They Saw a YouTuber With Tourette’s Disease – Then They Adopt His Ticks
It was Kristen Muller Val A big puzzle on her hands. It was June 2019 and Müller-Wahl, a psychiatrist at Hannover Medical School in Germany and head of the outpatient department at Torett, flooded patients with tics unlike anything she had seen before.
Not only were tics complex in nature, involving several muscle groups, patients’ most unusual symptoms were remarkably similar. Symptoms were identical. Not just similar, but identical. Although other doctors have all been officially diagnosed with Tourette syndrome, Muller-Vall, who has worked with Tourette syndrome patients for 25 years, was sure it was something else entirely. Then a student came forward who knew where she had seen those tics before.
All patients were exhibiting the same twitch-like behaviors as the star of a popular YouTube channel. Gewitter im Kopf (meaning “thunderstorm in the head”) documents the life of Jan Zimmermann, a 23-year-old from Germany with Tourette’s syndrome. The channel’s raison d’être is to speak frankly and humorously about Zimmerman’s disorder, and it has proven to be a hit, amassing over two million subscribers in a span of two years.
Some specific Zimmermann tics. He can often be seen saying the phrases “Fliegende Haie” (flying sharks), “Heil Hitler”, “Du bist häßlich” (you’re ugly) and “pommes” (chips). Other tics include smashing eggs and throwing pens at school.
Patients who visited the Muller-Wahl Clinic largely imitated Zimmermann’s tics. Many were also referring to their condition as Gisela, the YouTuber nickname for his condition. In all, about 50 patients in her clinic had symptoms similar to Zimmermann’s. Many patients readily admitted that they had seen his videos. Zimmerman did not respond to a request for comment.
Although the range of Tourette syndrome symptoms is wide, similar symptoms tend to reappear over and over again, says Muller-Wahl. Classic tics are usually simple, short, and sudden. They are mainly found in the eyes, face, or head, such as blinking, jerking, and shrugging of shoulders. The syndrome usually appears around 6 years of age, and is most often seen in boys – three to four boys per one girl. What comes to mind when you imagine Tourette — an uncontrollable urge to utter swear words in public — is actually rare, she says.
But if it wasn’t Tourette’s syndrome, what was it? According to Muller Fall, these patients were actually suffering from something called functional movement disorder, or FMD. This may appear like Tourette’s disease, but when the latter has a neurological basis (although the root cause is not yet known, it is thought to be related to dysfunction of brain regions such as the basal ganglia), the cause of FMD is psychogenic. In FMD, the hardware is fine, but the software doesn’t work properly, while with Tourette, the software works fine, but the hardware isn’t. People with FMD are physically able to control their bodies, but they have lost control, resulting in involuntary and abnormal behaviors.
For some patients, all of their symptoms disappeared when Mueller-Vall explained that what they were experiencing were not Tourette’s symptoms. For others, a course of psychotherapy significantly improved their symptoms. However, the sheer number of patients with the same symptoms baffled Muller-Vall and her colleagues.
Mass social illness – also known as mass mental illness or historically known as mass hysteria – spreads like a social virus. But instead of a felt viral particle, the pathogen and the method of infection are invisible. Symptoms are spread by unconscious social mimicry of vulnerable people, and emotional distress is thought to result from emotional distress. (It is not included in the Diagnostic and Statistical Manual of Mental Disorders, although it bears a strong similarity to conversion disorder, which entails “transforming” emotional distress into physical symptoms.) Historically, mass social illness affects women more than men. The cause is unknown, but one hypothesis is that females in general tend to have higher levels of anxiety and depression, which may make them more likely to develop the disease.