Woman, looking anxious and holding her head with both hands

Relapse after overcoming anxiety disorder: What to do when anxiety returns?

When anxiety disorders are treated with conventional methods like antidepressants or behavioral therapy, the relapse rate unfortunately remains very high. This is true even though the therapy duration is significantly longer than with the Bernhardt Method we developed. With our method, anxiety disorders can not only be noticeably reduced within days but can also be fully overcome within just a few weeks.

However, there are still occasional individuals who experience a return of their anxieties. Fortunately, this issue can usually be resolved quickly, as there are only four possible reasons for the recurrence of anxiety and panic:

Overview of Topics

Reason 1: Only the Anxiety-Stopping Techniques Were Used

The individual may use the anxiety-stopping techniques from my book or online therapy but does NOT work with the 10-Sentence Method or does so only sporadically. This is despite the fact that both the book and the online therapy repeatedly emphasize that only the combination of both methods can be permanently successful.

While using only the emergency techniques may bring quick initial results, as they interrupt the anxiety patterns in the mind swiftly and effectively, it misses the opportunity to build a new neural “data highway” in the brain with the 10-Sentence Method. In the brains of people with anxiety, there exists a well-worn neural highway of fear, while feelings like lightness and joy are much less established. I like to compare this to a narrow, overgrown path where progress is slow and difficult. Anxious thinking, on the other hand, is so deeply rooted neurally that the brain automatically triggers it, much like how one can travel faster and more easily on a well-developed highway.

So instead of just a positive “pathway,” you also need a full “highway” in your mind before your automated thinking can be redirected onto it, transforming fear back into joy. However, this opposing highway doesn’t build itself! You must actively support its development by training a new way of thinking. The quickest way to do this is the 10-sentence method mentioned earlier, combined with the 5-channel technique.

It feels amazing to quickly be able to nip fears in the bud with the anxiety-stopping techniques, especially when previous therapies or medications have provided little help. But only those who use this newfound freedom and energy to finally eliminate the greatest trigger of their fear can be permanently freed from anxiety and panic. The greatest trigger is the way the brain of someone with anxiety has been wired, often over years, by a faulty way of thinking. It has been trained to spend more time dwelling on problems rather than finding solutions in a fraction of the time. Such a trained brain perceives danger in the most harmless situations and quickly focuses on any lack instead of on achievements and positives.

Therefore, my advice would be: Use the new life energy provided by the anxiety-stopping techniques, and actively transform the structure of your brain with the 10-Sentence Method so that it can soon respond differently and, most importantly, better. There’s no better protection against relapses.

Reason 2: The 10-Sentence Method Was Mistaken for a Type of Medication

The individual felt better for a long time and at some point stopped practicing the 10-sentence method. Unfortunately, the 10-Sentence Method was mistaken here for a type of medication, something you take for a few weeks while you’re “sick” and then stop once you feel “better.”

However, the 10-Sentence Method is precisely NOT a medication. It’s more like a lifestyle choice, something you consciously commit to in order to benefit from it long-term—just like regular exercise or a healthy diet. Understand that the 10-Sentence Method teaches a way of thinking that is as natural for many healthy and successful people as daily brushing their teeth.

For those who didn’t grow up in a family environment that fostered this kind of thinking from an early age, they can now make the conscious choice to acquire this healthy mindset step-by-step and keep it for good. You should already have noticed how quickly this new way of thinking can improve your life if you have worked intensively with the 10-Sentence Method for even a few weeks.

Only by changing behavior consistently can one live healthier in the long run.

Short-term “quick fixes,” like extreme diets, can produce fast results—in this case, weight loss—but as soon as you return to old, unhealthy eating habits, the pounds come right back, often with a few extra. It’s much the same with the 10-sentence method. The problem isn’t the method, but rather not consistently integrating the new thinking into your life. Of course, it’s not easy at first, but, as with regular exercise or a healthy diet, it becomes easier each week the longer you stick with it.

It’s said that to establish a new habit, you need about three weeks.

To make it an automatic mental routine takes at least six months. This may feel tiring at first, but my advice is: Stick with it! Once you’ve achieved this, you’ll benefit for the rest of your life, not just because your anxiety disorder is gone.

Many aspects of your life will become easier, and you’ll start setting and reaching goals—maybe for the first time in your life—that previously seemed impossible.

Reason 3: Secondary Gain from the Illness

Reason 3 has to do with what’s known as secondary gain, which you may already know from my book or online therapy. For someone who suffers from anxiety so intensely that they can no longer go to work—or even shop for groceries or go outside—they naturally experience a huge loss in quality of life. But on the other hand, the illness can also bring certain benefits, strange as that may sound to some.

Let me explain with an example from our practice.

About a year ago, a 28-year-old man came to my office suffering from severe anxiety attacks. For five years, he’d held a job he hated, though it paid well. Day after day, he dragged himself to work in a bad mood, yet was too inflexible to apply for other jobs or pursue further training to improve his chances in the job market. Eventually, his mind pulled the emergency brake, and a diagnosis of “generalized anxiety disorder” forced him to quit this stressful job. However, the underlying issue—his “lack of flexibility”—hadn’t changed. With his sick leave, he now had more than enough time to look for a new job or further his education, but now he was officially sick. And that was a pretty convenient excuse to keep avoiding this overdue change.

This convenient excuse is called secondary gain. “Secondary” means “on a second level.” On the first level, the anxiety disorder was anything but a gain; it was very burdensome and clearly stemmed from the fact that this young man had ignored his gut feelings for far too long. For years, his intuition had been signaling that it was time to pursue a different job. On the second level, however, the illness was indeed a gain for him, as it now allowed him to stay away from work with a clear conscience—he was truly sick, after all. In his view, he was so sick that he couldn’t even take steps now to eventually thrive in a more pleasant work environment.

Perhaps, deep down, he thought, “Serves my employer right for having to manage without me now! That’s what they get for putting me under so much pressure.” But ultimately, who is responsible for this young man’s well-being? His employer—or himself?

Of course, an employer has some influence on employees’ well-being. But they’re not responsible for their employees’ lives. We are all responsible for our own lives, and the only reason an anxiety disorder could develop here is that someone was simply too comfortable to actively seek a better job in time. For other anxiety patients, it might be a better relationship or environment they need to work toward. No matter what we suffer from in life, it’s up to us—and ONLY us—to change it.

When I confront my patients with this “admittedly uncomfortable truth,” I often hear, “I can’t. The anxiety controls me so much that I can’t think of anything else!” But when I press further, it usually turns out that this isn’t entirely true. For most people, the truly extreme moments of anxiety last only a few minutes to a maximum of two hours. It may feel like an eternity, but in reality, this extreme state accounts for less than 10% of the entire day.

But what about the rest of the time? Younger anxiety patients, especially, can typically spend this time watching TV, playing video games, or surfing the internet. Thousands of hours per year are wasted this way—hours that could have been spent considering what kind of job might truly bring happiness or exploring online courses that could provide useful training from home. When I bring this up, the next excuse typically follows: they don’t have the money for it. The young man from my example responded the same way. Yet he hadn’t once looked into how much further education would really cost. Otherwise, he would have known that sites like udemy.com offer complete online therapys for almost any type of training, starting at just $13.99.

Anxiety patients frequently find reasons not to do something much faster than they find reasons to start changing their lives immediately. This is often because they lack a massive, clear goal worth the effort of becoming active again.

Reason 4: The Absence of Big Goals

The absence of truly big goals is the fourth reason anxiety can return. This was the case with the young man from my example. He had never pursued additional training because he had never seriously considered which job would be the right fit for him. I recommended the book “Designing Your Life” by Bill Burnett and Dave Evans—and it actually helped him discover the career that was a true match.

In his case, he realized his future lay in independently designing and building websites. He learned the necessary skills in less than four months, with a total investment of just around $80. That’s how much the various WordPress video workshops on udemy.com cost, which I suggested he take. WordPress, by the way, is a popular platform for creating professional and attractive websites, and my own site is based on it. During those first four months, he created a great website for his sister’s boutique and another for his uncle’s craft business. Both businesses experienced a noticeable increase in sales, which led more friends and acquaintances to request websites from him. Less than six months later, he was earning more with his newly established web design agency than four times what he had earned in his previous job that had made him so miserable. And the anxiety disorder? It disappeared on its own during the four-month learning phase because his mind no longer had any reason to warn him against self-destructive behavior.

Big Goals Help!

Having big and personally meaningful goals is essential for a happy and fulfilling life. Simply saying, “I’d be happy if the anxiety were finally gone!” is NOT a goal, because here your focus is still only on what you want to GET RID OF, rather than on something that makes it worth being active again. For those who have no idea where to start, I recommend our new online online therapy, How to Calm Anxiety In it, I explain, among other things, how to find your true goals in life and how to achieve them.

About us

Daniela- & Klaus Bernhardt — Institute for Modern Psychotherapy

Daniela & Klaus Bernhardt

Klaus Bernhardt runs the Institute for Modern Psychotherapy in Berlin together with his wife Daniela Bernhardt.

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