January marks Mental Wellness Month. According to the Department of Health (DOH), an estimated 2-3 million Filipinos suffer from serious mental health illness, while the World Health Organization (WHO) reports that 4.5 million Filipinos suffer from depression. Around the world, about 800,000 people die by suicide every year—that’s one person every 40 seconds.
One of the main reasons why depressed people are ashamed to speak up and get help is the stigma attached to mental health. Many Filipinos still believe the fallacies surrounding depression and suicide. We consulted mental health groups, doctors, and survivors to enlighten us on the most common (but worst) things people say to loved ones suffering from depression. Even if you have good intentions, your words may do more harm than good if you do not truly understand the nature of the illness.
1. “Everyone gets depressed, so what’s the big deal?”
To this day, many still believe the fallacy that depression and sadness are one and the same. In reality, there’s a huge difference. Sadness is a natural, human emotional response when something bad happens. Depression, on the other hand, is a deeper (but treatable) illness with debilitating symptoms that linger for weeks to months. [source: Psych Central]
Most depressives have a chemical imbalance in the brain, and exhibit biological and psychological signs. When you lightly throw around the word "depressed" to refer to sadness or when you belittle someone’s depressive struggles, you are adding to the stigma. The misuse of terms such as "depression" and "bipolar" leads to harsher judgments on people who actually suffer from them.
2. “It’s all in your head. Snap out of it.”
Depression is a chemical imbalance in the brain and manifests physical symptoms such as fatigue, insomnia, unusual changes in appetite, and chronic muscle aches. [source: Mayo Clinic] Asking a diagnosed person to snap out of depression is like asking a diabetic to stop being diabetic or telling someone having a heart attack that it’s all in their head.
3. “People have bigger problems than yours. Your life is so great and you have so much to be thankful for, so why are you depressed?”
A common mistake that well-meaning friends and loved ones make is judging the person’s problems to see if it’s grave enough to warrant depression. In reality, depression is an illness that can strike any gender, race, age, financial status, religion, and upbringing. It can happen to even the most intelligent, spiritual, and "blessed" people. Depression isn’t always caused by a traumatic event. For some patients, it happens even when everything in their life seems fine.
One of the cognitive symptoms of depression is distorted thinking. Whether the patient’s problems are realistic or perceived, in their mind these problems or triggers are debilitating, making them feel fatigued and hopeless. [source: Psych Central]
4. “Just think positive.”
While this line can work on a friend going through regular sadness, it may rub off the wrong way when said to a person suffering from clinical depression. When you trivialize depression and downplay the person’s sickness, you won’t make them feel any better.
"The treatment to depression and any psychiatric condition should be holistic-cognitive," said Ryan Edward Rabago, M.D., diplomate of the Specialty Board on Philippine Psychiatry and consultant at Makati Medical Center. "Being positive is just part of the treatment." In the same way a person with cancer or heart disease seeks treatment, a patient diagnosed with depression can opt for a combination of approaches, such as medication, therapy, and even alternative medicine. A sickness doesn’t magically go away in a snap.
5. “But you don’t look depressed.”
"Thanks to movies and TV shows, Filipinos still expect the stereotype depiction of a depressed person—taong grasa, Sisa in Noli Me Tangere, or a straightjacket-wearing person in a mental asylum," said Javi Atayde, one of the admins of SOS Philippines, an online support group for Filipinos undergoing depression. "In fact, with any psychiatric condition—whether it’s depression, anxiety, bipolar disorder, or psychosis—Filipinos tend to generalize it into one phrase: sira ulo," added Dr. Rabago. "Because of the stigma that goes along with having a psychiatric condition, people are uncomfortable with discussing the topic."
When you expect a person to look a certain way before believing that they are truly depressed, you are stigmatizing the illness. This stereotype limits people from identifying those at risk, and making it even more difficult for those suffering to identify it themselves. [source: Medical Daily] In reality, there are people with high-functioning depression carrying this invisible illness.
What then are the best things to say and do for a loved one exhibiting signs of depression?
Here are suggestions from SOS Philippines.
a. Listen and empathize. Say non-judgmental things like, "How are you feeling?" and "I may not know what you are going through, but I’m here to listen." Allow them to open up and share their feelings.
b. Don’t belittle their struggles. Even if their problems seem so small for you, remember that in the mind of a depressive, their struggles are overwhelming and debilitating.
c. Help them get help. Offer assistance, like taking them to a school counselor, calling a helpline, setting an appointment with a doctor, or helping them talk to their family.
d. Follow up. Even if the person seems better after a few days or weeks, check on how they’re doing. Verify if they are indeed getting proper help and support.
If your friend is suicidal, click here.
Crisis Line (free counseling):
Landline: (02) 893-7603
Globe Duo: 0917-8001123 / 0917-5067314
Sun Double Unlimited: 0922-8938944 / 0922-3468776
Hopeline (24-hour free counseling):
Landline: (02) 804-4673
Globe and TM: 2919
Center for Family Ministries (spiritual counseling):
Landline: (02) 426-4289 to 92