Panglao Island, Bohol, Philippines, 25 November 2017.
A friend of mine once told me that doctors and hospitals matter to us only when we feel terribly ill. I may not want to admit it, but such is true in my case.
When I had that severe anxiety attack in a hotel in London, I said that I needed to seek professional help as soon as I arrive home. But that decision took a back seat. I think the comforts of a home, where your family is, where your friends are, makes one forget the seriousness of a situation because you know that you have people around to support you when things go extremely bad.
When I arrived in Bohol after that London trip, I went back to my old routine. Part of the reason was that I needed to catch up on work, as the year was about to end, and travelling had delayed the reports that needed to be written, the research papers that needed to be reviewed. The other reason was I also needed to catch up spending time with my wife and kids, especially with all the travelling in previous months.
One afternoon, we decided to go to the beach. Panglao Island, famous for its white powdery beaches, is just a 15-minute drive from where we live. As I watched my kids play and swim along the shores of Bohol Beach Club, I identified several reasons why seeing a psychiatrist may not be the best thing to do just yet.
First, I thought I might have the capacity to manage myself. I planned to read books about my condition and see how I could help myself become better. For sure, anxiety is a normal feeling and is part of our emotional make-up, and maybe I could find ways of managing it on my own.
Second, the doctor might prescribe medicines that I might not take because of fear of becoming dependent on it. As much as possible, I wanted to deal with my sickness in the most natural way possible.
Third, most of the professionals recommended to me are based in Cebu, an island two-hour away by fast craft boat from the city where I live. It would be challenging to shuttle regularly for therapy, especially with the kind of work I had.
But the truth is, I was not comfortable talking about my mental health. To put it more bluntly, I am ashamed to admit that I am not mentally healthy.
In the Philippines, mental health illness is stigmatized. In a research published in the Philippine Journal of Health Research and Development, the authors argue that “stigmatizing attitudes and discriminatory behaviours are evident at home, school, workplace and healthcare settings”. People do not necessarily declare that they have mental health issues. It is easier to say one is hypertensive than depressed.
I was also afraid that admitting I have mental health issues would affect my work and my credibility as a professional. I was unsure whether people would understand, or people would say, “Let’s not give him work so he won’t have to deal with more stressors”. I was afraid that clients I worked with would walk out of contracts or hesitate in giving me one because I was mentally unwell.
Apart from stigmatization, people also trivialize mental illness. People would tell you, “you can control it; it’s all in your mind”. Or sometimes, they would say, “you are just overthinking it.”. “Chill, relax. Look at the bright side.” I was worried that people would tell me I just imagined it, that I was just faking the illness.
So I just acted as if I was okay. It was a tough act. When Mr Anxiety came at certain parts of the week, I used all my energy to suppress him. At the same time, I used all my energy to put up a front, to show that I was okay. Every day was very exhausting because I was faking normalcy.
For a time, it was productive. I could say that for several months of “faking it”, my work was not affected. As a matter of fact, I used my work to get through an anxiety attack by focusing on my required outputs to forget the anxious feelings.
Ironically, I was most productive during my “faking” years. I spoke in plenary sessions in international conferences, wrote book chapters with collaborators, designed data and democracy experiments, facilitated multi-country workshops, and shared extensively about my work in blog posts, articles, and media interviews. The more it became hard for me to admit that I have severe mental problems because, on the outside, I performed exceptionally well, modesty aside.
But the more I did this; the more my anxiety attacks became more frequent. They also lasted longer. Sometimes, muscle twitching lasted for hours and psychogenic tremors, that feeling as if your hands and legs tremble uncontrollably, lasted for more than a day, with rest intervals of an hour or so in between.
I had the feeling that something worse will happen pretty soon.