Often a tic begins with what some call an obsession (hence Tourette’s Syndrome’s vague categorization as an obsessive-compulsive disorder), an unpleasant thought or image that lingers in one’s mind until they succumb to the compulsion to make tic. This alleviates the mental discomfort, but then others’ response to the tic often becomes the problem, causing sadness, stress, and anxiety causing further tics. It’s a vicious cycle.