Author: Isidora Bugarski
We all live in uncertain times.
We are faced with numerous natural disasters and social upheavals occurring both around us and within us.
Anxiety and depression are increasingly common diagnoses in the modern world, and each of us has experienced such states of mind to some extent.
How can we recognize the symptoms of anxiety and depression in ourselves and others, and how can we act preventively and consciously promptly?
In an interview with EBC Balkans, Dr. Milena Bratičević explains the special techniques she has developed and teaches at the University of Toronto and in workshops with companies she collaborates with.
About the Preventive Program and Why
EBC: Everything changes throughout our lives, including people’s understanding, and as a result, various approaches in medicine and many aspects of life change as well. You have developed a special program, and given the speed of life, we are all looking for something simpler, shorter, and practical that we can incorporate into our lives.
MB: My programs are preventive for mental health. The goal is to help people quickly acquire certain skills and new concepts that can be beneficial in the long term. We need to learn how to cope with high levels of uncertainty and changes happening in today’s world, especially after the pandemic period. The pandemic has only highlighted how uncertain life is. This has always been the case, though it seemed less so in the past. I completed a doctorate in the prevention of frequent mental disorders such as anxiety and depression and spent about 7-8 years researching various approaches to preventive mental health.
This is a condensed program because I believe people simply do not have the time to invest; everyone is very busy with various life obligations. Thus, the goal was to familiarize them with some main concepts over four weeks and to teach them how to approach the development of awareness and mental health from a preventive perspective. The aim is to avoid waiting for a diagnosis, which people often wait for a long time. In Serbia, there is even a statistic that more than 50% of people who report symptoms of depression have never actually sought help. This is the main problem: not acting early enough and waiting too long to reach a solution.
EBC Balkans: How can you recognize anxiety in yourself or others?
What does it mean, and are these states temporary, or do they require specific action to prevent them from persisting?
MB: Anxiety occurs in stages. It is normal to experience a certain level of anxiety when facing problems at work, in family life, or any other area of life. It is also normal to have some degree of anxiety in situations involving change and uncertainty. However, it is crucial to develop an awareness of the symptoms of anxiety. One symptom is a feeling of restlessness, where we find it difficult to cope with negative thoughts. We feel that negative thoughts are frequent.
Stages of Anxiety:
Normal Anxiety Level: This is when worries arise but we can address negative issues and maintain positive thoughts about the events in our lives.
Clinical Anxiety Level: At this stage, negative thoughts and worries spread across various areas of life. We notice that we are worrying about many different things. The concern is no longer about one issue but rather spreads, making it harder to cope with these negative thoughts. There is also fear that something terrible will happen, or worry about our health or the health of our loved ones, which then spreads to various aspects of life.
When we reach the level of clinical anxiety, fear, and negative thoughts can impair our ability to carry out daily activities or enjoy things we once found pleasurable, such as our work, family, etc. At this level, we are unable to live a quality life, and this is when treatment is most needed.
With my preventive program, I aim to highlight that we can develop an awareness of how anxious thoughts begin, how the brain and nervous system function, and so on, much earlier. The goal is to “catch” these thoughts and redirect them before negative thoughts begin to multiply. This helps us overcome them before they escalate.
EBC Balkans: What is the difference between anxiety and depression?
MB: Anxiety and depression often occur together and can be related. If we have a lot of anxious thoughts and we can’t manage them in time because they spread, we can easily fall into clinical depression. Symptoms of clinical depression include frequently feeling sad, not being able to live life to the fullest, and no longer enjoying things we once found pleasurable. We may find it harder to think, reason, make decisions, and be productive. Motivation decreases, and we feel discouraged and disappointed in ourselves and in the world around us, including other people.
Depression often narrows our view of life and our role in it. It is typical for depression to make us feel isolated. This sense of separation and isolation is very common in depression. Recognizing this in time and finding a way to address it is crucial. Generally, our energy levels drop, and we lack motivation and energy to get out of bed and perform daily tasks. We feel isolated, as if our life is not important, and as though we have no control over our life or our thoughts.
In preventive approaches, the goal is to establish control over our thoughts and emotions. It is important to understand that we are not our thoughts or emotions. We need to identify with something greater and realize that we are much more than just these mental states.
EBC Balkans: Do emotions appear when a person is depressed, and if so, what are the typical emotions?
MB: Negative emotions can occur in both anxiety and depression, indicating a sense of separation. In depression, there is often a sense of self-criticism and criticism towards others. The feeling of isolation can lead to seeking someone or something to blame for the problem. This approach shows us that we are deeply connected to the world around us and that there is no real separation between people in nature. Recognizing this can help us seek help much earlier, and connecting with others can help overcome feelings of isolation.
One reason people delay seeking intervention is because they believe it is happening only to them and they feel shame, sadness, and self-criticism. They might think, “Something is wrong with me.” It is important to understand that with frequent disorders like anxiety and depression, each of us will experience some symptoms of anxiety and depression at some point in our lives. The extent depends on the individual and the circumstances, but it is something we all go through. It is very useful to help each other and recognize the symptoms, and to talk about mental health as something that can develop and improve throughout life. Various methods help our mental health. Just as we share experiences and discuss the positive effects of fitness and physical health, we can also discuss the development of our mental resilience and mental strength, and share information about methods in a positive way.
EBC Balkans: How can we help individuals when we recognize symptoms, given that resistance often occurs? How should we approach such a person, what should we say, and how should we advise them?
MB: It is crucial to understand that we all have our approach to life and our way of viewing things. What we see may be as it seems to us, but it might not be the case. It is important not to project our thoughts, emotions, and concerns onto others. However, if we notice symptoms such as sadness, or if we see that a person is very sad and frequently so, we can start a conversation about it from our perspective. For example, we might say, “I notice that you seem sad. Is there something you want to talk about? Do you feel this way?”
Sometimes people are not aware of their own emotions. Unfortunately, mental health is not something we focus on in our education, and often people cannot easily identify their own emotions. That’s why those close to us need to provide feedback. We should be considerate of how the other person feels, whether they want to discuss it or not. It is crucial to be there for them, as this is one of the most important things. We should ensure they don’t feel isolated and think they are the only ones going through this.
We can also share our own experiences. Everyone has had periods of sadness, and sharing our experiences can help the person feel better and less isolated. If we notice that the person is in a particularly bad state, we can encourage them to seek professional help from a doctor, psychologist, psychiatrist, or psychotherapist. This is especially important if the person is at a clinical level and cannot function daily. Seeking professional help, including medication, if necessary, is a primary step.
When it comes to medication, both here and in the West, there is an established approach to treating with medication, which can be useful in acute states of depression and anxiety when a person genuinely cannot cope with the chemical imbalances in the brain and nervous system. However, I view medication as a short-term aid while we stabilize. It is important to learn other methods for long-term management and to consider whether medication is needed for a longer period or just a few weeks until stabilization. In any case, medication should eventually be replaced with other methods that will work in the long term.
About the Program and Workshops
The paradigm of diagnosis and treatment is still prevalent everywhere. This approach is well-established, but gradually there is a shift towards a paradigm of prevention and intervention as it becomes clear that the current model is not sustainable.
My program is based on the principle of integral health, which includes physical, mental, emotional, and spiritual health. This integral approach is crucial for taking preventive action on mental health. When I was researching in Canada where I could apply my programs, I realized that this approach was not part of the mainstream path but rather more educational. I now teach at a school that is part of the University of Toronto, but it is more focused on knowledge enhancement, and I teach it in the format I designed.
I also work with companies and various organizations, which constitute most of my work. Companies have financial resources to invest in mental health and psychological safety education for their employees. I appreciate that this financial burden is not placed on individuals, as extended therapies can be quite expensive. Companies invest in employee education for several reasons. One is the ability to reach a large number of people at once, so I often work with large teams, sometimes several hundred people.
The program is typically conducted online, but also in-person. It’s beneficial because if everyone in a company is educated on how to approach the developmental paradigm for advancing and improving mental health, the whole organization can shift its culture and approach to discussing mental health. This reduces stigma and allows employees to better understand and support each other.
The program lasts for 4 weeks, with one hour per week, usually on the same day each week. In each session, I introduce participants to new mental health concepts, such as neuroplasticity. I explain what neuroplasticity is, how our mind, brain, and nervous system can constantly build new synapses, and how we can use these adaptive abilities of our mind to develop mental resilience and health. Each session also includes practical exercises to apply in daily life, and between sessions, there are behavioral exercises to practice implementing what was discussed. By the end of the 4 weeks, participants have a certain level of knowledge and applicable skills that they can continue using in their lives and discuss with others in a positive way. This helps in reducing the stigma associated with mental illness.
The paradigm regarding mental health is changing. All mental disorders fundamentally stem from a state of separation or fragmentation of the mind, which is recognized in science and psychology. Therefore, the idea of integration is crucial for maintaining mental health. Unfortunately, we are conditioned to see ourselves as separate. We are conditioned to identify with mental concepts, thoughts, and emotions, and no one has taught us that we are much more than these mental concepts, emotions, and thoughts. Therefore, it is important to understand that if we identify with our thoughts, we deny ourselves a multidimensional approach to life, which is our reality.
It is important to understand that we are integrated beings: the mind is connected to the body, and we are connected to other people on many levels. Our way of thinking is essentially a perception of who we are, which can change and positively impact our mental health. The question of who we are is a big one, and unfortunately, we did not receive enough knowledge about it as children and in school. How to approach this exploration is crucial, as it is, in fact, a lifelong investigation of who we are to the world around us.
Every Day Seems the Same?
Another topic I like to discuss in my programs is the inert state of consciousness and mind. Neurological research has proven that there is a network in our brain called the default mode network, which connects parts of the brain responsible for thinking, decision-making, and “long-term” reflection. This network links these centers with those related to deep emotions and memory.
If we live our lives with the same thoughts and emotions and if we identify with certain roles we are conditioned to embrace—whether related to family, work, or society in general—our life experiences will narrow down to these repetitive thoughts and emotions. This is the inert state of the mind where every day feels the same. Activation of the same brain centers and synapses can lead to increased anxiety and depression because we simply cannot see a way out of this established way of life.
The story that keeps repeating itself within us is very important to become aware of, because we are much more than the story we tell ourselves. It’s crucial to recognize when we are in that inert state of mind and to do things that will get us out of it, things that will activate new synapses. This is precisely why understanding neuroplasticity is important. Neuroplasticity is the brain’s and nervous system’s ability to regenerate, constantly create new synapses, and enhance our experiences. If we are not aware of this, the same thoughts and emotions repeat by inertia, but with a very simple approach, we can help ourselves daily to get out of that state, introduce new thoughts, new experiences, activate new centers in the brain, and actively work on this. Especially if we develop enough awareness to notice that we are returning to the same story. This isn’t easy, but with active work, the ability to do this naturally on a daily basis can develop quickly, and we can become much more open to new experiences, thoughts, and emotions, which can have an exponentially positive effect on our life, on the quality of our life, and our relationships with other people.
If we are satisfied with our life and the activities we engage in daily, then that’s great, nothing needs to change. However, if we notice a sense of dissatisfaction or something bothering us, if we often feel irritated or start to worry, etc., it’s important to expand the range of things we do and think about engaging in new activities. It is very important to be aware daily of the quality of our emotions and thoughts and to allow ourselves to do more of the things we enjoy and to spend time with people we like, who will give us feedback, with whom we have a quality relationship. On social media, there is a lot of talk about the number of people who follow us, the number of friends on Facebook, Instagram, etc. However, the quantity of people we are in contact with is not as important as the quality of those relationships. A person should consciously work on developing quality relationships. People who will be able to support us when we need something, with whom we can talk about things that matter to us and people who will have supportive thoughts and emotions towards us and our life. The quality of interpersonal relationships is very important in life for us to be healthy.”
Another important activity that people can engage in is spending time in nature. Research has shown that, especially during the pandemic, this was one of the best self-help methods for calming feelings of anxiety. Spending time in nature daily is very important, even if it’s just for 15 minutes or half an hour. Nature has a unique way of influencing our nervous system depending on the time of day, and specific sounds in nature have a significant impact on our nervous system, which can stabilize us most quickly.
Nutrition is also important. While much has been said about this, I’ll just mention that it’s important to eat as little processed food and stimulants as possible, and to consume enough fruits and vegetables, etc.
I would also like to emphasize that everyone should use some method of calming the mind, whether it’s meditation or just a few minutes a day focusing on breathing. This activates the parasympathetic nervous system, which is the opposite of the fight-or-flight response.
IN SHORT, NOT TO FORGET
There is much we can do for ourselves and the people around us if we learn to carefully listen to our inner world and consciously apply simple techniques to improve the quality of our lives and the world around us. The most important thing is to never forget that we have the power and strength within us, and if it falls asleep, we can consciously awaken it.
