Maintaining Sanity amid the Government's Insensitivity. An online discussion on mental health in COVID19 pandemic. Alliance of Concerned Teachers (ACT). 27 March 2020

1. Maintaining Sanity amid the
Government’s Insensitivity
An Online Discussion on Mental Health in Covid19 pandemic
Alliance of Concerned Teachers (ACT)
March 27, 2020

2. Flow of Discussion
• 1. How do we as individual or people react when there is a crisis or
during this covid19 pandemic?
• 2. How do we as individual and people cope with this?
• 3. What is the role of the government in times of crisis/ covid19
pandemic?

3. 1. How do we as individual or people react when there is a
crisis or during covid19 pandemic?

4. Introduction
• The psychological aspects of the outbreak have kernels of
misinformation, feed on uncertainty, grow in doubt as they incubate
in the limbic system, and then, through vectors of media and
communication, explode in form of individual or mass panic,
threatening to overpower the coping resources of an individual or an
entire community. (from Psychiatry of Pandemics, c2019)

5. A question of safety and trust…
• A pandemic goes against the widely held conception of a just world
ruled by a benevolent higher power; a plague gives lie to the belief of
Nature as a nurturing mother or omnipotent God as a nurturing
parent.
→ It’s not your circumstances that make or break you, it it’s your
attitude towards it.

6. Class status may matter during crisis
• Most of us get stressed and anxious and this is
NORMAL.
• Panic buying begets panic buying. But only to
those who has money to buy.
• We should not criticize or discriminate people
who does not know what to do in times of crises,
especially people at the lower socioeconomic class.
Some of them may have no access to information.
Their brains may not be functioning well just
like yours.

7. What is health? Is a state of complete physical, mental and social well-
being and not merely the absence of disease or infirmity.
(World Health Organization, 1946)
• What you do about the crisis depends on whether or not you’re
prepared – not just physically, but also mentally.
• Why are we reacting this way –
due to change of the regular situation,
“pagbabago sa kalagayan” – in our mind this could
be uncertainty and out of our control.

8. What happened to our brains when we are
stress –
• Research has shown that the pressures
of a crisis can trigger physical reactions
capable of distorting perceptions,
decisions and outcomes, including:
Stimulation of the amygdala,
which activates the "flight, fight and
freeze" reactions.

9. Symptoms of being stressed –
• An increase or decrease in your energy and activity levels
• An increase in your alcohol, tobacco use, or use of illegal drugs
• An increase in irritability, with outbursts of anger and frequent arguing
• Having trouble relaxing or sleeping
• Crying frequently
• Worrying excessively
• Wanting to be alone most of the time
• Blaming other people for everything
• Having difficulty communicating or listening
• Having difficulty giving or accepting help
• Inability to feel pleasure or have fun
• Problem with memory function
• Neglect of personal hygiene
• Withdrawal from daily or regular activities
• Decreased performance at school or work

10. A very emotional person can impair executive
functions in numerous ways, including:
• A tendency to mistake assumptions for facts
• The inability or reluctance to make any decision "until all the facts are
in" (a luxury rarely available in a crisis)
• "tunnel vision" (seeing only the fire that needs to be put out, or
focusing only on what has just happened)
• Confirmation bias (the tendency to filter out information, or
stakeholder perspectives, that do not confirm to preconceived
notions)
• Overconfidence bias (assuming we know more than we actually do, or
can handle more than we actually can)

11. Panic and Anxiety attacks
• Panic and anxiety attacks may feel similar, and they share a lot of
emotional and physical symptoms. You can experience both an
anxiety and a panic attack at the same time.
• For instance, you might experience anxiety while worrying about a
potentially stressful situation, such as an important presentation at
work. When the situation arrives, anxiety may culminate in a panic
attack.
• Fear can also trigger panic and anxiety attacks

12. Panic and anxiety attacks
• While anxiety can build gradually, panic attacks usually come on
abruptly from a calm state or an anxious state.
• Panic attacks typically trigger worries or fears related to having
another attack.
• This may have an effect on your behavior, leading you to avoid places
or situations where you think you might be at risk of a panic attack.

13. In panic attack, there is an abrupt surge of intense fear or intense
discomfort that reaches a peak within minutes and during which time
four (or more) of the following symptoms occur: (DSM 5)
• 1. Palpitations, pounding heart, or accelerated heart rate.
• 2. Sweating.
• 3. Trembling or shaking.
• 4. Sensations of shortness of breath or smothering.
• 5. Feelings of choking.
• 6. Chest pain or discomfort.
• 7. Nausea or abdominal distress.
• 8. Feeling dizzy, unsteady, light-headed, or faint.
• 9.Chilis or heat sensations.
• 10. Paresthesias (numbness or tingling sensations).
• 11. Derealization (feelings of unreality) or depersonalization (being detached from oneself).
• 12. Fear of losing control or “going crazy.”
• 13. Fear of dying.

14. How do we manage our stress and anxiety during covid19
pandemic?
• 1. Pharmacologic – taking medications/ drugs
• 2. Non-pharmacologic –
• a. psychotherapy – cognitive behavioral therapy (CBT), mindfulness
• b. self-help activities – physical exercises, sleep hygiene, breathing
relaxation technique, meditation, body massage, music therapy, etc
• c. nutritional intake
• d. psychosocial support

15. Breathing Relaxation Technique
• Deep breathing is one of the best ways to lower stress in the body. This is because
when you breathe deeply, it sends a message to your brain to calm down and
relax. The brain then sends this message to your body. Those things that happen
when you are stressed, such as increased heart rate, fast breathing, and high
blood pressure, all decrease as you breathe deeply to relax.
• The way you breathe affects your whole body. Breathing exercises are a good way
to relax, reduce tension, and relieve stress.
• Breathing exercises are easy to learn. You can do them whenever you want, and
you don't need any special tools or equipment to do them.
• You can do different exercises to see which work best for you.

16. Breathing Relaxation Technique
• 1. Sit or lie flat in a comfortable position.
• 2. Put one hand on your belly just below your ribs and the other hand
on your chest.
• 3. Take a deep breath in through your nose, and let your belly push
your hand out. Your chest should not move.
• 4. Breathe out through pursed lips as if you were whistling. Feel the
hand on your belly go in, and use it to push all the air out.
• 5. Do this breathing 3 to 10 times. Take your time with each breath.
• 6. Notice how you feel at the end of the exercise.

17. Cognitive Behavioral Therapy (CBT)
• A form of psychotherapy that focuses on modifying dysfunctional
emotions, behaviors, and thoughts by interrogating and uprooting
negative or irrational beliefs. Considered a "solutions-oriented" form
of talk therapy, CBT rests on the idea that thoughts and perceptions
influence behavior. Feeling distressed, in some cases, may distort
one’s perception of reality. CBT aims to identify harmful thoughts,
assess whether they are an accurate depiction of reality, and, if they
are not, employ strategies to challenge and overcome them.
• CBT is appropriate for people of all ages, including children,
adolescents, and adults.

18. Cognitive Behavioral Therapy (CBT)

19. Mindfulness Therapy
• Mindfulness is a therapeutic, secular perspective is a conscious
awareness of our present moment. This includes openness and non-
judgment about the experience. It is often coupled with other types
of therapy, such as Cognitive-based Therapy (CBT), Dialectical
Behavior Therapy (DBT), etc.
• Mindfulness therapy is not concerned with relaxation, though that
might be a result of certain practices. The focus is on increasing our
awareness of the thoughts, feelings, and actions that hinder our
progress.

20. Mindfulness Therapy
• Here and now
• No judgment

21. • But why are some people calm and rational,
while others become fearful and paralyzed?
• According to a psychologist, it all comes down
to training and experience.
• → Being prepared. (Laging handa)
• Is the Philippine healthcare system ready for
the covid19?
• The Bystander Effect

22. Question 2: How do we as individual and people cope with this
covid19 pandemic?
➢ The ABC of Mental Health during covid19 pandemic:
• Awareness
• Balance
• Connectivity

23. AWARENESS (Self-awareness and situational awareness)
• Sun Tzu - “If you know the enemy and know yourself, you need not
fear the result of a hundred battles.
• Know that everyone reacts differently to crisis and trauma and
expect/accept those differences … this is NORMAL.

24. Self-awareness
• Understanding ourselves and how we react to the people and things
around us.
• This ties in with emotional intelligence as we need to be aware of our
own feelings and emotions in times of crisis. While being aware of
your own self during crisis is important, we also need to be aware of
the situation around us to react appropriately.
• The key to self-awareness is to practice self-reflection and understand
ourselves and how we react in certain situations.

25. Crisis situation exposes our character to the others
• When a person’s “poor” character is revealed in a crisis, we know that
person is not someone we can trust, have confidence in, love, or keep
within our trusted circles.
• And when a crisis reveals a hero, a true friend we can trust; we should
do everything within our power to keep that person close to us,
within our circle.
• A crisis ultimately (always) reveals character. We can think and see
clearly the character in others when the crisis unfolds.

26. Awareness in the situation –
being aware of what’s happening around us calms our mind
• Get access to information and be informed – get truth of the facts.
• Be aware of what is happening and be updated.
• Note: Avoid to much information/news for the mentally vulnerable people.

27. If there’s no clear guidelines from the State --
• People resort to extremes when they hear conflicting messages or
lacking of clear direction from the State, like panic buying. But this
response is understandable. If we stay at home we must stock up on
essentials.
• When we face uncertainty, our minds crave explanations. If we have
no way to account for symptoms, we feel out of control and our fear
escalates. And, if we learn that our own minds may have caused these
very real symptoms, we tend to feel more anxiety about what our
minds might do next.

28. BALANCE (Your life, family and work, etc)
• 1. Keep yourself safe and healthy
• 2. Use practical ways to relax at home
• 3. Do physical activities
• 4. Try to keep the routine as much as possible (work-home-hobbies)
• 5. Get enough sleep

29. CONNECTIVITY (Communicate to your love ones/ family,
friends and your neighbors)
• 1. Established links and communication within your community
• Talk with people you trust about your concerns and how you are
feeling during this time of Covid19 pandemic.
• 2. Share important information to other people
• In times of crisis, social solidarity is essential. Helping each other cope
in this crisis is helpful in our mind. Doing good things and kindness to
the less fortunate Filipinos is a feel good emotion.
• Altruism is acting out of concern for another’s well-being.
Cooperative behavior allowed our ancestors to survive under harsh
conditions, and it still serves a purpose in a highly complex society.

30. CONNECTIVITY (Communicate to your love ones/ family,
friends and your neighbors)
• 3. Psychosocial support: This is often identified as a key component of
solid relationships and strong psychological health, but what exactly
does it mean?
• Essentially, psychosocial support involves having a network of family
and friends that you can turn to in times of need. It is social support
that builds people up during times of stress and often gives them the
strength to carry on and even thrive.
• Poor social support has been linked to depression and loneliness.

31. CONNECTIVITY (Communicate to your love ones/ family,
friends and your neighbors)
• Find and establish your support system: Exploring different types of
support might be something you feel able to do at these difficult
times.
• Family support
• Peer/ colleague support
• Community support
• Organizational support
→Yes to social connection not social distancing
→Yes to physical distancing not social disconnection

32. Psychosocial support (PSS)
You can give psychosocial support to anybody:
• by listening
• by being around
• by helping in everyday life
• by maintaining hope
• by showing that you have the time now and in the future
• by helping the person seek professional help, if necessary

33. Psychological First Aid (PFA)
• According to Sphere (2011) and IASC (2007), psychological first aid (PFA)
describes a humane, supportive response to a fellow human being who is
suffering and who may need support.
PFA involves the following themes:
• Providing practical care and support, which does not intrude;
• Assessing needs and concerns;
• Helping people to address basic needs (for example, food and water, information);
• Listening to people, but not pressuring them to talk;
• Comforting people and helping them to feel calm;
• Helping people connect to information, services and social supports;
• Protecting people from further harm.

34. Master your positive coping strategies
Encourage positive coping strategies Discourage negative coping strategies
»» Get enough rest.
»» Eat as regularly as possible and drink
water.
»» Talk and spend time with family and
friends.
»» Discuss problems with someone you
trust.
»» Do activities that help you relax (walk,
sing, pray, play with children).
»» Do physical exercise.
»» Find safe ways to help others in the crisis
and get involved in community activities.
»» Don’t take drugs, smoke or drink alcohol.
»» Don’t sleep all day.
»» Don’t work all the time without any rest
or relaxation.
»» Don’t isolate yourself from friends and
loved ones.
»» Don’t neglect basic personal hygiene.
»» Don’t be violent.

35. Question 3. What is the role of the government in times of
covid19 pandemic?
• In the light of what is considered as covid19 pandemic, decision-
making in crisis is very vital.
• The crisis management process requires making wise and sound
decisions, as they contribute to a successful exit of the crisis and
alleviate its effects.
• This might explain why decision-making often requires considerable
expertise and knowledge.

36. The Role of the State in Covid19 pandemic:
• 1. Safeguarding human rights of everyone
• 2. Financial support for the majority of the poor people especially the contractual
workers and elderly
• 3. Increase the health budget and make the healthcare system work better to
serve the Filipino people
• 4. Being transparent in its program and open to people’s criticisms.
• 5. Be a good role model/leader. No to privileges to government officials and
family members.
• 6. Free mass testing
of covid19
• 7. Support local
manufacturing,
scientists and farmers

37. Maraming Salamat.
• The people must ensure that the government is doing its job for the
people. Public health is a State’s responsibility in general.