A person with Tourette syndrome may appear calm and composed, but holding back tics—uncontrollable movements or sounds—can be mentally and physically exhausting. Tourette syndrome is a neurological condition that causes tics, which are sudden, repetitive movements or vocalizations that a person cannot control. These tics can change over time and often come with other challenges like attention issues, anxiety, or obsessive-compulsive behaviors. While some people can temporarily control their tics—like during a public event—this doesn’t mean the tics are voluntary or that the person is faking the condition. In fact, the ability to suppress tics is a common experience among those with Tourette syndrome and has even become a key part of modern treatment strategies. Suppressing tics, however, can take a toll. Neurologists who treat Tourette syndrome have heard from many patients that holding in tics requires intense focus and energy. After a period of suppression, people often feel the need to release the built-up tension, which can be both mentally and physically draining. Understanding the science behind tic suppression and the experiences of those who live with it can help people without the condition better recognize the challenges of the disorder and show greater empathy. In 2019, singer-songwriter Billie Eilish publicly shared that she lives with Tourette syndrome, sparking mixed reactions online. While some offered support, others questioned the authenticity of her tics, pointing to moments where she appeared tic-free. In a 2026 interview, Eilish explained how suppressing her tics requires immense effort, often using every ounce of her willpower to hold them in. Her openness has helped raise awareness about the condition and the invisible struggles that often accompany it. Tourette syndrome is often accompanied by other challenges, such as anxiety, obsessive-compulsive behaviors, or attention-deficit/hyperactivity disorder (ADHD), which can have a greater impact on daily life than the tics themselves. These invisible symptoms can affect relationships, school performance, and overall well-being. For example, a child may face teasing over small tics like blinking or shrugging their shoulders, but it may be untreated anxiety or difficulty focusing that limits their potential. Understanding these challenges can help friends, teachers, and employers provide better support. The exact cause of Tourette syndrome remains unclear, though researchers believe both genetic and environmental factors may play a role. It affects less than 1% of children worldwide, but the experience of the disorder varies widely from person to person. Some may have simple tics like blinking or sniffing, while others have complex movements or vocal tics that involve multiple muscle groups or repetitive sounds. Some people also develop rituals or behaviors that overlap with obsessive-compulsive tendencies, making it difficult to distinguish between a tic and an obsessive thought. Tourette syndrome exists on a spectrum, with each person experiencing a unique combination of symptoms. Tics can change over time, often worsening with stress, lack of sleep, or illness, and improving when someone is deeply focused on a task. This fluctuation can lead to confusion from others, who may question the legitimacy of a person’s diagnosis. However, the ability to suppress tics—while tiring—can be a valuable tool in managing the condition. In recent years, behavioral therapy has become a recommended treatment for Tourette syndrome. One method, called comprehensive behavioral intervention for tics (CBIT), helps individuals recognize the early signs of a tic and develop alternative responses to reduce their frequency and intensity. For example, someone might learn to breathe deeply through their nose to counteract the urge to clear their throat. This approach helps people manage their tics more effectively without relying solely on medication or surgery. Billie Eilish’s public discussion of her Tourette syndrome has helped reduce stigma and encourage more people to seek help and support. It has also inspired research into better treatments and increased awareness about the complexity of the condition. Recognizing that tic suppression is a real and often exhausting experience can help others understand the challenges faced by those with Tourette syndrome and support them more effectively.