Manila (CNN Philippines Life) — Although one in five Filipino adults has been diagnosed with a mental or psychiatric disorder, mental health remains to be a fraught topic among Filipinos. While the Senate has passed legislation to strengthen mental health education and services, attitudes remain very dismissive towards people with mental disorders.
People with mental disorders must deal with all sorts of uninformed (and unsolicited) opinions on their conditions. Words like “topak” or “nagdadrama lang” get thrown around carelessly, or people use aphorisms like “Happiness is a choice” without realizing that there is a lot that stands in the way of a mentally ill person being able to “choose” happiness.
Chalk it up to a culture of “pakikisama” that puts more value on the happiness of the whole community over the feelings of the individual, or the general lack of education on mental health. Another part of the challenge in understanding people with mental disorders is the invisibility of their conditions. You can see the symptoms of diabetes or flu, but bipolar disorder and major depressive disorder are harder to identify. The bottom line is that these are medical conditions that require medical solutions.
This stigma compounds the isolation people already feel from their mental disorder, and gets in the way of them seeking out effective treatment. What they need from their peers is support and empathy.
What follows is a general guide for engaging with a friend or family member with a mental disorder. This is culled from a number of sources such as Ainsley and Matthew Johnstone’s “Living With A Black Dog,” the World Health Organization’s mental health fact sheets, as well as my own experiences as a person with major depressive disorder. This is in the hopes that we can all work to share the burden of people around us suffering from mental disorders.
1. Acknowledge and understand the mental disorder.
First thing’s first, a mental disorder is as real as any other disorder or illness. Mental health comes with a lot of stigma, especially in the Philippines, because people assume that it’s all in your head; of course it is, but that doesn’t make it any less legitimate.
It helps to read up a little on the disorder beforehand — its manifestations and possible means to manage it. It’s key to go into the conversation with an implicit acknowledgment that what they’re going through is real and shouldn’t be discredited.
2. Don’t treat them like their problems are small.
When you’re mentally ill, one of the worst things to hear is “Nagdadrama ka lang” or that “There are children starving in Africa, so be thankful for what you have.”
Trying to put everyone’s suffering against a yardstick isn’t just insensitive; it’s unproductive. Whoever you’re talking to already knows there are people suffering somewhere else in the world. They know people are dying. Bringing up these hard truths doesn’t make them any less depressed.
Don’t make them feel that because “worse things are happening,” their suffering is invalid. A mental disorder like depression feels so overwhelming as it is; it need not be compounded by guilt.
3. Sometimes you just need to listen.
When someone opens up about a problem, we can be quick to offer solutions. “Maybe you should change your diet!” “Or take up a sport!” “Or maybe you should cut those people out of your life!” Remember that you’re up against a disorder. Grasp as you may for solutions, there’s no quick fix for it.
Sometimes all a person needs is someone to listen to all the dark thoughts in their heads. They need a space that’s free of judgment where they can just make sense of what they’re feeling. It can be enough to have a shoulder to cry on through a major episode. It’s also incredibly helpful to discuss and analyze the problem with them. Ask them questions like: “What made you feel that way?” “In what situations does your disorder manifest?” “What are the things that make you feel better?”
If they’re able to articulate the problem, it becomes easier for them to break it down and get through it. These are thoughts that are overwhelming and amorphous, but they lose some of their power when you’re able to put them into words.
4. Don’t wait for them to open up to you. Make the first call.
We’d like to think it’s enough to say, “I’m always here,” and that our friends will simply come to us if they have problems. Part of having a mental disorder, however, is constantly fearing the judgment of others, or worrying that you’d be a burden to other people if you opened up to them.
You need to be the one to check in on them periodically without being too invasive. Ask them how they’re feeling. Talk to them about their day. Send them memes (not kidding, this is a lifesaver). It matters for them to know there’s someone looking out for them and that they have a safe space to open up.
5. Understand, don’t attack.
Caring for someone with a mental disorder can be emotionally exhausting. There will be instances where they’ll withdraw from you or lash out at you unnecessarily. It’s important not to take these things personally or respond with anger. While a mental disorder isn’t a free pass on callous behavior, it should inform the way we respond. You need to be able to see past these actions, understand what the person is going through and work from there.
While the disorder can have extremely adverse effects on their behavior, a big part of taking care of someone with a mental disorder is helping them learn to manage and take control of the effects of the disorder.
6. Encourage and empower them to make decisions for themselves.
People with mental disorders often struggle to see the good in themselves. It helps to continually point out good things about them and good things they’re doing on a day-to-day basis.
Encourage them as well to explore options in managing their disorder. There’s a wide range of possible treatments from medication to cognitive behavioral therapy. These can be supplemented with personal means of self-care such as sports, meditation or simply taking time out for themselves.
The key here is talking them through their options, but allowing them their own agency. Remember that you can offer companionship, pivotal advice and essential support, but ultimately, how they move forward is their choice.