Nearly 5.000 people asked for help via free and anonymous SOS line 0800 001 002 and e-mail address podrska@nesalomivi.rs and social networks.

World Mental Health Day, which is marked every year on 10th October, is an opportunity to additionally draw public attention to the importance of preserving mental health, fight against social stigma and the effects it has upon lives of people around the world.

Research has shown that each fourth person is under impact of some form of depression, manifested through either emotional, motivational, cognitive, or somatic symptoms. Pathologically depressive mood, loss of interest and satisfaction, reduced energy, feeling of guilt, helplessness, low self-esteem, sleep and appetite disturbance, poor concentration, and dark thoughts, are just some of the characteristics of depression. The real problem is, in fact, that depression makes no difference between its victims. It does not recognise gender, social class, intellectual level, or even age, which is why the occurrence of this disorder among young people, who are only on the threshold of adulthood, has become increasingly radical (suicide is the second most frequent cause of death in the age group between 15 and 29). It cannot be detected by x-rays, it has no taste or smell, it attacks insidiously and the victim often becomes aware of it only after being significantly contaminated by its toxic effects.

Unfortunately, the situation in Serbia is not any better than in the rest of the world. Unresolved issues of the mass posttraumatic experience originating from the recent wars, poverty (as many as 7% of people in Serbia live on the edge of survival), collapsed system of values and extreme polarisation of society, are just a few factors that have impact on the worrying piece of information, additionally accelerated by the COVID crises, namely that 28.9% of population has symptoms of moderate to severe depression. Obviously, this number is even higher if we take into account that a large number of people tend to suppress symptoms of depression for fear of being stigmatised by the society, refusing to accept the factual situation or simply, for being insufficiently informed about the effects and side effects of this, in many ways, specific disease.

This is exactly why, following the initiative of Hemofarm Foundation, in collaboration with the Belgrade University Faculty of Philosophy, the UNBREAKABLE – the national campaign for fighting depression and growing stigma which haunts those affected was launched in the end of April this year.

Ana Perović, Clinical Psychologist and Psychotherapist: It is important to remind ourselves that one part of each situation we find ourselves in is always under our control

Are we really a melancholic nation? What is the real nature of people in our country?

I wouldn’t agree that we are a melancholic nation. One could rather say that as a nation, we are at risk of melancholy and depressive mood becoming our collective response to the challenging life circumstances. The reason for this could be sought in the term that psychologists call ‘learned helplessness’. If a person repeatedly experiences his/her actions do not lead to the result he/she was hoping for, the person might start to doubt if he/she is capable at all to take care of what he/she sees as important goals in life. Therefore, such a person can stop investing efforts in attempts to satisfy his/her needs and give them up completely. Moreover, he/she could create belief that life is out of his/her control and continue sliding ever deeper towards helplessness and depression. This is a very delicate terrain since in such a state of mind it can be very difficult to distinguish what is under our control from what is not.

Therefore, it is important to remind ourselves that one part of each situation we find ourselves in is always under our control. This part concerns the attitude we choose to assume towards ourselves and our feelings, as well as towards the experiences we are going through. Conversation about unpleasant feelings is still some kind of a taboo among our people. We are pressurised to feel good and ‘hold on’. In the long run, such limitations make us increasingly lonely and potentially distance us from activities that restore our life energy. The more we sometimes allow ourselves to be ‘not OK’, the more clearly we are going to see that we are not alone in it. With this learning, we can still feel as part of the community and find it easier to look for resources to help us feel better.

To what extent are we ready to get to grips with problems as a society? To what extent is in fact the world of today able to be supportive, empathetic, and to cherish humane values?

A somewhat contradictory aspect of the modern times is reflected in the fact that nowadays each of us is a click away from communicating with a large number of people who are always out there, online. One could say we are more connected than ever, that it is easier to be supportive and empathetic. Surely, this is so to certain extent, bearing in mind that we have a broader access to information about others, more opportunities to join various humanitarian initiatives. There are lots of such examples, especially in our country.

However, it seems that in this era – in which one has to try hard to manage to be alone, there is a risk of our interactions with others becoming more superficial and banal. In this way, our existence can turn to a state of constant desire for any kind of contact. While we are constantly available, surrounded by the sea of messages and information, we remain short of a healthy measure of retreat, loneliness and breaks from that connectivity. We need all these elements in order to develop a reflexion of our feelings, thoughts, and deeds, and to become really able to connect with ourselves, and consequently with others. Only when we have allocated enough time to feel ourselves, we could be able to feel others better as well, only then we could imagine their experience and investigate their point of view.

At the time of the pandemic, which has polarised a large segment of the population, we can notice that empathy is ever more fading, both at the individual and at the collective level. Psychologists warn that each of us is capable of ‘turning off’ empathy in a way, by perceiving another person as an ‘object’ in our mind. This is the right moment to remind ourselves that empathy is one of the most valuable human resources. The fading of empathy is therefore an issue of paramount importance for the health of our communities (the family, the nation, and the humanity likewise). Without empathy, we risk destroying relationships, we become capable of hurting others and provoking conflicts. With empathy, we have the resources to resolve conflicts, increase cohesion in the community and alleviate our own emotional pain and the emotional pain of another person.

The principle of self-centredness has become a paradigm of the ‘selfie’ civilisation. To what extent are we human beings if we primarily care for ourselves and our own wellbeing, and only then for others and the world around us?

I will use this opportunity to point out to one important distinction. In our society, ‘being human; is equated with ‘being a person who always puts himself/herself second. As a society, we have this tradition to praise persons who scarify themselves for others, and judge those who do not do it. Therefore, we tend to attribute a lot of guilt and shame to the awareness of our own limits and communicating them. Learning of our own limits and making choices in life primarily by bearing our own wellbeing in mind is desirable from the psychological point of view. This does not exclude our care for other people. It could even be said that it is a prerequisite for being able to care for other people. For developing healthy close relationships, it is essential to clearly communicate our own limits to other people, to check theirs, and to create space for negotiation.

Self-centredness which makes no space for others can reflect to psychological functioning which leads to complications in relationships. It can take different forms – sometimes it can be reflected in ‘selfies’, and sometimes in neglecting others. At the psychological level, too intensive self-centredness destroys our capacity for close relationships. Developing intimacy requires from us to create safe space which can accommodate (at least) two persons, two inner worlds, and two viewpoints. It demands our interest in another person as a unique individual, different from ourselves. We nurture intimacy by checking over and over how we feel in that contact and by asking others for their responses. Bearing in mind that the quality of our own life greatly depends on our satisfaction with our close relationships, self-centredness progressively leads to ever greater loneliness.

It seems as if we have all become characters from the Book of Job. Temptations have been constant for 30 years already in this region. How to save ourselves and remain true to real values?

I agree. There’s no lack of temptations in these areas. It could even be said that anyone who managed to preserve himself/herself to certain extent has already done a big job. It is extremely important to recognise what has saved us because this is where our resources lie.

It seems to me that saving oneself begins with dealing with one’s inner world. We can imagine it as a room in which we live every day. It would be a good idea to get interested in what there is and how it affects us; what we want to take, and what we don’t. It is good to listen more carefully to our own thoughts and feelings about ourselves and the world around us. We often tend to identify ourselves with our thoughts, so we do not see that we have a choice to develop an attitude towards them. It can happen to any of us to face situations in which we feel helpless and with which it seems impossible to develop a constructive relationship. It is very important to recognise such situations and to seek help. To admit oneself that we need help is an indicator of power, not weakness. Such a step enables us to find better resources than the ones we have available at the current moment and to help ourselves feel good.

Sources of social support are equally important. Friendships, especially with people with whom we can talk openly about our inner life; people we are interested in listening to, people we confide in; people we help and from whom we accept help. Such relationships are nourished and built, and they can serve as important pillars that could support us in a situation of personal crisis.

Suzana Đorđević, Director of Hemofarm Foundation: We can approach resolving of this problem only with a system. Responsibly, empathically, with joined forces

People with shattered faces are looking at us from billboards in city streets. Is it a metaphor or the real state of affairs of the present-day civilisation?

Reality is worrying. The soul pain the modern humans are soaked in almost to the brim has damaged human exterior appearance and this can often be seen with a bare eye. Just look around, and you will see a multitude of people with downcast eyes and with tired movements. The modern human is always in a rush, on a permanent move, wherein he/she has no time for himself/herself, let alone others. And this certainly takes its toll, because humans are not machines but living beings of particularly subtle make. When our inner world starts to collapse, be sure that sooner or later the consequences will start to surface. Unless you are a professional actress or actor, your face is not built to hide internal breakdowns for a long time. With time, cracks start to surface on it.

Is our society facing a breakdown? To what extent are we as a nation blown to smithereens?

The state of a nation is in direct correlation with the state of its individuals. And the state of an individual in our society is alarming, to say the least. I must stress this is not only my pessimistic viewpoint, but rather the facts deducted from the earliest available research. The data are unambiguously indicative of the trends that emerged at the beginning of the COVID-19 pandemic: 28.9% of our population have reported symptoms of stress, anxiety, or depression. While at it, do not forget that this percentage, critical as it may be, is only a provisional figure, since many people do everything in their power to conceal their depression in order to avoid being stigmatised by the society. Unfortunately, owing to the basic knowledge and ignorance, most people are even not aware that they suffer from depression, and are ready to attribute its symptoms to chronic fatigue or ‘a bad day at work’, until obvious cracks appear on their faces the subsequent ‘repair’ of which would demand a will of steel and superhuman effort. Depression does not make choices. It doesn’t care who you are or what your social or cultural background is. Neither does it chose the age: Suicide is the second most frequent cause of death in the population between 15 and 29 years of age. Do I need to continue?

How to return normality into the life of a society? Is there a system approach in that?

Only through a system, we can approach the resolving of this problem. Responsibly, empathetically, with joined forces. Simply, all the levels of the society must be animated. Everyone’s attention must be drawn to this most common disease of the modern age, which by some strange coincidence, always remains marginalised and unimportant. This is exactly why the UNBREAKABLE campaign was launched, with the aim of making this individual problem public. As part of this campaign, we have managed to secure an SOS telephone number for fight against depression: 0800 001 002, by means of which every citizen can ask for professional aid. The call is free of charge and available 24/7. This service is provided through really highly altruistic commitment of the professionals from special hospitals for psychiatric treatment in Vršac, Kovin, Gornja Toponica and Novi Kneževac. We are immensely grateful to them for that.

WHAT HAS THE UNBREAKABLE CAMPAIGN ACHIEVED SO FAR?

First of all, the UNBREAKABLE campaign has by now been followed by 4 million people via social networks, and its voice was heard outside the Serbian borders, too. This is very important, because it is crucial that as many people as possible hear about the campaign, in order to finally break the stigma in the community telling us that depression is something one should be ashamed of and something that should be ‘swept under the rug’, something that is always happening only to others. Encouraging is the information that over 5,000 people so far have asked for help via SOS number, e-mail: podrska@nesalomivi.rs, and social networks, and that the action has been supported by over 700,000 individuals, more than 600 institutions, companies, associations, various organisations, media, and distinguished individuals. We are grateful to all of them for their active participation and unconditional support, but we also have a message for all of them – we are still few! There are still many of those whom our voice has not reached and who fight their battles alone inside their four walls.

UNBREAKABLE ARE A MASSIVE MOVEMENT ENCOMPASSING ALMOST 1 MILLION PEOPLE AND OVER 600 ORGANISATIONS. HAS THE HUMANE GOAL OF THE CAMPAIGN REVEALED A DIFFERENT FACE OF PEOPLE IN SERBIA?

Absolutely! This campaign has, in a way, returned us the faith in people, in their humanity, empathy and solidarity. Every day we receive mails where professionals, organisations, persons who are fighting against depression or who have defeated depression offer their help. Clearly, the real fight is yet to come because the problem is serious and of national importance. This is why each voice, any kind of help and support are important – to be here for each other, and to fight together for a more humane and healthier society. We are proud of this campaign. We are proud of having the opportunity to help, of having been supported by a huge number of people and happy to see that a couple of other initiatives for improvement of mental health in the country have been launched. We are also proud of our partners – the Faculty of Philosophy in Belgrade and Dorćol Platz art commune. The support of the Ministry of Health, the Government of Serbia, and the four specialised hospitals for psychiatric disorders in Vršac, Gornja Toponica, Kovin and Novi Kneževac especially means a lot to us. We have gathered around the common goal, and that is – health and wellbeing of all of us. And this is the only thing that is important. Because, when we are together, nothing can break us.