It has been more than half a year since the island of Luzon and some other provinces were placed under quarantine due to the COVID-19 pandemic.
How have you been?
This, according to psychologist Cherie Ann Lo, MA, MSc, RPsy, is the key to curb the rising suicide rate in the Philippines — a dialogue about mental health.
Parallel with the COVID-19 cases, the number of calls that the National Center for Mental Health (NCMH) received from March 2020 to May was doubled compared with the daily calls from May 2019 to February this year.
In August, the National Union of Students of the Philippines reported that a 21-year-old male student took his own life. It was after being told that he needed to temporarily stop schooling due to financial problems and the ongoing COVID-19 crisis.
This is not the first case of suicide among students this year. Last June 16, an 8th grader also died of suicide. The victim was reportedly worried about the high cost of pursuing his education through online classes.
For many years, suicide and mental illnesses are veiled subjects of discussions due to the persistent stigma. This attitude then builds a significant barrier towards prevention and cure.
Fortunately, Lo said the generation of the digital age has become more aware and open to talk about these matters especially now that most are still in isolation because of the looming threat of COVID-19 infection.
Who is at risk?
There is still no updated figures on the suicide mortality rate in the country while under the lockdown. The latest number shows that contrary to what the media often portrays,
self-inflicted death is prevalent among the middle-aged to older individuals. Lo cites that adults have more access to ways to commit suicide.
She added people in this age group are not as expressive as the younger ones, thus making it seem an insignificant matter.
General and pediatric psychiatrist Dr. Constantine Yu Chua meanwhile noted that while all age groups are susceptible to be in a depressive state, most cases of depression are picked up late, sometime after five (5) or ten (10) years.
Cabin fever phenomenon
Everyone is probably familiar with the popular term ‘cabin fever’ which pertains to the difficulties in being stuck at home for a prolonged period.
Yu Chua said it can cause stress ranging from the lack of stimulation, strained familial relationships, and also a sense of detachment from the “real world” outside.
Lo asserts this phenomenon is not a psychological disorder, it’s a state of mind. “I think the closest psychological condition that you can say is claustrophobia.”
While it may not be an official diagnosis, the feelings it is associated with are valid, and most people might be experiencing this unconsciously.
Irritability, irregular sleep patterns, lack of motivation and patience are some of the effects of staying indoors for too long.
The abrupt changes in one’s daily routine also contribute to developing the mentioned behaviors, and it can take a toll on your mental health too.
Lo confirmed cabin fever can definitely aggravate into depression.
Stress, anxiety, and depression
Another popular phrase brought by the pandemic is ‘coronavirus anxiety’. The source of distress with this condition is the fear of getting infected and excessive overthinking of what may come next.
There’s no doubt, the worldwide pandemic is overwhelming, but if anxieties are not handled properly, it may further lead to a more serious mental state.
Yu Chua said depression knows no age so better be observant of your parents, family members, and friends to prevent self-harm and suicide attempts.
Some signs to look for include being sad all the time, not enjoying the things they used to like, feeling tired and sluggish most of the time, and having difficulty concentrating. Disrupted sleep and appetite also indicate more severe depression.
In children, depression can manifest as irritability, poor academic performance, and social withdrawal. In elderly adults, it can manifest as bodily complaints, slowed thinking, and sullenness.
Yu Chua added, there are mainly two categories of depressive disorders; low-grade and high-grade.
“There is what is called ‘persistent depressive disorder’ which is a low-grade depression lasting for years. Low-grade means that despite the sadness and associated symptoms, the person can still function. ‘Major depressive disorder’ is a high-grade depressive episode lasting for at least two weeks.
High grade means that symptoms are severe such as suicidal ideations, sleep and appetite disturbances, and function is already impaired.”
Meanwhile, individuals who have the persistent depressive disorder can further develop major episodes and might be diagnosed with “double depression”.
Influence of media on our mental health
Frustrations about the national situation, including the government’s approach to curbing the COVID-19 cases and the media presentation of the bad news, certainly add up to the stress that can result in depression and anxiety disorders.
Yu Chua said this is especially true for those who feel hopeless and disillusioned.
Moreover, some projects and campaigns of the authorities may act as triggers to some individuals. Sometime in March, several local governments left open coffins and even parade them along the streets to instill fear and to remind people to wear masks and to stay at their homes.
The intention of these actions is logical however, the constant exposure to fearful things increases anxiety, pessimism mindset, and a heightened state of alert.
The changes that the pandemic has brought to everyone’s lifestyle is a hard pill to swallow. Some experts suggest limiting the consumption of news and information to prevent getting overwhelmed and stressed out.
It would also be helpful to be vigilant of fake facts found online and on social media websites to avoid the further spread of misinformation on unproven medical treatments.
Debunking myths on suicide
Understanding suicide and mental health issues involve clarifying hearsay inferences. Lo enumerated a few myths on suicide and debunked them with scientific explanations.
Firstly, individuals who talk about suicide won’t do it. Lo claims this is common among teenagers who grew in families that are not expressive with their feelings and emotions.
“Frequently, parents and friends respond to these statements by saying the person is being too sensitive, ‘drama lang yan’, or the person just wants to get attention.”
(“Frequently, parents and friends respond to these statements by saying the person is being too sensitive, ‘what a drama queen’, or the person just wants to get attention.”)
Lo claims that talking about self-harm is a cry for help, a warning of what the person is about to commit. It’s better to be mindful of the conversations you’re having with your family members and friends as these statements should not be ignored.
Second myth: Anyone who tries to kill themselves must be crazy. Lo explains many people who commit suicide do not necessarily fit into the general categories of mental illness.
Sometimes people are just overwhelmed with the series of events which might make them think that ending their lives is the best option.
Lo added, there are instances when persons who are planning their suicide are not showing any signs of sadness, grief, and despair. Instead, they are having a moment of clarity, a sense of calm, thinking that suicide is maybe the only logical option that they have.
Third, people often think if people are determined to kill themselves, nothing will stop them. This is not true in fact, Lo said, individuals who have suicidal thoughts carry a lot of pain and guilt.
“There is a conflict between guilt from leaving their loved ones behind and the overwhelming pain that they feel. If someone talks to you about it (suicide attempt), it’s best to engage them in the conversation. You cannot have this mindset na ‘okay if talagang gusto niya then ba’t ko siya pipigilan?’.”
(‘Okay, if he/she is really determined to do so, why would I stop him/her?’)
Oftentimes, they’re looking for someone to tell them why they shouldn’t do it. Lo shares this is something that she heard many times before.
Fourth, people who attempt suicide are people who can’t or won’t ask for help. It is important to understand that those who tried ending their lives do not do so by choice.
Aside from experiencing mental illness or difficult life situations, persons who commit suicide often tried many ways to ease their pain and/or asked for help but have been rejected by the people they approached.
“It could be destructive, like alcohol abuse or drugs but definitely they have tried to make things better for themselves. Minsan kasi walang access to quality professional help or naging under-responsive yung hiningan nila ng tulong.”
(Sometimes they don’t have access to quality professional help or the persons they asked for help were under responsive.)
Lastly, talking about suicide may give someone the idea to commit suicide.
As far as studies are concerned, no one can instill an idea on another person’s mind. Lo commented not talking about it makes it even worse.
“Having that safe space to talk about our feelings and emotions, not necessarily just talk about these thoughts of death, it’s actually the best way to support someone who’s having not only thoughts of suicide but mental health struggles”, Lo said.
Ending the stigma
With the world continuously changing, bringing in many risks and challenges, it is time to put a halt to the widespread ignorance and stigma on mental health through conducting dialogues and thorough discourse.
As mentioned several times by the two experts, being vigilant of your loved ones’ behaviors is encouraged to help mitigate suicidal thoughts. After all, it is better to check rather than be wrong about it.
Yu Chua also pointed out it is important to include suicide talks in the school curriculum to reach out and encourage teens to be more open to seeking help.
Another way to end the stigma is to be a responsible netizen, being careful with words especially on social media, and to stop ‘sensationalizing’ suicide cases.
Lo said mental health disorders have a biological basis and that these conditions should be treated as “illnesses, as diseases that we need to cure, not something to be ashamed of”.
If you or someone you know is experiencing suicidal feelings, here are some hotlines to call:
CRISIS LINE BY IN TOUCH
TEL. (02)8893 7603
MOBILE: (+63)917 800 1123, (+63)922 893 8944
TEL. (02)8804 4673
MOBILE: (+63)917 558 4673, (+63)918 873 4673
NATIONAL MENTAL HEALTH CRISIS
TEL. (02) 8989 8727
MOBILE: (+63)917 899 8727