At what point is a childhood tic a sign of anxiety/mental health issues?

[usernamefromhell]

I've posted about this before (under a different user name), my DD (who is 7) seems to be prone to tics. She had a vocal/oral one about 18 months ago, which lasted about four/five months which has subsided, now she has one involving her hands which basically involves compulsive drumming of fingers on hard surfaces and is fantastically irritating (though I haven't expressed this to her).

I've read up a bit on this (including on here), and from what I've gathered tics are fairly common in children: there's not much to be done about them and most of them pass.

What concerns me is whether there's a point at which they should be seen as indicative of underlying mental health/anxiety/stress issues. As far as I can tell my DD is generally a happy child: we have a great relationship and she seems to enjoy life: she has her strops and tantrums like any other child. But nothing that overwhelmingly concerns me and she seems to be happy in life and at school.

But our lives are in many ways very stressful: I separated from her father three years ago and we're divorcing -- our relationship is reasonably cordial for a divorcing couple and she has a good relationship with him, but there are strains and she must pick up on this. He is also a fairly heavy drinker with a history MH problems although we are both careful to keep these things away from her. I work very long hours: I love my job but its stressful and takes up a lot of my time. In general I haven't picked up any particular unhappiness about any of these things, but I can't help wondering if these tics could be an outlet for stress which she doesn't feel she can express any other way.

I suppose I'm wondering whether I need to take this further with medical professionals/health visitor. On the one hand I'm loathe to go down the mental health services route if its not necessary and make her feel she has an "issue", particularly if there isn't much to be done about it and it will pass. On the other I don't want to ignore something which could be a warning sign.

Any thoughts? Anyone else been through anything similar?

Mumofmyboy that sounds like a sensible approach: I was getting ready to do this with the first tic when it suddenly disappeared.
I think talking to the GP without her might be the way forward. I don't want her to think there is something wrong with her if it turns out to be a transient thing.

I had childhood tics which may also have been linked to my parents divorce (that's what people always told me anyway, though I don't remember much about it). I went through a phase of pressing my stomach, then another or repeating certain things I'd just said. It lasted through primary school then went away completely until I was 21 and fell into an abusive realtionship. Then I developed a tic for making a kind of humming/ clicking noise and feeling like I had to hold my breath. It went away when we broke up (at 23) but came back last year (I'm now 30) for no reason I can identify. Until then I'd assumed it was linked to stress but I'm definitely not stressed ATM (well, no more than anyone else with young children!) Focussing on it definitely makes it worse. If I feel like people are noticing me do or laughing at me because of it then it becomes almost uncontrollable. I have been treated in the past for depression and anxiety so it might be connected to that. Essentially it's annoying and can be embarrassing but it doesn't really effect my life and I certainly don't blame any element of my childhood as a cause. I've never seen a doctor about it, athough my gran did send me to a counsellor as a child because if it, but that really didn't help. I would basically just not draw any attention to it, be patient and prime any one you feel you should to just ignore it. Might be worth seeing a doctor over but like I said for me it's an annoyance more in line with nail biting than a MH problem.

I will also say that after my parents divorced every one was very keen to attribute anything we did wrong or any bad feelings we had to The Divorce. I don't remember The Divorce but I do remember my brother being told he was angry and acting out because of The Divorce and that I was shy and scared of the dark because of The Divorce and the time I fell out with my friend when I was 6 was because I was struggling to adjust after The Divorce. You get the picture. I'm sure it's been a horrible and stressful few years for you all but The Divorce happened when your dd was still very small and she almost certainly won't remember it in any great detail. A lot of the things she'll feel or experience in her childhood would have happened anyway and I would try really hard to treat them as independent events rather than blaming them on The Divorce. I also remember people telling me ad nauseam that I shouldn't blame myself/ it wasn't my fault etc. It always really confused me as I didn't really understand why anyone would think I'd blame myself for it, but after I heard it for the zillionth time I did start repeating it as it seemed to be what I was expected to feel. I guess what I'm saying is try not to make assumptions about how the split should be affecting her/ how you think she should be feeling, because these are more likely to be projections of your own guilt for splitting up and they can mirror onto children like false memories. Sorry, that last bit was a bit of a tangent!

My DS started with a very obvious motor tic in year three. Schools first response was to want to refer him to CAMHS but we wanted to check with the GP first. She was very 'nonsense, nothing to do with mental health. Kids have tics, they grow out of them. But if doesn't change or stop in six weeks we'll refer him to a neurologist. Tell school CAMHS are not needed' then she snorted in derision.

His tic did change, to a vocal tic and over the years it has changed and come and gone. Now he hardly has anything. But doc stressed not to make a fuss of it, because bringing attention to it can make it worse. However where it became a nose clearing sound I did have to ask him to stop as it made me feel physically sick when I heard it.

When we took him to the doc we said we were 'worried about his muscles, they are doing this on their own' and she was able to read between the lines and talk without scaring him.

Nordic it's interesting that you bring this up: a lot of well-meaning friends are always looking for evidence that my DD is stressed or upset about the separation/divorce. Obviously I've always been very sensitive and alert to this and have bent over backwards to protect her from the negative consequences of it.

I may be deluding myself but I genuinely have not seen any obvious evidence that it's upset her. She has occasionally asked why we can't live with daddy any more but in a matter of fact way. She seems quite content with the level of contact with him and in fact now seems very happy to live alone with me.

I think people are so conditioned to think that divorce is always painful and awkward for children that they read this into every situation. Obviously its an upheaval and can be very upsetting, but I genuinely think if its handled well and is done for the right reasons it doesn't have to be traumatic.

Sorry, bit of a digression. I have to consider the possibility that this could be linked to the tics. But my gut feeling is that if this is stress-related, it isn't to do with the divorce itself, possibly the anxiety that has resulted from it.

Thanks everyone.

I agree with you and I'm glad to see it that way as well. I thinknas parents we spend 90% of our time looking for increasingly big sticks to beat ourselves with an getting divorced is a bit of a mother load in that respect. I also think that people are driven to try and problem solve and find "reasons" for things at any cost, and a divorce is a nice clear concrete "cause" that they can focus on. In reality most marriages end because they're unhappy and the home environment becomes unhappy and once they're over things get better. I know that I was confused and upset about my dad leaving but I also felt much happier because there was no more shouting and crying in our house after he left. My worst nightmare as a child would have been for my parents to reconisile or "stay together for the children". It sounds like you've handled the divorce well and that your daughter is content and well adjusted. So I'd just keep doing what you're doing, being "sensitive and alert", but otherwise not making connections where they don't belong.

My child has had tics on and off. They seem worse when he has not been getting enough sleep. I found giving him warm baths with magnesium in them helped.

Two of my three children have had tics - they've grown out of them.

They've also both had mental health issues that have appeared after they'd grown out of their tics.

I don't know what that means, if anything.

I think they key is to do what you're doing - be aware, be loving, be ready to seek help if it seems like it's required.