Among the total number of overseas Filipino Workers (OFWs) pegged at 2.2 million by the Philippine Statistics Authority in 2019, over 300,000 have so far been repatriated by the Department of Foreign Affairs because of pandemic-disrupted economies. Though this was deemed as the “biggest repatriation effort in the history of the DFA and of the Philippines” by Foreign Affairs Undersecretary for Migrant Workers’ Affairs Sarah Lou Arriola, the numbers indicate that majority of OFWs still remain in other countries.

Recent events have created stress for OFWs, who have their own struggles even without the health crisis. Psychologist Roselle G. Teodosio, owner of IntegraVita Wellness Center, explains that the OFWs’ primary source of stress is being away from their families. “The OFWs usually worry about the families they leave behind. This is especially true for those who have spouses and children.  Another stressor is the culture shock or how to cope with the daily grind of living in a foreign land. The language barrier is a major stressor for OFWs aside from adapting to the new culture.”  Financial obligations also create pressure as families and relatives tend to think OFWs make lot of money.  “The family and relatives do not realize the sacrifices and hardships the OFW makes to be able to send money. Another stressor is their employers and co-workers.  An abusive employer is not uncommon, and there may be multiracial co-workers. Different cultures tend to clash and lead to conflicts at the workplace.”

With the pandemic affecting economies and causing people to lose jobs, OFWs may be overwhelmed by multiple pressing problems. “There is fear, not only for the OFWs’ health, but also for the families dependent on them.  Knowing that there is a greater risk for their families back home, there will be greater pressure on OFWs to retain their jobs,” says Teodosio. “There is the fear of a family member contracting the virus.  The inability to be at the bedside of the sick family member will weigh heavily on the OFW. Also, the fear for one’s own health in a foreign land can be daunting. The OFW has to stay strong and not show the family back home that he is really scared since he thinks this will add to his family’s worries.” 

As if these complications weren’t enough, now the holiday factor is thrown into the stressful mix. Because of the pandemic, OFWs who normally go home at this time to celebrate Chrismas with their families are forced to stay in their countries of employment. “Even the families of the OFWs feel the fear of their loved ones contracting the virus abroad or if they force themselves to come home.  Another concern is if they go home, will they be able to go back to their jobs? So to make sure that there is a semblance of the security of tenure, then the OFW will remain where he is and not try to go back.  The risk of getting infected is much higher if the OFW will try to come home,” shares Teodosio.

Christmas away from Family

Agnes, who has been working in Taipei for almost 5 years, comes home once a year during the holiday season. Like most Filipinos, she regards Christmas as the time to be with family. “My siblings and I are all working professionals, and Christmas is the best time to be in the same place altogether, as we usually take a two-week vacation leave from work. I spend most of my December with family, and since we’ve had a baby in the family—my younger brother’s— it’s been a lot more fun and special.”

Agnes admits that this is her second time to skip spending Christmas with her family. “Last year, I had to go to Italy for the wake of my fiance’s mom. I didn’t feel the impact of not being with my family on this important holiday because I was in a different country, and also needed to support my fiance and pay my respects. But this year, I’m definitely feeling the impact.”

Husband-and-wife OFWs Armie and Boyet in Qatar

Because of the nature of their jobs, Armie and Boyet who have been working in Qatar for 9 years don’t really get to go home during the holiday season. “That’s a busy time in the office,” shares Armie. “So we go home usually in April or May. But we didn’t get to do that this year because of the pandemic. So we thought we’d go home in December for a change—but that plan fell through as well.”

Still, spending Christmas away from her children and her 80-year-old mom for almost a decade has taken a toll on Armie. “It gets sadder each year. Sometimes, I hear a piece of music that reminds me of home, and already, I get emotional. There’s this deep longing to have our family together. When my husband and I first arrived here, we missed our family, but there was the novelty of discovering a new place and culture. Now, we just simply miss our family.”

Armie with her daughter and her 80-year-old mom

Increased Anxiety and Worry

Affirming what Teodosio mentioned, Agnes confesses the stress and anxiety she experiences at work is compounded by the pandemic. “I know I have the choice to not tune in to the news, but I always worry about the effects of the government’s ineptitude on my family and loved ones. I sometimes think I may be getting too emotional and overreacting, but I’ve been feeling like this for quite a while. It’s hard to be in a different country with no support system.”

Even if she’s able to go home, Agnes would rather stay in Taiwan for several reasons. “Although my host country has handled the pandemic well, no one knows if you’ll be able to contract the virus in transit. I don’t have enough leave credits to do a long-period quarantine, and I certainly don’t want to spend Christmas in quarantine.” Though her family understands her decision, Agnes can’t help getting emotional. “The knowledge that I can’t be with my family on this important holiday is making me feel depressed.  We sometimes have video chats and I’ve brought up the topic of missing them a lot especially in these stressful times, and they’ve been supportive to a certain extent. Nevertheless, it’s still a painful decision even if it’s a necessary one.”

Armie and Boyet with their kids in 2018

Though Armie worries about her family contracting the disease, a temporary setback came in the form of her husband’s 5-month unemployment. “He works in a gym, which shut down during the pandemic. The gym is back in business now, but during those 5 months, I worried about making ends meet. Somehow, we did it by cutting back on expenses.”

November brought Typhoon Ulysses, which submerged their house in Bulacan. “My kids and my mom didn’t have electricity and drinking water for several days. I asked help from friends in the Philippines, who thankfully helped them out. Now, my kids are busy with house repairs.” Though her children are used to Armie and Boyet’s absence, Armie confesses that her heart broke when her husband asked them what else they needed. “My kids replied, ‘You. We need you both. Please come home.”’

Coping this Holiday Season

The combined challenges of the pandemic and the holiday season may be difficult, but they can be conquered. Our interviewees offer these tips:

Stay grounded.  “OFWs need to be resilient during these trying times. Focus on the things that they can control such as their thoughts, emotions, reactions and behavior. So in a time of pandemic, they can do their part in keeping safe by following safety protocols,” says Teodosio.

Find a support group. While taking a leave from work to “unplug from the stress,” Agnes is going to meet up with Pinoy friends in Taiwan. “We’re planning to have Noche Buena together and watch the fireworks display on New Year’s Eve.”

Stay healthy. Agnes tries to cope by taking care of herself physically and mentally. She adds, “So when it’s safe to travel, I’ll be in a better state and  be able to make up for lost time.” Teodosio advises OFWs to differentiate between good and bad anxiety. “Some anxiety may be productive; this is what makes us wash our hands often and socially distance ourselves from others and keep our masks on,” she explains.

Focus on the present. The OFW needs to take one day at a time.  “Excessively worrying about the future for himself or his family can sometimes paralyze a person with fear,” says Teodosio.  “Becoming aware and mindful of all his thoughts and feelings can be very helpful in managing these emotions.”

Connect with family. Armie and Boyet make it a point to virtually share the annual Noche Buena with their family.  “I plan their meal, take care of the budget, and make sure they decorate the house. When midnight strikes, Boyet and I eat with them via video chat,” shares Armie. Teodosio encourages OFWS to maintain constant communication. “Trying to weigh the pros and cons of coming home can help the OFW and their loved ones in understanding what is more important to them—the health of the OFW or being together during Christmas.  Having the patience for one another and thinking of what is best for everyone will help the families cope in these trying times.” Agnes affirms this: “Sometimes I feel helpless, but at least with the chats and messages, there’s still something I can do even if it’s a small thing.”

If you’re anxious or depressed, don’t hesitate to reach out to the following:

• Roselle Teodosio (psychologist) – 09166961223 and 09088761223 or email: selteodosio@gmail.com

• National Center for Mental Health Crisis – 09178998727

• Philippine Mental Health Association – 09175652036

• Philippine Psychiatric Association – 09189424864

Have you ever experienced repeatedly thinking about possible negative consequences of an action you haven’t done? How about being unproductive because of the countless thoughts running through your head? If you have, don’t worry because you’re not alone. I have experienced them, too.

I remember when I had to do an impromptu speech for class, and I kept thinking of what might possibly go wrong – such as not knowing what to say, not being familiar with the given topic, or experiencing mental block in the middle of the speech.

Overthinking can get exhausting, so to better deal with it, I had a chat with Dr. Raymond John S. Naguit, founder and national chairperson of the Youth for Mental Health Coalition, Inc.

What is overthinking?

Dr. Naguit describes overthinking as a phenomenon wherein we tend to get ahead of an action or an event before we do or experience it. Rumination is rooted in overthinking about the past, while anxiety involves overthinking about the future. Sadness, guilt and anxiety are normal and valid, but when these emotions hinder our growth and development, then we may have to consider a formal diagnosis.

Dr. Naguit explains that though overthinking in itself is not a clinical disorder, it can be a symptom of a mental disorder. He cited some signs when we’ve fallen into the pit of overthinking:

When we don’t live in the present moment

Overthinking takes away our focus on the here and now because we are too busy projecting into the future or digging into the past. I’ve noticed this in myself. Sometimes, I don’t even notice how my food tastes like because I keep thinking about the things I need to do. Scenarios like this make me question why I overthink since it prevents me from enjoying the little things. 

When it affects our work

Though thinking can help us mentally organize our to-do list, it becomes a concern when it keeps us from doing the very things we think about. 

When it affects our relationships

Overthinking about what people will think or how they will respond to our actions may keep us from taking risks and forming healthy relationships. 

When it causes deviant behavior

Dr. Naguit states that this is when we become “overly cautious about doing a certain action or going to a certain place.” This can sometimes contribute to the stress that we experience, which may lead to mental disorders which, Dr. Naguit assures, is not an immediate effect of overthinking. 

But if negative thoughts are repetitive, Dr. Naguit points out that it is possible to develop an anxiety disorder from overthinking. If we no longer have control over our emotions, feelings, or thoughts, it is best to seek the help of a professional.

Why do we overthink?

Dr. Naguit explains that overthinking is sometimes due to the “many stimuli that we’re faced with.” An example is the COVID-19 pandemic, which has given rise to health risks, political issues, and economic concerns. Too much stimuli can be overwhelming because they exceed our capacity to cope with different stress points. This can contribute to overthinking since we find it difficult to banish these thoughts.

Dr. Naguit says it is normal for us to sometimes overthink, especially if we have many concerns or tasks. He adds that our reactions to a current situation are sometimes a result of previous experiences. Someone who had been bullied in school may approach going to school with caution and anxiety. 

To manage overthinking, Dr. Naguit suggests the following steps:

Express our feelings.

Whether we’re experiencing heavy feelings or bothersome thoughts, we need to release them. Dr. Naguit suggests exorcising emotions on paper; some have “worry journals” that house their thoughts. We can also share our concerns, no matter how irrational, with trusted friends. Sometimes it just takes somebody to tell us that everything will be okay to make us feel better.

Divert our attention.

Dr. Naguit states there are times when we simply cannot control what goes into our minds. However, we can look for a positive diversion. We can try exposing ourselves to another source of stimulus – such as making art, watching television, or exercising. 

Understand our sphere of influence.

How do we differentiate the things we can control from those we cannot? Dr. Naguit advises to map out our sphere of influence. For example, instead of stressing over the number of COVID-19 cases every day, it is better to focus on wearing our masks and washing our hands because these are the things we can control. Doing so will not make us feel so helpless and will give us a sense of agency.

Practice mindfulness.

Mindfulness is the concept of being aware of the present moment. Because overthinking – or anxiety – is sometimes caused by our fears for the future, the idea is “to reorient [our] attention back to the present moment,” says Dr. Naguit. Mindfulness-based practices like meditation and mindful eating are deliberate and help maximize our five senses to “reorient [ourselves] to the present moment or to the current environment.”

Dr. Naguit adds that part of mindfulness is accepting that we cannot control our thoughts. Thoughts will inevitably enter our minds, and the more we try to control them or shield them, the more stressed we get. He advises to simply recognize and acknowledge our thoughts, and allow them to flow. Then take deep breaths and one by one, let them go.

Physically release our stress.

Some psychologists recommend using stress balls as a means for physical release. Dr. Naguit adds that one of the things he teaches is “progressive muscle relaxation,” wherein patients “cyclically flex and relax [their] muscles.”

Get enough rest and sleep.

Rest is also an important part of mental health intervention. Dr. Naguit explains that when we don’t get enough sleep, we become irritable and tend to conflate things, which then make us overthink. Interventions for physical wellness also contribute to our mental well-being.

When we are doing something, it is best to have our full attention on the task at hand so we can perform our best. However, there are times when certain thoughts pop-up in our minds– and this is perfectly normal. You don’t have to overthink overthinking!

Overthinking is definitely something I can live without. And that impromptu speech I mentioned in the beginning— the one I’d been so worried about? It turned out fine! I knew just what to say about the topic and I finished the speech without a problem. 

We don’t have to worry so much or about things because often, they turn out fine in the end. If not, then that’s fine, too. We’ll just learn from the experience and improve ourselves. 

If you or someone you know is struggling with a mental health condition, know that there are people whom you can talk to. Get in touch with them through these numbers:

National Center for Mental Health Crisis Hotline

0917-899-8727

UP Diliman Psychosocial Services – Free Online Counseling

0916-757-3157

0906-374-3466

psycserv.upd@up.edu.ph

Philippine Mental Health Association – Free Online Counseling

0917-565-2036

PMHA Facebook Messenger

Philippine Psychiatric Association – Free Online Counseling

0918-942-4864

When RJ Naguit decided to become a doctor, he wanted to fulfill, not a personal dream, but the much bigger goal of improving the country’s public health system. While working with the Alliance for Improving Health Outcomes which allowed him to work closely with PhilHealth and for the current health information system, Dr. Naguit joined the Philippine Society of Public Health Physicians, where he learned the many paths a doctor could take. “I discovered that there were a lot of doctors working outside the health system. Some of them entered government, while others took their masters here or abroad. It reassured that there’s no one direction toward public health. That’s why I’m forging my own path by focusing on community development and public health.”

At present, Dr. Naguit is the national chairman of the Youth for Mental Health Coalition, Inc., a driving force behind the Philippine Mental Health Law enacted in 2018 after 20 years of lobbying from psychiatrists and other professionals. While working with senators, Dr. Naguit proposed bills on various issues such as nutrition and teenage pregnancy, but mental health remained close to his heart. “When I was in high school, I received a suicide note from a loved one. That feeling of frustration and helplessness of not knowing how to respond to such a situation is something I don’t want other people to go through.” His advocacy was strengthened when his co-founder died by suicide before the law was formalized. “Mental health became more than just policy work; it was something near to us as young people.”

According to the World Health Organization (WHO), the 15 to 29 age group is the most vulnerable to mental health issues. In fact, mental health-related deaths rank second in the cause of fatalities for this group of young people. Dr. Naguit believes that the pandemic is exacerbating this situation. “Biological and psychological factors are not the only factors that affect our mental well-being. Social factors also come into play. We’re collectively grieving an ambiguous loss—things and people we’ve lost without certainty and closure. Grieving patterns are altered because of COVID-19. We can’t attend wakes and seek psycho-social support because of social distancing. Online meetings are not enough to substitute face-to-face support.”

On October 14, Dr. Naguit, psychiatrist Dr. Rowalt Alibudbud and yoga teacher Ananya Lea Thomas will share their knowledge in Panahon TV’s webinar, Peace of Mind during the Pandemic. “It’s not a light topic, especially now that people might be experiencing different forms of distress. We can’t force people to be okay if the situation is not. When we talk about finding peace, we should start with coming to terms with the current situation and acknowledging our feelings.” At the same time, Dr. Naguit believes in being pro-active in addressing the sources of our distress. “We can’t just cope and do self-care. The social factors need to be addressed. If the COVID-19 cases continue to rise, and people are losing their jobs and going hungry, you can’t expect people to smile all the time.”

At the end of the webinar, Dr. Naguit hopes that participants will feel validated.  “Emotions should not be kept under lock and key. Acknowledging our emotions is acknowledging our common humanity.”

To register for the webinar, click here: https://panahon.tv/webinar/index.php

According to the Department of Health (DOH), 1 out of 5 Filipino adult suffers from a mental health disorder. The three most common ones in the country, according to the National Center for Mental Health (NCMH), include specific phobia, alcohol abuse and depression.

Life coach and psychiatrist Dr. Randy Dellosa says that although sadness is normal and temporary, depression affects a person for a longer period of time and is associated with nine major symptoms:

– Sadness, irritability or anxiety
– Loss of motivation or enjoyment
– Changes in sleep pattern
– Changes in appetite
– Changes self-image or self-confidence
– Poor focus
– Overthinking
– Low energy
– Thoughts of death or suicide

Different factors, such as genetics, contribute to psychiatric disorders. If both parents have disorders, the chance for their offspring to be diagnosed with a disorder is higher. Another factor is stress, whether mental, emotional, physical or a combination of all.

Hormones can also be the culprit, leading to an imbalance in brain chemicals. Other factors include drugs, alcohol and lack of sleep. In other cases, situational triggers like death in the family, calamity, heartbreak or tragedy can also affect a person’s mind, body and emotions.

Dellosa explained that people tend to be suicidal because of recurring symptoms. Because they don’t know where or how to get help, they feel so hopeless that they want to end their suffering.

Cuts and Scars

Ven, a 27-year-old public school teacher, has been suffering from depression. She isn’t exactly sure when it started, but she thinks it might have been triggered by her parents’ separation when she was 8 years old. Her condition got worse when her grandmother died last year.

“Nitong last year lang, nagkasakit ‘yung lola ko. Sobrang daming gastos tapos tulung-tulong kami sa pagtustos ng gamut. Nagkautang-utang din ako. Tapos ‘yun, parang biglang bumagsak ‘yung buhay ko nung namatay ‘yung lola ko.

Nawala ako sa pagsisimba, talagang kwinestyon ko si Lord kung bakit…ginawa ko naman lahat, nagsimba ako…pero bakit kinuha, parang wala nakong kakampi.” (My grandmother died last year. I was buried in debt because of her medications. I did my best to help her. I went to church and prayed incessantly but God still took her life. I questioned Him. I felt alone and devastated.)

“Yung one time na naglaslas ako, pinakauna sa school. Kasi sobrang stressed na stressed na ako. Lahat kasi ng trabaho parang sa akin inaasa. Kinabukasan, may tinuruan ako na bata, para sa isang contest sa buong probinsya so mas mataas na level. Natalo ‘yung bata. Naglaslas na naman ako sa bahay. Ano na naman ba nagawa ko, mali na naman ba, kasi parang ‘yung expectations nila mula pagkabata ko na laging nananalo, laging nasa taas kaso wala, parang bigla akong bumulusok.” (My first suicide attempt happened in school where I started to cut my wrist because of too much stress at work. The next day, I was feeling extremely down because my student didn’t win the contest. As a teacher, I was blaming myself. I felt I wasn’t good enough.)

Because of depression, Ven has also experienced auditory hallucinations. She heard loud voices saying, “Wala kang kwenta. Wala ka nang silbi!” (You are worthless! You’re good for nothing!) Fear, loneliness and low self-esteem gnawed at her until she committed her fifth suicide attempt. Up to now, the scars are still visible on her wrist.

Easing the pain

To help a person with a psychiatric disorder, here are ways to ease the burden they are carrying:

– Educate yourself by getting involved in different mental health campaigns in the community or institutions

– Lend a listening ear so they can release their emotions and express their selves without judgment. This gives them relief and helps them cope with bad memories.

– If their condition is getting worse, accompany them to a psychiatrist for medication and psychotherapy.

– Encourage them to undergo wellness therapy wherein they can engage in activities that make them feel good mentally, emotionally and physically. Examples are exercise, good food or art therapy like dance, visual arts or singing, which serve as outlets for self-expression.

After Ven’s fifth suicidal attempt, her family finally learned about her condition. Her relatives are now helping her to cope with her illness. Her faith is also redeemed, and Ven now regularly attends mass.

Paiting and writing have also become her outlets. She has penned poetry also published on her blog site. Recently, she was also invited to perform her poems in a benefit gig that aims to promote awareness on mental health through art.

Mental Health in the Philippines

NCMH Chief Bernardino Vicente said mental health is not a priority in the country and is poorly funded. “There is also a lot of stigma attached to mental illness, and the stigma does not end with the patient. Even the mental health providers or psychiatrists are also stigmatized. You’ll often hear, anong trabaho mo, psychiatrist, hindi ka ba nahahawa, (As a psychiatrist, don’t you get infected with mental illnesses?) such remarks like that.”

There are only a few doctors who would want to take up psychiatry. If you compare it to our neighboring countries, like for example Japan, they have about 16, 000 psychiatrists nationwide. In the Philippines, we only have about 600 and what’s bad about it is the inequitable distribution. Most of them are here [in Metro Manila]. Pumunta ka sa probinsya, halos wala kang makikita (There are almost none in the provinces),” he added.

Recently, majority of the House of Representatives members approved the third and final reading of the Comprehensive Mental Health Act or House Bill 6452. It will be signed into law by President Rodrigo Duterte, hopefully before the year ends.

The bill gives emphasis on the responsibilities of all concerned government agencies and mental health providers, as well as fund allocation and services that should be accessible to all Filipinos, including those in the rural areas.

Watch our special documentary on Mental Health