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Many mental disorders major depressive disorder, bipolar and/or schizophrenia borderline require and or recommend the use of medications.

Is tourettes considered less severe such that you may go through periods of not needing or needing medication?

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The severity of Tourette's varies from person to person and can range from mild, requiring no treatment, to severe, requiring medication and/or behavioral therapy. The tics that are the hallmark of Tourette's also change over time in frequency, type, and severity, so it is possible that someone with Tourette's might need medication at some times and not others. In fact, changes in the tics is a required component of a Tourette's diagnosis. For severe tics, there is also deep brain stimulation (DBS), which involves implanting a device in the brain to deliver targeted electrical stimulation to movement centers. However, DBS is still in early experimental stages so its safety and effectiveness aren't known at this time.

https://www.mayoclinic.org/diseases-conditions/tourette-syndrome/diagnosis-treatment/drc-20350470

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