They watched a YouTuber with Tourette, then embraced his tics



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Kirsten Müller-Vahl had a major mystery on his hands. It was June 2019 and Müller-Vahl, a psychiatrist at the Hanover Medical School in Germany and head of Tourette’s outpatient department, was inundated with patients with tics like she had never seen before.

Not only were the tics complex in nature, involving multiple muscle groups, but even more bizarrely, the patients’ symptoms were remarkably similar. “The symptoms were the same. Not only similar, but identical, ”she says. Although all of them had been formally diagnosed with Tourette’s syndrome by other doctors, Müller-Vahl, who has worked with patients with Tourette’s syndrome for 25 years, was certain it was quite another thing. Then a student came forward who knew where she had seen these tics before.

All of the patients displayed the same tic-like behaviors as the star of a popular YouTube channel. Gewitter im Kopf (which means “thunderstorm in the head”) documents the life of Jan Zimmermann, a 23-year-old German with Tourette. The whole purpose of the channel is to speak openly and with humor about Zimmerman’s disorder, and it has proven to be a success, amassing over 2 million subscribers in two years.

Some of Zimmerman’s tics are specific. He is often seen pronouncing the phrases “Fliegende Haie” (flying sharks), “Heil Hitler”, “Du bist häßlich” (you are ugly) and “apples” (fries). Other tics include breaking eggs and throwing pens at school.

The patients who visited the Müller-Vahl clinic roughly mimicked Zimmerman’s tics. Many also referred to their condition as Gisela, the YouTuber’s nickname for her condition. In total, about 50 patients at his clinic had symptoms similar to Zimmerman’s. Many patients readily admitted to watching his videos. Zimmerman did not respond to a request for comment.

While Tourette’s symptom spectrum is wide, similar symptoms tend to come up over and over again, says Müller-Vahl. Classic tics are usually simple, short, and abrupt. They are mostly located in the eyes, face, or head, such as blinking, jerking, and shrugging. The syndrome usually manifests around the age of 6, and much more often in boys, on average three to four boys for a girl. What comes to your mind when you imagine Tourette – an uncontrollable urge to speak obscenities in public – is actually rare, she says.

But if it wasn’t Tourette’s, what was it? According to Müller-Vahl, these patients actually suffered from a functional movement disorder, or foot-and-mouth disease. It may present itself as Tourette’s, but when the latter has a neurological basis (although the root cause is not yet known, it is believed to be related to abnormalities in areas of the brain such as the basal ganglia. ), the cause of foot-and-mouth disease is psychological. In FMD, the hardware is intact, but the software does not work properly, whereas with Tourette, the software works fine, but it is the hardware that does not. People with foot-and-mouth disease have the physical ability to control their bodies, but they have lost control, resulting in involuntary and abnormal behaviors.

For some patients, all of their symptoms disappeared when Müller-Vahl explained that what they had was not Tourette’s. For others, a psychotherapy course improved their symptoms significantly. Yet the large number of patients with exactly the same symptoms puzzled Müller-Vahl and his colleagues.

Mass sociogenic illness – also known as psychogenic mass illness or historically referred to as mass hysteria – spreads like a social virus. But instead of a noticeable viral particle, the pathogen and the method of contagion are invisible. Symptoms spread by unconscious social mimicry to vulnerable people, which would be triggered by emotional distress. (It is not included in the Diagnostic and Statistical Manual of Mental Disorders, although it closely resembles conversion disorder, which involves the “conversion” of emotional distress into physical symptoms.) Historically, mass sociogenic disease affects women more than men. The reason is unknown, but one hypothesis is that women generally tend to have higher levels of anxiety and depression, which could make them more susceptible to the disease.

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