“In a healthy body a healthy spirit,” is the saying by which most people are guided. On the other hand, how much does a person actually pay attention to their psychological state as a crucial part of their health? Struggling with anxiety, insomnia and depression, are “normal” terms that surround us, and mental health impairment, especially of younger people, is an increasingly common and serious problem. Zrinka Ćavar, Head of the Department for the Protection of Child and Youth Mental Health, brings insight from the other side of the scene and represents a very accessible source of assistance – the Centre for Youth Health.

Impact of quarantine and pandemic on mental health

The global crisis situation caused by the epidemic has been complicated at the regional level by repeated earthquakes, which together represents a source of prolonged and intense stress for everyone. Children and young people, chronically ill, elderly and people of assisting professions are especially at risk

Stress is proven to affect the body and psyche, disrupting the psychophysical balance of each person, changing the structure and function of organs, leading to the disease. A person may develop immediate (acute) and delayed (adaptation disorders, PTSD, permanent changes) reactions to stress that can be thought, emotional, physical, behavioural, existential. The reaction depends on the acquired resilience and the learned way of managing stress that can be protective but also risky and threatening to the person and others.

Physical and mental health are interactive and equally important. With a hygienic and healthy lifestyle, we preserve physical health. No less important is the mental hygiene with which we preserve mental health. Mental hygiene includes familiarization of oneself (attitudes, habits, desires, emotional strength, psychic abilities, what helps and what retaliates), the development of self-confidence (based on virtues and weaknesses, learning new knowledge and skills), time for oneself ( Relaxation exercises, music, reading, meditating, walking, making you comfortable), regular physical activity (improves emotional stability, reduces anxiety and depression) and formation of close relationships with the family and others (support, new experiences, voluntary work – gives a sense of sense and satisfaction and strengthens self-esteem).

Mental health is gradually changing, from risky to illness. Specific symptoms indicating risk are nervousness, concern, irritability, anger, sadness, hopelessness, negativism, difficulty sleeping and changes in appetite, fatigue and lack of energy, muscle tension and headache, forgetting, procrastination, social isolation, frequent consumption of psychoactive substances, decreased functioning…


Anxiety is normal, ubiquitous, has motivational (e.g. before exam) and adaptive function (e.g. due to stress), cannot be completely removed but can be learned to control.

Anxiety is a way of responding by fighting or escaping when a person deems events threatening. The basis of anxiety are thoughts – specific wrong assumptions – personal vulnerability and helplessness, anxiety as a threat or socially unacceptable, about personal responsibility (self alone) and loss of control, about acceptance from others (critics=rejection) and competence (failure= disaster), about the likelihood of bad events, catastrophizing the consequences, and the focus of attention to threats and intolerance of uncertainty.

The internal or external trigger stimulates thought (about the threat/loss of control) and directs attention to “dangers” leading to physical (arousal), emotional (anxiety, restlessness) and behavioural changes – fighting (coping) or escape (avoiding, securing).

Overcoming anxiety includes changing thoughts (specific erroneous assumptions), reducing body sensations (relaxation, recreation, healthy lifestyle), changing emotions (increasing tolerance to anxiety), abolition maladaptive behaviours (avoidance, assurance) and building coping skills, and finally functionality and quality of life.

Overstating the likelihood of something happening and the degree of danger increases anxiety, while coping opportunities reduce it.

Fighting – anxiety as a boost for growth

People who are using protective mechanisms strengthen their stress resistance and positively influence their health. Therefore, it is important to recognize our own ways of responding by which we defend ourselves against unpleasant emotions caused by stress, which we can develop more appropriately.  Dealing with stress involves thoughts, body, emotions and behaviours by which we act on a stressful situation.

Mechanisms of coping with stress can be aimed at solving problems or relieving emotions. Problem-oriented dealing involves planning, negotiating, caution, seeking information or support whereby a person strives to act on a stressful situation. For example, fear of infection is solved by following the instructions of those responsible and searching for information, we solve the fear of isolation through virtual socializing. Facing focused on emotions includes highlighting the positive, reducing tension, turning to religion, reconciling with destiny, seeking emotional support to easily tolerate emotional distress fuelled stress. Coping with seeking social support and feeling the availability of support is an important protective way of dealing with stress.

The method of coping should be appropriate for the person and the situation, so first we need to identify the stressor that triggers our reactions and then use multiple coping methods suitable for this situation.

In situations of uncertainty in which we do not have control, it is recommended to use tolerance and acceptance of the situation, pay attention to other activities, stop disturbing thoughts, positive religious and spiritual confrontation, reducing emotional agitation and relaxation.

Recommendations are: recognize what disturbs you and your reactions, choose a way to cope with the stress that helps you feel better without endangering yourself, choose what will empower you and not weaken you, combine solving techniques problems with the techniques of dealing with emotions, ask for support from close people as well as experts.

Escape – pathological anxiety

People with specific misconceptions (which block reassurance by evidence that the threat is unrealistic) find some events threatening what they respond to – maladaptive — and which maintains anxiety and results in pathological anxiety.

Maladaptive ways of dealing with anxiety are passive avoidance and active insurance. Dealing with avoidance involves avoiding thoughts (denial, imagining, images, memories), bodily sensations, emotions (suppression, humour) and behaviours (avoiding situations, isolation, self-destructiveness e.g. intoxication) while ensuring it involves searching the environment for “dangers”, mobile phones, other people, which makes a person cognitively, emotionally and behaviourally away from stress, which currently reduces anxiety but maintains it in the long term and threatens the sense of self-efficacy.

Pathological anxiety is of excessive intensity and duration, out of danger, generalized, can not be controlled or explained, interferes with functioning.

Permanent consequences on the psychological state of youth – brave enough to seek help?

When a person or family member notes that they are alone or a family member of a changed psychological state (e.g. angry, sad, frightened), behaviours (e.g. withdrawn, intoxication, quarrelled) and functioning (e.g. avoiding and stalling obligations) the first thing to offer is the opportunity to talk, and then incentive and support to seek professional help by going to the family doctor. A family doctor can provide a person with support psychotherapy, and, depending on the problems, introduce some types of specific psychopharmacotherapy or recommend a competent institution where a person can receive professional support. Psychologists with psychotherapeutic education conduct psychotherapy, which in some mental health problems is as effective as medicines. Psychiatrists after diagnostic treatment and examination conduct specific psychopharmacotherapy and psychotherapy. In the case of mild and moderate levels of problems without much difficulty in functioning, psychotherapy is sufficient, but in the case of severe level of problems and dysfunctionality, it is necessary to introduce specific psychopharmacotherapy in addition to psychotherapy.

In conclusion, mental health problems are characterized by a subjective feeling of suffering, duration and intensification of difficulties with difficulty functioning and then it is necessary to seek professional help.

Getting used to the “new everyday life” — the possibility of returning to the old or permanent change?

This crisis situation is beyond the usual human experience and thus abnormal, therefore being abnormal is natural and normal. We can’t get away from stress exposure but we have a fight left and if the way is right then we will win. The recommendation is to retell the experienced events as much as possible and talk to close people about their own feelings (fears, situations), but also to develop the ability to listen (to hear how others experience and what they fear), which helps to make a person feel better for a long time and prevents emotional consequences of stresses. Furthermore, a person is not weaker, but more courageous than others if he asks for professional help, because with it it will be easier to solve his problems. With protective ways of dealing with stress, but also professional help this mental crisis everyone can win and get out of it mentally stronger.

Mental health is increasingly being discussed, which is no longer a taboo topic. However, mental health problems are still the most stigmatised due to prejudices based on ignorance and misconceptions, based on research 80% of people tend to accept mental than a somatic disorder. Prejudice against people with mental health problems is often an obstacle to seeking help and treatment, and a threat to mental health.

Method of providing assistance and location

Department for the Protection of Child and Youth Mental Health (Mental Health and Addiction Prevention Services, Teaching Institute for Public Health, dr. Andrija Štampar) implements mental health protection of persons from 12 to 25 at two locations Heinzelova 62a  and Remetinečki grove  14, and to engage in treatment is not required referral already prior telephone agreement term (Heinzlova 6468340, Remetinečki grove 3830088). Opening hours of Heinzelova are Monday and Wednesday 12-20h and Tuesday, Thursday and Friday 8-16h, and Remetinečki cultivar Monday, Wednesday and Friday 8-16h and Tuesday and Thursday 12-20h. Health activity is carried out through preventive and therapeutic activities through the teamwork of health workers (doctors, nurses) and associates (clinical psychologist, psychologist, social worker, defectologist), and cooperation with specialist-conciliar and hospital health institutions and other systems.

Service for Mental Health and Addiction Prevention of the Teaching Institute of Public Health dr. Andrija Štampar from 17.03.2020 conducts psychological support by telephone for all who need it and are our numbers on the website of the Institute.

In cooperation with other institutions, the Service has developed a manual with self-help skills in dealing with the negative consequences of stress available on the website of the Institute http://www.stampar.hr/hr/program-ocuvanja-mentalnog-zdravlja-borbom-protiv-negativnih-utjecaja-tjeskobe-i-stresa , which includes stress management techniques, control disturbing thoughts, self-help procedures for insomnia, relaxation exercises… and a manual specifically designed for students “Working on myself” available on the website of the Institute  https://www.stampar.hr/sites/default/files/Aktualno/prirucnik_radim_na_sebi.pdf

Read Mentalists of our Facebook https://www.facebook.com/mentalisti.nzjz/ and Instagram page https://www.instagram.com/mentalisti.stampar/?hl=en. Practice self-help skills, and if necessary call you come. All who need professional help are welcome.

Translated by: Ines Jurak

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