Marian Rojas Estapé: The Spanish Psychiatrist Bringing Mental Health to the Streets

On December 2, 2024, in front of a crowd of over 700 people, including executives from Planeta Publishing, journalists, and the general public at the International Book Fair in Guadalajara (FIL), renowned Spanish psychiatrist Marian Rojas Estapé presented her third book, “Recover Your Mind, Reclaim Your Life.”

Marian delights in observing people; she is fascinated by how individuals handle their emotions, choose partners, why they get depressed, and how they recover. She dedicates much of her time to helping people through her consultations. In her first book, “How to Make Good Things Happen to You,” she emphasized the importance of understanding that the mind and body are connected, how people manage their emotions, and aimed to bring them closer to the best within themselves—to connect with the best life has to offer and manage adversity. The main character of that book was cortisol, the well-known stress hormone.

Her second book, “Find Your Vitamin Person,” focused on oxytocin, the bonding hormone. Her latest book, “Recover Your Mind, Reclaim Your Life,” features two main characters: dopamine and the prefrontal cortex, rooted in the diagnosis of our times. We have all felt more irritable, impatient, and find it harder to pay attention or manage our impulses in recent years, struggling more with tolerating pain, boredom, and discomfort—a global phenomenon.

The author noted that we struggle to read a novel, engage in a conversation, or delve deep into a text, and we are more sensitive, which relates to dopamine and the prefrontal cortex. Dopamine, the pleasure hormone, helps us enjoy life and is present in pleasure. It is a hormone that ensured our ancestors, such as our parents, grandparents, and great-grandparents, released it during two key survival activities: during sexual relations and eating.

Dr. Rojas points out that dopamine helps us repeat what we enjoy; it's a substance in charge of making us want to repeat what gives us pleasure. This is emphasized throughout the book, which is highlighted in green to draw attention to important content. A recurring phrase throughout the book explains our current situation: “the brain remembers what calms it, what excites it, and what gives it pleasure.”

She asserts that we tend to repeat what calms us, excites us, and pleases us, which we understand when it comes to food, sexual relations, and bonds with people. However, drugs have hacked this dopaminergic system over the years, initially entering our systems through the nose, mouth, and veins, and are now designed to enter through the eyes. The book devotes an entire section to social media, TikTok, pornography, and video games, explaining how the dopaminergic world was engineered through these platforms by a group of people who said, “Let's try to manipulate people's reward systems through the screen.”

The danger, she notes, lies in being constantly flooded with dopamine because our body is always seeking balance. For instance, if we eat 25 delicious dulce de leche cookies, our glucose levels spike, which can be dangerous. Our body does not like this hyperglycemia and activates insulin to regulate the glucose. Just like our bodies regulate sodium, potassium, pH, fever, and glucose levels, our brains regulate dopamine because constant dopamine release can lead to addiction, a severe disease that can alter brain areas and behavior.

“In this dopamine-intoxicated life, one of the vitamin routines that saves us and allows us to enjoy pleasure healthily and tolerate pain properly to connect with life is occasionally accepting micro doses of pain,” she explains. This means sometimes waiting before purchasing something or checking Instagram. Tolerating a bit of pain is very rewarding for the brain.

She also emphasized, “It's much easier for our instincts to be hijacked than for us to dominate them. Our reward system is easily vulnerable.” She explained that the second main character of the book, the prefrontal cortex, is responsible for paying attention, concentrating, managing our impulses, and postponing rewards. It is the center of our self-governance.

“If you give a child a tablet from a young age, the tablet offers light, sound, and movement. The brain operates on a ‘use it or lose it' basis. If I use ChatGPT for everything, the part of my brain that helps me remember things shrinks. If I use Google Maps or Waze all the time, my sense of direction worsens. The same happens with the prefrontal cortex,” she remarked.

The book is divided into four sections: the first on dopamine, the second on the prefrontal cortex, the third on the history of social networks detailing events like the Facebook papers and the impact on mental health, and the fourth on establishing vitamin routines. These small acts help us enhance our prefrontal cortex and balance our pleasure-pain threshold. The book also discusses the importance of sleep protection, the concept of flow, and permitted boredom.

“Nobody has discovered anything important in a frenetic moment. To observe, understand, and create, I need to start getting bored,” she stated.

She advised not to try all routines at once as that can lead to a cortisol overdose. Instead, start gently and gradually. Finally, she talked about oxytocin, her favorite substance, the hormone of childbirth and lactation. Stimulating oxytocin reduces cortisol. Oxytocin is the biochemical sign of empathy, occurring with massages, hugs, and pets. In a world constantly flooded with cortisol, fear, and dopamine, we must not let oxytocin be taken from us. It helps us better interact with those around us.

MENTAL HEALTH IN COMPANIES

In a private meeting with the press during her visit to FIL, I asked her how she views mental health in companies. She shared that since she was a medical student, she knew she wanted to focus on mental health prevention, trying to understand the brain to explain it to people so that they would care about their minds, their behavior, and their relationships with others. Her father, the renowned psychiatrist Enrique Rojas, supported her because he thought it was a great idea.

She recounted that initially, when she spoke at universities, schools, and companies, they were reluctant to invite a psychiatrist. Leaders of these institutions would say, “If I, as a businessman or director or CEO, invite you as a psychiatrist, it means I consider my employees to be unwell mentally. So, if you don't mind, let's not say you're a psychiatrist. Let's say you're a general doctor.” But she insisted, stating that what she wanted was to talk about psychiatry in all areas: politics, the business world, the economic world, schools, and to make mental health a subject that could be taught in schools, providing teachers with tools to help teenagers.

Rojas Estapé mentioned that it wasn't easy at first; nobody believed in it because mental health had a huge stigma. Being mentally ill meant being sent to a very dark place, having a mental health problem meant being misunderstood and judged, and what she tried to do when she began all this dissemination was to explain that we all go through moments in our lives where we experience anxiety, depression, have a family member with obsessive-compulsive disorder, bipolar disorder, insomnia, or any type of mental pathology, symptom, or disorder that can be prevented and helped by talking about them. Talking about mental health is not a bad thing. In her opinion, the only good thing about the COVID pandemic was that afterward, people could say they had a mental health problem and not be judged.

The psychiatrist said that at least in companies, based on her experience in Spain, mental health is increasingly discussed. There are Well-being departments, departments that seek emotional well-being, and barriers are being broken. In the last five years, every time a company or school calls her to give a mental health conference for employees, it's another step forward.

What does she seek? That people want to improve, that people want to know themselves, and that, with more and more information available as neuroscience advances every year, it's important to apply this neuroscience in everyday life in a simple way, until this book came along—easy, simple, and accessible to everyone because neuroscience and mental health can sometimes be complex topics.

“I try to make sure that the reader never feels judged when they are with the book but rather feels accompanied, that there is someone on the other side who has written the book, who understands them and says: I know what you are going through, you should know that this has a solution, I give you some tools to either ask for help or move forward,” she concluded.

About Marian Rojas Estapé:

Marian Rojas Estapé is a psychiatrist, holding a degree in Medicine and Surgery from the University of Navarra. She works at the Spanish Institute for Psychiatric Research in Madrid. Her professional focus is primarily on treating individuals with anxiety, depression, personality disorders, behavioral disorders, and conducting family therapy. She is a guest lecturer at the IPADE business school in Mexico. She has been involved in various cooperation and volunteer projects abroad. Since 2007, she has been delivering lectures both in Spain and internationally on topics such as stress and happiness, education, screen time and social media, as well as depression and somatic illnesses. Recently, she has initiated a project called Ilussio, focusing on emotions, motivation, and happiness in the business world. With over 3.5 million followers on Instagram, she is the author of three books: “Cómo hacer que te pasen cosas buenas” (How to Make Good Things Happen to You), “Encuentra Tu Persona Vitamina” (Find Your Vitamin Person), and her most recent one presented at FIL, “Recupera tu mente, Reconquista tu vida” (Recover Your Mind, Reclaim Your Life).