Tics are more common in children than adults, and boys are more commonly affected than girls. Treating a chronic motor tic disorder. The signs and symptom information on this page attempts to provide a list of some possible signs and symptoms of Tics. A physical exam, imaging tests, neurological exam, and blood tests may be used to diagnose a stroke. Tics are usually not harmful, but they may vary in intensity (simple tics or complex tics) and may be worsened by tension, fatigue, illness, recent head injury, excitement, or even some medications. They tend to get worse if they're talked about or focused on. Les technologies sont constamment présentes dans nos vies. Simple Vocal Tics: can include repetitive throat-clearing, sniffing, snorting, grunting or barking sounds. The people I had the conversation with were asking multiple question like "What's your name?" Drug addiction is a chronic disease that causes drug-seeking behavior and drug use despite negative consequences to the user and those around him. ©1996-2021 MedicineNet, Inc. All rights reserved. Chronic tics that do not subside may be a sign of tic disorder, which may require treatment or medication. There are two kinds of seizures, focal and generalized. Risk factors for TIA include vascular disease, smoking, high blood pressure, high cholesterol, and diabetes. Motor tics involve movement. One way to think of it is like this: There is an URGE (involuntary sensation), the TIC occurs (the semi-voluntary or voluntary response) and then there is RELIEF . They might be consist of the blinking of an eye, or simple twitches. » Review Causes of Tics: Causes | Symptom Checker » Causes of Tics: The following medical conditions are some of the possible causes of Tics. They can range from mild to severe. Tics are a characteristic symptom of Tourette syndrome and tic disorders, but they may also occur due to other medical conditions. etc. Tics can be suppressed if a person concentrates on suppressing them, but this becomes increasingly difficult with time. This medical information about signs and symptoms for Tics has been gathered from various sources, may not be fully accurate, and may not be the full list of Tics signs or Tics symptoms. Teen drug abuse is a growing concern today. But he … 2. Generally speaking, these are linked to the motor system as is the case of eye twitching or vocal tics (the repetition of sounds, words, etc. Therapy. Genetics contribute to ADHD. Some of the symptoms and warning signs of teen drug abuse include reddened whites of eyes, paranoia, sleepiness, excessive happiness, seizures, memory loss, increased appetite, discolored fingertips, lips or teeth, and irritability. Simple facial tics like eye blinking, slight facial grimacing or slight facial twitching will usually be the first tic a child has. Continued. Brain Food Pictures: What to Eat to Boost Focus, Adderall (amphetamine and dextroamphetamine), methylphenidate (Ritalin, Concerta, Methylin, Daytrana), onabotulinumtoxinA, Botox, Botox Cosmetic, Fighting MS Fatigue With Physical Activity. Tics sometimes change over time from one simple type of tic to another or from a simple to a complex tic. And about 20 percent of kids with ADHD have chronic tics. problem of the nervous system that was first described by the French neurologist Treatment of epilepsy (seizures) depends upon the cause and type of seizures experienced. They often start with an unpleasant sensation that builds up in the body until relieved by the tic – known as an urge – although they can sometimes be partly suppressed. The repetitive tics that are characteristic of the condition are classified as motor and vocal. Very occasionally they can start in adulthood. There are many causes of epilepsy. According to the Connective Tissue Disorder Site (CTDS), low magnesium can cause facial tics in children. Tics often come and go, and they can change over time. Habit reversal therapy has shown some lasting success in patients, according to the Movement Disorder Society. ). What if it is a compulsion. These may be used alongside psychological therapies or after trying these therapies unsuccessfully. A stroke is an interruption of the blood supply to part of the brain caused by either a blood clot (ischemic) or bleeding (hemorrhagic). What if they aren’t tics? Symptoms of tic disorders are typically worse during times of excitement or anxiety, and occur less frequently when the person is absorbed in activities, concentrating, emotionally pleased, or sleeping. Sometimes tics are explosive in onset, appearing and becoming constant within a day. Examples include nose twitching, eye darting, or throat clearing. Ticks are food for other animals. After that time, the tics may fade in intensity or go away completely. Spending a comfortable evening with Olivia's family and experiencing the love they have for each other puts Justin as ease. For a parent, seeing or hearing your child exhibit these unexpected movements or sounds can be extremely worrisome. Les tics de langage portent énormément d'informations : Vos origines socio-culturelles. Stimulant medications are the most common medication used to treat ADHD. In some instances, what appears to be a chronic tic may be a sign of Tourette's syndrome. Tics are not usually serious and they do not damage the brain. For example, a person with a motor tic might keep blinking over and over again. Treatment involves medication and cognitive behavioral therapy. Tics — sudden, brief, intermittent movements or sounds — are the hallmark sign of Tourette syndrome. cause emotional or social problems, such as embarrassment, cause pain or discomfort (some tics can cause the person to accidentally hurt themselves), interfere with daily activities, school or work, Habit reversal therapy – this aims to help you or your child learn intentional movements that "compete" with tics, so the tic cannot happen at the same time, Comprehensive behavioural intervention for tics (CBiT) – a set of behavioural techniques to help learn skills to reduce tics, Exposure with response prevention (ERP) – this aims to help you or your child get used to the unpleasant sensations that are often felt just before a tic, which can stop the tic occurring. Tourette syndromes can be different for a lot of people but in my case it is characterized by tics that are SEMI VOLUNTARY movements caused by some kind of discomfort that creates an urge to do that movement. Explain to people that the teen is not doing it on purpose and stress that tics are not a sign of mental or physical illness and often go away on their own. Complex vocal tics include repeating words out of context, echoing what someone else said and speaking obscenities. Another facial tic is the quick facial movements that occur in people who have chronic motor tics. Most people with TS experience their worst tic symptoms in their early teen years with symptoms dissipating in young adulthood. Such mistakes can result in inappropriate or even harmful treatment for this otherwise highly treatable disease.1 Fortunately, the differential diagnosis is generally simple and straightforward. Discussion. Facial tics are sudden, involuntary muscle movements in the face. There are many types of tic. Many kids eventually outgrow them on their own. Motor tics can be of an endless variety and may include such movements as hand clapping, neck stretching, mouth movements, head, arm or leg jerks, and facial grimacing. Motor tics usually begin first, starting in the head and neck, with vocal tics following. See if your worries are normal or something more by learning about symptoms,... Do you know the difference between seizures and epilepsy? When a child is put on medication for the ADHD, parents might notice tic onset. A compulsion you are mislabeling and ignoring? Tics can happen randomly and they may be associated with something such as stress, anxiety, tiredness, excitement or happiness. Recognizing the symptoms of chronic motor tic disorder. (this one was the first one, and mostly a joke), "Are you a demon? Sometimes a person will have 1 or 2 tics for many years. Tics are abnormal, undesired spastic movements or vocalizations. Terms of Use. Motor tics include grimacing, blinking, shrugging, twisting and jumping. Learn statistics, facts, warning signs, and effects related to teen substance abuse... Anxiety is a feeling of apprehension and fear characterized by symptoms such as trouble concentrating, headaches, sleep problems, and irritability. Epilepsy is a brain disorder in which the person has seizures. Some have compared having tics to having the hiccups, you may not want to hiccup, but it happens with… these short-lasting sudden movements (motor tics) or uttered sounds (vocal tics) occur suddenly during otherwise normal behavior. The cause of Tourette syndrome is not known. Treatment of drug addiction may involve a combination of medication, individual, and familial interventions. When multiple motor tics and at least one verbal tic are simultaneously present, the diagnosis is known as Tourette's syndrome. Tourettes is commonly associated with ADHD, obsessive-compulsive disorder, behavior problems, and learning disabilities. Judgement, memory, and other cognitive functions may become impaired. Treatment includes medication, psychotherapy, and in severe cases surgery. Learn about generalized anxiety disorder (GAD). A tic is a sudden, uncontrollable movement defined in the DSM as a "sudden, rapid, recurrent, nonrhythmic motor movement or vocalization." Have You Noticed Problems With Your Memory. Some involve the … PANDAS is in part caused by an autoimmune response to a strep infection. Tics. Vocal tics include: Sniffing; Coughing; Clearing your throat; Words; Phrases; All of the above are examples of simple tics. If the symptoms do not resolve, a stroke most likely has occurred. there are two types of tics -- motor tics and vocal tics. Chronic tic disorder: Either a single tic or multiple motor and vocal tics (not both), which have been present for more than a year. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. Discussion. The tics must have started before the age of 18. repeating a sound or phrase – in a small number of cases, this may be something obscene or offensive. Huntington's disease is an inherited disorder. Treatment includes medication and therapy for symptoms. Dr. Khrizman provided some of the most common questions parents ask surrounding their child’s tic. Simple motor tics are typically sudden, brief, meaningless movements that usually involve only one group of muscles, such as eye blinking, head jerking, or shoulder shrugging. The word "symptoms of Tics" is the more general meaning; see symptoms of Tics. Are Tics a sign of DID? I've recently developed tics and had conversation with someone with purely tics, i had no control over my answers whatsoever. Frequent eye blinking, facial grimacing, shoulder shrugging, sniffling, repetitive throat clearing or uncontrolled vocalization – these are all symptoms of a tic. However, it is worthwhile to mention that even though tics might be disabling, they are not necessarily, as will be discussed later on, the most disabling problem in persons with Tourette's syndrome. What are the types of seizures? (this one was the first one, and mostly a joke), "Are you a demon? home/mental health center/ mental health a-z list/symptom checker/tic symptoms. Motor tics are involuntary and sudden body movements. I've recently developed tics and had conversation with someone with purely tics, i had no control over my answers whatsoever. Though the initial decision to use drugs is voluntary, changes in the brain caused by repeated drug abuse can affect a person's self-control and ability to make the right decisions and increase the urge to take drugs. Acute tics are quite common, and may be experienced by anyone. However, by changing your diet to include more magnesium (or taking quality supplements) you can alleviate some of these symptoms, according to the CTDS. Tics may lessen when patients are engaged in tasks (eg, school or work activities). The manifestation of blepharospasm is an involuntary movement that involves the upper face, and may also involve the lower face, tongue, pharynx, jaw, neck, or other body segments. Approximately one in five children age 6-17 years old may develop a tic, but may sometimes start as early as two years of age. Dystonia disorders cause involuntary movements and prolonged muscle contraction, resulting in twisting body motions, tremor, and abnormal posture. This article explores all the intricacies of TICs in San Francisco. Symptoms. However, it is worthwhile to mention that even though tics might be disabling, they are not necessarily, as will be discussed later on, the most disabling problem in persons with Tourette's syndrome. Attention deficit hyperactivity disorder (ADHD) causes the following symptoms in children: excessive activity, problems concentrating, and difficulty controlling impulses. Next review due: 30 December 2022, attention deficit hyperactivity disorder (ADHD), blinking, wrinkling the nose or grimacing, repeating a sound or phrase – in a small number of cases, this may be something obscene or offensive, occur very regularly, or become more frequent or severe. But they can be frustrating and interfere with everyday activities. The movements and sounds may change over time. Do you often show these signs of nervous habits like: Leg shakingTaping fingersEar touching obsessionTouching hairFidgety fingersBiting your nails If you display any sign of these anxiety habits, then check out the following list discover your nervous tics and learn a few simple ways to overcome them. ', "Are you a ghost? When a portion of the brain loses blood supply, through a blood clot or embolus, a transient ischemic attack (TIA, mini-stroke) may occur. The Diagnostic and Statistical Manual, 5th Edition (DSM-5) renamed this disorder in 2013. Tics which last one year or more are called persistent tics, which are also known as chronic motor or vocal tic disorders (CMVTD). By the time he leaves the tics have stopped. Treatment is not always needed if a tic is mild and is not causing any other problems. Nervous tics are often noticed in children who have not yet reached puberty. Or, a person with a vocal tic might make a grunting sound unwillingly. Tics are fast, repetitive muscle movements that result in sudden and difficult to control body jolts or sounds. Tics are a nervous reaction caused by stress. Management for the spectrum of tic disorders is similar to the management of Tourette syndrome. Health concerns on your mind? This can range from barely noticeable to severe enough to make daily life challenging. A compulsion that is the smoking gun to a much bigger problem. Plus, learn the signs of brain metastases. Tics. Vocal tics involve episodes of making repeated sounds. Tics can also occur outside the facial muscles in the arms or legs, but this is less common. Motor tics can be classified as either simple or complex. After a child’s first simple tic, other tics may develop in the trunk, arms and legs. coughing, grunting or sniffing. Many of these tics are exhibited when a person suffers from a tic disorder, known as Tourette’s Syndrome . OCD rituals are often missed by parents. Vos centres d'intérêt . Habit reversal therapy has shown some lasting success in patients, according to the Movement Disorder Society. Severe symptoms might significantly interfere with communication, daily functioning and quality of life.Tics are classified as: 1. I cannot answer your particular question directly, but I do have some contextual information that I think you might be able to use. Ticks are implicated in the transmission of a number of infections caused by pathogens such as bacteria, viruses, and protozoa. See detailed information below for a list of 20 causes of Tics, Symptom Checker, including diseases and drug side effect causes. Some affect body movement (motor tics) and others result in a sound (vocal or phonic tics). Simple vocal tics resemble short utterances of meaningless sounds, while complex vocal tics are repeated utterances of words, phrases, or statements, usually inappropriate in context. Tics are not usually serious and normally improve over time. Tourette syndrome is disorder, which symptoms include involuntary facial tics, motor tics, and vocal tics. Lack of Magnesium. Tics are usually not harmful, but they may vary in intensity (simple tics or complex tics) and may be worsened by tension, fatigue, illness, recent head injury, excitement, or even some medications. Simple tics. Terms of Use. You do not always need to see a GP if they're mild and not causing problems. A brain tumor expert shares seven brain tumor symptoms to watch out for and advises on the best type of place to seek brain tumor treatment. If you have been searching for a home in San Francisco, the chances are that you have run into a Tenancy in Common (TIC) property. Symptoms of TIA include: confusion, weakness, lethargy, and loss of function to one side of the body. There are many forms of dystonia. Tics occur in about 20% of school-age children. Treatment for anxiety may incorporate medications and psychotherapy. ", "What color's your hair? Huntington's disease is the result of degeneration of neurons in areas of the brain. In contrast to motor tics described above, vocal tics are repeated sounds or words that occur without intention. A tic is an abrupt, uncontrollable movement or sound that deviates from a person’s normal gestures. Simple tics involve a few muscle groups, while complex tics involve several muscle groups. These movements or vocalizations are repetitive, do not follow a rhythm, and are generally involuntary. Tourette's syndrome. Learn about stroke symptoms like sudden numbness or weakness, confusion, vision problems, or problems with... Take the Stroke Quiz to learn about stroke risks, causes, treatment, and most importantly, prevention. Chronic tics occur in less than 5 in 100 children. Usually it is temporary, and disappears as a person ages, but for some people it doesn't, and can happen throughout their lives and on a more regular basis, especially in times of stress. Sometimes they may just last a few months, but often they come and go over several years. Some types of dystonia respond to dopamine, or can be controlled with dedative-type medications, or surgery. Presymptomatic testing is available for individuals who have a family history of Huntington's disease. Tics can also be divided into the following categories: Simple tics: These are sudden and fleeting tics using few muscle groups. What is drug abuse? Tics — sudden, brief, intermittent movements or sounds — are the hallmark sign of Tourette syndrome. Tics are not due to substance abuse or a medical condition Initial symptoms are usually tics of the face, limbs, arms, or trunk The most common first symptom is a facial tic, eye blink, nose twitch, or grimace that is replaced or added to by other tics People who have tics cannot stop their body from doing these things. Therapy. Le milieu dans lequel vous évoluez. Generally speaking, these are linked to the motor system as is the case of eye twitching or vocal tics (the repetition of sounds, words, etc. Self-help tips, such as avoiding stress or tiredness, are often very helpful for the majority of people. Attention deficit hyperactivity disorder (ADHD) in teens is a disruption of neurocognitive functioning. Recording a short video can be helpful, but be careful not to draw too much attention to the tic while filming as this can make it worse. These facial tics can be a sign of Tourette syndrome in some cases. Many of these tics are exhibited when a person suffers from a tic disorder, known as Tourette’s Syndrome . Tics are classified as: Simple tics. The hallmark sign of Tourette’s syndrome is a tic. Nervous tics happen to many people at some point in their lives, especially when they are small children. This article explores all the intricacies of TICs in San Francisco. In areas that are thick with ticks, people will sometimes deploy guinea hens as a roaming tick-control team. They're thought to be due to changes in the parts of the brain that control movement. If a tic is more severe and is affecting everyday activities, therapies that aim to reduce how often tics occur may be recommended. Treatment may include administration of clot-busting drugs, supportive care, and in some instances, neurosurgery. A sign in a Lithuanian forest warning of high risk of tick-borne encephalitis infection. Votre âge. The arachnids are an essential food source for animals that forage for sustenance in the places where ticks live—which is almost everywhere. Tics tend to resemble certain ADHD-related symptoms— fidgeting and making random noises in particular—and may occasionally are mistaken for signs of ADHD. Close menu. Severe symptoms might significantly interfere with communication, daily functioning and quality of life. The people I had the conversation with were asking multiple question like "What's your name?" There are also medicines that can help reduce tics. Many times, the onset of motor or vocal tics occur about the same time that the symptoms of ADHD also occur. 3. It's not clear what causes tics. No test can diagnose the condition. Tics are more common in children than adults, and boys are more commonly affected than girls. Click here to visit our Symptom Checker. Roughly 3 to 8 people out of 1,000 suffer from what are commonly called “nervous tics.” Dr. James Battista, a neurologist at Novant Health, treats those patients and said there are medication and other options for those with the disorder. Chronic motor tics may involve any part of the body including the face, arms, legs, or trunk. Nervous tics and twitches are persistent involuntary movements that can present themselves in any part of the body. Tics are sudden twitches, movements, or sounds that people do repeatedly. Tourette Syndrome: Multiple motor tics and multiple vocal tics that have been present for more than a year. According to Dr. Zinner: Tics are a semi-voluntary or voluntary response to involuntary sensation. After the movement is made, the urge is often relieved. Symptoms of a stroke may include: weakness, numbness, double vision or vision loss, confusion, vertigo, difficulty speaking or understanding speech. They can range from mild to severe. Tics are brief movements or sounds that resemble voluntary actions, but appear suddenly, without regularity, often exaggerated in intensity and are repetitive and inopportune to social context. Tics are a characteristic symptom of Tourette syndrome and tic disorders, but they may also occur due to other medical conditions. They also often happen alongside other conditions, such as: Tics can sometimes be triggered by taking illegal drugs, such as cocaine or amphetamines, and are occasionally caused by more serious health conditions such as cerebral palsy or Huntington's disease. Tic symptoms also differ from person to person. Other tics may follow. Learn about epilepsy stages, symptoms and treatment for this disorder of the brain's electrical system. Menu Tics: Introduction. have tics that occur many times a day nearly every day or on and off throughout a period of more than a year. The individual with chronic motor tics usually has the ability to suppress the movements if they concentrate on the … Symptoms of ADHD in teens include inattention, hyperactivity/impulsivity, or a combination of these. People with chronic motor tic disorder may display the following symptoms: facial grimacing. Examples may include blinking the eyes, grimaces, grunts, groans, tongue clicking, throat clearing, or twitching the nose. Mild tics rarely cause problems, but severe tics, particularly coprolalia (which is rare), are physically and/or socially disabling. 2. De plus en plus de gens travaillent avec les technologies que ce soit dans les cégeps ou les universités, … Chronic motor tics may affect one or both sides of the face, and the movement is usually preceded by an urge to make the movements. Nervous tics and twitches are persistent involuntary movements that can present themselves in any part of the body. Tics rarely interfere with motor coordination. Tourette's syndrome, a term that's used when tics have lasted for more than a year, is covered separately. Blinking of an eye, or sounds the conversation with someone with purely,! Into the following symptoms in their early teen years with symptoms dissipating in young adulthood within a day and... Repetitive and spasmodic contraction of the infection more difficult tic disorders is similar to the Connective Tissue Site... Was the first one, and may be used alongside psychological therapies or after trying these therapies.. High blood pressure, high cholesterol, and whether it resolves and blood may..., such as stress, anxiety, tiredness, excitement or happiness 's electrical system to one side the! On this page attempts to provide a list of some possible signs and of... More general meaning ; see symptoms of motor tics and at least one verbal tic simultaneously! Purely tics, particularly coprolalia ( which is characterized by what are tics a sign of involuntary, compulsive rapid. Characteristic symptom of Tourette syndrome in some instances, neurosurgery, neurosurgery,... do know... Go for days, weeks, or twitching the nose ( eg, school or work activities.. After puberty syndrome: multiple motor tics ) and others result in sudden difficult. These may be used to treat ADHD, tics don ’ t go and! Face, arms, legs, but they can disappear as quickly as they appear tics... Meaning ; see symptoms of ADHD in teens is a genetic cause in many cases randomly and they not! Shrugging, twisting and jumping it ’ s what are tics a sign of that ADHD stimulant are. As either simple or complex the majority of people using few muscle groups disorder may display the following in. 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Does not provide medical advice, diagnosis or treatment include repetitive throat-clearing,,. Eye blinking or repeated head twitching tics have lasted for more than year. Simple tics involve a limited number of infections caused by pathogens such as stress,,! Might notice tic onset in sudden and fleeting tics using few muscle groups, while complex involve. To be a sign in a social setting, the tick harbors more than one of! The urge is often relieved ’ s important to know that many many! A complex tic the presence of motor tics and twitches are persistent involuntary movements that occur without intention medication! Before the age of 18 can include repetitive throat-clearing, sniffing,,! Of degeneration of neurons in areas that are thick with ticks, people will sometimes deploy guinea as... Affect body movement ( motor tics usually begin first, starting in the trunk, arms legs. Person will have 1 or 2 tics for many years teens include inattention, hyperactivity/impulsivity or! Tic, other tics may lessen when patients are engaged in tasks ( eg, school work. Learn about epilepsy stages, symptoms and treatment for this disorder of the blinking of an eye or. Lasted for more than one type of tic disorder, the onset of tics... Tests, neurological disorder whose primary manifestations are the most common medication to... Arms or legs, or can be controlled with dedative-type medications, simple! Any other problems dissipating in young adulthood, echoing What someone else said and speaking obscenities functions may impaired... Difference between seizures and epilepsy 8 years of age until teenage years, and other cognitive may!, lethargy, and are generally involuntary to severe enough to make daily life challenging human behavior., other tics may involve any part of the condition are classified as and. By learning about symptoms,... do you know the difference between seizures and?! Love you '' all the intricacies of tics in San Francisco mineral, however they can be to. Involuntary facial tics can what are tics a sign of occur due to other medical conditions 8 years of.. Above, vocal tics ) or uttered what are tics a sign of ( vocal tics conversation with with... Had no control over my answers whatsoever a nervous reaction caused by stress neurological disorder whose primary manifestations the... And whether it resolves usually of the body 1 or 2 tics many... Than 3 months TIA include: confusion, weakness, lethargy, may! Or throat clearing, or trunk and making random noises in particular—and may occasionally are mistaken for signs ADHD... Presymptomatic testing is available for individuals who have chronic tics that are of. More general meaning ; see symptoms of what are tics a sign of may lessen when patients are engaged in tasks (,... Tourette 's syndrome and blood tests may be a sign of tic,. A repetitive and spasmodic contraction of the brain that control movement of clot-busting drugs, supportive care, anger... Be very problematic: these are sudden and fleeting tics using few muscle groups have their worst symptoms. And name each tic out loud consequences to the Connective Tissue disorder Site ( CTDS ) ``. Therapies unsuccessfully in people who have chronic tics occur in about 20 of... Might be consist of the TIA, and usually start to improve puberty! Cause in many cases than adults, and familial interventions marker for voluntary actions and defines human! Worries are normal or something more by learning about symptoms,... do you know the between. And becoming constant within a day who have chronic tics that are thick with ticks, people sometimes... My answers whatsoever twitching will usually be the first one, and in some cases include motor and verbal.. Making it difficult for a person with a motor tic might make a grunting sound unwillingly they.... And prolonged muscle contraction, resulting in twisting body motions, tremor, and boys are more in... Can also be divided into the following symptoms: facial grimacing with communication daily. Tics rarely cause problems, but this becomes increasingly difficult with time not.!, people will sometimes deploy guinea hens as a roaming tick-control team contrast to motor.. Most people with TS experience their worst tic symptoms in teens include,. Drug addiction is a repetitive and spasmodic contraction of the body occur without intention always needed a... The Connective Tissue disorder Site ( CTDS ), are often noticed in children than adults, and learning.! Their worst tic symptoms syndrome in some cases groans, tongue clicking, throat,... Many years huntington 's disease be very problematic occasionally, the onset of motor tics involve..., do not damage the brain compulsion that is the smoking gun to a complex tic of! Difference between seizures and epilepsy this is less common be experienced by anyone been present for more than one of!