Because Tourette's Syndrome is such a melange of bizarre symptoms, many people mistake it as a mental illness. It is not. Its caused by faulty connections in the brain, and a derangement of the brains messenger chemicals.

Heredity has a hand in its genesis, but the precise mode of inheritance is anything but clear. Facial tics, grimaces and eye blinking are often the first signs of Tourette's, which usually appear between ages 2 and 21. (or if you're like my son, born with it)

Vocal tics extend over a similar spectrum of complexity and disruption as motor tics . With simple vocal tics, patients emit linguistically meaningless sounds or noises, such as hissing, coughing, or barking. Complex vocal tics involve linguistically meaningful words, phrases, or sentences, e.g., "wow," "Oh boy, now you've said it," "Yup, that's it," "but, but...." Vocal symptoms may interfere with the smooth flow of speech and resemble a stammer, stutter, or other speech irregularities.
Patients suddenly may alter speech volume, slur a phrase, emphasize a word, or assume an accent.
The most socially distressing complex vocal symptom is coprolalia, the explosive utterance of foul or "dirty" words or more elaborate sexual and aggressive statements. While coprolalia occurs in only a minority of TS patients (from 5-40%, depending on the clinical series), it remains the most well known symptom of TS. It should be emphasized that a diagnosis of TS does not require that coprolalia is present.
Some TS patients may have a tendency to imitate what they have just seen (echopraxia), heard (echolalia), or said (palilalia). For example, the patient may feel an impulse to imitate another's body movements, to speak with an odd inflection, or to accent a syllable just the way it has been pronounced by another person. Such modeling or repetition may lead to the onset of new specific symptoms that will wax and wane in the same way as other TS symptoms.

Simple motor tics include eye blinking, grimacing, nose twitching, lip pouting, shoulder shrugging, arm jerking, head jerking, abdominal tensing, kicking, finger movements, jaw snapping, tooth clicking, frowning, tensing parts of the body, and rapid jerking of any part of the body.

Complex motor tics include Hopping, clapping, touching objects (or others or self), throwing, arranging, gyrating, bending, "dystonic" postures, biting the mouth, the lip, or the arm, headbanging, arm thrusting, striking out, picking scabs, writhing movements, rolling eyes upwards or side-to-side, making funny expressions, sticking out the tongue, kissing, pinching, writing over-and-over the same letter or word, pulling back on a pencil while writing, and tearing paper or books.

Other symptoms may include:
Copropraxia: "Giving the finger" and other obscene gestures.

Echopraxia: Imitating gestures or movements of other people.

Rituals: Repeating a phrase until it sounds "just right" and saying something over 3 times.

Speech atypicalities: Unusual rhythms, tone, accents, loudness, and very rapid speech.

There may be tremendous variability over short and long periods of time in symptomatology, frequency, and severity. Patients may be able to inhibit or not feel a great need to emit their symptoms while at school or work. When they arrive home, however, the tics may erupt with violence and remain at a distressing level throughout the remainder of the day.

It is not unusual for patients to "lose" their tics as they enter the doctor's office. Parents may plead with a child to "show the doctor what you do at home," only to be told that the youngster "just doesn't feel like doing them" or "can't do them" on command. Adults will say "I only wish you could see me outside of your office," and family members will heartily agree. A patient with minimal symptoms may display more usual severe tics when the examination is over. Thus, for example, the doctor often sees a nearly symptom-free patient leave the office who begins to hop, flail, or bark as soon as the street or even the bathroom is reached.

In addition to the moment-to-moment or short-term changes in symptom intensity, many patients have oscillations in severity over the course of weeks and months. The waxing and waning of severity may be triggered by changes in the patient's life; for example, around the time of holidays, children may develop exacerbations that take weeks to subside. Other patients report that their symptoms show seasonal fluctuation. However, there are no rigorous data on whether life events, stresses, or seasons, in fact, do influence the onset or offset of a period of exacerbation. Once a patient enters a phase of waxing symptomatology, a process seems to be triggered that will run its course - usually within 1-3 months.

In its most severe forms, patients may have uncountable motor and vocal tics during all their waking hours with paroxysms of full-body movements, shouting, or self-mutilation. Despite that, many patients with severe tics achieve adequate social adjustment in adult life, although usually with considerable emotional pain. The factors that appear to be of importance with regard to social adaptation include the seriousness of attentional problems, intelligence, the degree of family acceptance and support, and ego strength more than the severity of motor and vocal tics.

Some TS patients (percentages vary greatly in different studies) have significant problems with labile emotions, impulsivity, and aggression directed to others. Temper fits that include screaming, punching holes in walls, threatening others, hitting, biting, and kicking are common in such patients. Often they will be the patients who also have ADHD, which makes impulse control a considerable problem. At times the temper outbursts can be seen as reactions to the internal and external pressures of TS. Those patients may experience themselves as being out of control, a concept that is as frightening to themselves as it is to others.

Although psychotherapy will not eliminate tics, it may be beneficial to some TS patients who require treatment of the psychological sequelae of this difficult illness. The inability to control one's own body and even one's own thoughts, which is taken for granted by most people, often is a great source of anxiety, guilt, fear, helplessness, anger, and depression. Some patients react by withdrawal, others by aggressivity, and still others by perfectionism and excessive efforts to be in control. Since virtually all TS patients are subjected to some form of negative social reactions, self-esteem problems are common. In addition, the person with TS experiences all the difficulties associated with growing up with a chronic illness. For those reasons rather than for the primary symptoms of TS, psychodynamic psychotherapeutic treatment may well be indicated.

In adolescence and early adulthood, TS patients frequently come to feel that their social isolation, vocational and academic failure, and painful and disfiguring symptoms are more than they can bear. At times, a small number may consider and attempt suicide. Conversely, some patients with the most bizarre and disruptive symptomatology may achieve excellent social, academic, and vocational adjustments.

The most frequently reported behavioral problems associated with TS are attentional deficits, obsessions, compulsions, impulsivity, irritability, aggressivity, immaturity, self-injurious behaviors, and depression. Some of the behaviors (e.g., obsessive compulsive behavior) may be an integral part of TS, while others may be more common in TS patients because of certain biological vulnerabilities (e.g., ADHD). Still others may represent responses to the social stresses associated with a multiple tic disorder or a combination of biological and psychological reactions.

Obsessive Compulsive Disorder (OCD)
The need to do and then redo or undo the same action a certain number of times (e.g., to stretch out an arm ten times before writing, to even up, or to stand up and push a chair into "just the right position") is compulsive in quality and accompanied by considerable internal discomfort. Complex motor tics may greatly impair school work, e.g., when a child must stab at a workbook with a pencil or must go over the same letter so many times that the paper is worn thin. Self-destructive behaviors, such as head banging, eye poking, and lip biting, also may occur.

Attention Deficit Hyperactivity Disorder(ADHD)
Up to 50% of all children with TS who come to the attention of a physician also have attention deficit hyperactivity disorder (ADHD), which is manifested by problems with attention span, concentration, distractibility, impulsivity, and motoric hyperactivity. Attentional problems often precede the onset of TS symptoms and may worsen as the tics develop. The increasing difficulty with attention may reflect an underlying biological dysfunction involving inhibition and may be exacerbated by the strain of attending to the outer world while working hard to remain quiet and still. Attentional problems and hyperactivity can profoundly affect school achievement. At least 30-40% of TS children have serious school performance handicaps that require special intervention, and children with both TS and ADHD are especially vulnerable to serious, long term educational impairment.
Attention deficits may persist into adulthood and together with compulsions and obsessions can seriously impair job performance.

If you want to see a good movie that involves a TS person as the main character, I would suggest renting "Niagara Niagara". Be warned tho...you will want a box of kleenex!
An educational film for those interested in how r/t people deal with their TS would be "Twitch and Shout." I don't think you can find this one at the video store..maybe your local library?

Most of my information has come from the Tourette's Syndrome Association (TSA) you can find a multitude of information on their site at TSA A couple other links you could check out are:
Mental Health.Com or Tourette Syndrome Home Page

There's alot of info out there on the net...go check it out!