Gratitude beats fear

Living with an anxiety disorder: control, control, control

Panic for no reason, whether in the subway or on the couch. Every sixth adult in Germany suffers from anxiety disorders. Also our author.

Diagnosis: generalized anxiety disorder. That means that fear can appear in almost any situation Photo: Karsten Thielker

BERLIN / GEORGSMARIENHÜTTEtaz | Sweat always stinks. I'm wedged between people with headphones, people reading books, people talking. And feel alone While everyone else is simply riding the subway, my brain fires images and sentences into my consciousness: a doctor poking around in a patient's open stomach. A bungee jump from a high cliff. Men who kick someone in the head who is lying on the ground. My jaw muscles are twitching.

Alexanderplatz stop. Doors open, even more people in. Stay back, please, that is, you can't escape for two more minutes. The images in my head that make my body pretend I'm in danger. Klosterstrasse. I wipe my wet hands on my pants, cool my neck with them. My ears are racing, I'm floating. People are already looking. Or?

One more stop and then I'll be on the other side of the Spree. I could walk from there. I pinch my arm and feel I'm still there. Märkisches Museum. The subway slows down, the subway stops, I stumble out and walk blindly towards the exit, walk, walk, walk until the world is composed of many pixels into one picture again. That I'm late for work - it doesn't matter. I've had the hardest part of the day behind me.

Around every sixth adult in Germany suffers from anxiety disorders. I am one of them. The international disease catalog ICD lists our diagnoses under F40-F48: neurotic, stress and somatoform disorders. The findings are called: agoraphobia; social phobias; specific (isolated) phobias; other phobic disorders; Panic disorder and so on. I have generalized anxiety disorder. The fear is not tied to a trigger, it gets me anytime and anywhere.

Wimps. Don't they have any real worries?

Anxiety disorders are the most common mental illness, ahead of depression and alcoholism. However, those affected do not like to talk about it. Perhaps because being afraid is irrational and unproductive in our secure and efficient society. What kind of people are they who panic for no reason, in the subway, talking to friends, at home on the couch? Wimps. Wealthy children with fears of prosperity. Don't they have any real worries?

Sentences that I heard before I wrote: "If your future employer reads this, you won't get a job." "The whole world doesn't have to know about your problems." . "

One need not be surprised that anxiety disorders are stigmatized.

Nicholas Müller doesn't care anymore. Until two years ago he was the singer in the band Jupiter Jones, which had its breakthrough with the song "Still". Afterwards sold out concerts, gold record, platinum record, echo. Suddenly Müller got out. “I've been walking through world history with a damned anxiety disorder for several years now,” he wrote in an open letter to his fans, and: “It was never really clear how and how long I could be resilient, which in turn became a great burden for everyone involved. I am now taking care of my recovery. "

In the meantime he has a new band, is an ambassador for the German fear self-help and says he is healthy. How to get there? I want to get to know him. He says yes.

Meeting in the "Lala-Ranch"

We meet in the Magdalenen Clinic near Osnabrück, formerly a nurses' home, today a clinic for mental and psychosomatic illnesses. “Lala-Ranch”, says Müller, “but that is a kind of humor that you can only allow yourself to have if you are concerned.” He wears a green and blue checked flannel shirt and has a comb in his breast pocket. His hair is gelled back.

Nicholas Müller likes to talk, but that's why we meet. He spent ten weeks here, when he was still singing with Jupiter Jones. The clinic, six floors, balconies made of exposed aggregate concrete, a parking lot in front, forest on the right, a construction crane on the left, is not a nice place. Nicholas Müller says: "The cornerstone for everything that concerns my recovery has been laid here."

His treatment plan: three one-on-one interviews per week, in between art therapy, body and emotion training, stress management group, solution-oriented group. This time was incredibly exhausting, he says. "In between I thought: I'm worse now than I was before. But if you feel comfortable in psychotherapy, then something goes wrong. "

The clinic is on the Harderberg. Patients call it Magic Mountain because they are protected here. Before the life where most people don't understand what's wrong with them. But “there is no fairy dust here,” says Nicholas Müller. No medicine that cures everything. And at some point you have to go back down.

Nicholas Müller thinks it's great that I write about my fear. “Actually, that shouldn't be any more unusual than a cold,” he says. “The probability that we know someone who has an anxiety disorder is 100 percent. Or you just know incredibly few people. "

I am not ashamed

I am writing this text without a pseudonym because I am not ashamed of something that I did not choose. A year ago that would have been unthinkable - or a lie.

When I start working as an editor, I am regularly in charge of the service and have to be present at the conference to present the topics. Others have stage fright, I'm afraid I might faint, slip off my chair, and then wake up again, worried faces overhead, then whispering in the stairwell: What happened to me? the Come on? While the others fight to get their topic on the prominent page 3, I sit on my wet hands to keep myself from running away.

After a year I can't do it anymore. Panic hits me with machine gun bullets: rattattat, hot, rattattat, cold, rattattat, dizziness, get out of here, out, fast. I fake a coughing fit and run out of the room, miss my mission, ashamed. I need help. Or I have to quit.

What happens in the body during a panic attack: The cerebral cortex forwards stimuli to the limbic system, which is responsible for feelings. Parts of the limbic system, the hippocampus and the amygdala, activate the hypothalamus, which via nerve pathways in the adrenal medulla ensures that stress hormones are released: adrenaline, noradrenaline, cortisol and cortisone. The heart beats faster, blood pressure rises, breathing accelerates, blood vessels constrict, digestion shuts down. Cold sweat.

The alarm reaction is followed by the adaptation reaction, in which the parasympathetic nervous system breaks down the stress hormones in order to bring the body back into balance. The digestion goes up, which can cause nausea, nausea and diarrhea. In the third phase, the body recovers. If the stressful situation persists, exhaustion can become chronic. This leads to deep tiredness, sometimes even to depression.

Result: severe anxiety disorder

In November 2009 I will start behavior therapy. Playing through situations and practicing dealing with fear should act particularly quickly and have the highest success rate, according to studies. The first few hours are for rehearsals. The therapist looks like Hannibal Lector and recommends the book “Finally free from fear”, with which I should practice between our appointments. There is an anxiety test in it, in which I am supposed to answer questions. Do you feel inferior because of your fear? Are you afraid of going crazy? I give one point, times five. Result: severe anxiety disorder.

In one session I should describe my daily routine in minute detail, from getting up to being afraid. Then the therapist reads out what he has written down: go to the kitchen. Make coffee. Attract. Go to work. Systematic desensitization is the name of this technique, in which I should imagine the situations so vividly that the same feelings are triggered as in reality. I feel nothing. In the third lesson, the therapist suggests that I tell the editorial team how I am doing. I break off.

Not just because he asks for something unimaginable. But also because it's not enough for me to simulate fear in a room. I want to understand where it comes from.

I am looking for a new therapist, specializing in: psychotherapy based on depth psychology. No more exercises, just talk - about everything that concerns me. I still talk a lot about fear. For example, about getting on the vacation plane and handing over control of my life to the pilot, but the conversations often lead us away from my panic, my sweaty hands. I am drawing a tree. We're talking about my childhood. I draw a diagram with my friends - who is close to me, who is far away? We talk about my worries about the future. I ask myself: Why is it so important what others think of me? What picture do I have of myself? Why is it so important to be in control?

I no longer feel reduced to my fear. And I am learning that there are many causes of an anxiety disorder. Inheritance. Education. A traumatic event. Stress. Drugs. Diseases. Social circumstances. However, several factors must come together.

Faint or panic attack?

Then there was this visit to the doctor, when I was twelve, to take a blood sample. No vein to be seen, well, we'll take it out of our back, stand up, it's quick. I was faster and fell over. A rushing noise in the ears, flickering before the eyes, crazy dreams. Then: disorientation, where am I? Here, a drink of water, legs up. Don't worry, it was only a few seconds.

What scared me most was that I was completely at the mercy of the doctor. Much later, my therapist will suggest that it wasn't a faint, but my first panic attack. But then I don't know yet. And have been constantly afraid of tipping over since the doctor's visit. For presentations. At the school concert on stage. On the plane. In the cinema. In the theater. In conferences. In the subway. In situations from which I cannot escape at any time. At least not without making a fool of myself.

“Fear eats up the resources it can find,” says Nicholas Müller. “It's like Pacman.” We are standing in his former room. Salmon pink sofa and armchair, beige patterned curtains, television, DVD player, refrigerator, cross over bed. Some patients take it off, but not Müller. Although he arrived at the clinic with a fear of God: "I thought that he wanted to punish me."

What else Nicholas Müller is afraid of: frogs, bridges, dying. At first he only panicked at home, on the couch. The stage, on the other hand, was his comfort zone. Strange, he thought, but that's how it is. “And the fear noticed that.” So one day she came to his concert, at some point she was at every performance. His very special groupie.

A little trigger is enough

The therapy works, I feel better. The anxiety attacks are less intense, come less often, sometimes not for weeks. But then a little trigger is enough and I never want to go outside again. When a friend talks about the pain of inserting her IUD, I imagine myself lying in the chair. When the line at a club gets tight, I picture the crowds trampling me down. If someone puts their newborn baby in my arms, I break sweats because I might drop it.

We are extending the therapy from 25 to 50 hours, which will also be over in October 2011. “You can come back in two years,” says the therapist. The break is stipulated by the health insurance company, only then will it cover the costs again. He extends his hand to me for the last time in a long time.

A year and a half later my first book is published, I am supposed to read it in front of an audience and put it on television. I can't sleep all night. What if I pass out on the talk show? I don't want to be the one everyone laughs at on YouTube.

Nicholas Müller takes a pragmatic view of this. The other day he was on “Volle Kanne” on ZDF to talk about his fear story and panicked shortly before the show. He pulled it off anyway. “I'm not in the mood for it,” he says, “but maybe it would really make sense to have a panic attack live during a broadcast. So that the audience can see: This is what it looks like. "

Müller had his first panic attack after the death of his mother. He went to a day clinic for outpatient therapy, took antidepressants, moved back to his father when he was 27, puffed himself to the point of psychosis and at some point just waited for the next panic attack, up to five a day. "But actually the whole day was a single fear." Cardiophobia, fear of cardiac death. Müller knows that his heart is healthy. As healthy as it can be in the body of someone who once weighed over 150 kilos and has smoked for 20 years. Cigarettes lighter than me, though.

"Then I'm dead"

Then there was this panic attack during a session. His therapist asked: "Mr. Müller, what is the worst that can happen to you now?"

"Well, that I'm going to pass over here now."

"And what if you fall over here now?"

"Then I'll probably die."

"What if you die?"

"Then I'm dead."

"Yes that's true. Well, then we can go on now. "

I take lessons from an acting teacher who has eyes like a bird of prey and is so strict that I break sweats. She says, “You can't faint when you're excited. There's way too much adrenaline in your body for that. ”I'm relieved. A reading, a talk show, I'm still alive, I'm so proud.

I am learning to listen to myself. Once I sit in the subway and get a racing heart and wet hands. Great, I think, another panic attack. Then it occurs to me that I was at a party the night before. I have a hangover. And am happy about it. I train to classify what my body is doing. Much that feels like fear is not. I feel ill? Menstrual pain. I break out in a sweat? Midsummer. Everything is normal.

In the spring of 2014 I am going with my parents to the south of France to our campsite, which doesn’t belong to us, but somehow it does because we were there every Whitsun vacation. It's the first vacation together since I grew up. I'm lying in a hammock on the beach and for the first time in a long time I don't feel responsible for anything. I don't even grind my teeth.

I am a machine

When I open the mailbox at home, it's full of mail. Return debits, account not covered. The fear is back. Because I can't get my life under control. Because at 30 I am still dependent on my parents. Because I would have to change a few things in my life and I just can't do that. I am paralyzed for weeks. I keep going to work, I function, I am a machine. Then the fear disappears. I don't feel anything anymore.

That I'm freshly in love right now? No matter. That the sun is shining? No matter. That I will feel better at some point? Locked out. I'm in the wrong movie, in the wrong life. I'm not real

My therapist will later call this a "depressive episode"; it is the first of three, always a few weeks apart. He explains to me that my body protects me when the fears get too big. Like a power failure: overheating, zack, dark.

People who notice this often mistake it for sadness because they know and understand it. Don't let yourself get down, come out of your hole, they say then. But depression cannot be controlled. Nicholas Müller knows that too. “It's really cynical to say: 'Just stay positive,'” he says, “when I'm surrounded by a great, almighty blackness.”

There is too much going on in my head

In November I book a week's vacation in a monastery near Hanover. Without a cell phone, without a laptop, just with a suitcase full of books. Already on the train I start crying, the tension falls away from me.There is a large garden, single rooms, a communal kitchen for guests and a half-hour group meditation every morning at eight.

Of course, I'm afraid of meditating. What if I have to leave the room and disturb the others? What if I don't manage to let the thoughts go by, but am at the mercy of them? There is too much going on in my head. While taking a nap, I dream of embarrassing myself. During a classical concert I want to leave early and I can't get the lid of a huge thermos flask shut. Loud music is booming from my backpack.

The next morning, when I am sitting on a small wooden stool wrapped in a blanket, there is a crack in my neck, feet, and tailbone. I have a body. Somehow I had forgotten that lately.

After a few days, the tinnitus will decrease. I look forward to meditation every morning and I actually manage not to think. I wipe my hard drive and finally have space again. Sometimes I hear my cell phone ringing phantom.

I am weak. Selfish bastard

January 7th, 2015. I'm free, my friend is visiting. When I get out of the shower, the TV is on. Two men are the editor of the French newspaper Charlie Hebdo stormed and killed eleven people. We find a video on the Internet that will later no longer be shown in full: While escaping, the perpetrators shoot a policeman who is wounded on the ground. Right on his head. I'm sitting on the bed crying. I usually can't even watch violence in movies, but this is real. We go out, the sun is shining, people are laughing. I want to hold on to the air so I don't fall over.

I have to go to work the next day. I don't want to, I'll drive anyway. After all, the colleagues come too. I can barely breathe in the tram, when I hear a loud noise my heart gallops. In the office, I sit with my back to the door and turn around every time I hear footsteps. I duck my head. After a few hours, it feels like my earlobes have grown together with my shoulders. The colleagues find it pointless that a police car is parked in front of the taz. I feel safer - and bad. You are strong, I'm just happy when nothing happens to me. Selfish bastard, I think.

I'm meeting with a friend who is a psychotherapist in training. She finds me pretty reflective. “There aren't many people who can accept their fear,” she says. "Then why is it still there?" I ask. “Because you can only stand the fear. But accepting means accepting them. Even more: you have to learn to love them. "

To love fear, that's crazy.

"That is exactly your problem," says the friend. “Fear belongs to you. You've heard of that before, haven't you? "

Clear. Everyone has. But I don't want fear to be a part of me. I want to get rid of them. Can I actually learn to love fear? And how?

I feel grateful

I start therapy again, over three years after my last one. The therapist is the same as then, but the sessions are different. We don't start with my fear, but with my life. We talk about my job, my friendships, my relationship. Fear is no longer the main issue, we just keep coming back to it.

And I realize that it has a purpose: it indicates to me when something goes wrong, when something becomes too much for me. Others get stomach problems or headaches, I am afraid. But at least someone will let me know if there is a problem that I don't notice myself. I feel grateful. I've never been closer to love.

Just why didn't I think of it earlier? The knowledge is not that ingenious. "If you stand on the wrong platform, you can wait a long time for the train," says the therapist. "Sometimes you just have to change your perspective."

I am reading a book by Eckhart Tolle, who himself suffered from fear and depression for years and who became a spiritual teacher. He thinks we should stop identifying with our minds. It revolves exclusively around the past or the future. He writes: “The psychologically justified fear [...] always has to do with something that is happening could, not with something that is happening. You are in the here and now while your mind is in the future. This creates a void that fills with fear and worry. "

The first step towards liberation from the mind is therefore to observe one's thoughts without analyzing or evaluating them. And to ask yourself: is there a problem right now? Not tomorrow or in ten minutes, but now?

The next time I'm on the subway, I'll do just that. I watch my thoughts. In my head there is a regular table full of retirees:

"Phew, hot here."

“And bad air! If it continues like this, your circulation will definitely be exhausted. "

“Why does the train stop? There's no stop here. "

"Imagine what's going on here, if you just throw up on the floor, that would be something."

I giggle, let her talk and look out the window. Is there a problem right now? Nope.

Everything at the beginning again?

I will continue to do well, also in the following months. But what if fear returns? Is everything back to the beginning? “If the fear comes back on difficult days, then it has to stop. But then it goes again. She never left before. And I think that's the goal, ”says Nicholas Müller, who calls himself healthy since people have been surprised again when he shows signs of panic.

Then a friend invites me to his wedding in Lebanon. I learn by heart what is on the side of the Foreign Office, "partial travel warning", "increased risk of kidnapping for foreigners", read the news and trick myself. I chat with the future groom and quickly say yes to him. I can't go back now.

On July 1st, I'm flying to Beirut, with a stopover in Istanbul, three days after the attack on the airport. We drive to Baalbek on the Syrian border, drunk in the car and in a motorboat on the open sea, we hear gunshots, wait in front of a tank for the taxi. I consider abseiling off a 38-meter-high rock and then I don't do it. On the return flight, for the first time on the plane, I am relaxed enough to be able to sleep.

I wasn't afraid for a single second in the ten days.