Talking about depression in PH: Nothing unusual about it


By now, I feel comfortable enough to joke to my friends about my visits to the psychiatrist. It was a bit awkward at first, but I remember feeling liberated after blurting out to my friends that I just visited my psychiatrist, but not to worry, she says I'm normal.

I waited a bit to see if they'd say something judgemental, but luckily, they thought it was funny. (Or perhaps they were afraid to tell me they think I'm "crazy." Whatever.) 

But on a serious note, after I published my most recent blog on December 5, dozens of emails, Facebook messages, and Tweets came flooding in. Readers I've never met began emailing me, sharing their ordeals with depression, how they could relate to the same things I mentioned in my piece, the feeling of emptiness, about masking feelings, and other heavier dark thoughts which I cannot mention here.

(On a sidenote, I am still in the process of responding to those messages. Please forgive me if I haven't yet.)

I didn't mention suicide in the piece, but I'd be lying if I said I've never thought about it.

I was touched by the responses. But at the same time, I began to feel heavy and realized that there were so many people struggling to cope with their mental health issues. What's even more sad is they feel like they have no one else to talk to about it who would understand.

Not family, not friends, not their pastors or teachers. Why? This was quite troubling.

The only thing worse than being depressed is feeling alone, like there is no one else in the world who understands you.

To be honest, writing about my personal mental health ordeals is still very uncomfortable for me. But the feedback reminds me of why it's important to do it: to lead by example and talk about this under-discussed issue and to remind others they are not alone.

I've gotten all kinds of comments before when I would be open about my mental state to friends. "Cheer up," "do yoga," "get out more;" or worse "ang emo mo, wag kang masyadong seryoso (you're so emo, don't be so serious)," and the go-to statement here, "there are people who have it worse."  (READ: How not to speak to a suicidal person

No matter how well-meaning you are, to someone with depression or any other kind of mental health condition, these are oversimplifying solutions to complicated problems. It's not that easy.

So I will not pretend like I know how to answer everyone's problems, but I will share a few things that I've learned.

The scale of the problem with mental healthcare in the Philippines, I realized, is huge.

Most health plans do not cover mental health, and visiting a psychiatrist can be costly ranging between P3,000 to over P6,000 per visit (not including medicines), making mental healthcare inaccessible for the poorest in the country. 

University of the Philippines professor and psychiatrist Dinah Nadera told Rappler in October that there are only 490 psychiatrists in the Philippines, where the population is now 100 million. 

In 1998, then President Fidel Ramos signed Executive Order 470, establishing the Philippine Council for Mental Health. The Philippine Psychiatric Association (PPA), said, however that no council exists today and its policies are "poorly implemented."

The first mental health legislation was introduced in 1989 by Senator Orlando Mercado, then again a year later by Senator Jose Lina.

Sixteen versions of mental health bills have been filed since then, the latest filed in the House of Representatives by Camarines Sur Third District Representative Leni Robredo, with Representatives Barry Gutierrez, Walden Bello, Kaka Bag-ao, Romero Kimbo, Karlo Nograles, and Emmi de Jesus.

The Senate version was filed by Senator Pia Cayetano.

HB 5347 and Senate Bill 2910 – the Philippine Mental Health Act of 2015 – require the government to "uphold the basic right of all Filipinos to mental health and to respect the fundamental rights of people who require mental health services."

While legislation and policy changes are important, we cannot move forward if we do not first change the way we think about and discuss mental health in this country.

Most will tell you that the first step to healing is admitting you have a problem. But this is easier said than done when mental health is widely considered a taboo topic, and shameful to even bring up.

De-stigmatizing mental health issues is an important first step as a community. For those going through depression, it's about having the courage to not be ashamed to talk about it in spite of the taboo.

A doctor friend of mine said it best: "Mental health IS health." It's about time we all think about mental health this way. One should be able to say, "I'm going to my psychiatrist (or psychologist)" in the same way we say we are going to any other physician.

The reality is that we may not all be lucky enough to have family or friends, or know anyone we can comfortably talk to about our mental health. I get the courage to admit (what I think) are embarrassing things about myself, and write about them, when I remind myself of what the character Tyrion Lannister tells Jon Snow in one of my favorite shows, Game of Thrones.

"Let me give you some advice, bastard. Never forget what you are. The rest of the world will not. Wear it like armor, and it can never be used to hurt you."  – Rappler.com

Ryan Macasero

Ryan covers Cebu and the Visayas for Rappler. He covers all news in the region, but is particularly interested in people stories, development issues and local policy making.

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