Ray Donovan's Dash Mihok and Tourette's: What is Tourette's?

Tourette's, characterized by involuntary physical 'tics' and verbal outbursts, this syndrome is not well understood. Photo: Dash Mihok (Wikipedia)

WASHINGTON, September 21, 2013 — Hollywood actor Dash Mihok has almost 20 years of movie and TV show experience and is now appearing in the Showtime hit “Ray Donovan.”

Recently, Mihok openly discussed his ability to hide his affliction, Tourette’s Syndrome (TS), from his professional associations.

As movements and speech associated with Tourette’s is involuntary and difficult to control, this was quite a feat.

The Mayo Clinic tells us TS, named after French physician George Tourette, is a neurological disorder that reveals itself between the ages of two to twelve and is recognized by involuntary ‘tics,’ primarily facial tics and involuntary movements. Males are three to four times more likely to have TS than women.

Currently, it is conservatively estimated that about 200,000 people in the U.S. have TS.

Genetics and/or brain abnormalities such as dopamine and serotonin levels may play a role in TS, so family history with particular attention to males is an important factor for diagnosis.

Those with TS live a normal lifespan, but TS may disrupt learning and create social and behavioral issues particularly as a child and regarding self-esteem.

Many times, TS is comorbid (along with) other disorders such as attention deficit/hyperactivity disorder, obsessive compulsive disorder and sleep, depression and anxiety issues.

Some with TS suffer from an inability to control verbal outbursts. This may mean socially inappropriate swearing or language.

Those with the unfiltered language issue often choose to inform those they will be interacting with about the issue to avoid problems. Many with verbal TS find great success with co-workers and clients understanding the situation.

Stress and anxiety seem to affect TS and the associated tics. Simple tics are sudden, seemingly inexplicable changing facial expressions: shoulder shrugging, eye darting and/or blinking, finger flexing, sticking out the tongue and head jerking.

Complex tics include touching the nose, touching other people, smelling objects, obscene gesturing, arm flapping and hopping. There are reported cases where, for example, shoulder shrugging can be so severe as to dislocate the shoulders.

Simple vocal tics include hiccupping, yelling, throat clearing and barking. Complex vocal tics can be repeating one’s or another’s words or phrases, vulgar and obscene language and using different tones of voice.

As one approaches adulthood, the symptoms diminish and the syndrome gets easier to control. This may explain why Mihok was able to successfully hide TS. Often, symptoms disappear entirely.

There is no cure for TS and no medication that has lasting effects, but research at the National Institutes of Health is underway with clinical trials.

As with any research and studies, the greater numbers of people afflicted with a disease or disorder, the better financed the research

With 200,000 folks having TS and few poor, lasting outcomes, this syndrome is seemingly not a priority for study.

However, researching TS may open doors to other etiologically related neurological disorders as well so hopefully, research and clinical trials will be effective.


Paul Mountjoy is a Virginia based writer and psychotherapist



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