"I have always been in agreement with the phrase 'just watch someone carefully to make that person interesting'" writes, in his bestseller, Marian Rojas Estapé. The Spanish psychiatrist begins by telling a personal episode spent on a plane bound for Madrid: the moment when, absorbed in her medical studies and initially uninterested in the environment that surrounds her, she ends up having a conversation with a stranger. It turns out that this man had just retired from the CIA, after more than 30 years of investigating terrorism, and could finally talk about his journey, eventually inviting her to go through this important agency in order to do work as a forensic or psychiatrist. investigation.
The Spanish psychiatrist evokes this episode as a metaphor to explain that good things happen, and interesting people come into our lives, when we pay attention. "Nobody will come to us to get the house to propose the project of our life. We must go to it" he writes. With a family history linked to Psychiatry, Marian Rojas Estapé followed in the footsteps of her grandfather and father, graduated in Medicine and Surgery from the University of Navarra and became a psychiatrist. He works at the Spanish Institute for Psychiatric Investigations in Madrid, but has already visited several European hospitals. Currently, Marian Rojas Estapé focuses on treating people with anxiety, depression, personality disorders, conduct disorders and family therapies. The passage through Portugal is marked by the launch of the book How to make good things happen, by Editora Planeta, which was the best-selling nonfiction book in Spain in 2019 (having already sold more than 150 thousand copies). In addition to working in an office, he has been giving lectures in Spain and abroad on stress and happiness, education, social networks, as well as depression and somatic diseases for more than 10 years. It argues that understanding the brain and managing emotions, substantially improve our lives. That is why, in the book, it gives tools for any reader to do so. The destiny? Happiness, always.
Why did you decide to become a psychiatrist?
I come from a family of psychiatrists. My grandfather was a psychiatrist, my father is a psychiatrist, and my family has revolutionized psychiatry in Spain. My grandfather tried daily that all people who suffered from mental health problems were not displaced from the population. My father took psychiatry "to the streets" by writing many books, giving interviews, taking trips and conferences. I tried to talk about two things (in the book). First on the topic of prevention, trying to find out why so many people started to suffer from mental health problems – from anxiety to depression, to insomnia – with the access that exists today to almost everything. Then explain, in the simplest way but with a scientific basis, what is the union between the mind and the body. I have always been attracted to perceive human behavior, emotions, in order to help people.
Is there pressure from society for us to always be well? Because we constantly read that it is necessary to meditate, to practice mindfulness, to always be happy …
I believe so. That there is an obsession with being happy, enjoying things, being perfect, and showing people an aura of perfection, of control, of health, of well-being. But society is deeply "sick", full of sadness, and hyper-stimulated because it has to be "connected" all day, and has an obsession with being aware of everything (what Americans call FOMO – Fear of Missing Out). You are afraid of "losing", be it the latest novel, the latest trend or the latest news. On the one hand, society promotes a series of behaviors, and on the other hand it also forces you to be happy, to live in zen mode, to do mindfulness, to do a super detox diet, and in a way that affects us because it is a great pressure.
Portugal was considered the fifth country that consumes the most OECD antidepressants (10 million packages) according to data from the latest report by the National Health Council dedicated to mental health. How to understand these frightening numbers?
Without knowing exactly the profile of the Portuguese population, it can be two things. The first is that when someone first discovers the medications, there is a boom, because they provide great instant relief. They remove anxiety at once, make the person sleep well from the first night, provide feelings of happiness, relieve suffering. This happens a lot with new medication, which makes everyone ask to be prescribed. There are many countries that take years in this dynamic. Eight years ago, I worked at a hospital in London where doctors only prescribed drugs when the patient had already been diagnosed and tested several times. Medications such as anxiolytics or benzodiazepine derivatives and tranquilizers were reduced as much as possible. The less the better. Now the opposite is true in some countries. Some are just beginning to discover the "goodness" of these drugs.
And addiction? Can't it be one of the causes?
It is a medication that creates a lot of addiction, because it creates a sense of well-being quickly. Many people do not want doctors to take it from them. I support the theory that therapy should be done and reduce medication whenever possible so that the brain is able to learn to question, too. If the brain cancels all moments of stress, any situation of fear, sadness or uncertainty will become difficult to question.
In the book it teaches you to discover how to deal with fear, through tools such as emotional intelligence. Why did you decide to write this guide, even though it is not a self-help book?
I always say that happiness consists in living in the present, having overcome the seriousness of the past and seeing the future with hope. Those who live in the past are depressed, those who live in anguish for the future are anxious, and anxiety is very much related to fear. If we do not connect to the present, it is because we are stuck with the past or the future and forget to live in the present. And 90% of the things that concern us never happen, they are in our mind, but they have a direct impact on our cells, our organism and our vital prognosis. That is why it is so important to connect with the present, questioning our fears and overcoming the problems of the past, for a more balanced and full life as possible.
One of the aspects it addresses is that of toxic cortisol. What are the impacts of it?
Cortisol is a good hormone, because it leads us to face "threats", challenges, moments of stress and alertness. It activates our nervous system so that we can face something that threatens us. The bad thing is when we are producing cortisol all day. If there is a feeling of constant alertness, high cortisol peaks are generated, which causes psychological and physical changes. We are irritable, our mood changes, we have memory loss, we concentrate worse, we are sad… And on the physical level our head hurts, it affects our intestines, our muscles hurt, we are tired, we have more prone to infections, we can develop hormonal problems, of thyroid, for example. Toxic cortisol is harmful to health.
Anxiety is something that affects many people. Why does it affect more than others?
There are personalities more prone than others, either for genetic reasons or some kind of childhood suffering. There are people who have personalities more predisposed to suffering and pain, or to view life from a more negative point of view.
Does medication solve most of these cases? Or does it not cover the long term?
The easiest is the medication that relieves momentarily. But there are people who never ask for help or who ask for help from family members who are also on the edge because they live surrounded by these people. Panic attacks and severe depressions require immediate help, and at this point you need to help with medication. But also with therapy, psychotherapy, to help improve this state and prevent relapses.
Is building emotional intelligence crucial? At what point does the construction of the "I" begin?
What we know today is that up to 3/4 years old, how the child felt wanted and loved by his parents in many ways marks his personality and emotional development as an adult. When we talk about emotional intelligence we talk about the ability to teach empathy, knowing how to put yourself in the other's shoes. Until that age, the child has no memory, but the body remembers and there is a zone of the brain that will be essential for the management of fear, which is the amygdala, a zone that is hyper activated between 2/3 years. The first years of life are basic to emotional development.
What surprised you most in all the research carried out for the book?
It was to reconfirm the hypothesis, the intuition of how health is so related to emotions. From the personality type, the way of being that is more prone to certain heart diseases or certain skin problems, or certain intestinal problems, including some types of cancer. For many years they studied the role of tobacco, the role of food, of pollution … I am pleased that at last the way we question life events also has an impact (on our health). When I studied medicine, I was never told about the emotional part of illness. Today, it is studied more and more. Going to the doctor cannot mean just fetching pills, but the doctor must …
(tagsToTranslate) Medicine (t) Psychiatry (t) Psychiatrist (t) Book (t) How to make good things happen (t) Madrid (t) Marian Rojas Estapé (t) Spanish Institute for Psychiatric Investigations (t) CIA (t) ) Portugal (t) Editora Planeta (t) Diseases (t) Medicine (t) Health (t) Mental Health