- 5 days ago
Anxiety, depression, mania — when do psychological issues require medical help? In Good Shape hears from those affected and explores broken heart syndrome.
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00:30Heart problems can strain the mind and vice versa.
00:34Kati shows us how to break the vicious cycle.
00:37Now on In Good Shape.
00:53Writing helps her calm down.
00:55She's faced plenty of upheaval.
00:57As a small child, Kati Müller had to fight for her life.
01:02At age two, she was diagnosed with bladder cancer.
01:05The aggressive chemotherapy damaged her heart.
01:08By the time she was 18, she needed a donor organ.
01:11The call came at one o'clock in the morning and I immediately started crying and my whole body was shaking because I was really scared I might die during the operation.
01:24The surgery went well, but then her body rejected the donor heart.
01:32Medication helped, but still the fear of dying weighs heavily on her mind.
01:37On Instagram, she speaks openly about organ transplantation and her struggles.
01:44As you know, I have my ups and downs and I talk about it here.
01:50After the rejection episode, I was lying in bed with zero motivation and I realized I needed professional help.
01:56The heart and mind are closely connected.
02:01Stress, anxiety and depression constrain the heart and the reverse is also true.
02:07A vicious cycle for 25-year-old Kati.
02:10She decided to see a psychocardiologist, someone who's specialized in this mind-heart interaction.
02:16Anna-Katerina Wagener also had a heart transplant.
02:25When she received hers 15 years ago, she felt she didn't get enough psychological support.
02:32There's an intersection.
02:34You need to understand the medical side, but also the psychological side.
02:40Psychocardiology is a new field,
02:41even though early studies on the connection between heart and mind date back to the 1950s.
02:47Many people are familiar with one particular phenomenon.
02:54Especially with older couples who've lived together for decades,
02:57you hear these stories all the time that one spouse dies and the other follows soon after.
03:04The soul is grieving or in pain and just goes along with them.
03:08And at some point, the heart just stops beating.
03:11This connection from heart to soul, soul to heart, I find it absolutely fascinating.
03:18And heartbreak is even visible.
03:22Broken heart syndrome often happens when patients go through a lot of stress
03:28or experience something traumatic, like a loss or even a breakup.
03:33The heart reacts to that psychological pain.
03:44That's been proven.
03:46You can actually see it on an ultrasound or MRI.
03:51The heart changes, especially the left ventricle.
03:54It responds to what's happening in the mind.
03:55Through therapy and writing,
04:02Kati Müller is determined to find her own way to keep her heart and mind in balance.
04:12Life on a roller coaster.
04:14One minute in the light, then a sudden plunge into an abyss.
04:18That's how people with bipolar disorder describe it.
04:21They experience severe depressive episodes, lows where nothing is okay.
04:28Then suddenly, a manic phase, absolute euphoria, drive, inexhaustible energy,
04:33even leading to hypersexuality and recklessness.
04:38Then another crash back into depression.
04:41One in four affected attempt suicide.
04:44Many lose their jobs or drop out of education.
04:47Relationships with partners and family break apart.
04:51Amelia Agblevo from Nigeria shares her story in DW's series, Healthy Me.
04:59Have you ever felt like you're in an emotional roller coaster?
05:03On one hand, extremely happy, maybe even too happy.
05:07And on the other hand, extremely sad to the point where you can't do basic tasks.
05:11And these two extreme states are mutually exclusive of yourself.
05:14Maybe you're familiar with the states.
05:16Or maybe you know someone who's experiencing the states.
05:19Which is one of the reasons why we need to talk about bipolar disorder.
05:21Like, looking back, I am sad about the relationships that I have lost.
05:27My big brother, I said some really hurtful things to him.
05:30How long have you been living with bipolar disorder?
05:35So I was 23 when I was diagnosed.
05:37It's difficult to diagnose bipolar disorder.
05:40Sometimes people think it's schizophrenia.
05:42But I was very lucky because we were seeing the same doctor.
05:46What happened was I did not make a first class.
05:48So I was part of my old student association.
05:52I was a very active member of the Rotoract Club.
05:54And I was also working at the Investor Radio Station.
05:57So my sleep became very erratic.
05:58And I did not even realise.
06:00Those were the days when Twitter would lock it out.
06:02Like, I can stay at night and out.
06:05I'll shoot, like, maybe a hundred tweets in maybe five minutes.
06:09I was peeing in bed.
06:10Like, I was bedwetting for a very long time.
06:13So those around me noticed that there was something a bit off.
06:16I was given medication.
06:17But then I just took a wipe in two weeks.
06:19And then when I am manic, I just go all out.
06:23I shop.
06:24Whatever money is in my account, savings.
06:27I spend all of it.
06:29Apart from that, I have all of these grandiose ideas, you know.
06:33There are so many projects that, you know, I want to do.
06:36And then I'm multitasking.
06:37I'm doing, like, a hundred things at a time.
06:40So you see me, I am cooking, I'm washing, I am writing.
06:44When I'm even talking, I talk so fast.
06:46And sometimes you just realize that the thought process, like, one doesn't end, and then I'm saying something else.
06:54What are some of the symptoms of bipolar disorder?
06:56While a lot of these symptoms are usually shared across numerous conditions, you need to look out for things like extreme changes in behavior.
07:03Either in the hypomanic side or in the depressive side.
07:06Things like hopelessness about the future, changes in appetite, reduced energy, sudden burst of energy.
07:12Sometimes even risky sexual behaviors might be a sign that's pointing towards that.
07:17But you need to understand that it is important that you get diagnosed by a psychiatrist.
07:22So usually, before the symptoms come up, do you, like, have any premonition?
07:28You know, can you feel it's coming?
07:30For me, I don't have any traumatic experience, struggling.
07:34It's just a lack of sleep.
07:37The more tired you are, the more energy you feel.
07:39How has this affected you?
07:42You know, your personal life, relationships, career?
07:45When I am manic, I say things without filters.
07:50Like, looking back, I am sad about the relationships that I have lost.
07:55My big brother, I said some really hurtful things to him, and it's taken us quite a bit of time.
08:02For over six months, I would reach out to him, and he would not, you know, pay me any attention.
08:08He would just communicate to my husband that if I am fine, he's okay.
08:12Are there any other ways that, you know, this has affected you?
08:16When I had my daughter, I went manic, so my daughter had to be taken away.
08:21I had to stop breastfeeding, because they were not sure if the medication was going to seep into the breast milk or not.
08:27There was once when I jumped out of my dad when he was driving a car.
08:31I lost a lot of confidence, because I wasn't sure who saw me and who did not.
08:36So did you face any form of stigma?
08:38Just being in the vicinity, you know, of that hospital,
08:41was something that I did not want to associate with, because of the stigma that's attached to it.
08:47I think in 2020, I wrote a post on my Facebook.
08:52Yeah.
08:52I am bipolar, and I thank God for amazing friends.
08:56There was a lot of empathy.
08:58There was a lot of understanding.
09:00One person that really struck me was a friend I was in the same MPhil course with.
09:05And I also, we always, we would not, like, laugh at her, but we were like, oh, you are too dull, you are too quiet.
09:11And then she reached out to me and she told me that she also had bipolar disorder.
09:15But she was on the depressive side.
09:17Bipolar 2.
09:18The major difference between bipolar 1 and 2 is usually the presence of mania.
09:22Extreme changes in behavior, usually associated with psychosis,
09:26which means the person who is experiencing this has lost torture reality.
09:30With bipolar 2, you don't have mania.
09:33What you have instead is hypomania with neurosis instead.
09:36The person doesn't really lose torture reality.
09:39Sometimes in bipolar 1, they might require hospitalization,
09:42while many cases of bipolar 2 do not.
09:44So we have a question from Jojo Morris, and the question is,
09:47how can bipolar disorder be solved?
09:50The first thing you need is a psychiatrist to work this journey with you.
09:53It might require medication, therapy, counseling, some lifestyle changes,
09:58and even a strong support system can actually help a person on their journey.
10:03So let's talk management.
10:05And that's because from the first time you're diagnosed to this time,
10:08some time has passed.
10:10And I'm sure you've gotten some things better.
10:12So I just started taking my medication properly.
10:16So right now I'm on mood stabilizers, lamotrigin,
10:20and I'm on an antipsychotic ketiapine.
10:23I do a lot of outdoor activities with my friends.
10:27And I also do psychotherapy.
10:28Because of my medication, I sleep eight hours.
10:31For stress, I am learning to delegate.
10:34Thank you so much, Amelia, for sharing your story with us.
10:36Researchers want to better understand the biology behind bipolar disorder.
10:44That's why, in a large global study, they examined which genes play a role in its development.
10:51Other mental health disorders have genetic factors, too, like ADHD,
10:56which stands for Attention Deficit Hyperactivity Disorder.
10:59For a long time, people thought only children had ADHD.
11:04But millions of adults are affected, too.
11:07It can manifest as chaos in everyday life, trouble-keeping appointments, mood swings.
11:13Many struggle with disappointment, which often leads to problems in relationships and at work.
11:19Walking the dog.
11:22What's relaxing for others is therapy for Zelina Jeks.
11:26Because it has to happen three times a day,
11:28the activity gives her everyday life a structure she desperately needs.
11:32Even as a child, she noticed she was different.
11:35Constantly moving, unfocused and impulsive.
11:39For me, it's not just sometimes being inattentive or unfocused.
11:44I'm basically always inattentive and always unfocused, 100% of the time.
11:51And I've always needed some kind of extra stimulation.
11:54I'd always listen to music while reading or studying,
11:58or I'd have a show or a movie on while I'm working.
12:01It somehow helps me concentrate better.
12:06The brain just works in a different way.
12:10And talking helps a lot.
12:11Understanding that a person with ADHD just functions a bit differently.
12:18And that understanding is really important.
12:22At the clinic, Zelina finally received a diagnosis.
12:27Attention Deficit Hyperactivity Disorder, or ADHD.
12:31Treatment involves a mix of different approaches.
12:35Medications can have a positive effect on the brain and are very effective.
12:41That's one part.
12:44But there are also many non-drug therapies.
12:48Typically, these include psychotherapy.
12:52A behavioural approach targeting specific problems and challenges that people with ADHD face.
12:57One issue is impulse control, which can be addressed in these therapies.
13:04Time management is another big challenge.
13:08And it can also be treated effectively through therapy.
13:14About 3% of all adults in Germany have been diagnosed with ADHD.
13:19That number is rising because, like Zelina Jeks, many are still learning about the condition through social media
13:25and recognising the symptoms in themselves.
13:29I've painted tote bags, printed T-shirts.
13:33I've done crochet, pottery.
13:36It's like I learn new skills until I get really good at them, and then I lose interest.
13:40The great thing about photography is there are so many different possibilities.
13:45I'm always learning new things.
13:47Which is why, even after 10 years, I still love it.
13:51That's why she turned photography into her career.
13:54At first, Zelina worked freelance, but then missed having structure.
13:58A part-time job helps her organise her day and work through her assignments.
14:03Her diagnosis helped her recognise what she needed.
14:05It's a malfunction in the brain.
14:12It doesn't mean I'm worse than anyone else.
14:14I just think and function differently than others.
14:17Which is why things look a bit more chaotic with me.
14:24Zelina Jeks has developed strategies that make everyday life easier.
14:28And the medication helps a lot too.
14:30She says she's gained enormous quality of life.
14:35Severe chest pain and sudden sweating.
14:39Shortness of breath and a choking sensation.
14:43Dizziness and fainting.
14:45Nausea and diarrhea.
14:48Sounds like a life-threatening emergency, but in the ER, doctors find nothing.
14:54It was a moment of extreme anxiety.
14:57A panic attack.
14:58Sometimes they're in reaction to a particular situation.
15:04Other times they show up out of nowhere.
15:07If these attacks keep recurring, it's called a panic disorder.
15:11And it can take over a person's life because they avoid situations out of fear of fear itself.
15:20Finally being able to go to the cinema again.
15:23Zelina Luhmann hasn't managed that in years.
15:25She's been too afraid of having a bad panic attack.
15:30It starts with nausea.
15:32Then dizziness, heart racing.
15:34I get really flushed.
15:36And feel like I'm walking on clouds.
15:39There was one time at the cinema I could feel the panic coming on and it was really unpleasant.
15:43I had to leave during the film and figure out where the door was, where the exit was.
15:49I haven't been back to the movies since then.
15:54Zelina is now 33.
15:56The symptoms first appeared 15 years ago, out of the blue, in a supermarket.
16:00I was in a long line at the checkout, and I suddenly felt unwell.
16:08My heart started racing, like it was going to jump out of my chest.
16:12I felt sick, hot, sweaty.
16:15I thought I was having a heart attack.
16:17I just thought, I need to get out of here.
16:19So I pushed my car to side and ran out.
16:23She still managed to drive home, where the symptoms subsided.
16:27For a few years, things quietened down.
16:30But then the attacks came back, and Zelina got worse and worse.
16:36Some weird neck issues started, all that tension in my body.
16:41She began to worry and went to a doctor.
16:44But blood tests and an ECG showed everything looked fine.
16:48Physically, she was healthy.
16:51The root of her symptoms is psychological.
16:54She has a panic disorder.
16:57A specialist in psychosomatic medicine and psychotherapy,
17:00Bernd Löwe knows the illness well.
17:04A panic disorder is defined by repeatedly occurring panic attacks.
17:10These are sudden, unexpected surges of intense anxiety,
17:14typically accompanied by strong physical symptoms.
17:18A racing heart, pressure in the chest,
17:22dizziness, tingling in the fingers,
17:26shortness of breath,
17:28the feeling of choking, fear of dying,
17:31sometimes even the sensation of being detached from yourself.
17:34And when those attacks keep happening,
17:37and are combined with fear of having another one,
17:40or fear of the consequences,
17:41that's what we call a panic disorder.
17:47A panic attack begins in the brain,
17:49specifically in the amygdala, where fear is processed.
17:52The autonomic nervous system goes into alarm mode.
17:57Stress hormones like adrenaline and noradrenaline are released and surged through the body.
18:03That causes the heart to beat faster,
18:05the muscles tense up,
18:06and sweating starts.
18:08The brain then misreads these physical reactions as a new threat,
18:13and ramps up the alarm mode even more.
18:15The stress response intensifies,
18:17a vicious cycle.
18:19Many people are afraid they're dying.
18:21We know that people with panic disorder
18:25tend to perceive bodily signals more intensely and more threateningly.
18:29That's probably partly genetic.
18:33In 2023, Selina sought help at this clinic,
18:37with a course of cognitive behavioral therapy, or CBT.
18:41To find out how the treatment works,
18:42we talked to psychotherapist Inza Neumann.
18:45The idea is that patients actively confront
18:51the situations or symptoms that trigger their anxiety.
18:57In exposure exercises,
18:59together we deliberately try to provoke those symptoms.
19:05The goal is always for them to sit with the symptoms
19:07without doing anything to counteract them.
19:10And we know that by experiencing the anxiety in this way,
19:15it gradually decreases over time.
19:19Many people hyperventilate during a panic attack.
19:21That's something we can reproduce quite well,
19:24for example, by breathing deeply and quickly,
19:27or by breathing through a straw.
19:29We use all kinds of techniques to get as close as possible
19:32to those physical sensations that trigger the panic.
19:35Selina also practices walking through shopping centres
19:40with her therapist,
19:42without her handbag,
19:43where she usually keeps her phone, water,
19:45and just-in-case medication.
19:50I had to walk around the shopping centre
19:52for 45 minutes without any of my things,
19:55and when it hit me that I didn't have them,
19:57that was pretty challenging.
20:00The aim is to show her that the symptoms come,
20:03but they also go, and that she can handle them.
20:07In general, patients like Selina
20:09are encouraged to let their symptoms happen,
20:11but for occasional panic attacks that can hit anyone,
20:14there are coping techniques.
20:19Breathing out slowly and for a long time can help.
20:22Or trying to reorient yourself,
20:25noticing what you can see around you,
20:27what you can hear,
20:30whether you can feel or smell or taste something.
20:35That works too.
20:38During a panic attack,
20:39the attention is focused intensely
20:41on the frightening physical sensations,
20:43so the aim is to shift attention
20:45to what's happening externally.
20:49Through CBT, Selina has gradually improved.
20:51She can now be around people
20:54or in busy shopping centres
20:55with much less anxiety.
20:57She's learned to mentally prepare
20:59for situations that used to overwhelm her.
21:04You're supposed to tell yourself
21:06when you go somewhere that used to scare you
21:08that you're ready,
21:09and that if a panic attack comes,
21:11that's okay.
21:15You don't avoid things anymore
21:17just because it might happen.
21:19And if it does happen, you let it.
21:21Fighting it usually makes it worse.
21:25Selina Luhmann still hasn't been back to the cinema,
21:28but it's high up on her to-do list
21:30for the next few months.
21:34Any film, I just want to go to the movies.
21:42Not every psychological trait
21:44is the symptom of a disease.
21:45However, if you no longer find joy in anything,
21:49can't work anymore,
21:50or rarely leave the house
21:52and stop seeing friends,
21:54if you're constantly worried that you're ill
21:56or are turning to excessive alcohol
21:58or other drugs,
21:59then it's time to reach out for help.
22:03Treatment is always personal,
22:05usually a mix of medication and therapy.
22:09But we all have to find our own way
22:11to deal with the unique aspects of our minds.
22:15Being outdoors gives Christian Saathorff something vital.
22:20He first noticed it back in school.
22:24During my high school exams,
22:27I always struggled with my mental health.
22:30I was constantly tired,
22:32felt like I was missing out
22:33on all the graduation parties.
22:36I'd go to school
22:37and then just crash into bed,
22:38totally exhausted,
22:40no energy for anything.
22:43The turning point came during a scooter trip
22:46across Europe with a friend.
22:48Having an adventure
22:49and meeting people
22:50made him feel better.
22:51A year later, at 21,
22:53he felt burned out again.
22:55But this time,
22:55he knew what to do about it.
22:57He decided to walk,
22:59raising money as he went,
23:00and ended up hiking 800 kilometers
23:02across the country.
23:07I study in Bremerhaven in the north,
23:09and Munich is the biggest city in the south,
23:12so I could basically cross the whole of Germany
23:14and send the message
23:15that adventure is great for mental health,
23:18and it's important to be aware of that.
23:20Christian didn't just want
23:25to take the journey for himself.
23:27He wanted to show others
23:28the importance of getting moving
23:30and stepping out of your comfort zone.
23:32Every day, he posted short videos
23:34from his hike on social media,
23:36and almost everywhere he went,
23:38people were open to talking about mental health.
23:46I spoke to a lot of different people
23:48on this trip.
23:50Teachers, farmers, academics,
23:53and everyone told me, in some way,
23:55that this is something they deal with too.
23:58But you don't see it in public.
24:01Teachers tell me their students
24:02are more tired and stressed than ever.
24:08The first step, says Christian,
24:09is talking to others about how you feel,
24:12admitting that you're struggling,
24:14and then doing something about it.
24:16For him, the 800 kilometer walk helped.
24:19Each stage was a marathon in length.
24:24The first five stages weren't much fun.
24:27They really hurt.
24:28But after about a week,
24:29I started enjoying the nature.
24:32You notice the animals,
24:33and you realize just how beautiful Germany really is.
24:36There are so many places,
24:38and so many people you meet in the small villages along the way.
24:43In the evenings, at hotels or guest houses,
24:46he talked to his people he probably wouldn't have met otherwise.
24:50They discussed depression,
24:51but lots of other topics as well.
24:54During the day, he mostly walked alone.
24:56It's very meditative.
25:01You slip into it quickly, and that's the cool part.
25:05You can just switch off.
25:07That's what I want,
25:08to switch off from my daily routine
25:10and see something new.
25:15Christian also mostly unplugged from social media.
25:18He enjoys it, but found the hours of scrolling draining.
25:22He sees the same in many other young people.
25:26You realize you're in a negative spiral
25:30that you can't get out of.
25:33I want to show people, proactively,
25:36that you need to build routines to help counter that.
25:38Even a daily walk can help you see the world differently, he says.
25:45After his tour, he returned to the new semester
25:47with fresh motivation
25:49and hopes he's inspired others.
25:55We're wishing you lots of inspiration and motivation too.
25:59Take care and see you next time on In Good Shape.
26:08In Good Shape
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