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Understanding Mental Illness Stigma in the Philippines

Medically reviewed by Mike Kenneth Go Doratan, MD · General Surgery · The Medical City Ortigas
Written by Bianchi Mendoza, R.N. · Updated Sep 20, 2023

Mental illness stigma in the Philippines is still rampant. But in recent years, there has been a steady progression towards real, lasting change.
Slowly, the culture of prejudice against those diagnosed with mental disorders is shifting towards acceptance and understanding.
We see this in how more spaces are opening up in Filipino society for healthy dialogue. Each story is slowly reversing this sense of shame and pushing the conversation forward.
Recent legislation further supports these long overdue changes. In 2018, after almost 20 years in Congress, the Mental Health Bill (Republic Act No. 11036) was signed into law. This affirms
mental health as a basic human right in the Philippines.
DOH names Depression a Serious Health Condition
The Department of Health (DOH) now considers depression as a serious health condition.
This is a reassuring development, especially considering that over 3 million Filipinos are living with some form of depression.
In fact, depression has become as prevalent as the common cold, with the ones most at risk being young Filipino adults (ages 18-34). 8 in every 100,000 Filipinos die by suicide. These cases
mostly involve Filipino men between the ages of 15 and 29.
When it comes to overcoming mental illness stigma in the Philippines, we are at the cusp of a real breakthrough. But in order to better visualize the possibilities, we must first look back to
where it all began.

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The Root Causes of Mental Illness Stigma in the Philippines

To better understand mental illness stigma in the Philippines, we must first consider it within the context of the country’s culture and history.
Filipinos pride themselves in being able to endure. This culture of resilience is defined by Filipinos’ ability to adapt well in the face of often overwhelming “tragedy, adversity, trauma,” such as
natural disasters and socio-economic upheavals, which have become major sources of stress and anxiety for generations.
Historian Jose Canoy sees Filipino resilience as a defense mechanism, assumed by many in the absence of choice. So it’s become common to practice to solve problems on our own and to
downplay mental health issues—whether it’s our own experience or that of someone close to us.
The local language reflects these limitations. The catch-all word “baliw” (crazy) is often used to refer to almost all mental health conditions on the spectrum.
On a larger scale, mental illness stigma in the Philippines is borne of a lack of public health education. To this day, there are still people who have not been fully educated about the distinctions
between bipolar disorders or schizophrenia, for instance.
But through more mental health awareness programs in schools and in the workplace, societal and cultural biases about mental illness will slowly fall away to make way for awareness and
understanding.

Common Obstacles to Seeking Care in the Philippines

According to the Gallup 2019 Global Emotions report, the Philippines is one of the world’s most emotional countries.
Even though this culture of catharsis could be viewed as helpful for those struggling with mental health issues, it can also be precisely what hinders expression.
Why? Because those suffering from mental health issues seek help from family and friends or simply retreat into themselves, without considering professional help.
When someone does decide to open up about mental and emotional struggles, most dismiss their conditions as easily remedied, often by religion or simple socialization.
Others can also make hasty generalizations, saying that someone with a mental illness cannotAdvertisement
function properly in society. And the only option is for them to be committed to a mental
institution.
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The price of therapy in the Philippines also becomes another obstacle. Professional help is costly, requiring several thousands of pesos. A typical therapy session at a private hospital costs
about P2,000.
However, these obstacles are now being addressed, as the government is recognizing that breaking mental illness stigma in the Philippines is a pressing need.
So the recent Philippine Mental Health Law has improved access to mental health services. The Philippine Health Insurance Corporation (Philhealth) now covers confinement, checkups, and
medication for mental health patients.

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How Can We Overcome Mental Illness Stigma in the Philippines?

The World Health Organization (WHO) estimates that 1 in 4 people worldwide will experience mental or neurological disorders throughout their lives.
At present, 450 million people suffer from mental disorders. So this hits closer to home than we might think. At some point in our lives, we or someone we care about will likely experience some
form of mental illness.
There is not an overnight solution to breaking mental illness stigma in the Philippines. But we can start by taking steps towards change, in our own interactions within our social circles.
Filipino culture is defined by openness. So this can translate to how we treat social issues, like a lack of mental health awareness. We can begin by acknowledging the varying degrees and
wide spectrum of mental illnesses and how it manifests differently in each person.
A person’s mental health is defined by certain characteristics, such as biology, experience, and trauma.
Breaking mental illness stigma in the Philippines can start with seeing people as more than just their condition. We must encourage one another to speak our truth and create a culture that
encourages dialogue without shame.
How to Support Someone with a Mental Illness
If you’re unsure where to begin, here are some tips to supporting a loved one with mental illness, according to the Mental Health Foundation UK:
1. Create a safe space. Let them share without judgment or distractions. Put your cellphone away. Clear your schedule to let them know you value the privilege of this conversation.
2. Let them determine the pace of the conversation. Don’t rush or force them to share more than they are willing to. Just be attentive to their cues. Stop or pause when needed.
3. Don’t try to fix things immediately. As much as it’s tempting to give your own opinion, refrain from making assumptions or generalizations. Don’t try to fix them. Simply be there for them
and make them feel that you are there.
4. Ask open-ended questions. This will allow them to share, in their own words. It also lets the conversation flow freely. The less pressure, the better.
5. Listen intently. Even though you don’t agree with certain things, don’t negate them. Constantly reinforce that you understand them, or at least you are trying to.
If you sense that they are not ready to talk just yet, don’t take this personally. Just be ready to offer support. And direct them to the right resources in more serious cases, such as a mental
health crisis. Simply empower them with choice.
Forging the path to understanding takes time. And any lasting, social change requires patience. This means breaking mental illness stigma in the Philippines on every level—from the highest
rungs of government to the local government units, down to the most basic unit of society, which is the family.
Breaking stigma is a continuous cycle of raising awareness, but also inspiring compassion and empathy.
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What Is the Difference Between Clinical and Situational Depression?
Medically reviewed by Jezreel Esguerra, MD · General Practitioner
Written by Den Alibudbud · Updated Dec 23, 2022

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As the world fights the pandemic, a growing number of mental health experts are calling on everyone to take care of their mental health. As people are forced into lockdown or quarantine, the
lack of physical and social interaction affects them in different ways. One of the results is depression. Find out more about the different kinds of depression here, including clinical depression
vs situational depression.
What Is Depression?
The World Health Organization states that depression affects over 264 million people worldwide.
It’s a common mental disorder that has the following symptoms:
• Bouts of sadness that may last for a long time
• Sudden apathy towards activities that used to be pleasurable or rewarding
Depression can lead to other irregularities like:
• Lack of sleep or disturbed sleep
• Loss of appetite
• Unexplained tiredness
• Poor concentration
Because of these symptoms, depression can affect a person’s ability to function normally. Since depression may last for a long time, its effects can also be long-lasting. And it may even recur.
Several factors can contribute to depression. These causes are different for each individual. A childhood trauma, unemployment, isolation, or financial worries can trigger depression. Causes
can be biological, social, or psychological.
There are two types of depression– clinical and situational depression. Let’s examine each one in more detail.
What Is Clinical Depression?
Clinical depression is more commonly known as chronic or major depression. As the alternative names indicate, this type of depression can be persistent. Or it can happen just once but in a
serious manner. And when depression is triggered, the overall mood of a person suffers.
More specific types of depression also fall under this condition:
• Persistent depressive disorder – a depressed mood that can last for at least two years
• Postpartum depression – severe sadness that can afflict mothers who have just given birth
• Seasonal affective disorder (SAD) – a change in season can trigger this severe depression, and most cases happen during winter
• Psychotic depression – a type of depression triggered by psychosis
A person with clinical depression must exhibit at least five symptoms, with a persistent depressed mood being the most common sign.
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This mood is similar to a feeling of sadness, emptiness, hopelessness, or pessimism. Although sadness is considered a normal human emotion, it is when a person experiences it consistently
that it becomes a serious issue.
Other common symptoms are:
• A sudden loss of interest in normal activities or hobbies
• Developing a sense of guilt, helplessness, or worthlessness on top of the depressive mood
• Having less energy, feeling tired or slowing down even when doing ordinary tasks
• An inability to concentrate on normal tasks, remember details, or make decisions
• Developing sleep-related problems like insomnia or oversleeping
• Developing food-related issues like overeating or experiencing a lack of appetite
• Being persistently restless, irritable, or anxious
• Developing physical issues like chronic headaches, stomach problems, or heart palpitations
• Having suicidal thoughts or attempting suicide Advertisement
According to the US National Institute of Mental Health, the symptoms of clinical depression can vary according to the gender of a person.
Women usually develop emotional symptoms such as sadness or notions of worthlessness or guilt. Meanwhile, men are more likely to develop behavioral symptoms, such as insomnia or loss
of interest in activities or hobbies.
What Is Situational Depression?
Situational depression is also called adjustment disorder with depressed mood. Basically, it happens when a person goes through a traumatic situation and the person cannot cope with the
change that happens. When the person has adjusted to the event or the change, then the depression can eventually go away.
Like clinical depression, there are many causes of situational depression like the death of a loved one, marital problems, retirement, or bullying at school. The root of these causes, though, is
the same: stress. People who cannot deal with stress are more at risk of suffering from situational depression.
This type of depression has symptoms similar to that of clinical depression. These include changes to a person’s emotional condition (such as sadness, or pessimism), or behavioral condition
(such as irritability, or turning to drugs). It also includes changes in physical condition (such as chronic headaches or stomach aches).
For a case to be diagnosed as situational depression, a person needs to undergo physical and psychological exams first so that physical illnesses or post-traumatic stress disorder (PTSD) can
be ruled out as the cause of the symptoms.
Clinical Depression Vs Situational Depression
Clinical depression vs situational depression has two major differences.
Length of the Depression
As stated earlier, clinical depression is persistent and can last for years. Meanwhile, situational depression may go away when the person adapts to the new situation or talks about the event
that triggered the depression.
That means a person with clinical depression may recover faster than someone with situational depression. However, this doesn’t mean that situational depression has less of an effect on a
person. Both types can affect the mental well-being of a person in serious ways. Further, if situational depression persists, then it can eventually develop into clinical depression.
Clinical Depression Vs Situational Depression: Triggers
Specific events in a person’s life trigger situational depression. Such major events can also trigger clinical depression. However, genetics or substance dependence can also trigger clinical
depression.
If you experience any of the events or symptoms stated above, don’t keep your condition a secret. Remember, depression is a common mental condition because it affects many people. The
most important step is to consult your doctor so that you can take steps to manage and eventually, overcome your depression.
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