In Spain, one in four people has or will have a mental health problem throughout their lives, and almost 7% of the population suffers from anxiety, and a very similar percentage suffers from depression, according to data from the Spain Mental Health Confederation. . Because? "Our brain is not designed for well-being, but for survival," says Anders Hansen.
This psychiatrist from the Karolinska Institute in Stockholm, also a graduate in Economics, is an acclaimed popular science author in his country, and has now just published The Depressed Brain (Dome), a book where he reviews the mechanisms of anxiety, stress, depression or loneliness. "Stop happiness!" Hansen exclaims, while stating that "pretending to be always happy can have the opposite effect." He looks after us, smiling and energetic, from his office in Sweden.
Why do we feel so bad when we live with such abundance, in relation to previous times?
Our brain is not designed for well-being. The brain has not changed for the last 10,000 years, it still believes that we live in the savannah and its main objective is not to make us happy, but to keep us alive. The brain is designed for survival, to get as many calories as we need. Even though we have access to all those calories today, the brain doesn't know it.
If the brain is designed for survival and not for well-being… Is it normal to feel bad from time to time?
Emotions take us in the direction of survival and reproduction, which is what our ancestors needed. This is still active and pretending that our brain leads us to well-being is an unrealistic expectation, that's where the conflict is created. The dopamine system makes us crave things, it seeks to reset itself when the needs have been met. Today we want the same thing that we had yesterday, and we worry about whether we will have it tomorrow as well. We enter a cycle of continuous desire and we are never satisfied.
According to you, the brain does not allow us to perceive the world as it is, and that leads to anxiety. How does the mechanism work?
Our ancestors died before reaching adolescence, they died of hunger, infections, assassinations, dehydration... This made our system always prepare for the worst. The brain continues to act like this, as if it had to prepare for the worst. That's why I tell my patients that it's not surprising that there are people with anxiety, it's surprising that there are people who don't! Thus they realize that it is not true that they are damaged, and that represents a relief. Anxiety is not a symptom that your body is not working well, rather, on the contrary, it is a sign that you are functioning correctly.
Trying to think positive or be happy, he says, doesn't work. Does self-help or positive psychology, then, work?
Yes, of course they can work in some way, but anxiety is a very powerful resource. If it had been possible to cancel it just by thinking "cheer up", "be happy", then it would not have been so strong as to condition our behavior in the beginning, historically. Just realizing that you're not messed up if you're feeling anxious can be very helpful for many people. Anxiety ruins lives, so it is not about living with it, but seeing that it is normal to feel it, and if it prevents you from functioning, asking for help.
At what point do you have to ask for medical help?
If there are things that you stop doing because of anxiety, like going to celebrations, working... then seek help. Consulting a specialist if you have anxiety is the same as consulting if you suffer from diabetes. If you have very strong arms you can lift a lot of weight, if you have strong legs you can run very fast, but having a strong brain does not mean that you can go through periods of stress without noticing anything. If you have anxiety, it is because you have a strong defense mechanism in your brain.
What exercises can help in case of anxiety?
There are two things you can do if you have anxiety, one of which is to take a deep breath, exhaling for six seconds. This reduces stress, because it leads the nervous system out of fight or flight mode, and helps it react in a different way. The second thing you can do is put words to the feelings: you activate the frontal lobe, and reduce the activity of the amygdala. This decreases anxiety, but sometimes it is not enough. You may need therapy, medication, exercise, or you may need all at once.
Physical exercise protects against anxiety and depression. What mechanisms are activated in our brain and how does our body react?
If we see mental health from a biological point of view, this is treated from the HPA axis that has to do with physical activity. With anxiety, the level of stress on this HPA axis increases and physical exercise helps reduce that stress. In addition, it promotes the segregation of hormones such as dopamine, serotonin and others that are beneficial in reducing anxiety. When the brain creates emotions and feelings, it is not based only on what it perceives from the outside, but also on what it perceives from the inside, on how our internal system is working. Therefore, if you exercise, all your organs work better and will send more positive signals to the brain, stress will be reduced. A new study published just two days ago has shown that physical exercise can be more effective than therapy or medication.
With a deep level of depression it is difficult to exercise…
If you have high levels of stress, you can reach levels of depression with which you are not able to get out of bed, thus reducing the level of activity. That is why we have to see physical exercise as a factor of prevention.
What is the minimum physical exercise needed? How many steps per day, how many hours of weekly activity?
The most important thing to keep in mind is that the brain counts every step we take: just one hour of brisk walking a week has been shown to reduce the risk of depression by around 10%. The maximum effect achieved is running about three times a week, 45 minutes each time.
Some depressions are related to viruses and bacteria. Is depression a defense mechanism?
Completely. Inflammation in the body is registered in the brain and the more inflammation, the lower motivation and mood. Inflammation, in the past, was linked to infectious diseases. Despite the fact that inflammation can now come from other causes, the brain interprets them in the same way, and when there is an infection it wants the system to reduce the level of activity. That's why we end up despondent, because the brain wants rest, rest, to fight the infection.
What inflames us, currently?
Today inflammation comes from sitting too long, eating too many processed foods, not exercising enough, stress... Our current lifestyle is activating this defense system as if it were fighting bacteria. One third of all depressions come from inflammation. This means then that we must see depression not only from the perspective of psychology, but also from physiology, from the internal factors of the body that influence it.
Loneliness can be as dangerous as smoking 15 cigarettes a day, you say. And between 20 and 30% of the population may feel lonely and isolated. Its a big problem…
It is important to understand that loneliness is subjective, it cannot be measured in the number of friends or the number of parties you are invited to. If you feel lonely, you are lonely, if not, no. In the short term it is not dangerous, but it is when it lasts for months or years. And now we know that loneliness is associated with increased risk of cancer or cardiovascular disease. The probable reason is that, during the story, when you were alone you didn't survive, the stress level increased because loneliness was a danger to survival. We are an incredibly social species, we are used to doing activities with other people.
And social networks do not help to combat loneliness?
When we transfer social behavior to screens, this doesn't work because we don't relate in the same way, and it affects us in a very negative way, generating many problems. The good news is that very little is needed to solve it: some studies have found that three phone calls a week of just ten minutes improve the well-being of patients and make them live longer.
You say that "the more you pursue happiness, the more risk it will slip through your fingers." Because?
The brain does not register what is happening to us, but tries to anticipate what is going to happen. If we try to always be happy, this is an unrealistic goal. The modern vision of happiness, of being happy all the time, is totally unrealistic, it makes us feel that we are not good enough. We set our expectations too high and we can't meet them. Studies have shown that happiness is not about feeling good all the time, but about having a long-term direction, which is what makes you feel most satisfied. If you accept this, the most important thing you can do is have good relationships. Relationship is essential.
