The Face of Mental Illness in the Philippines

November 20th, 2017 wasn’t just a day of victory; it was a promise slowly materializing: no Filipino shall ever have to suffer in silence.

This is an ambitious idea—advocacy has always been a limbless vessel of ambition and opportunity—but there are champions willing to serve as legs to forward and arms to spread the cause. The mental health community, after all, is about helping each other understand the need to find strength from within.

After earning the approval of the lower congress, the Philippines is now only two steps away from officially having a national policy on mental health. What the bill guarantees is the protection of the rights of Filipinos with mental health needs. Facilities will be modernized to provide quality services. Community-led services will be developed. Mental health will be integrated in schools’ curricula.

What it does not guarantee, however, is a stigma-free country. The Philippines is just one of several countries that continue to suffer from deeply-rooted stigma against mental health, alongside many social issues such as gender inequality and HIV awareness. 

This is the curse of living within a culture known for upholding resilience and optimism amidst personal struggle: people expect you to withstand all storms. To them, depression is only a phase of self-doubt, a matter of principle and not psychology. If you’re lucky enough, the downside will be having to endure both the illness and the stigma. If you’re on the other end of the spectrum, the self-branded doubters of invisible illnesses, it is an entirely different struggle.

The troublesome truth is that a vast number of mentally ill Filipinos cannot just enter a well-ventilated hospital room and talk to a therapist about how the last two weeks have been for them. They’re not just given prescription for psychotropic meds they can afford. Their pain is un-defined by DSM terminologies; they’re not categorized according to their type of disorder.

The face of mental illness in the Philippines does not even recognize what the word depression means, because to him, the aching void he carries around is just a punch in the gut: an endless echo of who he used to be, a constant reminder of who he could have been. He makes the bottom of the bridge his home, sniffing his third plastic of rugby, which is cheaper than food, he’ll say, but dispels hunger just as well. No, he will not admit that he needs help, no matter how many times he has been in and out of prison. But his criminal records will not pass as a medical certificate. His cries for help are deemed threatening; when he implodes, others shield themselves. The difference between rugby and lamotrigine goes way beyond chemical compounds and social hierarchy.

This is the curse of living within a culture known for upholding resilience and optimism amidst personal struggle: people expect you to withstand all storms.

The face of mental illness in the Philippines will laugh when he hears someone else talk about psychological struggle. To him, seasoned alpha male who has faced more failed marriages than failed careers, mental illness is just a matter of who has balls. He will tell you, with one hand holding another bottle of beer, his fifth one for the night, that depression is for the weak. In between chugs and puffs on his dimly-lit cigarette, he will say that bipolar is for women—a naturally fickle-minded sex, he’ll add. Of course, he will leave out the part where he drinks to make one more day bearable, sleeps around in the hope that the moans of strangers will shut out the intrusive thoughts that rob him of sleep and calm. 

The face of mental illness in the Philippines thinks that faith alone can disentangle the knots inside her brain. She thinks that only God can save her from her personal demons, from the walking dead bombing their town. She doesn’t even know whether the enemy is the state or the outsiders; she's lost track after the many times she had to duck down and cover her ears, close her eyes and pray for a miracle. Gripping her rosary as tight as she could, as if it was her only lifeline, she’ll tell you that her depression feels like a betrayal to God. Is this feeling of emptiness the result of carelessly thinking that her prayers remain unanswered? She wakes up screaming, crying, terrorized by nightmares—a vignette of scenes from the bloodshed—but still she will say that she does not need a doctor to label her pain; what she needs is a restoration of faith. 

How can you validate the existence of something that cannot be seen, that does not want to be believed in? How can you help someone who does not want you to?

This advocacy is thriving, but there remain gaps that need tending to. The problem goes way deeper than the lack of budget for better facilities. Perhaps the integration of mental health education to schools’ curricula will make a difference, but to what extent? How do we change the mindset of those whom have spent most, if not the entirety, of their lives holding on to the paradox that “it’s all in your mind”—that all there is to solving so-called mental disorders is a fresh change of perspective? We cannot blame them for subscribing to deeply-embedded misconceptions, to intentionally shying away from the idea that mental illnesses are real and they need help. But the fact remains: we have to try to change their minds. Intersectionality is the key to equality, and we can only hope that through the passage of the Philippine Mental Health Bill, more people will come to understand that they are part of this narrative, that they are heard. Only then can they actually start to realize that they have something to say.

For what it’s worth, the champions of mental health will carry on. Through this struggle, may the silenced suffer no more.