"Beautiful" and "truly heartwarming" footage of Lewis Capaldi fans finishing the chorus of one of his songs while he experienced Tourette syndrome tics on stage is being shared on social media after his live show in Germany.
Capaldi was singing Someone You Loved when his shoulder started twitching.
He turned away from the microphone, with fans carrying on the song for him while he took a step back.
Footage of the performance was shared on social media, along with praise for Capaldi and his fans.
"It's beautiful to see fans see him experience his episodes and, instead of being mean or selfish about it, they sang until he was gained back control," one Twitter user said.
"For someone who struggles with Tourette [syndrome], this means the world," another said.
"The way his fans at his shows react if he's unable to finish a song is truly heart warming and gives me hope in this bleak world," another said.
Capaldi re-shared a fan's video of the moment on his Instagram account, which has 5.9 million followers.
When was Lewis Capaldi diagnosed with Tourette syndrome?
Capaldi told fans he had Tourette syndrome in an Instagram live video in September 2022, after being diagnosed several months earlier.
Appearing on Jonathon Ross's comedy chat show, the singer said he thought he had a degenerative disease because of his shoulder twitches.
"So to be told it was in fact that I have Tourette's was, as you can imagine, quite the relief," he said.
"It's fine … everything works."
In a BBC article last year, he was quoted saying said he had tried using Botox injections to try to reduce his tics.
"I do the shoulder twitch quite a lot," he said.
"And you see underneath every TikTok [video], people are like, 'Why is he twitching?', which is fine — curiosity is fine."
What is Tourette syndrome?
It's a neurological disorder where people have repetitive and involuntary movements and vocalisations, which are better known as "tics".
Tourette Syndrome Association of Australia (TSAA) president Mandy Maysey said tics were "as unique as the human brain and vary from person to person".
"Lewis ticcing on stage might be something people are unused to but for Lewis it's just like hiccups or blinking," she said.
There's a vast range of ways tics can show up, with the TSAA breaking them down into two main categories: simple and complex.
Here's a few examples of the vocal and motor tics in both categories:
Simple
- Motor: eye blinking, head jerking, shoulder shrugging, facial grimacing, nose twitching
- Vocal: throat clearing, barking noises, squealing, grunting, gulping, sniffing, tongue clicking
Complex
- Motor: jumping, touching other people and things, twirling about, repetitive movements of the torso or limbs, pulling at clothing and self-injurious actions, including hitting or biting oneself
- Vocal: uttering words or phrases, coprolalia (the involuntary utterance of inappropriate or obscene words), echoalia (repeating a sound, word or phrase just heard) or palilalia(repeating one's own words)
However, while these tics can be disruptive, the association says people with Tourette syndrome can lead normal lives and have completely normal life spans.
TSAA says symptoms usually begin between the ages of two and 21.
Capaldi was diagnosed in his mid 20s, but said he's "always had it, apparently".
"Typically tics increase as a result of tension or stress and decrease with relaxation or concentration on an absorbing task," the TSAA says.
"Symptoms have long been misconstrued as a sign of behavioural abnormality or 'nervous habits', which they are not."
It's also something that varies from person to person, so some people might have more severe symptoms than others.
Is there a cure?
No.
However, there are some medications that can help people manage their symptoms.
And, while Tourette syndrome is not a psychiatric disorder, some people find targeted behavioural therapy helpful.
Can people with Tourette syndrome control their tics?
Some can.
However, it's a skill the TSAA says inhibiting tics for even a few minutes takes "considerable energy and concentration".
And it points out that's only delaying the movement or vocalisation, not completely suppressing it.
"...the control which can be exerted, from seconds to hours at a time, only delays more severe outbursts of symptoms," the TSAA website says. "Tics are experienced as a build up of tension, are irresistible and eventually must be performed."
Does it get worse over time?
It's not a degenerative disease, meaning it's not an illness where the affected organ — in this case, the brain — deteriorates over time.
The TSAA describes a fluidity to the onset of symptoms, even with the use of medication.
"Symptoms may be reduced, sometimes substantially, but they will continue to wax and wane, and they will commonly appear more pronounced during stressful periods," the TSAA website says. "Some people experience periods where the symptoms seem to disappear, others experience a marked improvement in their late teens or early 20s."
Rule of thumb: ignore tics where possible
"Acceptance and understanding is all people with Tourette syndrome really want from the public," Ms Maysey said.
"The way those around them react to tics has a massive impact on their mental health and wellbeing.
"It was a wonderfully supportive reaction from Lewis's fans.
"The rule of thumb is to ignore tics where possible but with something like this, I'm sure Lewis was exceptionally grateful."
