1986. Paris Syndrome is an extreme form of culture shock where people are so taken aback. By their surroundings that they become depressed and suffer physical and psychiatric symptoms. The condition is thought to be a result of the intense juxtaposition between visitors expectations and their actual experiences in a new place Mail Online reports.

Previously reported cases include a man who believed he was Louis XIV. And a woman who thought she was being attacked with microwaves. Journal du Dimanche reported. Experts don’t agree on the cause of the disorder but say it can be triggered by a combination of factors like language barriers or cultural differences.

RELATED TAGS

  • cause of the disorder
  • Florence syndrome
  • Tourist Syndrome

SHARE, LIKE, REPEAT

Let's connect.

  • Privacy Policy

U.S. flag

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

  • Publications
  • Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

  • Advanced Search
  • Journal List
  • Rev Bras Hematol Hemoter
  • v.39(4); Oct-Dec 2017

Economy class syndrome: what is it and who are the individuals at risk?

The term ‘economy class syndrome’ refers to the occurrence of thrombotic events during long-haul flights that mainly occur in passengers in the economy class of the aircraft. This syndrome results from several factors related to the aircraft cabin (immobilization, hypobaric hypoxia and low humidity) and the passenger (body mass index, thrombophilia, oral contraceptives or hormone replacement therapy, cancer), acting together to predispose to excessive blood coagulation, which can result in venous thromboembolism. Several risk factors, both genetic and acquired, are associated with venous thromboembolism. The most important genetic risk factors are natural anticoagulant deficiencies (antithrombin, protein C and protein S), factor V Leiden, prothrombin and fibrinogen gene mutations and non-O blood group individuals. Acquired risk factors include age, pregnancy, surgery, obesity, cancer, hormonal contraceptives and hormone replacement therapy, antiphospholipid syndrome, infections, immobilization and smoking. People who have these risk factors are predisposed to hypercoagulability and are more susceptible to suffer venous thromboembolism during air travel. For these individuals, a suitable outfit for the trip, frequent walks, calf muscle exercises, elastic compression stockings and hydration are important preventive measures. Hence, it is essential to inform about economic class syndrome in an attempt to encourage Brazilian health and transport authorities to adopt measures, in partnership with the pharmaceutical industry, to prevent venous thromboembolism.

Introduction

Venous thromboembolism (VTE) is a clinical condition that involves two related situations, venous thrombosis and pulmonary embolism. 1 It affects approximately 2–3 people per 1000 individuals per year. VTE is the third cause of death by vascular diseases, only surpassed by myocardial infarction and ischemic stroke. In addition, it is the most common cause of preventable death in hospitalized patients. 2 , 3

The term ‘economy class syndrome’ refers to the occurrence of thrombotic events during long-haul flights, mainly in economy class passengers. This syndrome results from several factors related to the aircraft cabin (immobilization, hypobaric hypoxia and low humidity) and to the passenger (such as obesity, thrombophilia, oral contraceptive use, hormone replacement therapy and cancer), that act together predisposing to excessive blood coagulation, which can result in VTE. 4

Several risk factors, both genetic and acquired, are associated with VTE. The most important genetic risk factors are natural anticoagulant deficiencies: (1) Deficiency of antithrombin, protein C or protein S; (2) Factor V (FV) Leiden, which is resistant to protein C inactivation; (3) The G20210A mutation in the prothrombin gene, which leads to an increase in gene expression and prothrombin plasma levels; (4) The C10034T mutation in the fibrinogen gene, which produces a variant form of fibrinogen; and (5) Non-O blood group (A, B and AB) as individuals have higher von Willebrand factor and factor VIII plasma levels than O group subjects and have increased risk of thrombosis.

Acquired risk factors include age, pregnancy, surgery, obesity, cancer, hormonal contraceptives and hormone replacement therapy, antiphospholipid syndrome, infections, immobilization and smoking. 5 , 6

Venous thromboembolism and air travel

Data from the Brazilian National Civil Aviation Agency (ANAC) revealed that the number of passengers carried by civil aviation in 2015 surpassed 100 million. 7 Table 1 , Table 2 8 , 9 , 10 show the main domestic and international flights in and from Brazil in 2015. The aircraft microenvironment provides very specific conditions, such as reduced oxygen tension, immobilization (in general, people are in tight uncomfortable seats) and circadian dysrhythmia, due to differences in time zones (jet lag). These factors may disturb the passenger's health, causing fatigue, anxiety and nausea. 11 , 12

Major domestic flights of Brazil in 2015.

Major international flights from Brazil in 2015.

The first cases of VTE associated with air travel were reported in 1954, and since then, other cases have been described. 4 The vast majority of victims suffer pulmonary embolism and/or deep vein thrombosis, but cases of subclavian vein thrombosis, 13 cerebral vein thrombosis, 14 stroke and arterial thrombosis 15 have also been reported.

The actual incidence of VTE in air travel is unknown. It is difficult to arrive at an estimation given that this condition may be asymptomatic or may develop days or even weeks after the flight. 16 In a cohort of healthy subjects, the absolute risk of VTE on flights lasting more than 4 h was 1 in 6000. 17 A meta-analysis 18 involving 14 studies reported 4055 cases of VTE in trips lasting up to 8 h. These studies included both air and overland trips with the follow-up time after the journey ranging from two to eight weeks. The relative risk of VTE was 2.8 [95% confidence interval (95% CI): 2.2–3.7] and at each increment of 2 h in travel time, there was an approximate 18% increase in the risk of VTE. Considering only air travel, this risk increased to 26%, suggesting a cumulative effect of flight time in the genesis of VTE.

MacCallum et al. 19 demonstrated that on flights lasting less than 4 h, the risk of VTE is approximately two times higher compared to non-traveler subjects [odds ratio (OR): 2.20; 95% CI: 1.29–3.73] and remained high in the four subsequent weeks. In long-haul flights (greater than 12 h as one or more flights), the risk of VTE is around three times higher (OR: 2.75; 95% CI: 1.44–5.28). After 12 weeks, no time-flight effect was observed in the occurrence of thrombotic events.

A number of factors associated both to the aircraft or passengers have been singled out as responsible for triggering VTE. 20 Stasis and hypercoagulability, two components of Virchow's triad, have a crucial role in the occurrence of thromboembolism in flights. 18

The factors associated with the aircraft include:

  • • Hypobaric hypoxia: The hypoxia caused by reduced air pressure in the aircraft cabin contributes to VTE. At sea level, normal atmospheric pressure is 760 mmHg, which corresponds to a partial oxygen pressure of 159 mmHg. Under these conditions, oxygen saturation in healthy individuals is 95%. In the cockpit of an aircraft at flight altitude, the pressure is usually 570 mmHg and the partial oxygen pressure is 125 mmHg, resulting in oxygen saturation of 90–93%. However, in the elderly and people with lung and/or heart diseases, reductions of up to 80% of oxygen saturation can occur. The relative hypoxia in the aircraft leads to a decrease in fibrinolytic activity and the release of venous relaxation factors, which help to increase the hemostasis. 12
  • • Low humidity: The relative humidity inside the aircraft is approximately 10%, while at sea level is 30–40%. Low humidity is associated with increases in plasmatic and urinary osmolarity, which result in hemoconcentration that favors VTE. 12

The main passenger-related factors are:

  • • Immobilization: Lack of movement in the sitting position during the flight results in hemostasis of the lower limbs predisposing the individual to VTE. 12 An evaluation of coagulation biomarkers showed that there is an increased generation of thrombin during flights lasting more than 8 h; this does not occur in other situations where the subject is immobilized in the sitting position. It suggests that there is an additional mechanism resulting in hypercoagulability during flights. 20
  • • Body mass index (BMI) and height: In obese subjects (BMI > 30 kg/m 2 ), there is a reduction in blood flow in the lower limbs, favoring hemostasis. It has been observed that individuals at the extremes of stature (>1.90 m or <1.60 m) have an increased risk of VTE during air travel. 12
  • • Thrombophilia: The presence of genetic thrombophilia is an independent risk factor for VTE. Martinelli et al. reported that the risk of VTE is 6.6 (95% CI: 3.9–11.3) times higher in patients with thrombophilia, compared to individuals without these mutations. In patients with thrombophilia, the risk of VTE was 16.8 times higher (95% CI: 3.8–74.7), compared to non-thrombophilic, non-travelers, which suggests a synergistic interaction resulting in an increase in thrombotic risk. 21
  • • Oral contraceptives and hormone replacement therapy: The use of oral contraceptives increases the risk of VTE by about fourfold in the general population (OR: 4.2; 95% CI: 1.9–9.3). A synergistic association between air travel and oral contraceptive use in the genesis of VTE can be inferred since the occurrence of thrombosis is high in women under oral contraceptives use during or after air travel (OR: 23.4; 95% CI: 2.6–11.2). Similarly, hormone replacement therapy predisposes to VTE. 2
  • • Cancer: It is well established that cancer patients have an increased risk of developing VTE throughout the history of the disease, mainly in the first three months after the initial diagnosis (OR: 53.5; 95% CI: 8.6–334.3). 22 Kuipers et al. 23 estimated that the presence of a malignant disease is associated to an 18-fold increase in thromboembolic risk during flights.
  • • Other factors: Although it is admitted that factors such as diabetes and smoking are associated with a hypercoagulable state, 24 there is a lack of studies about the association of these conditions and the incidence of VTE during flights.

Pregnancy, air travel and venous thrombosis

Pregnancy progresses with important physiological changes in the hemostatic system, which determines a hypercoagulable state. These adaptive changes aim to prepare the maternal organism to the great hemostatic challenge of placenta expulsion and simultaneous disruption of numerous blood vessels to prevent excessive bleeding. 25

Literature data suggest that 1:6000 young passengers without risk factors for thrombosis have a risk of symptomatic VTE in a four-hour flight. 26 Pregnant women in four-hour flights have a thromboembolic risk five to ten times higher than non-pregnant women have. This risk rises exponentially on long-haul trips, by around fourfold and eightfold if the flight time exceeds eight or 12 h, respectively. 26

For pregnant women with thrombophilia who fly over 4 h, the thromboembolic risk is 1:200. For women with Factor V Leiden in homozygosis or those heterozygosis for both Factor V Leiden and the prothrombin mutation, the risk is about 1:40. 26 In addition to genetic thrombophilia, parturients with an acquired thrombophilia such as antiphospholipid syndrome also have an increased risk for VTE. These findings raise the debate about the relevance of the adoption of pharmacological prophylaxis in pregnant women while flying. 27 , 28

It has been reported that hypoxia during flights and, consequently trophoblastic injury, favors the occurrence of preterm birth and intrauterine death, especially in pregnant women aged over 35 years, with preeclampsia, abruptio placentae or intrauterine growth restriction. 29

Aware of the risks, many commercial airlines allow pregnant women to travel only up to the 36th week of pregnancy. Other companies make restrictions for international flights in early pregnancy and require evidentiary documentation of gestational age or state that cases should be evaluated individually. Pregnant civilian or military crewmembers should check with regulatory bodies with regard to restrictions on their professional activities. However, the main concern with pregnant women of airlines is associated with the risk of labor during the trip, which could disrupt or interrupt the flight. In addition, there is a lack of skilled professionals to manage obstetric complications occurring aboard. 27

Obstetricians advise at-risk pregnant women not to fly. All pregnant women should be informed of the obstetric emergencies that can occur in the first and third trimesters of pregnancy and it is prudent to avoid travel during these periods. 30

Currently, with the progressive increase in the possibility of air travel given by the expansion of routes and drop in ticket prices, the risk of venous thrombotic events associated with long hours of immobilization during air travel has emerged as a topic to be discussed. Preventive measures are extremely important. Passengers should be informed of potential risks and encouraged to exercise regularly, with short walks in the aisles, and to avoid dehydration. It is controversial as to whether drinking alcoholic beverages increases the risk of thromboembolic events, but it may contribute to dehydration and there is still the possibility of fetus damage during pregnancy. Thus, the intake of alcoholic beverages must be discouraged. 29

The choice of a suitable outfit for the trip is also important and must prioritize comfort, avoiding tight garments with elastic. Adequate hydration should be encouraged. 27

Individual risk stratification is essential to define the most appropriate measures. The Aerospace Medical Association (AsMA) has published guidelines on the use of prophylaxis in individuals who travel by air. The risk groups defined in these guidelines are shown in Table 3 . 31 Pregnancy and the puerperium are defined as moderate risk. For individuals with moderate risk, the guidelines suggest acetylsalicylic acid associated or not with compression stockings. 32 However, the evidence about acetylsalicylic acid use is controversial as it crosses the placenta and therefore it cannot be recommended prophylactically in pregnant women according to the American College of Chest Physicians Guidelines. 33

Risk categories for the occurrence of thromboembolic events.

Elastic compression stockings exert graduated pressure of the lower limb with greater pressure at the ankle. When combined with muscle activity, they direct the blood flow from the superficial venous system to the deep system, reducing venous stasis and potentially preventing the occurrence of venous thrombosis. A Cochrane systematic review included nine randomized trials (2821 individuals) comparing flyers who used compression stockings with those who did not (seven studies in low- or medium-risk individuals). The study noted a significant reduction in the risk of asymptomatic travel-related deep venous thrombosis with the use of compression stockings (OR: 0.10; 95% CI: 0.05–0.25). 15 The tolerability of compression stockings was good in all studies and no adverse effects were reported with the exception of superficial thrombophlebitis. 15 , 34

For high-risk individuals, frequent walking, calf muscle exercises and compression stockings should be encouraged. 27 , 31

Despite the fact that thrombophilia constitutes a major risk factor for VTE, routine screening is not recommended in pregnant women, since there are multiple risk factors in pregnant women (even though each individual factor is not associated to high risk). 35

Considering the large extension of the Brazilian territory, thrombosis during long overland trips (with immobilization in a sitting position) should be expected however only one case report was found in the Brazilian literature concerning the occurrence of a thromboembolic event. 36

Final considerations

In the context of Brazil, the majority of domestic flights last less than 2 h, although trips from the south to the north and northeast can last from 8 to 10 h. With respect to international travel, most flights are of long duration and thus represent a greater risk of VTE. Despite this, there is no data about Brazilian individuals who travel with a risk of hypercoagulability or about VTE related to flights.

It is essential to inform about economic class syndrome in an attempt to encourage the Brazilian health and transport authorities to adopt some measures, in partnership with the pharmaceutical industry, to prevent venous thromboembolism.

Acknowledgments

The authors thank the financial support granted by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and Fundação de Amparo à Pesquisa do estado de Minas Gerais (FAPEMIG). LSD and MGC are grateful to CNPq for providing Research Fellowships.

Psychology of travel logo in rectangle format

  • Privacy Policy
  • Disclosure Statement
  • Terms of Use
  • Psychology of Travel Book
  • Work With Me

The Paris Syndrome: All you Need to Know

eiffel tower paris

The effervescent city of Paris is known for it’s romance, art, culture, and…a syndrome? If you’ve never heard of Paris Syndrome, you may be surprised to learn that the very City of Light has also been associated with a neuropsychiatric condition. Here is all you need to know about Paris Syndrome.

Paris Syndrome was the term originally coined by a Japanese psychiatrist, Dr. Hiroaki Ota, who observed a pattern of symptoms after Japanese tourists had visited the city of Paris. These symptoms included dizziness, sweating, and even hallucinations. It can be considered somewhere in the range of the term “culture shock”.

Why would anyone experience psychiatric symptoms after visiting such a lovely destination? According to some specialists, one theory was that Paris had been so eagerly anticipated as glorious perfection by reputation, the inevitable disappointment with not meeting those impossible standards created the rise of these symptoms.

Is Paris Syndrome Real?

Of note, Paris Syndrome is not a recognized psychiatric disorder in the DSM-V-TR , the diagnostic manual by the American Psychiatric Association that mental health professionals use to identify psychiatric illness. It has received relatively little research attention. There are also no empirically established treatments for Paris Syndrome (at least, none that have made it through peer-reviewed academic journals).

Still, reports seem to trickle through every year regarding a small handful of individuals that seek medical care in the context of the Paris Syndrome collection of symptoms.

These days, Paris Syndrome has become more generalized to mean any significant disappointment after encountering circumstances that did not live up to their lofty billings. In other words, it’s not unique to Paris (or any other esteemed city), but rather can refer to any experience such as a disappointing Broadway performance.

Stendhal Syndrome vs Paris Syndrome

beautiful palace ornate paris syndrome

There are other cultural syndromes described in the literature, including Stendhal Syndrome. Stendhal Syndrome may perhaps be considered somewhat the “opposite” of Paris Syndrome.

In Stendhal Syndrome, neuropsychiatric symptoms arise after a person is overwhelmed by aesthetic beauty or poignancy of the experience. It has been observed in patients that presented to the hospital after visiting exquisite museums with artwork masterpieces.

Again, Stendhal Syndrome is more of a description of observed patterns of symptoms, rather than an established and researched psychiatric disorder. Plenty of additional research would need to be done to find its way into the DSM-V-TR. However, opportunities for research are limited by the relatively small number of individuals that experience these symptoms.

So, Can I still go to Paris?

Eiffel Tower in Paris architecture blue sky city cityscape Paris Syndrome

No need to cancel your vacation to Paris. It’s not something you catch from someone on an airplane or by drinking the Paris municipal water. If you do happen to experience a similar pattern of symptoms of Paris Syndrome, the good news is that the symptoms appear to go away within a few days on their own accord. Rest and hydration are the reported keys to help relieve the symptoms.

Do some perspective-taking before your next vacation and set realistic expectations for what you might encounter to help reduce the chances of experiencing similar symptoms.

Social media, photo editing software, and glowing marketing efforts can pain an unrealistic picture of a destination or experience.

Do you hold an over-idealized version of your planned vacation destination? Talk to someone who lives there (or at least has visited) and they’ll likely be able to share a more balanced view of the place than those filtered instagram shots.

What are your thoughts on Paris Syndrome? Comment below!

Remember to sign up for the free Psychology of Travel Newsletter for all the latest updates. Also, check out the Psychology of Travel ebook here !

Happy Travels, Dr. L Founder, PsychologyOfTravel.com

The content on this page may include affiliate links from advertisers.  It may earn a commission from actions readers take on these links (at no cost to you), such as a click, purchase, or subscribe.  As an Amazon Associate I earn from qualifying purchases.  Read our  Privacy Policy .

Share this:

Leave a comment cancel reply, privacy overview.

  • The A.V. Club
  • The Takeout
  • The Inventory

Support Quartz

Fund next-gen business journalism with $10 a month

Free Newsletters

Paris Syndrome: Troubles in tourism

The culture clash phenomenon that almost exclusively affects japanese travelers..

The Eiffel Tower stands framed by green trees and blue sky.

Disenchanted to meet you

Imagine walking through Paris for the first time, admiring the City of Lights, thinking of croissants, crème brûlée, and Gene Kelly tap-tapping on the streets, only to find that sidewalks of Montmartre are covered in dog shit.

It could almost make a visitor faint with disappointment. Some tourists nearly do. The phenomenon is known as Paris Syndrome, and it is almost exclusively experienced by Japanese travelers who find themselves in a state of extreme culture shock when encountering the grittier realities of the French capital.

Called Pari shōkōgun in Japanese, the illness is estimated to strike a couple dozen unsuspecting tourists a year. So why does this particular clash of cultures turn the City of Lights into the City of Frights?

Turns out idealizing any city is a dangerous path. Alors, join us on this tour to find out why.

By the digits

44 million: Number of tourists that visited Paris in 2022 according to the region’s tourism committee, making it the most visited city in the world for the second year in a row. Dubai came in second with 12 million visits.

$64.2 billion (€58 billion): Revenue France brought in from tourism in 2022

1.3 million: Number of Japanese tourists visiting France in 2023, according to data analytics firm GlobalData

20 : Number of cases of Paris Syndrome occurring annually among Japanese tourists, according to Miyupi Kusama, a staffer at the Japanese embassy in Paris, as cited in a 2006 Guardian article

1: Ranking of Paris as the unfriendliest city in the world, according to a survey conducted by Rough Guides, a British travel guide publisher

Culture clash

Signs of the syndrome

Paris Syndrome is not formally recognized in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), but has been recognized by medical professionals as a real disorder. Symptoms include dizziness, anxiety, vomiting, hallucinations, delusional states, and even tachycardia, or increased heart rate.

The term was first coined by Hiroaki Ota, a Japanese psychiatrist who worked at Sainte-Anne Hospital in Paris, in the 1980s. He and several co-authors published an article (link in French) on the subject in psychology journal Nervure in 2004.

It describes Paris Syndrome as a state of complete culture shock. Tourists from Japan, they theorized, are especially susceptible to having a disappointing experience in Paris because of how the city has been idealized in Japanese pop culture and media.

The language barrier, as well as differences in cultural norms and expectations are also identified as precipitating factors behind the disorder. “The stereotypical image of Paris, a city of consumption of luxury goods, widely conveyed by media sources, does not resist everyday life,” Ota et al. explain in the paper.

“Meaning comes from the use of shared symbols and depression is a loss of meaning. This depression is the essence of culture shock. Culture shock is the anxiety and emotional disturbance experienced by people when two sets of realities and conceptualisations meet.”

—Rachel Irwin writing in her study, “ Culture shock: negotiating feelings in the field ” in Anthropology Matters Journal

Furansu, je t’aime

Japan’s love affair with France

Japan has long had a fascination with France. In the public imagination it is often regarded as a pinnacle of art, culture, fine dining, beauty, and good taste. Just look to Japan’s capital, where you can find Tokyo Tower, an imitation of the Eiffel Tower, and Odaiba’s Statue of Liberty, an ode to the French-built monument.

Tokyo even has a devoted French quarter , Kagurazaka, which is clustered with Parisian-influenced shops, cafes, and bakeries. If you pop into one of the area’s bookstores, you might be able to pick up some Proust or Voltaire translated into Japanese, or maybe a copy of The French have only 10 clothes , a popular book series in Japan (link in Japanese) on élégance et chic à la française .

“The Japanese see Paris as the City of Light, the most beautiful city in the world, the capital of refinement and romance. A mix of Chanel N°5 commercials, Amélie Poulain and black and white photos of Robert Doisneau,” said Eriko Nakamura , a Japanese journalist living in Paris, and author of the book (link in French) Naaande!? Les tribulations d’une Japonaise à Paris ( Whhhy!? The tribulations of a Japanese woman in Paris ).

Folie à deux

Other travel syndromes

Paris isn’t the only city to induce negative psychological effects. Similar, albeit rare, disorders have also been observed in two other famous cities.

Jerusalem has been found to cause some to fall into a psychotic state , especially those who are religiously inclined. An individual suffering from so-called Jerusalem Syndrome believes, upon visiting the ancient and holy city, that they are a Biblical figure (it even happened to Homer Simpson ).

Stendhal syndrome is a mental condition that was first documented in the city of Florence, Italy. It refers to feelings of faintness, heart palpitations, or even hallucinations one might experience upon seeing great works of art and architecture. The phenomenon was named after Marie-Henri Beyle, known by his nom de plume Stendhal, who recorded his psychosomatic reaction to the Tuscan capital’s artistic treasures in 1817.

He wrote in his book Rome, Naples, and Florence (1818): “I was in a sort of ecstasy, from the idea of being in Florence, close to the great men whose tombs I had seen. Absorbed in the contemplation of sublime beauty... I had palpitations of the heart, what in Berlin they call ‘nerves.’ Life was drained from me. I walked with the fear of falling.”

A man adds books to a display for sale on the banks of the Seine in Paris.

Which is NOT a real quote about Paris written by a novelist?

A. “To err is human. To loaf is Parisian.”

B. “I like Paris, but I’m not really sure Paris likes me.”

C. “There should be a name for the syndrome that occurs when you’re in Paris and you already miss it.”

D. “Paris, I believe, is a man in his twenties in love with an older woman.”

Wind your way through the charms of this email and you’ll stumble across the answer at the bottom.

The French croquette was introduced to Japan in the late 1800s , and adapted to local palates. The resulting dish, called korokke, is in its most basic form a mashed potato patty covered in panko breadcrumbs and then deep fried. Korokke is a popular yōshoku dish, a style of cooking that arose in Japan during the Meiji Restoration (1868 – 1889) that was influenced by Western cuisine.

Watch this!

Japanese media, with a French twist

The Rose of Versailles , a classic and influential shōjo manga (a genre of comics targeting a younger female audience), was first published from 1972 to 1973 is another example of French influence on Japanese culture. The story takes place in Versailles prior to and during the French Revolution, and features Marie Antoinette as a main character. Have a listen to the anime’s opening theme song, “Bara wa utsukushiku chiru” (Roses Scatter in Beauty).

Take me down this 🐰 hole!

French avant-garde movements that emerged in the mid-20th century were very much interested in the impact of geography on psychology, creating a field of study known as “psychogeography.” The term was first defined by Guy Debord, a French marxist and philosopher, in his 1955 essay “Introduction to a Critique of Urban Geography.”

“Psychogeography could set for itself the study of the precise laws and specific effects of the geographical environment, consciously organized or not, on the emotions and behavior of individuals,” Debord wrote. He then mused: “Is it illogical or devoid of interest to observe that the district in Paris between Place de la Contrescarpe and Rue de l’Arbalète conduces rather to atheism, to oblivion and to the disorientation of habitual reflexes?” (We’re not sure what exactly that means, and might need to take a trip to find out.)

Debord also developed the concept of dérive (“drifting”) or the idea of wandering through urban spaces and immersing oneself in the surroundings without the usual motivations for movement (e.g. work, travel, shopping)—a concept somewhat similar to that of Charles Baudelaire’s sauntering and dandyish flâneur .

To those who have visited Paris, how was your experience?

  • Loved it! It is truly one of the greatest cities in the world
  • It was OK—some charms, but definitely overhyped
  • I definitely felt some fainting spells coming on
  • I have yet to risk Paris Syndrome by making a trip

Take a trip to our poll : no lines, no waiting, and never overbooked.

💬 Let’s talk!

🐤 Tweet (or X?) this!

🤔 What did you think of today’s email?

💡 What should we obsess over next?

🩴 In last week’s poll about flip-flops , a whopping 66% of you wear your rubber footwear without socks, as nature intended. It was a relief to hear that only 2% of you wear them with specially made socks.

Also, many of you wrote in to tell us the words for “flip-flops” where you live, which was a great day in our inbox:

  • Joshi says it’s “chappals” in India
  • Tak says no self-respecting Hawaiian local would say “flip-flops” in favor of “slippa”
  • Mike says Russians have three words, transliterated to “shlyopantsy,” “vietnamky,” and “slantsy” (after a town where a flip-flop manufacturer set up shop and printed its name on the soles)
  • Catherine points out it is only “thongs” in Australia

Today’s email was written by Julia Malleck (orders two baguettes at a time, not one, because she can’t remember masculine/feminine articles), and edited by Annaliese Griffin (used her high school French to buy a truly ridiculous amount of cheese in Paris, impressing a Parisian fromager).

The correct answer to the quiz is B. “I like Paris, but I’m not really sure Paris likes me,” which is a line spoken by the character Emily in the oft-reviled, love-to-hate-watch show Emily in Paris . Option A. is a quote from Victor Hugo, C. is Rosecrans Baldwin, and D. is John Berger.

📬 Sign up for Quartz Weekly Obsession

Want to escape the news cycle? Try our Weekly Obsession.

GTE

How to Avoid Paris Syndrome: 9 Truths About Paris (2024)

' src=

Paris is both an incredibly popular and controversial city. While it attracts millions of tourists every year for its beauty, vibrancy, culture, and history, Paris has also been the host to a phenomenon known as ‘Paris Syndrome’. If you’ve ever encountered this term before or have heard about it in passing then you might be wondering what it is and if it’s something you should be worried about.

In this post, I am going to share all the information you need to know about Paris Syndrome and how to avoid developing it. This way, you’ll hopefully be able to make the most of your time without walking away disappointed!

What Is Paris Syndrome?

Put simply, Paris Syndrome is a form of extreme and severe culture shock. Some people are so taken aback and disappointed by the reality of Paris that they experience serious medical complications.

This phenomenon was initially recognized in 1986 by Japanese psychiatrist Hiroaki Ota. He was working at a hospital in France and noticed the phenomenon of several Japanese tourists, who experienced medical complications as well as psychiatric symptoms.

A picture of architecture of the exterior of the Louvre.

Paris Syndrome Psychology

Currently, there is an extremely limited amount of research available on Paris Syndrome, so I couldn’t confidently tell you about the psychology of Paris Syndrome.

That said, one of the prevailing theories by physician Youcef Mahmoudia is that some tourists become so excited while traveling around Paris, that their heart rate accelerates, which in turn causes shortness of breath. And in some cases, this leads to hallucinations — one of the symptoms of Paris Syndrome. And for those who don’t know — because medical jargon can be confusing…

🥐 NOTE: A syndrome is a defined group of medical signs and symptoms that are correlated to each other. They’re often associated with a particular disease or disorder.

Paris Syndrome Symptoms

The syndrome manifests itself through a range of psychiatric (mental) and psychosomatic symptoms. Just a little refresher — psychosomatic symptoms are physical symptoms that are caused by internal conflicts (i.e. stress) and usually lack a medical explanation.

With regards to psychiatric symptoms, they can include hallucinations, paranoid persecutory delusion (perception that they are being oppressed or prejudiced), derealization, depersonalization, and anxiety.

Meanwhile, psychosomatic symptoms of the syndrome range from dizziness, tachycardia (increased heart rate), heart palpitations, sweating, and even vomiting.

A picture of people sitting on fountain ledge outside of the Louvre. You can see the iconic glass pyramid.

So lots of things that don’t sound particularly fun to experience…and you may be thinking that’s ridiculous!

How could someone get this from traveling!? If you really think about it and even research it, these symptoms are not that different from what someone experiences when they have a panic attack.

And, we know panic attacks happen all the time.

How Do You Get Paris Syndrome?

I’ll be completely honest — the chances of you actually developing Paris Syndrome are extremely low. Like, realistically, you’re way more likely to get hit by a car trying to cross the roundabout to reach the Arc de Triomphe or get your wallet stolen by someone like mine was… But again, for anyone who is curious, these symptoms are believed to be caused by the dissonance between a person’s idealized image of Paris and the reality that they encounter when they arrive in the city.

People may become exceptionally overwhelmed by the hustle and bustle of the big city, the cultural differences, and language barriers. It could be vastly different from what they’re used to back home. In turn, they become severely disappointed with the truth of Paris and may manifest the previously mentioned symptoms.

Why Tourists Are Disappointed by Paris

While the chances of you being so immensely disappointed with the French capital that you become one of the handful of travelers diagnosed with Paris Syndrome is quite low, this doesn’t mean that a good portion of tourists doesn’t walk away from Paris feeling some level of disappointment.

And as someone who has been to Paris five times and lived in the city while studying abroad, I’ve definitely experienced a lot and understand why people would feel at least a little disappointed.

Don’t get me wrong, I love the city and try to travel through Paris at least every other year…But, Paris is far from perfect.

A picture of the sunset over the Parisian cityscape from my apartment when I lived in Paris.

And what makes people disappointed is usually the discrepancy between the real Paris and their expectations of the city, which are often heavily influenced by tourist advertisements, social media posts, TV shows, movies, etc,.

These portrayals often make it seem as if Paris is this glamorous city that’s full of romance where everyone is impeccably dressed, people look like models left and right, there’s amazing architecture everywhere you turn, and art and creative expression are flourishing.

Essentially, anything that might be remotely attractive is sensationalized by the media. As a result, first-time visitors come to the city expecting perfection, only to find out that this exaggerated and idealistic version of Paris they were promised doesn’t quite exist in reality.

So, if you ask me, it’s really not entirely surprising that a lot of people feel disappointed when they arrive in the French capital.

🥐 NOTE: Here’s a 2004 article from the French newspaper, Libération , that goes into depth about this overly positive portrayal. But, unless you’re fluent in French (kudos if you are 😅), you’ll need a translation extension to read it.

How to Avoid Paris Syndrome

But, just because some people feel disappointed doesn’t mean you have to be one of them — as corny as that sounds lol.

From my perspective, it’s all about tempering your expectations. If you know what to generally expect, you won’t be so disappointed.

A picture of the Seine in Paris at sunset.

This is also why I try to research places a little bit and read about them in other people’s blogs.

It helps me avoid any surprises when I get there and allows me to appreciate the city for what it is instead of constantly comparing it to some other version that doesn’t actually exist.

Well, that, and blogs are great for planning some semblance of an efficient itinerary lol.

Anyways, in the spirit of transparency and avoiding disappointment to the point of being classified as Paris Syndrome…

9 Truths About Paris to Avoid Syndrome (2024)

Here are 9 truths of Paris and what you can actually expect to witness and experience while visiting! I’ll present the myth or how the media likes to perceive Paris first and then the truth about Paris!

Truths to Avoid Paris Syndrome

1. paris is jammed packed with locals and tourists.

You know how in the movies and TV shows, people say, “I’m going to walk around the Louvre or Musee d’Orsay.” And then, suddenly, the next shot pans to them walking around the museum and there’s like only 20 other people in the entire room… Like I get it, for the sake of the viewers, they gotta speed things up… but there’s this funny little misconception that you can easily see all the major Parisian tourist attractions in one day.

And as the friendly neighborhood travel expert of my friend group, some of the most common questions I get amongst my friend group are, “How long do I need to spend in the city?” and “Can I just spend a day or two in the city?”

A picture of a massive long line outside of Versailles.

The truth is that touring all the major tourist sites in one day is virtually impossible. There are literally tens of millions of tourists in Paris every single year. This equates to huge crowds pretty much at every single tourist site, long lines that are nearly impossible to avoid unless you opt for a private tour, and tons of foot and car traffic, especially if it’s morning or evening rush hour.

All of these factors make it basically impossible to see more than a couple of attractions in a single day.

And even if you did manage to get from one place to another without too much trouble, you would be pressed for time. This would prevent you from actually enjoying and processing the beautiful sight you’re experiencing. Not to mention, you’d be absolutely spent by the end of it, which would just make the following day miserable! So my advice is to expect long queues and excessive crowds and just take your time. I know many people try to see as much as possible in as short of a period as they can, but slow travel is hugely underrated. You get to experience so much more and really get a feel for the city. Plus, you’ll likely be surprised at how much more you get to discover!

2. Paris is Relatively Dirty, Chaotic, and Loud

A lot of people perceive Paris as a clean and beautiful city filled with stunning architecture and an abundance of romantic views. You may think gorgeous models are constantly strutting down the street and everyone is wearing high-end luxury fashion. It’s almost like a dream or fairytale — effortlessly perfect… Unfortunately, this is all true to a very limited extent.

A picture of the greenish-brown Seine river water in Paris.

Yes, Paris offers visitors stunning architecture and definitely has more romantic views than other major cities, like Milan … But, it is also dirty, chaotic, and loud in a lot of parts.

For example, there are lots of homeless people sleeping along the streets. You will see dog poop along the cobblestone walkways because there aren’t exactly green spaces everywhere. And, if you get super lucky, Ratatouille and his friends may even pay you a visit within the metro station!

Other memorable experiences for me include visiting the Eiffel Tower in the morning while running. What I thought would be super beautiful because no one would be around so early turned out to be a fat reality check.

I discovered that in the morning on any given day, you’ll see upwards of a hundred discarded alcohol bottles from the night before. You also notice trash strewn around the lawn everywhere.

Furthermore, the Seine river is far from clean. The water has a bluish-brown color, and you’d never want to swim in it like you would with the beautiful clear turquoise waters of the Rhône river in Geneva .

I know this all sounds super depressing and you might be dissuaded to go, but I’m just telling you the reality of Paris. There are some areas that are less attractive. Obviously, not everywhere is like this and you can still find beauty in the city. But, it’s important to remember that it truly does take a herculean effort to keep a city as popular as Paris clean!

Also, I believe the city is allegedly making a greater effort to clean the city for the 2024 Paris Summer Olympics! The hope is that with the help of an efficient underground network of pipes, tanks, and pumps, the water will be safe and clean enough to set up 20 designated swimming areas along the 483-mile-long river!

3. Smoking Culture Is Big in the City

The air quality in Paris is great and you’ll only see a few people smoking. This is in a similar vein to the last one about Paris being all clean… but I felt like it deserved its own section because it’s not something most probably consider when deciding where to go.

Plus, it became one of my biggest culture shocks.

A picture of a man smoking. Smoking culture is huge in Paris and this was a major culture shock for me. Paris Syndrome is believed to be a severe form of culture shock.

You will encounter a LOT of smokers, which can be an absolute shock to your system.

I come from a household with no smokers, and rarely encounter anyone smoking in California . Well, at least not in Southern California areas like San Diego . Meanwhile, in Paris, approximately every 5th person that you pass on the street is smoking or vaping.

In fact, I inhaled so much secondhand smoke during the first few days I was in Paris, that my lungs burned. For a few days, it hurt to talk, take a deep breath, and cough. My throat simply wasn’t used to that level of smoke inhalation.

The sensation goes away after a few days, and you’ll adjust. But, it’s something to be aware of if you aren’t from somewhere where smoking is prevalent.

And not to shame, because to each their own, I frequently saw moms pushing their kids in strollers while smoking too. So, it’s a pretty common sight throughout the city.

The upshot — You can expect a fair amount of air pollution from smokers because the smoking culture is huge.

4. It’s Not That Safe

Unless you’re watching Liam Neeson in the movie Taken, you never really see the crime that happens in Paris in movies. It is more about love stories and accidental faux pas. Thus, a lot of people hold the perception that Paris is pretty safe, and it’s unlikely anything will happen to you.

A picture of officers near the Arc de Triomphe. Sometimes people develop Paris Syndrome because they realize that Paris is not nearly as safe as they believed it to originally be.

Unfortunately, this isn’t exactly true. I’m not saying that Paris is the crime capital of the world or anything but I would go as far as to say that Paris is not as safe as people make to like it seem.

There should be a greater focus on safety in the city because petty crimes are INCREDIBLY common. Every day, hundreds of pickpocketing and theft reports are filed.

And unfortunately, I was a victim of a pickpocketing incident. It occurred at the metro station and I 100% swear to you, I knew the exact moment it happened.

All it took was a slight bump while moving through the throngs of people exiting the station. I looked down as soon as it happened because I had this horrible sinking feeling in my chest. Lo and behold, my wallet was gone from my purse.

I’ll save you details of all the ugly tears that followed, but it was highly traumatic for someone who was solo-traveling abroad for the first time.

Oh! And once I was standing near the Arc de Triomphe and heard a ton of screaming. I looked over to find a considerable flurry of money in the air as someone was trying to run away…

The moral of the story, take proper safety precautions and stay extra aware of your surroundings while in Paris.

5. Paris is VERY Expensive

Paris isn’t that expensive… I’ll be the first to admit that my guilty pleasure is watching Emily in Paris. As in I’ve binged watched all three seasons four times.

In the show, people see Emily, Camille, and Mindy always out at expensive parties, sporting couture clothing, and generally living it up in Paris. And while I understand the show is totally a form of escapism, it’s also wildly popular.

As such, people who have never been to Paris may not realize how expensive it actually is…

A picture of the Dior store on the Champs Elysees. Avoid Paris Syndrome by adjusting your expectations and budget!

Depending on your financial bracket, the myth statement might vary a bit, but Paris is pretty expensive. In fact, it consistently ranks as one at the top of the list of most expensive cities in Europe , right next to the likes of Zurich, Geneva, Amsterdam, Copenhagen, London, and Monaco .

And I have been to every single one of those cities, so I can 100% confirm the validity of it. Unless you’re flushed with cash, Paris will likely do a number on your bank account — and not the good kind.

But, to give you an idea of what to expect… the average price of a meal costs $23-25 USD. And that doesn’t include drinks. Add a few drinks and desserts, and your tab will quickly increase.

That’s not to say Paris is totally unaffordable. If you’re on a budget, it’s just going to take a bit of legwork, literally and figuratively. Avoiding tourist traps and finding the real hidden gem places that are literal holes in the wall, takes effort. But, it can be done — I promise!

Just remember to budget more cash than you think you’ll need for Paris. This city will literally make money vanish from your account in no time.

6. Some People Will Not Be so Pleasant

Locals in Paris are always welcoming and the customer is always right. In American culture, we love to focus on the customer first, and we often think that this is the same in all cultures.

As such, it’s common to want to correct someone when you think they’ve got it wrong. Or, you may be tempted to call someone out when you don’t receive a certain level of friendliness and service.

A picture of the Mona Lisa inside the louvre. You can see a very serious man and lots of people. To avoid Paris Syndrome, expect some French people to not be so friendly.

However, this isn’t really the case with Paris. While some people will be incredibly welcoming and helpful to tourists, there are still those who won’t be so nice. In fact, I’ve had a few experiences where locals were downright rude. I think they were frustrated because of the language barrier or maybe the fact their city was overrun with tourists… Regardless, these kinds of experiences can leave a sour taste in your mouth, and make you want to react. The important thing to remember is that you shouldn’t expect every interaction with locals to be pleasant and friendly. Oh and the whole, I’ll practice French and use it while I’m in Paris thing… yah, the part where French people immediately recognize you aren’t fluent in French and switch to English…that happens a LOT. Don’t be discouraged… it’s just that it’s easier and more efficient for them to speak to you in English sometimes. My one piece of advice is to learn the basic phrases of French. Also, it goes a long way to say, “Bonjour,” when you walk inside any establishment, and to say, “ Merci beaucoup, bonne journee, or bonne soiree ,” as you leave. It shows that you are making an attempt to learn and respect their culture!

🥐 NOTE: Merci means thank you. Bonne Journee means good day. And Bonsoir or bonne soiree means good evening.

7. This Is NOT A True Representation of French Culture

Paris allows you to experience true French Culture. It’s no surprise that when people think of France, the very first place that comes to mind is Paris.

We think of the Eiffel Tower, the Arc de Triomphe, Notre Dame, the Louvre, and many other iconic landmarks. Thus, our perception of french culture is often entangled with whatever we think of Paris.

And while Paris does illustrate French culture to some extent, it is again, far from an authentic representation.

A picture of the half-timbered houses in Strasbourg. People get Paris Syndrome because their expectations of Paris don't match reality. And in my opinion, Paris doesn't really represent authentic french culture.

In reality, Paris heavily caters to tourists and is just the tip of the iceberg. French culture is far richer and more complex than what you can find in the city of Paris.

By exploring different regions, like Provence, Brittany, and Normandy, or even bigger cities like Nice and Lyon , you’ll realize that each region has its own customs, dialects, cuisine, and landscape to offer.

There are so many small towns and breathtaking coastal villages worth exploring. You’ll truly be taken aback by how different just about everywhere else in France is compared to the massive metropolis that is Paris.

And if you can’t travel to areas outside of Paris, try and talk to the locals. Start a conversation and ask them how long they have been living in the city. Ask them what changes they have seen in recent years.

This is how I learned stories of how the Paris of merely 10 years ago is vastly different from the Paris we see and consume today. It really is worth the time and effort if you want to form connections and immerse yourself.

8. Dinner Is at 7 PM

Restaurants are open all day, so you can eat whenever you’re hungry. I know Emily in Paris tries to address a few of the cultural differences between America and Paris, but one they don’t cover is this.

Thus, if you’re coming from America or a non-European country and don’t do your research, you likely wouldn’t know that Parisian restaurants don’t stay open all day long.

A picture of escargot I ordered for dinner. Part of avoiding Paris syndrome is knowing that dinner may happens later than what you're used to.

The truth is that most restaurants in Paris open around 7 PM, so if you’re expecting to have dinner any earlier than that, chances are you’ll be disappointed.

This was probably the second biggest culture shock for me when I first visited.

Personally, I’m used to eating dinner between 5 and 6 PM when I travel because I like to start my day with an early morning run. As a result, I often sleep earlier than most and like to eat earlier than others.

So when I initially went to Paris, I walked around everywhere trying to find a sit-down place to eat. But, finding a dinner establishment open before 7 PM proved to be just about mission impossible. As such, you’ll want to plan accordingly and make sure you won’t be hungry between 2 PM and 7 PM. This is the time period that most restaurants close so staff can rest and take care of their needs before the night shift.

The flip side is that compared to American establishments, restaurants in Paris normally are open until midnight or even past midnight. So, if you’re a night owl, this is fantastic news for you!

9. Expect to Be Fashionably Late

Paris is easy to navigate and move through. Yes, Paris has an amazing transportation network to the point that even Montreal has modeled its metro system after Paris… And yes, Paris is a walkable city in that you can easily and comfortably walk within a particular arrondissement.

But, navigating the city as a whole is a different story.

A picture of a bunch of people walking and a french man on an electric scooter. To avoid Paris Syndrome, expect lots of crowds and walking!

Even though Paris is technically smaller than a lot of other major cities like ( London , Stockholm, and Zagreb ), it is time-consuming to maneuver around.

Don’t get me wrong — I think the public transportation system is a work of art. It really is great, but Paris can make you want to scream.

It’s kinda like how traveling a mile across Los Angles via car can take you 45 minutes. You could literally walk there faster… that same kind of energy.

And because attractions are spread out far and wide, you’ll definitely want to use all forms of public transportation or beware the death to your feet.

And honestly, even with public transit, expect to be fashionably late. Google maps can be misleading sometimes, and it’s easy to take the wrong metro line or bus route if you’re not totally familiar with it.

Plus, traffic can get exceptionally bad in the morning rush and evening rush. If you’re planning on getting somewhere at a certain time, plan for an earlier departure than usual with some room for error!

🥐 PRO TIP: My favorite app for navigating major cities is Citymapper! My friend (shoutout to Aurelien), introduced it to me in 2019, and it’s been a lifesaver. The app is better than Google Maps and will help minimize navigational mistakes!

Paris Syndrome: FAQ

The validity of Paris Syndrome is a bit of a gray area as there isn’t a lot of scientific research available or being conducted That said, personally, I do think the phenomenon is real. It makes sense that people from hyper-clean, friendly, and efficient areas, such as Japan, might experience a higher degree of culture shock compared to those who are acclimated to a less organized and clean environment.

Paris Syndrome is not that common. Published research papers suggest that there are only about 20 cases a year. But, these are statistics from the early 2000s and are probably out of date.

A picture of Kristin at Giverny visiting Claude Monet's Lily Garden.

For first-time visitors, I would recommend spending a good 4 – 5 days in the city. That should give you enough time to spread out activities, do a day trip to the French countryside to see a more authentic side of French culture, visit a couple of smaller museums in Paris , and take the city at a more leisurely pace. That said, even after 6 trips to the French capital, there are still so many places and hidden gems I’m yet to discover. But, alas — there’s probably never enough time to see it all 🙃

Where to Stay in Paris

If you’ve made it this far and are still interested in visiting Paris (just with adjusted expectations 😉) feel free to check out a few different housing options! These are based on where I’ve personally stayed in the past and all the extensive research I normally do anyways…

You can also explore with the interactive map below. It provides up-to-date prices, and you can easily change the dates, the number of guests, and other filters to see what’s available according to your needs!

My Favorite Hostels in Paris

  • the People Hostel Paris Nation  | Lovely hostel I loved ( see review ) – ⭐️ 8.8 / 10
  • The People Paris Marais  – another very popular hostel | ⭐️ 8.8 / 10

Lower-Cost Hotel Stays

  • Maison ELLE Paris Etoile   – 4-Star Hotel
  • Hôtel Vic Eiffel : 3-Star Hotel

Mid-Range Hotels

  • Chouchou Hotel :  an absolute gem 4-Star Hotel
  • Hotel Monte Cristo Paris : 4-Star Hotel

Luxury Hotels

  • Hotel Le Walt Paris : 4-Star Hotel
  • InterContinental Paris – Le Grand : 5-Star Hotel

Wrap-Up: 9 Ways To Avoid Paris Syndrome? (2024)

Paris Syndrome is a real phenomenon caused by unrealistic expectations of the City of Lights.

And despite the fact it’s pretty improbable that you’ll develop it, it’s not outside the realm of possibility that you won’t experience a bit of disappointment with the reality of Paris.

But by taking the time to research, understand, and temper your expectations, you can ensure that your visit is filled with mostly positive experiences.

So, with that, I hope you have learned a lot about Paris Syndrome and that your trip to the French capital is a wonderful one! Happy Travels! 🤠

📸 Appreciation Note: You’ll notice that a few of the pictures in this post were taken by my friend good friend Sol! You can see more of his amazing photography here !

Read More About France

  • Looking to travel off the beaten path? Travel to Carcassonne in the south of France ! It’s easy to reach from Toulouse , and you’ll be transported to the 1500s.
  • Planning a trip to the seaside town of Nice ? Don’t forget to indulge in all the regional Niçoise food and sample lots of rosés , which the region is most famous for!
  • Thinking of seeing the Festival of Lights in Lyon, check out this city guide for visiting during the winter !

Save This Post for Later!

' src=

Kristin is the founder of Global Travel Escapades, a blog dedicated to helping travelers explore beautiful destinations and planning their wildest travel dreams. She has explored 30 countries and is on a mission to visit 50 by age 30. Along the way, she has lived in places like sunny San Diego and the vibrant French capital! Ultimately, Kristin hopes her passion for adventure, delicious food, and all things F1 & tennis inspires others to plan their next travel escapade!

StarsInsider

StarsInsider

Paris syndrome: what it is, and how to avoid it

Posted: February 3, 2024 | Last updated: February 3, 2024

<p>The capital of France is the dream destination of many people. Home to the Eiffel Tower, the Arc de Triomphe, and the world's most visited museum, the Louvre, the City of Light is filled with history and culture. But despite all its delights, some tourists find themselves unable to enjoy a trip to <a href="https://www.starsinsider.com/travel/352191/paris-treasures-that-you-simply-must-visit" rel="noopener">Paris</a>.</p> <p>Disappointed with the lack of Parisian romance and magic, some tourists get extremely shocked when they're met with the reality of the destination. And a small percentage of those who venture into the city experience "Paris syndrome," a psychological condition with symptoms that include nausea, vomiting, increased heart rate, and hallucinations. </p> <p>But what exactly is it? And who tends to be affected? Find out by clicking through this gallery.</p><p>You may also like:<a href="https://www.starsinsider.com/n/131755?utm_source=msn.com&utm_medium=display&utm_campaign=referral_description&utm_content=524572v1en-us"> Do you suffer from back pain? Here are 30 tips to avoid spinal problems </a></p>

The capital of France is the dream destination of many people. Home to the Eiffel Tower, the Arc de Triomphe, and the world's most visited museum, the Louvre, the City of Light is filled with history and culture. But despite all its delights, some tourists find themselves unable to enjoy a trip to Paris .

Disappointed with the lack of Parisian romance and magic, some tourists get extremely shocked when they're met with the reality of the destination. And a small percentage of those who venture into the city experience "Paris syndrome," a psychological condition with symptoms that include nausea, vomiting, increased heart rate, and hallucinations. 

But what exactly is it? And who tends to be affected? Find out by clicking through this gallery.

You may also like: Do you suffer from back pain? Here are 30 tips to avoid spinal problems

<p>Paris syndrome is an extreme form of <a href="https://www.starsinsider.com/lifestyle/509738/what-is-culture-shock-and-how-can-you-deal-with-it" rel="noopener">culture shock </a>and homesickness. But while you should expect some culture shock when you travel, the biggest forms are usually reserved for people who study and settle in a new country for months at a time.</p><p><a href="https://www.msn.com/en-us/community/channel/vid-7xx8mnucu55yw63we9va2gwr7uihbxwc68fxqp25x6tg4ftibpra?cvid=94631541bc0f4f89bfd59158d696ad7e">Follow us and access great exclusive content every day</a></p>

A form of culture shock

Paris syndrome is an extreme form of culture shock and homesickness. But while you should expect some culture shock when you travel, the biggest forms are usually reserved for people who study and settle in a new country for months at a time.

Follow us and access great exclusive content every day

<p>In 1986, Franco-Japanese psychiatrist Hiroaki Ota first used the term "Paris syndrome" to describe this transient psychological disorder.</p><p>You may also like:<a href="https://www.starsinsider.com/n/157708?utm_source=msn.com&utm_medium=display&utm_campaign=referral_description&utm_content=524572en-us"> The most shocking scandals in sports history</a></p>

When was the term first used?

In 1986, Franco-Japanese psychiatrist Hiroaki Ota first used the term "Paris syndrome" to describe this transient psychological disorder.

You may also like: The most shocking scandals in sports history

<p>This unusual condition is supposedly brought on by four factors. And it has been noted mainly in Japanese tourists.</p><p><a href="https://www.msn.com/en-us/community/channel/vid-7xx8mnucu55yw63we9va2gwr7uihbxwc68fxqp25x6tg4ftibpra?cvid=94631541bc0f4f89bfd59158d696ad7e">Follow us and access great exclusive content every day</a></p>

It has four factors

This unusual condition is supposedly brought on by four factors. And it has been noted mainly in Japanese tourists.

<p>The first condition is the language barrier between the vast majority of the visiting Japanese and their French hosts.</p><p>You may also like:<a href="https://www.starsinsider.com/n/172563?utm_source=msn.com&utm_medium=display&utm_campaign=referral_description&utm_content=524572en-us"> Who are the world's most generous celebrities?</a></p>

The first factor

The first condition is the language barrier between the vast majority of the visiting Japanese and their French hosts.

You may also like: Who are the world's most generous celebrities?

<p>Tied to the first factor are the differences in manners, which can be extremely upsetting. These include decreased levels of formality, frequent fluctuations in mood or tone, and incomprehensible humor.</p><p><a href="https://www.msn.com/en-us/community/channel/vid-7xx8mnucu55yw63we9va2gwr7uihbxwc68fxqp25x6tg4ftibpra?cvid=94631541bc0f4f89bfd59158d696ad7e">Follow us and access great exclusive content every day</a></p>

The second factor

Tied to the first factor are the differences in manners, which can be extremely upsetting. These include decreased levels of formality, frequent fluctuations in mood or tone, and incomprehensible humor.

<p>Thirdly, there's the physical exhaustion. Whether travelers are in Paris for business or pleasure, they'll pack their schedules so much it gets overwhelming.</p><p>You may also like:<a href="https://www.starsinsider.com/n/173978?utm_source=msn.com&utm_medium=display&utm_campaign=referral_description&utm_content=524572en-us"> These foods will make you look younger</a></p>

The third factor

Thirdly, there's the physical exhaustion. Whether travelers are in Paris for business or pleasure, they'll pack their schedules so much it gets overwhelming.

You may also like: These foods will make you look younger

<p>Finally, there's the jet lag, which is especially true for visitors from Japan. Add that to the mix and it's no wonder why someone would be stressed out.</p><p><a href="https://www.msn.com/en-us/community/channel/vid-7xx8mnucu55yw63we9va2gwr7uihbxwc68fxqp25x6tg4ftibpra?cvid=94631541bc0f4f89bfd59158d696ad7e">Follow us and access great exclusive content every day</a></p>

The fourth factor

Finally, there's the jet lag, which is especially true for visitors from Japan. Add that to the mix and it's no wonder why someone would be stressed out.

<p>One might wonder: isn't this equally the case for Japanese holidaymakers in other major European or American cities? Surely Berlin and New York must be as destabilizing?</p><p>You may also like:<a href="https://www.starsinsider.com/n/183694?utm_source=msn.com&utm_medium=display&utm_campaign=referral_description&utm_content=524572en-us"> The worst animal bites and stings a human can experience</a></p>

But why Paris?

One might wonder: isn't this equally the case for Japanese holidaymakers in other major European or American cities? Surely Berlin and New York must be as destabilizing?

You may also like: The worst animal bites and stings a human can experience

<p>The theory is that the image of an elegant and sophisticated Paris creates extremely high expectations. The sight of dirty sneakers instead of fancy heels sends these visitors over the edge.</p><p><a href="https://www.msn.com/en-us/community/channel/vid-7xx8mnucu55yw63we9va2gwr7uihbxwc68fxqp25x6tg4ftibpra?cvid=94631541bc0f4f89bfd59158d696ad7e">Follow us and access great exclusive content every day</a></p>

No picture-postcard scenes

The theory is that the image of an elegant and sophisticated Paris creates extremely high expectations. The sight of dirty sneakers instead of fancy heels sends these visitors over the edge.

<p>Many people want to visit Paris because of the way it's portrayed in the media. But the reality is that Paris is a real city, and not a romantic comedy like 'Amélie' (2001).</p><p>You may also like:<a href="https://www.starsinsider.com/n/214578?utm_source=msn.com&utm_medium=display&utm_campaign=referral_description&utm_content=524572en-us"> The most random things foreigners dub as \"American\" but really aren't</a></p>

Paris in the media

Many people want to visit Paris because of the way it's portrayed in the media. But the reality is that Paris is a real city, and not a romantic comedy like 'Amélie' (2001).

You may also like: The most random things foreigners dub as "American" but really aren't

<p>Just like in every densely populated city, Paris also deals with rats, trash, pickpockets, and various unpleasant aromas. All of which are terribly unromantic.</p><p><a href="https://www.msn.com/en-us/community/channel/vid-7xx8mnucu55yw63we9va2gwr7uihbxwc68fxqp25x6tg4ftibpra?cvid=94631541bc0f4f89bfd59158d696ad7e">Follow us and access great exclusive content every day</a></p>

The reality of big cities

Just like in every densely populated city, Paris also deals with rats, trash, pickpockets, and various unpleasant aromas. All of which are terribly unromantic.

<p>Although it's a rare syndrome, there have been reported cases. In 2006, about a dozen tourists suffered severe symptoms that needed medical attention.</p><p>You may also like:<a href="https://www.starsinsider.com/n/224764?utm_source=msn.com&utm_medium=display&utm_campaign=referral_description&utm_content=524572en-us"> Random everyday things you'll be shocked to learn have names</a></p>

Is Paris syndrome actually real?

Although it's a rare syndrome, there have been reported cases. In 2006, about a dozen tourists suffered severe symptoms that needed medical attention.

You may also like: Random everyday things you'll be shocked to learn have names

<p>In that same year, the Japanese embassy repatriated at least four visitors who had severe cases, including two women who believed their hotel room was bugged.</p><p><a href="https://www.msn.com/en-us/community/channel/vid-7xx8mnucu55yw63we9va2gwr7uihbxwc68fxqp25x6tg4ftibpra?cvid=94631541bc0f4f89bfd59158d696ad7e">Follow us and access great exclusive content every day</a></p>

Reported cases

In that same year, the Japanese embassy repatriated at least four visitors who had severe cases, including two women who believed their hotel room was bugged.

<p>The symptoms are very similar to anxiety and psychosis. Victims have typically experienced hallucinations, dizziness, sweating, feelings of persecution, and even vomiting.</p><p>You may also like:<a href="https://www.starsinsider.com/n/233769?utm_source=msn.com&utm_medium=display&utm_campaign=referral_description&utm_content=524572en-us"> These abandoned locations have been reclaimed by Mother Nature</a></p>

What are the symptoms of Paris syndrome?

The symptoms are very similar to anxiety and psychosis. Victims have typically experienced hallucinations, dizziness, sweating, feelings of persecution, and even vomiting.

You may also like: These abandoned locations have been reclaimed by Mother Nature

<p>Even if Paris syndrome sounds scary, Paris is still a wonderful city. Tourists should simply remember that, like any city, it will have its pros and cons.</p><p><a href="https://www.msn.com/en-us/community/channel/vid-7xx8mnucu55yw63we9va2gwr7uihbxwc68fxqp25x6tg4ftibpra?cvid=94631541bc0f4f89bfd59158d696ad7e">Follow us and access great exclusive content every day</a></p>

How can Paris syndrome be prevented?

Even if Paris syndrome sounds scary, Paris is still a wonderful city. Tourists should simply remember that, like any city, it will have its pros and cons.

<p>Embrace the chance to visit a new city and the beauty it has to offer. Also, by keeping your expectations realistic, you’re sure to like Paris more than you would imagine.</p><p>You may also like:<a href="https://www.starsinsider.com/n/236449?utm_source=msn.com&utm_medium=display&utm_campaign=referral_description&utm_content=524572en-us"> Did you know that many of your favorite characters are played by LGBT actors?</a></p>

Keep it realistic

Embrace the chance to visit a new city and the beauty it has to offer. Also, by keeping your expectations realistic, you’re sure to like Paris more than you would imagine.

You may also like: Did you know that many of your favorite characters are played by LGBT actors?

<p>Don't forget, Paris is one of the most visited cities in the world, and for good reason. Expect a lot of visitors in museums, like the Louvre.</p><p><a href="https://www.msn.com/en-us/community/channel/vid-7xx8mnucu55yw63we9va2gwr7uihbxwc68fxqp25x6tg4ftibpra?cvid=94631541bc0f4f89bfd59158d696ad7e">Follow us and access great exclusive content every day</a></p>

Expectations

Don't forget, Paris is one of the most visited cities in the world, and for good reason. Expect a lot of visitors in museums, like the Louvre.

<p>And while you might dream of seeing the 'Mona Lisa' up close, you're not the only one. Expect a big line to see that famous smile.</p><p>You may also like:<a href="https://www.starsinsider.com/n/254861?utm_source=msn.com&utm_medium=display&utm_campaign=referral_description&utm_content=524572en-us"> Wildlife photos captured at the perfect moment</a></p>

Not the best close up

And while you might dream of seeing the 'Mona Lisa' up close, you're not the only one. Expect a big line to see that famous smile.

You may also like: Perfectly timed wildlife photos

<p>The truth is that you won't be alone near the Eiffel Tower. So don't expect to get a picture without any tourists behind you.</p><p><a href="https://www.msn.com/en-us/community/channel/vid-7xx8mnucu55yw63we9va2gwr7uihbxwc68fxqp25x6tg4ftibpra?cvid=94631541bc0f4f89bfd59158d696ad7e">Follow us and access great exclusive content every day</a></p>

It is, after all, a big city

The truth is that you won't be alone near the Eiffel Tower. So don't expect to get a picture without any tourists behind you.

<p>If you're there during the warmer months, you'll likely find a bunch of people laying on the grass. Instead of getting annoyed by it, join the crowd!</p><p>You may also like:<a href="https://www.starsinsider.com/n/256255?utm_source=msn.com&utm_medium=display&utm_campaign=referral_description&utm_content=524572en-us"> The life and times of HRH Prince Philip Duke of Edinburgh</a></p>

Join the crowd

If you're there during the warmer months, you'll likely find a bunch of people laying on the grass. Instead of getting annoyed by it, join the crowd!

You may also like: The life and times of Prince Philip, Duke of Edinburgh

<p>You will find that Paris can be picture-perfect. Just imagine seeing famous monuments like the Sacré Coeur and the Arc de Triomphe for the first time. It's an unforgettable feeling.</p><p><a href="https://www.msn.com/en-us/community/channel/vid-7xx8mnucu55yw63we9va2gwr7uihbxwc68fxqp25x6tg4ftibpra?cvid=94631541bc0f4f89bfd59158d696ad7e">Follow us and access great exclusive content every day</a></p>

Sometimes it can be picture-perfect

You will find that Paris can be picture-perfect. Just imagine seeing famous monuments like the Sacré Coeur and the Arc de Triomphe for the first time. It's an unforgettable feeling.

<p>But, of course, you won't be alone. And you'll notice that's the case with any major city—especially if it attracts a lot of tourists.</p><p>You may also like:<a href="https://www.starsinsider.com/n/273888?utm_source=msn.com&utm_medium=display&utm_campaign=referral_description&utm_content=524572en-us"> Slithering serpents! Australia’s deadliest snakes</a></p>

You won't be alone

But, of course, you won't be alone. And you'll notice that's the case with any major city—especially if it attracts a lot of tourists.

You may also like: Slithering serpents! Australia’s deadliest snakes

<p>The Paris metro is the fastest and smoothest way of getting around Paris. And if you're lucky, you might find an empty wagon.</p><p><a href="https://www.msn.com/en-us/community/channel/vid-7xx8mnucu55yw63we9va2gwr7uihbxwc68fxqp25x6tg4ftibpra?cvid=94631541bc0f4f89bfd59158d696ad7e">Follow us and access great exclusive content every day</a></p>

A romantic ride

The Paris metro is the fastest and smoothest way of getting around Paris. And if you're lucky, you might find an empty wagon.

<p>But people actually live in Paris, so be sure to avoid taking any public transport during rush hour. The good thing with central Paris is that you can walk around to most places. Do that instead, or hop on a boat tour on the Seine river.</p><p>You may also like:<a href="https://www.starsinsider.com/n/299215?utm_source=msn.com&utm_medium=display&utm_campaign=referral_description&utm_content=524572en-us"> Famous people who lost their significant other</a></p>

Rush hour is real

But people actually live in Paris, so be sure to avoid taking any public transport during rush hour. The good thing with central Paris is that you can walk around to most places. Do that instead, or hop on a boat tour on the Seine river.

You may also like: Sandra Bullock and other famous figures who lost their significant other

<p>Most films set in Paris have painted an image of a clean city. However, many tourists have been shocked with how dirty it actually is.</p><p><a href="https://www.msn.com/en-us/community/channel/vid-7xx8mnucu55yw63we9va2gwr7uihbxwc68fxqp25x6tg4ftibpra?cvid=94631541bc0f4f89bfd59158d696ad7e">Follow us and access great exclusive content every day</a></p>

Clean streets?

Most films set in Paris have painted an image of a clean city. However, many tourists have been shocked with how dirty it actually is.

<p>The reality of everyday Paris is often at odds with the postcard version. You'll definitely experience urine-soaked streets and tons of cigarette butts.</p><p>You may also like:<a href="https://www.starsinsider.com/n/310383?utm_source=msn.com&utm_medium=display&utm_campaign=referral_description&utm_content=524572en-us"> McDonald's most expensive and cheapest locations in the world</a></p>

But not always

The reality of everyday Paris is often at odds with the postcard version. You'll definitely experience urine-soaked streets and tons of cigarette butts.

You may also like: McDonald's most expensive and cheapest locations in the world

<p>Often dubbed as the city of love and romance, you might notice that it isn't all that romantic when you leave the astonishing monuments and picturesque streets behind.</p><p><a href="https://www.msn.com/en-us/community/channel/vid-7xx8mnucu55yw63we9va2gwr7uihbxwc68fxqp25x6tg4ftibpra?cvid=94631541bc0f4f89bfd59158d696ad7e">Follow us and access great exclusive content every day</a></p>

Oh the romance

Often dubbed as the city of love and romance, you might notice that it isn't all that romantic when you leave the astonishing monuments and picturesque streets behind.

<p>With the rush of daily life, the romantic image of Paris might fade away. But that doesn't mean you won't find French romance!</p><p>Sources: (<a href="https://www.nbcnews.com/id/wbna15391010" rel="noopener">NBC News</a>) (<a href="https://matadornetwork.com/read/paris-syndrome/" rel="noopener">Matador Network</a>) (<a href="https://www.livescience.com/what-is-paris-syndrome" rel="noopener">Live Science</a>) </p><p>See also: <a href="https://www.starsinsider.com/health/442525/everyday-things-you-didnt-realize-are-harming-your-mental-health">Everyday things you didn't realize is harming your mental health</a>  </p><p>You may also like:<a href="https://www.starsinsider.com/n/319500?utm_source=msn.com&utm_medium=display&utm_campaign=referral_description&utm_content=524572en-us"> Gruesome Valentine's Day murders</a></p>

It isn't that romantic

With the rush of daily life, the romantic image of Paris might fade away. But that doesn't mean you won't find French romance!

Sources: (NBC News) (Matador Network) (Live Science) 

See also: Looking back on 140 years of the Orient Express

You may also like: When love kills

More for You

mcdonalds_2

McDonald's menu brings back a new take on an iconic item

Ukraine takes out £134,000,000 warship stolen by Putin

Ukraine takes out £134,000,000 warship stolen by Putin

A person's emotional reaction when waking up at night can affect sleep quality, according to neurologist Dr. Brandon Peters-Mathews of Virginia Mason Franciscan Health in Seattle. - Cavan Images/Getty Images/File

Why do I wake up at 3 a.m. every night?

The 11 Rudest Things You Can Do In Someone Else’s House, According To Etiquette Experts

The 11 Rudest Things You Can Do In Someone Else’s House, According To Etiquette Experts

Harvard psychologist: If you answer 'yes' to any of these 9 questions, you're 'more emotionally secure than most'

Harvard psychologist: If you say 'yes' to any of these 9 questions, you're 'more emotionally secure than most'

***BESTPIX*** Former President Donald Trump Attends Pre-Trial Hearing In New York Hush Money Case

Judge hands Trump another gag order as he grants restrictions in hush money trial

90 of Zendaya's Best Outfits That Prove Her Style Is Timeless

Zendaya Wears a Stormy Gray Gown with a Heart-Racing Deep V-Neckline

Russian President Vladimir Putin attends a ceremony to present awards in the field of literature and art to young cultural figures in Moscow

Vladimir Putin can be tried for his crimes now

Inside ‘the world’s least-visited country’ – where dirty cars are illegal and social media is banned

Inside ‘the world’s least-visited country’ – where dirty cars are illegal and social media is banned

Experts Say These Are The 5 Worst Foods For Your Cholesterol

Experts Say These Are The 5 Worst Foods For Your Cholesterol

Dave Ramsey takes adults living at home to task

'Momma can't protect you': Dave Ramsey delivers a blunt message to young adults still living with their parents — 3 things you need to do to get ahead (and get your own place)

DanielCraigSkyfallGunv1

James Bond ranked: from Sean Connery to Daniel Craig, who played him best?

A Pennsylvania Lottery kiosk at a minimart in Erie, Pa., shows the Mega Millions jackpot on March 22, before that night's drawing, without a jackpot winner.

Winner drawn for $1.13 billion Mega Millions jackpot

The Kerch Strait Bridge in Crimea is a major choke point in Russia's war effort. By: MEGA

Ukraine Damages Crimean Bridge, a Key Russian Supply Line, After Moscow Missile Attack Injures Kyiv Residents

The 5 most common deathbed regrets, according to a palliative care nurse

The 5 most common deathbed regrets, according to a palliative care nurse

mtg bridge collapse community note

Marjorie Taylor Greene Hit With Community Note on Baltimore Bridge Post

Planking is another type of isometric exercise. - SeventyFour/iStockphoto/Getty Images

Blood pressure is best lowered by 2 exercises, study finds

Why You Should Never Boil Pasta In Water For Mac And Cheese

Why You Should Never Boil Pasta In Water For Mac And Cheese

sams-club-costco

Costco rival Sam's Club makes major food-court change

Here Are 6 Things White People Say That Highlight Their Privilege And OMG I Hear These Allllll The Time

Here Are 6 Things White People Say That Highlight Their Privilege And OMG I Hear These Allllll The Time

High schooler with Down syndrome crowned prom queen after viral ‘prom-posal’ from football player

MANDAN, N.D. ( KFYR /Gray News) – A high school student whose “prom-posal” caught national attention last week was crowned prom queen.

Alayna Tetzloff, a high school senior who has Down syndrome, was crowned prom queen on Saturday at Mandan High School in North Dakota.

Her big win comes on the heels of her date’s sweet “prom-posal.”

John Bugbee and Alayna Tetzloff attended prom together at Mandan High School in North Dakota.

John Bugbee is a 6′8′' football star and is known as the “big friendly giant.” He surprised Tetzloff during weights class when he asked her to be his prom date with a sweet sign and a Crumbl cookie.

“She always picks up your day,” Bugbee said.

Tetzloff said, with a smile, that she was excited when he asked.

Grant Risser and Alayna Tetzloff were crowned prom king and queen Saturday night.

This was their second formal dance together. The pair went to a dance together earlier this winter.

Although Bugbee did not win prom king, Tetzloff will never forget her crowning moment.

Bugbee said he’s not really doing anything special. He’s just looking forward to spending an evening with a good friend and sharing some laughs, but said he also hopes to inspire acceptance, inclusiveness, and friendship.

Copyright 2024 KFYR via Gray Media Group, Inc. All rights reserved.

The long court battles and debates over Walton County’s beaches has been making headlines...

Business owner speaking out on Walton County beach controversy

We’ll keep this story updated as more information is released.

Bicyclist dies after car and bike crash in Panama City Beach

Deputies are still investigating who shot the third person involved and the motive behind it.

More details in fatal shooting investigation

Arrests made in Bushnell death investigation

Panama City hunter killed in Georgia

Kirsten Clark, Bainbridge Chick-fil-A co-general manager, and he unborn baby died in a car...

Bainbridge Chick-fil-A employee and unborn baby die in Saturday car accident

Latest news.

The latest Georgia lottery sign after no one won Monday night’s Powerball jackpot.

Single ticket wins $1.13 billion Mega Millions jackpot, ending a long lottery drought

FILE - Kouri Richins, a Utah mother of three who authorities say fatally poisoned her husband,...

Mother who wrote book on grief hit with new charges alleging earlier attempt to kill her husband

Tuesday, Panama City Commissioners voted to enter negotiations with St. Andrews Marina...

Panama City Marina Plans

The Bay District School Board meeting this evening wasn't just about the best ways to spend...

BDS School Board Meeting

Newschannel 7 took a deeper dive into the condition of bridges in our area, after a major...

Check on Bay County bridges after Baltimore bridge collapse

IMAGES

  1. The Tourist Syndrome 1

    what is tourist syndrome

  2. THE TOURIST CLASS SYNDROME, COMBAT IT.

    what is tourist syndrome

  3. Bauman Zygmunt

    what is tourist syndrome

  4. What is the Tourist Syndrome?

    what is tourist syndrome

  5. The Tourist Syndrome An Interview With Zygmunt Bauman

    what is tourist syndrome

  6. (PDF) 49054530 the Tourist Syndrome an Interview With Zygmunt Bauman

    what is tourist syndrome

VIDEO

  1. ヤマアラシ (カナダヤマアラシ) / 東山動物園

  2. TBCT BCH V7,8 DVR18 2K 59 94

  3. Damaged Film Reel from "vinegar syndrome"

  4. The Burj Khalifa Syndrome || Dr. Isscam || Social Kandura

  5. Teacher kidnaps Australian tourist

COMMENTS

  1. Tourette's Syndrome: Causes, Symptoms, and Treatment

    Tourette's syndrome is a problem with the nervous system that causes people to make sudden movements or sounds, called tics, that they can't control. For example, someone with Tourette's might ...

  2. Tourette syndrome

    Tourette (too-RET) syndrome is a disorder that involves repetitive movements or unwanted sounds (tics) that can't be easily controlled. For instance, you might repeatedly blink your eyes, shrug your shoulders or blurt out unusual sounds or offensive words. Tics typically show up between ages 2 and 15, with the average being around 6 years of age.

  3. What is Tourette Syndrome?

    Español (Spanish) Print. Tourette Syndrome (TS) is a condition of the nervous system. TS causes people to have "tics". Tics are sudden twitches, movements, or sounds that people do repeatedly. People who have tics cannot stop their body from doing these things. For example, a person might keep blinking over and over.

  4. Tourette Syndrome: What Is It, Symptoms & Treatment

    Tourette syndrome is a disorder that causes uncontrollable movements and vocal sounds called tics. It often shows up in early childhood and improves in adulthood. Tics can be mild or severe. About 200,000 people in the U.S. have a severe form of Tourette syndrome. Medication and therapy can help reduce tics.

  5. Tourette Syndrome

    Tourette syndrome (TS) is a neurological disorder that may cause sudden unwanted and uncontrolled rapid and repeated movements or vocal sounds called tics. TS is one of a group of disorders of the developing nervous system called tic disorders. The motor (involving body movement) or vocal (involving sounds you make) tics of TS come and go over ...

  6. What is Tourette

    What is Tourette. Tourette Syndrome is a neurodevelopmental disorder that affects children, adolescents and adults. The condition is characterized by sudden, involuntary movements and/or sounds called tics. Tics can range from mild/inconsequential to moderate and severe, and are disabling in some cases. Tourette Syndrome is one type of Tic ...

  7. What is Tourette Syndrome?

    Tourette's disorder (also called Tourette Syndrome [TS]) Persistent (also called chronic) motor or vocal tic disorder. Provisional tic disorder. The tic disorders differ from each other in terms of the type of tic present (motor or vocal, or a combination of both), and how long the symptoms have been occurring.

  8. Learn About Tourette Syndrome

    January 25, 2023. Source:  National Center on Birth Defects and Developmental Disabilities,, Centers for Disease Control and Prevention. Tourette Syndrome (TS) causes people to have "tics". Tics are sudden twitches, movements, or sounds that people do repeatedly.

  9. Tourette syndrome

    Tourette syndrome. Tourette syndrome or Tourette's syndrome (abbreviated as TS or Tourette's) is a common neurodevelopmental disorder that begins in childhood or adolescence. It is characterized by multiple movement (motor) tics and at least one vocal (phonic) tic. Common tics are blinking, coughing, throat clearing, sniffing, and facial movements.

  10. Depathologizing the tourist syndrome: Tourism as social capital

    First, the tourist syndrome is a metaphor for contemporary living in liquid modernity and second, tourism is referred to as `a substitute satisfaction of a genuine need' (Franklin, 2003: 214). The interview presents a critical and somewhat sceptical perspective on tourism and social life, in which the tourist syndrome is labelled a `peg ...

  11. Pediatric Tourette Syndrome

    Tourette syndrome is a neurological disorder. It affects more boys than girls. The disease causes repeated tics. These are sudden, uncontrolled vocal sounds or muscle jerks. Symptoms of Tourette syndrome often begin between ages 5 and 10. Tourette syndrome can occur differently in boys and girls. Boys are more likely to have long-term (chronic ...

  12. Tourette syndrome

    Tourette syndrome is a complex neurological disorder that is characterized by repetitive, sudden, uncontrolled (involuntary) movements and sounds (vocalizations) called tics. Tourette syndrome is named for Georges Gilles de la Tourette, who first described this disorder in 1885. A variety of genetic and environmental factors likely play a role ...

  13. The tourist syndrome: an interview with Zygmunt Bauman

    Living from one moment to another, living for the moment, is a crucial trait of the 'tourist syndrome'.When you juxtapose the 'tourist syndrome' with a 'pil- grim syndrome' - with the modality of the pilgrim's travels, where the signifi- cance of every stage is derived fully from the diminishing distance separating the traveller ...

  14. [PDF] The Tourist Syndrome

    The Tourist Syndrome. This interview with one of the world's leading sociologists, Zygmunt Bauman, explores how his work on liquid modernity, consumerism, space, hospitality, the 'full planet' and extra territoriality impact on tourism theory. This interview launches perhaps a new concept, that of 'the tourist syndrome' and examines ...

  15. The Tourist Syndrome

    Tourism is both a major transportation system and a metaphor for contemporary life -what he calls the "tourist syndrome" -specifically regarding "to be in a temporary place and know it, no ...

  16. What is the Tourist Syndrome?

    Tourist Syndrome is a set of symptoms that develops in people who travel to an unfamiliar place. Breathtaking TikTok videos and glamorous Instagram reels can lead to high expectations for a place, and when those expectations don't meet the reality of the city, some tourists might experience real pain in their hearts and minds. ...

  17. The Tourist Syndrome: What is it?

    Tourist syndrome describes people who experience confusion, depression, and occasionally even hospitalization when they travel to specific locations. A group of symptoms known as "Tourist Syndrome" appear in persons who visit an unfamiliar location. High expectations can be created for a location by breathtaking TikTok videos and glitzy ...

  18. Economy class syndrome: what is it and who are the individuals at risk?

    Abstract. The term 'economy class syndrome' refers to the occurrence of thrombotic events during long-haul flights that mainly occur in passengers in the economy class of the aircraft. This syndrome results from several factors related to the aircraft cabin (immobilization, hypobaric hypoxia and low humidity) and the passenger (body mass ...

  19. The Paris Syndrome: All you Need to Know

    Here is all you need to know about Paris Syndrome. Paris Syndrome was the term originally coined by a Japanese psychiatrist, Dr. Hiroaki Ota, who observed a pattern of symptoms after Japanese tourists had visited the city of Paris. These symptoms included dizziness, sweating, and even hallucinations. It can be considered somewhere in the range ...

  20. What is Paris Syndrome?

    Paris Syndrome: Troubles in tourism ... Stendhal syndrome is a mental condition that was first documented in the city of Florence, Italy. It refers to feelings of faintness, heart palpitations, or ...

  21. How to Avoid Paris Syndrome: 9 Truths About Paris (2024)

    That said, one of the prevailing theories by physician Youcef Mahmoudia is that some tourists become so excited while traveling around Paris, that their heart rate accelerates, which in turn causes shortness of breath. And in some cases, this leads to hallucinations — one of the symptoms of Paris Syndrome.

  22. Paris syndrome: what it is, and how to avoid it

    Paris syndrome is an extreme form of culture shock and homesickness. But while you should expect some culture shock when you travel, the biggest forms are usually reserved for people who study and ...

  23. High schooler with Down syndrome crowned prom queen after viral 'prom

    MANDAN, N.D. ( KFYR /Gray News) - A high school student whose "prom-posal" caught national attention last week was crowned prom queen. Alayna Tetzloff, a high school senior who has Down ...