What Is Tourette Syndrome?

Tourette Syndrome, also known as Tourette’s or TS, is a neurodevelopmental disorder distinguished by the presence of chronic motor and vocal tics. The severity of TS can vary; according to the NINDS, it is estimated that one in 100 have a mild case, and around 200,000 Americans suffer from the most severe form of Tourette Syndrome.

What Is Tourette Syndrome?

Symptoms typically appear during childhood, and in many cases, the severity of one’s tics reaches its peak around the pre-teen years with symptoms improving post-adolescence. However, for some individuals, Tourette’s is a chronic lifelong condition with its own set of daily challenges to cope with.

What Are Tics?

Tics are uncontrollable movements, gestures, or vocalizations that are often sudden and repetitive. Tics are described as either simple tics (involving a limited number of muscle groups) or complex tics (involving several muscle groups).

The specific type of tics a person has and their frequency typically fluctuates over time. Tics can also change, evolve, or even react to internal or external triggers, including anxiety or stress.

Many people with Tourette’s notice their tics lessen or stop altogether if they are intensely focused on something. Some people may also experience premonitory urges — a sense that a tic is about to occur. While some may be able to suppress a tic when this happens, it can often make tics emerge more frequently afterward.

Motor Tics

Some examples of simple motor tics are grimacing, blinking, shrugging, and jerking movements. Complex motor tics can include jumping, twisting, hopping, or a combination of movements. More severe motor tics can include obscene gestures or actions such as hitting or punching that can cause self-injury to the individual.

Vocal Tics

Simple vocal tics can include barking, sniffing, whistling, or popping noises. Complex vocal tics typically involve words or phrases.

  • Echolalia is a type of vocal tic where the individual repeats something that someone else has said.
  • Coprolalia is a severe vocal tic involving inappropriate or crude language like swearing or racial slurs. It is perhaps one of the most heavily stigmatized symptoms, although only approximately 10%-15% of those with Tourette’s have this kind of vocal tic.

Living with Tourette’s

Many people with Tourette Syndrome don’t need any kind of medication for their condition, although it may benefit certain cases. Typically, the most effective ways to live with Tourette’s are to find healthy coping mechanisms and a support system that will help the individual live without their condition hindering their ability to live a normal life.

Options for Treatment

When it comes to treatment, speech therapy, behavioral therapy, or medication may be beneficial in some cases. Most often, there is no formal treatment necessary for Tourette’s unless the person’s tics are causing harm to the individual. In some cases, Tourette Syndrome can be accompanied by other conditions such as ADHD, anxiety, sleep disorders, or issues with social functioning, sensory processing, or behavior. Certain therapies can often help with concurrent problems in those with Tourette’s.

If you or a loved one suffer from symptoms of Tourette’s or any co-occurring conditions, Pandora’s House Psychiatry is here for you. Serving the Collin County community, we are committed to providing compassionate psychiatric care with understanding and trust. Contact us today for more information or to request an appointment.

Why and How to Tell Your Family You’re Suffering from Anxiety

Anxiety can make you feel like you are completely alone in your life. Even if your life is filled with family and friends who love you, they probably have no idea that you are suffering from anxiety every day. Don’t suffer alone. Allow someone to help you through.

Why and How to Tell Your Family You're Suffering from Anxiety

Why You Should Tell Your Family

To alleviate your stress- By discussing your feelings with your family, you won’t have to hide your symptoms and feelings anymore. You can share when you start to feel worried about something and know that you have someone who will listen.

The relief of sharing your feelings- Once you share your worries and express the emotional pain you have been dealing with, you may feel some relief from your anxiety. Obviously, this will not solve the underlying issue. But by having an outlet to share your feelings, the bottled up feeling of worry may start to ease.

To get help taking the next steps- If you have even one or two family members or friends that you trust, ask them to help you through this. Explain your struggles and what you feel you need to do to move forward. Perhaps they could come with you to speak to a therapist or even just watch your children to give you some time away.

How You Should Tell Your Family

Speak with those you are closest to– You know which of your family members are most supportive. Speak to the person you feel most comfortable with first so that they can help you feel better and not judged for your feelings.

Ask someone to help you– Once you have opened up to someone you feel close to, ask them to be with you as you explain your feelings to other members of your family. Allow them to help you answer questions when you start to feel overwhelmed.

Tell them how they can help you- Make sure your family understands that your feelings are not their fault, but also be clear about how they can help. If you’re feeling overwhelmed with work or cleaning you have to get done, ask if someone could help you with that. Don’t be afraid to ask for the help you need to feel better.

Don’t allow the loneliness of anxiety to overtake you. Speak with those closest to you about how you are feeling and how they can help. If you do not have anyone you can speak to or you need further steps to help you through while suffering from anxiety, contact a therapist. The only way to get through is with support. Please contact us for further information.

How Dangerous Is Major Depressive Disorder?

Mental illnesses aren’t something that should be taken lightly. There are many forms of mental disorders, however, Major Depressive Disorder is one of the most debilitating. Of all the types of depression, this form is one of the most vicious, cold, and mind gripping of them all, and if you know a loved one who has been diagnosed with this disorder, there are a few things you should learn about it. After all, It just might save a life.

How Dangerous Is Major Depressive Disorder?

Major Depressive Episodes

It’s different for everybody, however, there’s a very common theme with MDD. Not only is it a silent killer, but it tends to sneak up on you when you least expect it. Your entire day could be going perfectly, but if any small or sudden inconvenience springs up, it could ruin your whole mood. MDD is the depression disorder for sudden, strong attacks of depression- rather than a prolonged state. Like most, it relies on triggers to be activated and can leave the person in a fragmented state of mind. Few things can help a person once they’ve entered an episode. Normally, in most cases, they simply either need to solve the issue that caused their episode, or wait it out and hope that they start to feel better. Major Depressive Disorder has been known to be a leading cause of suicidal tendencies, causing up to 25% more cases in young adults and teens.

How Can You Prevent Episodes?

Medication, weekly therapy visits, and an otherwise happy environment are all great ways to start the healing process. They all have their cons, however, and you should be aware of all of them when caring for somebody with MDD. Therapy, for example, is a great way to get things off your chest on a weekly basis- however, most people may find it to be tiresome and grow exhausted of it quickly. Medication can also cause a mental drain that affects the user in a hormonal way while taking the prescribed medication. The best advice is to make sure the affected know they have people to turn to in their times of need, and should be open when they are feeling an episode or an attack. As long as there are people to assist them, most will feel a security blanket begin to settle in, which can make MDD a little harder to affect them. It varies with everyone, though, so try all of these methods in hopes of keeping this silent killer at bay. Major Depressive Disorder certainly isn’t anything to take lightly.

Anxiety Disorders & Feeling Confined

Anxiety disorders often create difficulties for dealing with daily situations and tasks. Feeling confined is a common, consistent feeling that evokes the symptoms of anxiety.

Anxiety Disorders & Feeling Confined

Feeling Confined

Many people take for granted the ways in which their physical bodies are confined by situations and social norms. For those with anxiety, however, this confinement can create increased heart rates, trouble breathing, disorientation, and the desire to immediately escape the situation. It’s important to let others know when you experience anxiety as a result of confinement, as well as to work through these feelings with a mental health professional.


Wearing seat-belts is required by law in most areas. Some people don’t wear seat-belts just because they don’t want to, while others, even those without anxiety, may fear being trapped by seat-belts if they get into a wreck. For those with anxiety, the feeling of physical confinement can start as soon as the strap touches the neck.

If you have anxiety and you find yourself constantly trying to get the seat-belt away from your neck, you have difficulty breathing while you’re driving, or other anxiety symptoms occur, it’s likely this is a result of seat-belt confinement anxiety. While it’s important to follow laws, it’s also important to take care of yourself. Pull over if you need to and take a few minutes to calm and center yourself. Also consider exploring options for added seat-belt padding and other aids that may relieve the feeling of confinement.


Standing in the confined space of an elevator can be a huge source of anxiety, and for those with anxiety disorders, the feeling can become overwhelming. Keep in mind that it’s okay to tell others, even strangers, about your anxiety if you have to get into an elevator. If you have more anxiety while alone in an elevator, wait on another person to ride the elevator with you. Also look for alternative stair routes and work with a therapist to adapt your breathing and calming techniques to different circumstances.


COVID-19 and mask-wearing is a significant, often extreme, source of anxiety for those with anxiety disorders. The masks confine our most basic human function: breathing.

Instead of trying to just deal with the added anxiety, do everything you can to create windows of time when you’re not wearing a mask throughout the day. Let your employer know that you suffer from increased anxiety due to mask-wearing, and that you may need to step outside for a moment when the anxiety symptoms increase. Explore mask options to find the one that is most comfortable and least restrictive, while still being protective.

To schedule an appointment with a caring counselor in the North Dallas area, contact us today.

Treatment-Resistant Depression and Why You Shouldn’t Lose Hope

Treatment-resistant depression (TRD) can be a pretty scary diagnosis to have thrown at you. The phrase “treatment-resistant” immediately conjures a hopeless outlook for treating your depression. To be given this diagnosis you must have already failed at least two different treatments, with adequate dosing and duration confirmed. Not only is it frustrating to continue trying different medications, as well as deal with side effects, but it is also frustrating to find out that typical medications won’t work for you.

Treatment-Resistant Depression and Why You Shouldn't Lose Hope

This doesn’t mean there is no hope for treating your depression. Resistant does not mean untreatable. It just means we have to fight a little harder. It also means we should explore other treatment options.

There are several treatments that have been shown to work well in patients with treatment-resistant depression. Electroconvulsive therapy (ECT) has been shown to be very successful in treating TRD, and unlike what movies may show, it is actually quite safe and done by specially trained medical professionals. Another treatment that has been shown to work is Transcranial Magnetic Stimulation (TMS). TMS works by delivering painless magnetic pulses in order to stimulate regions of the brain that are involved in mood and depression.

There is also another treatment that has been gaining traction, Ketamine. In the past this medication has been used as an anesthetic, but research has shown that in smaller doses it can have a very rapid, positive, effect on severe depressive symptoms, particularly in patients with TRD. Ketamine has to be given as an intravenous infusion, but the FDA recently approved esketamine, which is a slightly different version of the ketamine molecule, to be used as a nasal spray in outpatient settings, under physician supervision.

All of this means that there are now more options for treating TRD. It also means that being given a diagnosis of treatment-resistant depression does not have to conjure the same hopeless feelings as it has in the past.

Contact us at Pandora’s House for further help and information.

What Is Bipolar Depression?

Bipolar depression is a subpart of bipolar disorder. It is the “lows” or an extreme sense of hopelessness those with bipolar disorder experience. If you have bipolar disorder, you experience unpredictable patterns of mania and major depressive episodes. Dealing with bipolar disorder can leave patients and their caretakers feeling frustrated. The mental health professionals at Pandora’s House in Farmersville, Texas, help restore hope by providing treatment tailored to each patient’s specific needs.

What Is Bipolar Depression?

Signs You May Be Experiencing Bipolar Depression

The differentiating factor between bipolar depression and unipolar depression is the manic episodes (the “highs” of those with the disorder experience. Bipolar depression is often misdiagnosed, so be sure to mention any episodes of mania you may experience.

Here are signs you may have bipolar disorder:

  • You’ve experienced a mania or hypomania episode
  • You feel depressed almost every day
  • You can’t sleep at night
  • You have trouble staying up during the day
  • You suffer from feeling worthless or guilty nearly every day
  • Your symptoms disrupt major areas in your including family, work, and social life

Depressive symptoms must be evaluated by a mental health professional to be properly diagnosed.

Long-term Effects of Bipolar Disorder

Left untreated, bipolar disorder can lead to some serious long-term effects. You may have memory issues and trouble focusing or paying attention. You can also have problems with impulse control, making decisions, planning, and even remembering words. People with bipolar disorder are also at risk for self-harm and suicide.

Treatments Available for Bipolar Depression

Since antidepressants can trigger manic episodes, bipolar treatment usually includes a cocktail of mood-stabilizing drugs. The treatment plan may consist of an anti-manic drug like lithium, an antipsychotic drug, or both. Along with medication, patients usually participate in one-on-one talk therapy or support groups.

Managing bipolar depression can be frustrating when you face it alone. If you or a loved one has a bipolar disorder, call Pandora House in the North Dallas area at (972) 784-064 or contact us online to schedule an appointment.

What Is Autism Spectrum Disorder?

What Defines Autism Spectrum Disorder?

Autism spectrum disorder, or ASD, refers to a range of neurodevelopmental disorders including autism disorder, Asperger’s syndrome, and pervasive developmental disorder — not otherwise specified (PDD-NOS). Autism spectrum disorder is characterized by symptoms such as experiencing difficulties with both verbal and nonverbal communication, facing challenges with social interaction, and exhibiting repetitive patterns of behavior. According to the National Institute of Mental Health, autism is defined as a “spectrum” disorder due to the vast differences in severity and specific symptoms individuals with ASD will encounter.

What Is Autism Spectrum Disorder?

Some common symptoms of autism include, but are not limited to:

  • Delayed development of speech in early years
  • Difficulties understanding some social cues, like facial expressions, eye contact, body language, or gestures
  • Excessive fixation on specific objects, interests, or activities
  • Speaking in an unusual tone, such as a sing-song or monotone voice
  • Repeating specific phrases or dialogue
  • Challenges with making and/or maintaining relationships
  • Showing distress or throwing tantrums in new or overwhelming situations

What Causes Autism Spectrum Disorder?

There is no exclusive risk factor determined to cause ASD, according to the Environmental Protection Agency, although it is proposed that autism may be caused due to a mixture of environmental and genetic factors. Some research findings suggest that environmental risks may present a greater chance of developing ASD, as cases of autism continue to see a rising trend in prevalence that the EPA states cannot be explained by genetic factors alone.

How Can Autism Spectrum Disorder Be Treated?

Although there is no known cure for autism spectrum disorder, symptoms can greatly improve with early diagnosis and treatment, according to the American Psychiatric Association. Because ASD affects such areas as speech and behavior, intervening early can significantly benefit a child’s development during their formative years. Some therapies that can help those with ASD include applied behavioral analysis (ABA) among other behavioral modification techniques, speech and language therapy, occupational therapy, and more.

Children do not typically outgrow autism, and in fact are often at a higher risk of developing comorbid disorders such as ADHD, depression, or anxiety later in life. Continuing treatment throughout adolescence and adulthood can be particularly beneficial for individuals as they grow and adjust to different stages of life.

If you or a loved one experience symptoms of ASD and are seeking treatment or a professional diagnosis, Pandora’s House Psychiatry is here for you. Located in Farmersville, Texas, we are dedicated to serving our Collin County community with diligent psychiatric care delivered with sensitivity, understanding, and trust. At Pandora’s House, we strive to increase access to mental health care and raise awareness of the many benefits of treatment. To make an appointment, call us today at (972)784-3064 or visit us online.

Warning Signs of Sensory Processing Disorder

Sensory processing disorder is a condition in which a person has trouble receiving the information that comes in through his senses.  Many kids with SPD are often hypersensitive, and this is why certain food textures, smells, and sights might overwhelm your child at times.  Kids with SPD might also struggle with coordination, and could have meltdowns over the smallest things.  Other kids with SPD might be picky eaters and won’t wear certain types of clothing due to their sensory issues.  Here are other warning signs of SPD.

Warning Signs of Sensory Processing Disorder

Highly Distractible

Some kids with SPD might be easily distracted and bored.  They thrive on activities that have lots of movement such as jumping, walking, running, and other types of play-based activities.  This makes sitting still for homework or other everyday tasks difficult for those with this condition.  It is also why many occupational therapists recommend a sensory diet as part of a child’s therapy if he was diagnosed with SPD.

Not Understanding Boundaries

A common characteristic of SPD is the lack of understanding of someone’s personal space.  This explains why your child tends to get in your face frequently, get too friendly with strangers, or touch everything in sight even though some objects could hurt him.

Poor Motor Skills

There are also some kids with SPD whose motor skills aren’t the best.  They might have a hard time with fine motor skills and it is difficult for them to learn how to tie shoelaces, hold a pencil, write words on paper, or dress themselves properly.  Other kids with SPD struggle with gross motor skills and it affects their ability to catch a ball or walk without losing balance.

Extreme Picky Eating

All kids can be picky eaters at times, but if your child will only eat crunchy foods or have a severely limited diet, then he might have SPD.  Your child might also have extreme food texture preferences such as spicy or sour foods.

How To Get Help for Your Child

The first step is to meet with your pediatrician and discuss the concerns you have about your child.  From there, the pediatrician would recommend a good occupational therapist or pediatric neurologist in your area. Once your child is diagnosed, he can begin occupational therapy and any additional treatment to improve his symptoms.

In conclusion, your child can thrive with SPD. With the best treatment, patience, and effort from you, your child will succeed despite his condition.

If you need help with getting a SPD diagnosis and treatment for your child, contact us. We’re here to assist you in getting the services you need.

What are Neurodevelopmental Disorders?


Neurodevelopmental disorders are those that affect the brain and nervous system. Some examples include attention-deficit/hyperactivity disorder (ADHD), autism, learning disabilities, intellectual disabilities (previously referred to as mental retardation), conduct disorders, cerebral palsy, and vision and hearing impairments. People with neurodevelopmental disorders can have difficulties in many areas of their lives. They may have trouble with memory, language and speech, motor skills, behavior, or learning. Although some neurodevelopmental disorders may improve with age, many people will have their disorder for their entire lives. Treatment for these disorders usually include a combination of therapy, medication, and home- and school-based programs.

What are Neurodevelopmental Disorders?


Genetics play a big role in the acquiring of neurodevelopmental disorders. Some disorders, especially intellectual disabilities, are even linked to specific genes. However, most are caused by a combination of genetic, environmental, and psychosocial factors. Genetic causes may include (but are not limited to) chromosomal deletion, or the loss of genetic material, or single-nucleotide polymorphism, where one molecule of DNA is miscopied. Environmental causes include maternal use of drugs or alcohol, childhood or prenatal exposure to harmful substances, preterm delivery, low birth-weight, and low socioeconomic status. Psychosocial causes include exposure to repeated psychological stressors like trauma and abuse.

Types of Neurodevelopmental Disorders

According to the University of Texas Medical Branch (UTMB), neurodevelopmental disorders can be split into six categories: attention deficit disorders, developmental movement disorders, language and learning disorders, intellectual disabilities, mood and anxiety disorders, and autism spectrum disorders. Below is a list of the most common types of disorders for each category.

Attention Deficit Disorders

  • ADHD combined Type
  • ADHD Inattentive Type- or ADD

Developmental Movement Disorders

  • Cerebral palsy
  • Developmental Dyspraxia
  • Developmental Oral Apraxia

Language and Learning Disorders

  • Expressive or Receptive Language Disorders
  • Articulation Disorders
  •  Stuttering
  • Dyslexia (reading)
  • Dyscalculia (math)
  • Dysgraphia (writing)
  • Nonverbal Learning Disorder

Intellectual Disabilities

  • Fragile X Syndrome
  • Down Syndrome

Mood & Anxiety Disorders

  • Mood: Dysthymia, Major Depression, Bipolar Disorder.
  • Anxiety: Phobias, Selective Mutism, Generalized Anxiety.
  • Obsessive-Compulsive Disorder

Autism Spectrum Disorders

  • Asperger Syndrome
  • Autism

Finding Help at Pandora’s House Psychiatry

If you or a loved one have been diagnosed with a neurodevelopmental disorder or are in need of a diagnosis, Pandora’s House Psychiatry can help. We are dedicated to serving our Collin County community with diligent psychiatric care delivered with sensitivity, understanding, and trust. At Pandora’s House, we strive to increase access to mental health care and raise awareness of the many benefits of treatment. Call us at (972) 784-3064 or visit us online today.


Information for this article comes from the Environmental Protection Agency (EPA), The University of Texas Medical Branch (UTMB), The Mayo Clinic, and the National Center for Biotechnology Information (NCBI) at the U.S. National Library of Medicine.

Agoraphobia Is A Serious And Even Detrimental Anxiety Disorder

Agoraphobia is a specific anxiety disorder that can manifest in several specific ways, all of which can involve numerous panic attacks and a refusal to leave a place the sufferer feels is safe. The word, in Latin, directly translates into the fear of the marketplace. In an ego-driven, consumerist society, the entire world outside the home is that marketplace.

Agoraphobia Is A Serious And Even Detrimental Anxiety Disorder

Many people with agoraphobia can be misdiagnosed with a generalized anxiety disorder, but in reality, almost 2% of all adults have agoraphobia and 40% of those already diagnosed have it severely. There are several specific symptoms of agoraphobia to look out for.

Specific Symptoms

Many people with this disorder fear that they will wander into an unpredictable situation that they may not be able to run away from or get out of. People with agoraphobia may feel intense fear and anxiety in the following situations:

  • leaving their home, or safe space, either alone or with a partner
  • large crowds and waiting in lines for extended periods
  • open and enclosed spaces (movie theaters, parking garages, parks, elevators, for example)
  • using any form of transportation, especially public transportation around several other people

Sometimes, even thinking about being in these situations can start an anxiety attack while those of us around the individual may not see or understand the threat. Those who suffer from severe agoraphobia may not be able to leave their homes or their safe spaces without serious physical responses that can mimic a heart attack and then further increase the already high level of fear and anxiety.

The Safe Space

Cognitive behavior therapy for anxiety symptoms teaches us to close our eyes and visualize ourselves inside our designated safe space. The theory is that our anxiety symptoms will decrease once we begin to smell the familiar scents and feel the familiar feels. The anxiety for someone who suffers from agoraphobia begins at this safe space, so this behavioral modification practice must also be modified through a more specialized treatment and even medications.

If you are a family member or are close to a person who seems to suffer from agoraphobia, don’t fall into the trap of thinking that they are being lazy or entitled, as some have done. Your loved one needs help to get back to living their best life.

Contact us at Pandora’s House for further information on how we can help you and your loved ones get back to the lives you want to lead. Our high-quality and compassionate team is dedicated fully to giving you comprehensive and quality psychiatric care. Let’s meet and discuss an individualized treatment plan to combat your problems. You can be happy again.