Mental health and resilience - the secrets of inner strength | DW Documentary

We are living in an era of crises worldwide, around one billion people are suffering from stress-related illnesses and that number is rising. The key to resilience is staying healthy even when faced with life’s great burdens. What keeps people mentally healthy in spite of serious crises while others break down? Resilience is a natural phenomenon that enables people to continue developing after they experience a catastrophe or traumatic event. Leading researchers are trying to identify the secret

to resilience. As resilience researchers, we aim to identify strategies that can help prevent people from developing mental illnesses. Can we learn to be resilient? It was as if part of me had been ripped out. It’s the greatest loss that a father can experience. Georg Ballmann’s son Luca was killed here on a January evening. Luca’s mother Helen called me on a Saturday morning just after seven. She just said one thing: “Luca is dead”. After a birthday party at a club, Luca and his friend Freddy,

both 16, got into an argument with another group of teenagers. They tried to calm things down. But the situation escalated and ended with Freddy being pushed in front of an oncoming train. Luca was pulled along with him. It’s a tragedy that Georg Ballmann shares with Céline and Björn Wilke, Freddy’s parents. They all grieve for their two sons. In 2019, the police appeared at the Wilkes’ door early in the morning. They said we should sit down. It was the worst sentence of my life, really just th

at one sentence: Your son died last night. And you’re sitting there at the table, you don’t want to believe it, but you don’t say “this can’t be happening”. It’s as if the earth is opening up and sucking your whole soul away. That your whole world is collapsing. The day plays out like a bad movie and you don’t realize what’s happened. You call a few people and then you’re sitting at home. We were lucky that friends came to us very quickly and looked after us. I fully understand people who can’t

cope. I felt that too: why do I get to live - but my son doesn’t? The two families have an endlessly long and painful road ahead. Stress and even crises are part of life. Nevertheless, many people stay mentally healthy. The question is how? The largest center for resilience research in Europe is in Mainz, Germany. Here, neuroscientist and brain researcher Professor Raffael Kalisch researches the mechanisms of mental resilience. What is mental health? My interest in this question comes from my ve

ry early days as a university student. A schoolmate and close friend of mine had a breakdown in the first year of his studies while I was having a wonderful time. To me it was all fascinating and great and new. And during that time, I watched my friend fall apart. And that made me ask myself: Why does it happen to some people and not to others? What are the risk factors for mental illness? The interesting thing is that it’s not just really big, extreme life events that can make people mentally i

ll. It’s not just a serious accident, an act of violence, or the death of a loved one, but also minor stresses that can affect people if they occur frequently and over an extended period of time. What do those with resilience do differently? To find out, Kalisch is conducting a long-term study of healthy people who find themselves in a particularly difficult phase of their lives. We take young people who are in this transitional phase from family and school to adult life, that are leaving a fami

liar environment. We see that in this phase of life, stress-related illnesses tend to emerge for the first time or, if they are pre-existing, become more severe. Every three months, the 200 participants in the study answer a questionnaire about their mental state. To what extent have you felt more calm or tense in the past two weeks? Sitting on a packed train on my way home from work was a bit stressful. But in the mornings, I would occasionally just make myself a cup of tea and relax for ten mi

nutes and then I was able to settle down. Because we do this every three months, we get a very good picture of stress levels over a long period of time. So that we can see over that time how strongly they react psychologically to life’s challenges. Some are affected more, others affected less. And in the end, this gives us a picture of what mental resilience looks like when encountering stressors. At regular intervals, participants come to the institute for a thorough examination. Kalisch and hi

s team use MRI machines to look for indications of how mental stress is processed in the brain. And they examine how stress affects the body. To do this, they take blood and hair samples. We can measure the concentration of the stress hormone cortisol from a hair sample. One centimeter of hair typically corresponds to one month of hair growth, so the analysis of one centimeter, or in this case three centimeters, tells us something about the activity of the stress hormone system over the previous

three months. The results have been logged since the study began in 2016, so there is now a large database of information. Ultimately we want to understand what mechanisms people use to stay mentally healthy in the face of adversity. And once we know these mechanisms better, to utilise or strengthen them, especially in people who do not succeed in doing that. The study in Mainz is due to be finished soon. Kalisch has already identified certain resilience factors one of which is how positively o

r negatively the participants themselves assess their stress levels. There seems to be a connection to optimism and the fact that people believe they can somehow cope, that it will probably work out somehow. That seems to be connected to resilience, so someone who cultivates this kind of positive assessment style or develops it over time is less likely to be affected. So can we influence how resilient we are? Professor and Psychiatrist Marianne Müller is also conducting research at the resilienc

e center in Mainz, investigating what makes some people particularly resilient. I think this is promising in terms of better understanding psychiatric illnesses. For many decades, we’ve had only moderate success in trying to understand how psychiatric illnesses, for example stress-related illnesses such as clinical depression, develop. While psychiatric research focuses primarily on the clinical picture, the science of resilience is more concerned with healthy people. Müller is first exploring t

he basics: What does resilient behavior even look like? With her colleague Ulrich Schmitz, she is investigating this in mice. Resilience can only be measured in the context of stress. That’s why they put small brown mice in the cage with a much larger and stronger white mouse. We take male mice, which, like all or almost all other male vertebrates, show territorial behavior. This means that if you place a test mouse with a larger mouse in its home cage, the larger mouse won’t accept it and will

try to scare or drive it away. This leads to social stress. The brown mouse is removed in order to prevent it from becoming injured. The experiment is repeated for 10 days. They want to know: What is the long-term effect of this permanent stress on the behavior of the stressed mice? After a day’s break, they undertake a second experiment: The brown mice are again exposed to the white aggressor mouse. But this time the white mouse is in a cage. The researchers now observe the following: How do th

e previously stressed mice behave? Do they stay away fearfully? Are they brave enough to approach the white aggressor in the cage? We assumed that the mice were resilient if they always investigated the white mouse a lot, as if they had never experienced stress. However, we thought this might not be resilience at all, but rather the result of a less than optimal learning process over time that the test mouse has not learned, has not understood that this white mouse strain is potentially dangerou

s. If that were the case, this mouse could not be described as resilient. So is the intrepid mouse perhaps just too... dumb? The researchers investigate this question in a third experiment. Here, two large mice are placed behind bars in the cage: The aggressive white one and a brown one, with which the stressed little mouse has had no negative experiences so far. Our test mouse was allowed to freely explore the box, examine and visit the different social partners and interact with them. And we w

ere able to show there are mice that are able to distinguish between the white mouse, which comes from the aggressor strain, and the brown mouse, which is neutral and with whom it has not had any negative experiences. Is resilient behavior about being able to distinguish between threat and safety? We currently see a resilient mouse as a mouse that examines the brown mouse in a completely normal and unimpressed manner, but keeps its distance from the white mouse because it has learned that the wh

ite mouse is a potential threat. We consider this a resilient behavioral phenotype. That means resilient behavior in mice doesn’t mean simply bravely confronting every impending danger but rather weighing up the situation and adapting behavior accordingly. This is directly transferable from mice to humans. There’s a lot of data showing that people who can distinguish between negative stimuli and neutral stimuli are better protected against stress and associated stress-related mental illness. In

this respect, we are also quite confident that we can use this to derive further neurobiological findings. Moving on. Finding her way back to life Céline Wilke tries to do this every day after the death of her son Freddy. I said goodbye for the last time on Friday evening, when he told me cheerfully. “Mom, I’m off.” I told him to have fun. That was our farewell. I can still see him in that moment. He was in a good mood, looking forward to the evening with his friends. And in retrospect, I’m glad

that the last time we saw each other was really a pleasant moment and that we said goodbye to each other nicely without knowing that we’d never see each other again. On the day of the funeral, the whole town mourned with the families. Luca and Freddy are buried together in the same grave. And then the whole congregation walked a good kilometer here from the church in a funeral procession. It was like being in a trance. And the burial itself, of course you noticed that there were a lot of people

there, but it passes you by and somehow you don’t really have any clear memory of the moment. And the funeral, it felt like this whole heaviness, this coffin with both of them, I don’t know if heaviness is the right word - this burden, which is so heavy. Like I already described it, the earth opens up, that someone accepts the burden for me, that I could now pass it in to other hands. Maybe there is a bit of religion in me after all. The physical part will be buried for now, but the emotional p

art, it will take a very long time before this wound is no longer quite so open. Munich. Here, at the Max Planck Institute of Psychiatry, neuroscientist Elisabeth Binder wants to find out: Why do some people remain mentally healthy despite severe stress, while others become ill under the same stress? One topic we researched was genetic predisposition. Could it be that certain people are genetically predisposed to react more or less to stress and are therefore more or less at risk of negative eff

ects later on, such as depression or post-traumatic stress disorder? Elisabeth Binder wants to know: Could it be a gene variant that alters our perception of stress? To find out, she is tracking down the hormone cortisol, an important hormone for our metabolism and immune system that’s also released when we’re under stress. It’s regulated by something called the HPA Axis. When we experience stress, the brain is activated. This sets off a complex cascade of events. In the brain, stress signals ar

e sent to the hypothalamus. This in turn releases hormones that make their way to the pituitary gland. The pituitary gland then releases its hormones to the adrenal cortex, which instructs our bodies to make extra cortisol to deal with the stress. Cortisol allows all the cells in our body to flood with additional energy to aid the fight or flight response. Cortisol is our main stress hormone and it travels to all organs in the body. It’s very important that we are well prepared for a stressful e

vent. Cortisol binds to receptors in our cells and that’s a good thing Because the receptors then report back to the brain: “Thank you! We have enough cortisol bound here now.” The stress response is then switched off in the brain and we calm down again. At least when everything is functioning correctly. Many people are nervous at interviews, but normally, when the situation is over, our stress hormone levels should downregulate again. People with this particular genotype are not so good at this

. So for them, the stress hormone stays higher for longer. The question Binder asks is: Why is that? Why are some people not as good at calming down than others? And this is where genetics come into play. One of the genes responsible for our stress regulation is the FKBP5 gene. It is activated during stress and ensures that an important enzyme is released. It has the same name as its corresponding gene - fkbp5 The problems start when too much of it is released Then the enzyme wedges its way betw

een the stress receptor and the cortisol, and thus blocks the stress receptors’ message to the brain that there is enough cortisol. The brain is misinformed - it keeps firing and we can no longer calm down. We think that stress causes too much of this fkbp5 to be released and that people simply release too much of the stress hormone after even the slightest stress. And we know that too much of this stress hormone in the long term is bad for many processes including in the brain, which also incre

ases the risk of psychiatric illnesses. The researchers have identified the FKBP5 gene as one of several important causes of our hormonal stress regulation. Variants in this gene could be partly responsible for why we react with more or less stress. The researchers are now looking for a way to block activity directly at the FKBP5 gene. And here at the institute, this has been investigated in mice that have been given this FKBP5 blocker whether they are more resilient to stress and are better abl

e to cope with it to the extent that this can be measured in a mouse. The next step is to develop a drug specifically for people in whom this stress gene variant can be detected in the blood, and who therefore presumably have a higher risk of mental illness. The South of France. Psychiatrist and neurologist Boris Cyrulnik lives and works in Toulon. He’s considered a pioneer of resilience research. The traumatic experiences of his own childhood give him a personal perspective. I had a somewhat di

fficult childhood, which motivated me to go into research because I wanted to understand how we can find our way back into life after war, as I had lost almost my entire family in Auschwitz. As a four-year-old, Boris was left on his own, without a mother or father. Hidden by foster families, he was eventually arrested and narrowly escaped death. The officers said: he should be killed. So I knew they wanted to kill me and I was all alone. And I heard adults say: He has no family, he is lost to li

fe. When I was a child, I thought: This can’t be true. I reject this curse! At the age of 11, Cyrulnik already knew that he wanted to become a psychiatrist. After the war, he studied medicine in Paris. The memory of his loving parents also helped him to forge his own path. I fought to study, even though everyone told me: Don’t bother studying, you won’t make it. Well, I made it. When the trained psychiatrist came across the term resilience for the first time, he found his life purpose. When I ca

me across the word resilience, I said to myself, this is a word that needs to be developed scientifically, and we need to bring it into our culture to make people understand that if we abandon injured people, there will be no resilience. Due to his own painful experience, one focus of Cyrulnik’s research is child protection. He’s particularly interested in the interaction between mother and child. We started our research into early childhood in 1981 on the island Embiez, near Toulon, where we ga

thered a team of international researchers. The question was: What makes one child more resistant to crisis, while another is very vulnerable to it? He sees one of the reasons for this in the mothers of these children. If the mother is not doing well, her relationship with her child suffers This is a vicious circle that can begin during pregnancy. We have been able to scientifically demonstrate that when a pregnant woman is stressed the stress hormones enter the uterus and the baby swallows stre

ss hormones such as cortisol, which are harmful to the baby’s brain This means that the baby is born with cognitive changes that are not caused by the mother, but by the mother’s unhappiness. The researchers identified a particularly sensitive phase in the final weeks of pregnancy and the first two years of a child’s life. New networks are constantly being formed in the brain during this time. If nobody does anything, it’s a neurological catastrophe. The brain atrophies. But we can intervene, we

can intervene gently very early and easily. And the earlier we intervene, the easier it is to trigger the resilience process. But if the child is left very isolated for a long time, the resilience process will be difficult to initiate. Elisabeth Binder is also studying this particularly vulnerable phase of life at the Max Planck Institute in Munich. The biggest correlation is an almost 40-fold risk of having attempted suicide when someone experiences severe traumatic experiences as a child. Eve

n during pregnancy, too much stress or trauma can lead the embryo’s natural barrier against the mother’s stress hormones to break. Why is chronic stress harmful to the brain? Because chronic stress leads to our neural circuits becoming weaker. Binder suspects the stress hormone cortisol causes this. But to prove it, she would have to be able to examine the brain of an embryo under stress. It’s difficult of course to get to the developing brain and to expose it to certain factors and investigate

how it reacts. Because this obviously is not an option, the researchers are using a novel method to recreate a developing brain outside the womb. A brain-like cell structure is grown from stem cells. The researchers call this simulation a brain organoid. We can only properly model very early brain development. We can’t model all cell types in the brain and we can’t model how different brain areas talk to each other. So it’s a very simple and limited model, but it’s the first time we’ve been able

to do this. How old are these organoids now? These ones are about 40 days old. 40 days old. So that means we could begin. Yes, this would be a good time to start. Once the simulated embryonic brain - the brain organoid has reached a certain stage of maturation, Binder and her team add synthetically produced cortisol. The effects of the hormone on the development of the brain cells are then investigated. And then we see that this stress hormone actually alters the development and, in particular,

the gene expression of genes that have also been associated with the risk of psychiatric illnesses. There’s no doubt about it: Even in the womb, the mother’s stress influences how strongly genes manifest themselves in the child and can therefore have a lasting effect on their mental health. A finding that could have real life implications. It’s also important to screen for psychiatric symptoms during pregnancy. Some clinics already screen for depression and treat the mother in good time. There

are now many studies experimenting with using therapy during pregnancy to possibly mitigate risk. Environmental influences therefore have a direct impact on our genes. Scientist and psychiatrist Katharina Domschke in Freiburg is investigating exactly what this looks like. We think that environmental influences can trigger illnesses. So now the question is, how does the environment affect our genes? Domschke is Head of Psychiatry at the University of Freiburg Medical Center. In her laboratory, sh

e investigates epigenetic processes how and why changes occur in our genes. Let’s imagine we have a certain genetic predisposition and there is a particular adverse environmental event. But how does this environmental event cause our genes to express, or trigger, so to speak, and ultimately lead to illness. This is where epigenetics play a role. In order to understand this communication between environment and genes in more detail, Domschke and her team are looking at another stress gene the MA

OA gene. It provides instructions to make an enzyme also called maoa. This enzyme migrates into our nerve cells and attaches itself to the synaptic clefts, the area between the nerve cells. This is where our happiness hormones - serotonin and norepinephrine are normally transported from cell membrane to cell membrane. However, if too much of the maoa enzyme attaches itself to the synaptic cleft, it turns out to be a real happiness eater: it simply degrades away the serotonin and norepinephrine.

one of the main suspects in the development of mental illness is monoamine oxidase A, or MAO-A for short. This is because MAO-A breaks down norepinephrine and serotonin. But in some of us, this happiness-eating Maoa enzyme is more active than in others. Why is that Domschke takes blood samples to monitor the MAOA gene and see how much methylation has occured. Methylation is a chemical process where a methane derivative binds itself to specific sites on our DNA, deactivating them. This can be ima

gined as a kind of cap that sits on our genes, putting them to sleep. If the cap sits on the gene, it is considered methylated, and the gene is dormant, silencing its activity. If the cap is removed, however, it becomes active again. In the case of the MAOA gene, more happiness eaters are produced. The MAO-A enzyme is more active and breaks down more serotonin and norepinephrine. There’s less of those hormones available in the synaptic cleft between the nerve cells and it may be easier for depre

ssion and anxiety to develop. This means that we are in a state of risk. If these caps are on our stress genes, they protect us from producing too many happiness eaters. This can make us happier and more resilient. But that doesn’t always happen for everyone. What we saw was that negative life events were more likely to lead to the MAO-A being less methylated, i.e. having fewer caps on the gene, and possibly being at risk, while positive life events were more likely to be associated with increas

ed methylation. So that means the caps were more likely to be on the MAO-A gene, possibly indicating resilience. Positive environmental influences and experiences can affect how our genes are expressed. Domschke’s next question is can this also be demonstrated in successful use of therapy? We’ve known for a long time that psychotherapy works. Psychotherapy is one of the most effective treatments anxiety disorders. What we don’t yet know is how it works in detail And based on our research finding

s, one possible mechanism could be working at the cell nucleus level Can we put these caps back on the stress genes with the help of psychotherapy? Domschke examines the blood of patients who are afraid of heights she climbs the tower of the Freiburg Cathedral with them every day for two weeks. The patients did what we call exposure exercises, where they exposed themselves to their fear of heights So they went up the tower, had to look down and after the therapy we took blood samples again. And

what we saw was that in patients with a successful response to psychotherapy, MAOA methylation had returned to the level of the healthy control subjects. Domschke also obtained the same result in a study on psychotherapy. The number of test subjects is still too small to make a definitive statement, but the initial results are promising. So there are stress gene variants that we bring into the world with us, and yet we can have a major influence on our resilience if we manage to shape our enviro

nment consciously and well. At first, I was paralyzed, I couldn’t do anything. The will to keep going was gone, you’re no longer capable of anything. That was at the beginning. And then things got better. Music was like a prayer, a meditation, a connection that helped me tremendously. A lot of people might ask, where is God, but that didn’t happen to me. For me, music was my religion, and my family and my friends. That was what saved me during that time. Luca’s father, Georg Ballmann, often cons

iders going to therapy. The fact that his son had to die, the senselessness of it, almost brings him to despair. When you think about the trivial reason that led to this terrible end, you just don’t understand It’s so meaningless. Georg Ballmann wants to do something about that meaninglessness. And that’s why we very quickly had the idea of setting up a foundation to turn this meaninglessness into something meaningful. Together with Freddy’s parents, Ballmann established the “faustlos” foundati

on, a program that starts in kindergarten to prevent violence as early as possible. It allows him to stay active, and keep the memory of his son alive. At the Mainz resilience center, psychologist Michèle Wessa focuses her research on very practical help for people in crisis situations. She says that resilient behavior can only develop very gradually. It doesn’t work to develop training courses that somehow make people more resilient and more efficient within an hour and a half or even a day, wh

ich is perhaps what some people would like to see. That won’t work and that’s not what we aim to do. For Wessa, resilience is regulated by the self. She tells us her favorite story to help explain what she means. The story of the elephant in chains by Jorge Bucay is about a very small elephant, a newborn, being chained to a small wooden peg in a circus. The baby elephant keeps trying to break free from the chain, but to no avail. But it eventually grew bigger and stronger, in fact, it could have

broken free long ago. It lacks the belief that it can do it, and that alone causes it to stand still and not try to free itself. When we have the feeling that we can do nothing, that we are powerless and at the mercy of others, this is known in psychology as “learned helplessness”. Wessa examines this state in detail in various experiments. In the experiment, the test subjects are first given an unpleasant noise and at the same time a somewhat unpleasant stimulus on their skin. They are shown c

ircles, triangles and squares, on which they have to press a different button. If the participants press the right button, they can stop the unpleasant noises. This applies to one group. In a second group, however, pressing the right button sometimes causes the noises to stop, but sometimes it doesn’t. What one group learns is, I press a correct button, so I have the situation under control, the stimulus is over. The other group learns that no matter what I do, chance determines what happens. If

this happens several times in a row, it leads to an experience of helplessness there is nothing we can do. We might recognize this from our working life: I do a certain task and I always do it the same way. One day the boss is very happy, the next day he throws it back at me and says it’s terrible. In other words, I have the feeling that I have no control over it. And that’s a very important aspect of how stressed I actually feel. How does the experience of losing control affect future behavior

? In a follow-up experiment, the two groups can only stop the unpleasant noise by finding the safe green squares on a field as quickly as possible. Do the two groups behave differently when searching for these squares? The result is that people who have already felt they were in control in the previous experiment find these safe green places much faster than the group that experienced a loss of control. This experience that I have never been able to do this before also leads to passivity and som

ething like the story with the elephant: That I just give up, I submit to my fate. And so I move further and further into this cycle of helplessness and passivity. According to Wessa, when we manage to free ourselves from this cycle, we can effect change in our lives. But what about the situations in life that we cannot change? I may not be able to change the actual situation that triggered the stress, but I can always change something about how I react to the stress. And I think it’s really imp

ortant that I learn for myself that although I don’t always have control over the stressor, I do have some control over my reaction to it. Wessa puts her research findings into practice at a school in Bad Dürckheim, Germany She is conducting a WHO-sponsored resilience training program in a 7th grade class. Mental stress has increased significantly in recent years, particularly among children and young adults, largely due to the Covid pandemic. For me it’s important that we give them strategies a

t an early stage that they can use themselves to protect their mental health. She works with the students on how they can free themselves from a stressful spiral of negative thoughts and feelings. First, she asks the question: What happens when we are convinced that we will fail at something? Your thoughts influence your actions. If you think you can’t do it, then it may well be that you really can’t do it. So you would then say yes, I can’t do it anyway, so I won’t even try. If negative thought

s lead to bad results, shouldn’t the reverse also be possible? That’s precisely where we can do something for our health and resilience, namely by looking more closely at things that we have already achieved. We often pay much more attention to the things we haven’t achieved. And we remember things that went wrong. And we somehow forget even the little things that have gone well. She does a simple exercise for this by asking the students to remember what they did particularly well over the weeke

nd even if it’s something small. It was my grandma’s birthday last weekend and I baked her a cake. I’m not actually that good at baking, but I managed to do it. She really liked it and that made me happy. Great, and it made your grandma happy too. I helped my dad tidy up my room on the weekend. I never do that! I always throw everything in drawers and that’s it. But this time I really did it with some structure and it was much, much better than just throwing everything in somewhere. Remembering

the successes, trying not to judge experiences too negatively, staying active despite adversity - these are key factors for resilience. We’ve learned a lot. I understand the term now, and know more about the topic of resilience. We also learned how we feel and that we can influence what is happening inside of us: our fears and how we can fight against them. And yes, it was a great experience. We can equip ourselves mentally at an early age to cope better with crises later on, which we will all e

xperience in one form or another. But to what extent does being resilient also mean social pressure to self-optimize to be ready to perform at all times? Resilience simply means finding ways to deal with stress. And that doesn’t mean that you should try to cope with as much stress as possible, but that you should perhaps recognize for yourself: Well, if I have ten appointments a day, that’s too much. I’d rather try to have fewer appointments, or I will plan time to relax to compensate. And that

increases overall resilience to be able to cope better with the various factors in life. In Toulon, resilience researcher Boris Cyrulnik also sees government and society as having a duty to create an environment that enables us to remain mentally healthy. Resilience is genetic, biological, emotional and political. Because it’s politicians who are going to make the decisions to keep pregnant women safe, to create jobs in early childhood care. These are all political decisions. In 2019, the French

government launched a nationwide program based on Cyrulnik’s work. I’m very happy to welcome you here and to launch this mission for children’s first thousand days. And I’d like to thank Boris Cyrulnik, since this work is based on his reflections. The first 1000 days is the name of the government program. Under the leadership of Cyrulnik, projects are financed nationwide in maternity wards and kindergartens to better protect children and soon-to-be parents. At the Nymphenburg Palace in Munich,

the Ballmann and Wilke families are awarded the Bavarian Innovation Prize for Volunteering their “faustlos” foundation it’s a great honor. And they can fund new projects with the 10,000 euros prize money. Working for the foundation means a lot to Céline Wilke. It’s my way of dealing with the days when I’m not feeling great, when my husband isn’t feeling great. That we have something to work on. Their lives can never go back to how they were. The scars will remain forever. But the families carry

on as best they can. A loss like that puts a lot into perspective. I don’t think you get upset about the small things so quickly anymore. You enjoy the moment more because you know how quickly moments can change, how situations can change. You move through life with much more awareness. Resilience is not a state of being, but rather a continuous process. Our psyche is a complex mix of environmental influences, genes and our own ability to act. Resilience is not about happiness it’s about living

with all of life’s gray areas, surviving crises without losing your mental health. To have a realistic understanding. Everyone told me it’s not even worth trying. I tried anyway, but that doesn’t mean everything went like I wanted. Like everyone else, my resilience is never perfect, never 100%. I managed to achieve a lot in spite of everything, but I haven’t solved everything, and I think that can be said of you, of me, of everyone.