Whether you suffer from panic attacks or general anxiety, Klaus Bernhardt’s proven anxiety cure will help you lead a calmer, happier life fast.
Drawing on the very latest therapies and research in neuroscience The Anxiety Cure explains how to master tried-and-tested mind training and pattern breaker techniques. Discover:
Klaus Bernhardt’s practical and easy-to-action book is your chance to move from a place of worry and uncertainty to confidence and control, all in just a few weeks!
KLAUS BERNHARDT worked for years as a science and medical journalist before two of his friends started to suffer from anxiety and asked him for help. He immersed himself in anxiety research, trained to become a complementary psychotherapist and developed his own treatment methods with staggering success rates. Klaus Bernhardt runs a psychotherapy clinic in Berlin that specialises in treating anxiety disorders, and is a member of the Akademie für neurowissenschaftliches Bildungsmanagement (AFNB) and the Initiative Neues Lernen e.V. (INL).
www.the-anxiety-cure.com
IN THE UK, more than 11 million people have been diagnosed with anxiety disorders. Almost two million of them suffer from constantly recurring panic attacks. More than anything else, they would love to live a normal life again as soon as possible: a life free from fear of fear.
Many years ago my experiences in the field led me to decide to do everything in my power to help people suffering from panic attacks faster and more comprehensively than previously possible. In our Berlin clinic, where we specialise in the treatment of anxiety dis-orders, my wife and I use a completely new methodology for treating anxiety, one derived from modern neuroscience. Our methods have little in common with the usual treatments anxiety patients have come to expect. At our clinic there is no exposure therapy, no breathing exercises, no progressive muscle relaxation and no digging around in childhood memories. With very few exceptions we also strictly reject the use of antidepressants and tranquillisers. When we are asked just why our form of therapy is so radically different from that of most of our colleagues, I like to quote Albert Einstein: ‘The definition of insanity is doing the same thing over and over and expecting different results.’
Regrettably, this clever quote perfectly describes much of the manner in which anxiety patients are currently treated. The same therapies are turned to again and again, despite their painful slowness in producing results – if they even help at all. At the same time, it appears that ground-breaking developments in neuroscience are being ignored. Instead of taking these new findings on board to finally establish better therapeutic standards, antidepressants continue to be prescribed and methods are still being used that in many cases have barely evolved in decades. Yet in the last 20 years, our understanding of the brain and how it works has been transformed. Thanks to imaging technology we can watch our grey cells think. We can test which thoughts and mental exercises produce which reactions, and thanks to the Internet, experts can keep in contact and up to date worldwide.
Thanks to these developments, we now have a very good understanding of what has to happen in the brain to make panic attacks possible, and we also know what can be to done to stop anxiety in its tracks. All of the techniques described in this book have undergone years of testing and refinement in our clinic. You may find it hard to imagine, but we are now at a point where 70 per cent of our patients need fewer than six sessions to be completely freed of their panic attacks.
Of course, a book can and should never replace an experienced doctor or therapist. But this book can still help you understand what really causes your panic attacks. You will also get to know a series of exciting and simple to learn techniques that have already helped many of our patients to live a life free from anxiety and panic.
I sincerely hope that the following chapters will help you to achieve that life as quickly as possible.
Yours
Klaus Bernhardt
Science and medical journalist, registered alternative psychotherapist and member of the Academy for Neuroscientific Education Management AFNB
ANXIETY IN GENERAL – and that includes panic attacks – is, first of all, our body’s perfectly healthy and appropriate reaction to danger. For fear has only one job: to protect us. For example, if a hungry lion were to leap out of the brush directly in front of you, your body would immediately start producing adrenaline, your heart rate would go through the roof and within milliseconds you would decide whether you were prepared to fight – ill-advised, perhaps, with a lion sizing up its dinner – or flee. This is a completely normal and necessary reaction, which ensures our survival.
But what happens when there is no lion waiting to pounce? When your heart starts racing seemingly for no reason at all, when you feel like you are losing control or even going crazy, when for no apparent reason you suffer symptoms including dizziness, numbness, shortness of breath and nausea?
What exactly is happening in your brain, and why is it reacting the way it is? Well, there are basically four different causes, and I will devote a chapter to each cause. You can help yourself to recover more quickly by reading these chapters without skipping any of them, because panic attacks often have more than just the one cause. Only once you know all the causes, and are able to use the appropriate technique to deal with each one, will you be able to take charge of your anxiety quickly and sustainably.
Here’s a short overview of the four most common causes of panic attacks.
If there is one thing that I have learned from my years of clinical work, it is that ignoring warning signs is usually what triggers the initial occurrence of panic attacks.
But what exactly are these warning signs? Mostly, it starts when you have ignored your gut for far too long. Gut instinct is the voice of your unconscious. And the more often you use your conscious brain to come up with yet another argument as to why you can’t listen to your gut, the louder your discontented unconscious will make itself heard. With the help of an eclectic variety of warning signals, which can be both mental and physical in nature, your unconscious seeks to get you to change something about your life that has long since stopped doing you good.
The mental warning signs include sudden forgetfulness and difficulty concentrating, lack of motivation, exhaustion and feeling sad for no apparent reason. A panic attack, incidentally, is the final stage and hence the strongest of the mental warning signs.
Among the physical warning signs are stomach and digestion problems, sudden problems with vision, rashes and other skin disorders, involuntary muscle twitching (tics), as well as increased urinary frequency. Even slipped discs and shingles have been shown to be often psychosomatic in nature, and therefore count among these warning signs. How this all connects together, and what you can do about it to save your psyche all this unpleasantness, is dealt with in detail in Chapter 2.
There are certain medicines that have been proven to trigger panic attacks. Alongside antipsychotics, which are prescribed, for example, to schizophrenia patients, the thyroid hormone thyroxine, which is used in cases of an underactive thyroid, is also a potential trigger. In particular, women who have been diagnosed with Hashimoto’s thyroiditis can react to the wrong dose of synthetic thyroxine with panic attacks. In any case, it is certainly a good idea to check whether you are still taking the right dose as this can change over time or with lifestyle changes. Several of my patients have also had good experiences with switching their medication to natural thyroid hormone supplements taken from pigs. You will find more on this in Chapter 3.1. and also on our website www.better-life-with-hashimotos-disease.com, which my wife and I set up specially for Hashimoto’s thyroiditis patients.
Panic attacks are, however, much more frequently triggered by recreational drugs than by prescription medication. Psychoactive drugs change brain function, altering mood, perception and behaviour. The active ingredient in cannabis, THC, can trigger anxiety, as can ecstasy (MDMA) and cocaine. Psilocybin too, the psychoactive substance in magic mushrooms, is high on the list of panic-triggering substances. All of these drugs have a massive impact on our body’s neurotransmitter balance, and temporarily switch off certain of our brain’s protective systems. The interesting thing about this is that in certain ways, this can even make our brain more productive: consider famous painters and writers who have created great work under the influence of drugs, for example the best-selling author Stephen King.
To visualise the protective filters in the brain that are switched off by the consumption of drugs, imagine removing the filter from a water supply. The water can flow a lot faster now, but dirt and particles in the water are free to flow through the entire system, potentially causing significant damage. Damage that might be inflicted on the brain, for example, includes the formation of the neuronal connections that trigger panic attacks. If this happens just once, the risk of panic attacks reoccurring rises massively each time you take drugs. If you suffered your first panic attack within 48 hours of consuming drugs, you should stop taking them immediately. Be aware that it makes no difference if this was the first time you took that drug, or you have had years of experience using it. Once your body has reacted to a substance with a panic attack, then this substance should be off-limits for you from now on. Even – in fact, especially – when you are feeling better again. You are especially at risk of triggering renewed panic attacks by using drugs, because your brain has already undergone and remembered this experience.
Did you know that over the course of their lives, most people will experience at least one or two situations that feel like panic attacks? Their intensity can vary widely and they also have an extremely wide variety of causes: an allergic reaction to an antibiotic, for example, or a temporary vitamin B12 deficiency. A temporarily underactive thyroid caused by dietary issues is another known trigger, as are food intolerances. Yet no sooner than we start suffering a lack of a particular vitamin or other nutrient, our body will as a rule solve the problem on its own. We get cravings for a particular foodstuff that contains large amounts of the missing substance, and the feeling of panic disappears as fast as it came.
For vegetarians and vegans who miss out on important sources of vitamin B12 because of their diets (liver, meat, milk and eggs, for example), I recommend taking vitamin B12 in the form of a dietary supplement should you ever suffer a panic attack.
Foodstuffs that cause bloating, or gluten (a protein found in almost all cereal products) intolerance, can also lead to panic attacks. At fault here is ‘Roemheld syndrome’. It is named after its discoverer, the internist Ludwig von Roemheld, who made a significant discovery at the start of the twentieth century. He found out that many people suffering from bloating or wind also complained of symptoms common to anxiety patients: hot flushes, shortness of breath, heart palpitations, anxiety, dizziness, disturbed sleep and irregular heartbeat (also known as extrasystole).
But what is behind it all? In the compendium of clinical medicine, the phenomenon is described as follows: ‘Due to accumulation of air in the gastrointestinal tract the diaphragm is pressed upward and can directly or indirectly place pressure on the heart. This can result in various heart complaints, including pain that resembles angina pectoris. In extreme cases this can lead to brief loss of consciousness.’1
If you suffer from bloating or wind, there exists a real possibility that you too ‘just’ have Roemheld syndrome. Fortunately, a test exists that can quickly establish whether or not this is the case, and there is also a whole series of tried and tested home remedies that you can make use of here. Especially in the initial stages of an anxiety disorder, when the anxiety still has not deeply anchored itself structurally in the brain, the rule of thumb with Roemheld syndrome is: no pressure on the diaphragm, no anxiety.
The simplest thing to do is, as was done in Shakespeare’s day, burp and fart to your heart’s content. Trapped wind would then never get the chance to build up the amount of internal pressure necessary to trigger these unpleasant symptoms in the first place. However, as this method of anxiety reduction is unlikely to be well received by your family, colleagues and friends, I suggest you modify your diet. Start out by avoiding anything that gives you wind for 14 days. If you really are suffering from Roemheld syndrome, simply changing your diet will notably reduce your anxiety symptoms. You’ll find further information and a list of foods that tend to cause bloating, as well as a second list of foods that tend not to, on our website (www.the-anxiety-cure.com).
As the list of everything you should not be eating in this situation is rather long, and a well-balanced diet is so important for quality of life, here are four tricks that can help you significantly reduce bloating, without taking drastic steps to alter your diet.
To start off with, avoid anything containing gluten for a week. This means everything produced using cereals such as wheat, rye, spelt, oats or barley.
The fact is, many people suffer from an undiagnosed gluten intolerance. One reason for this is that blood tests only demonstrate whether you produce antibodies against gluten, and don’t reveal anything else about how your body and brain react to the protein.
Fortunately, there is a simple way you can test this yourself. For a couple of days, make sure to keep track of whether and how quickly you start to feel tired after eating, and whether your concentration suffers. How well are you able to concentrate, for example, on days you only eat vegetables and perhaps a little meat or fish, compared to days you eat plenty of gluten? For my part, I notice a massive difference. I love fresh bread, but the days I eat it I find myself much less productive and able to concentrate than on days I avoid foodstuffs that contain gluten. Not to mention that my digestive system has a much easier time of it the days I go without.
Eat individual foodstuffs in the correct order and if possible separately from each other – and take a small break between each course.
Eating in the correct order means eating foods with the highest water content first! So don’t enjoy fruit as dessert, but as an appetiser instead. Then treat yourself to a short break, and only then should you eat the foods containing a lot of protein and fat. You will find that this greatly reduces your problems with bloating.
Let’s take a juicy piece of honeydew melon, for example, wrapped in Parma ham. Personally, I love this combination, but for many people it guarantees stomach troubles and bloating. Why? If you ate the melon on its own, it would pass through the stomach to the intestines within 30 minutes. But if you eat it with the ham, the melon needs much longer to digest, starts fermenting in the stomach, and the gases this produces press the diaphragm upward. In susceptible people this induces Roemheld syndrome together with its unpleasant side-effects.
Sprinkle caraway seeds as a condiment on to your food, and try taking a teaspoon of freshly grated ginger before eating – both significantly reduce susceptibility to bloating. If you find raw ginger too spicy, ginger tea is a good alternative. Fennel tea, as well as tea made from a mixture of aniseed, fennel and caraway, effectively counteracts gas.
Exercise, or at least go for a walk regularly. This strengthens the musculature of the diaphragm, and the stronger the diaphragm is, the harder it is for gases in the digestive tract to exert pressure on your heart.
Ideally, of course, you can combine all four of these tricks, in which case you will only have to avoid a handful of really gassy foods such as beans, leeks and some sweeteners. As a reward, you will find yourself fighting fatigue much less often, and who knows, perhaps getting a little more exercise combined with some new eating habits will be enough on its own to free you from panic attacks.
After a single panic attack, many people start fretting about what is wrong with them. Maybe something is wrong with their heart, or they have a brain tumour, or some other terrible illness. Terrified, they head to A&E to get themselves checked out. Usually, they are sent home after being told that it was ‘just’ a panic attack, and physically there is indeed nothing wrong with them.
For most people that is hard to believe; after all there is obviously something not right. So the worry continues. Further visits to the doctor are undertaken, in the hope that further check-ups will finally find the ‘cause’ of the attack.
Yet it is this pattern of behaviour itself that can lead a one-off event to develop into regular panic attacks. The combination of regular worrying with strong negative emotion has been shown to alter the structure of the brain. Within weeks or even days, fear of fear turns into a completely automated pattern of thought that deeply roots itself in the synaptic connections of the brain. How is this possible?
When you think something, you are able to remember the thought afterwards. So it must somehow have been stored in your brain. But of course we don’t have a hard drive in our head to write data to, as would happen with a computer. Instead, we save our thoughts biologically, in the form of synapses. Every single one of your thoughts creates neuronal connections in your head, even in the very moment you think that thought. In 2000, this discovery was honoured with the Nobel Prize in Medicine and has made a significant contribution in the development of new and more effective methods to combat anxiety. The scientist who we can thank for this discovery is Professor Eric Kandel, one of the most significant neuroscientists of our time.
Professor Kandel2 conclusively demonstrated that all the thoughts we have and impressions we receive are stored in our brain in the form of synaptic connections. The stronger the emotions that underlie these thoughts, whether positive or negative, the more efficient the neuronal networks in our head. Therefore, one might say that repeated negative thinking builds the neurobiological foundation that allows panic attacks to happen in the first place. Anyone who thinks negatively for long enough is automatically laying down an information superhighway in their brain that travels directly toward negative feelings and anxiety. The route to joy and ease, on the other hand, is often reduced to a potholed lane.
Patients often ask me why their anxiety so often surfaces when they should be relaxing. Sitting on the sofa in the evening, on holiday, or even during a routine task like a long, boring drive on the motorway. The answer is simple: the human brain reacts not just to stress, but to periods of quiet too, depending on how it has been wired. What makes things more difficult is that our brain always wants to have something to do. As long as we have to fully concentrate on something, a telephone call, for example, a tricky chore, or just a pressing deadline, then our conscious brain has enough to do and we are largely free of anxiety and worry. However, as soon as calm returns, we become caught up in our thoughts again. Our brain tries to find something to do as quickly as possible. And where is it likely to find it most quickly – via that multi-lane information superhighway of negative thinking and anxiety, or the crumbling lane of joy and ease? Correct: from the information superhighway. In that moment, thanks to its established networks, it really is much easier for your brain to generate anxiety than a feeling of relaxation.
The way you think is constantly rewiring your brain. Every day, hundreds of thousands of connections are made in your brain, which stores everything that you have thought. Thoughts that repeatedly come to mind become ever more prominent, while neuronal access to thoughts that you have not paid attention to for a long time is dismantled. This is also the reason why you might struggle to recall the mathematical formulae you learned in school. If you did not actively think about it, direct neuronal access became lost. The very same thing has happened to your positive thoughts.
Our brain reacts completely automatically based on the way it is wired and used. That is, it adapts biologically to how you use it. Automatic processes are generated and, at some point, they control your brain, not you. This state of affairs is particularly insidious when it comes to pessimism. Instead of safeguarding you from disappointments, your brain is drilled to perceive more negatives than positives. Or to put it another way: you become blind to the beauty that surrounds you in the truest sense of the word, as well as all the possibilities open to you to make your life more enjoyable. I will explain again in more detail in Chapter 4 what exactly is happening in your brain.
Whether