Chapter 3: Assessing and Treating Mental Illness in the ending their lives because of these

Community conflicts.
_______________________________________________ - To add this is to say that another psyche of
mental illnesses is targeting younger
Mental Illnesses and Its Causes people as per se by the records and
transcripts (University of the Philippines
Different Nature of Mental Illnesses in the Philippine Population Institute, 2022).
Community
● Mental Illness is one of the major issues that still Different Nature of Mental Illness in the Philippine
have a stigma affecting a lot of people of any age Community
that are living in the community
● This said incapacities may come in different In a recent study, according to the World Health
natures and forms from how the communities Organization, mental illness is the third most common
perceive these issues, especially in the Philippines.
disability in the Philippines. Around 6 million Filipinos are
Mental Illnesses may come in different forms and it can be estimated to live with depression and/or anxiety, making
seen through different viewpoints of the community: the Philippines the country with the third highest rate of
mental health problems in the Western Pacific Region.
a. Through Perception of the Filipino People- a (Melissa co, et.al 2020)
recent study characterized mental illness among
Filipinos as an adverse attitude and a predicament The following causes could potentially result in a period of
as something to be ashamed of. poor mental health problems/ Mental illnesses:
- In general, the nature of mental illness in
the Filipino community is perceived as a ● childhood abuse,
reluctant issue and shall be taken when the
● trauma or neglect
action is severe.
b. Scientific Means- mental health disorders were ● social isolation or loneliness
defined as the presence of neurologic or ● discrimination and stigma, (including racism)
psychiatric conditions that may cause to impair the ● poverty or debt
individual’s well-being w/c leads to disturbance of ● bereavement
developmental and psychosocial aspects. It has no ● severe or long-term stress
difference from other physical illnesses. ● having a long-term physical health condition
c. Catastrophic Events- mental health conditions
due to these events are classified as liabilities that ● unemployment or losing your job
imposes a lot of fear, anxiety, distress, and ● homelessness or poor housing
substance abuse w/c can create a danger to the ● being a long-term carer for someone
vulnerability of human life living in the ● drug and alcohol misuse
community. ● domestic violence such as bullying or other abuse
d. Education- (Ramos, 2023) talked about the as an adult.
difficulties imposed by the pandemic in education,
● significant trauma as an adult, such as military
w/c shows the nature of mental illnesses and
struggles engaged even more students to end their combat etc.
life, due to their self disturbances such as ● physical causes – (for example, a head injury or a
depression, school violence, and psychological neurological condition.)
fatigue. ● Lack of sleep
- Statistics mentioned a total of 404 suicide ● Drugs
cases were marked and 2, 147 were tallied
in the academic year 2021-2022 alone by Pandemic, Covid-19 Hit the Philippines.
the educational sector.
e. Economic Aspect- due to the lack of mental Mental disorders/illnesses increased in prevalence of
health professionals, the identity of mental
insomnia, anxiety, and depression. Many Filipinos
infirmities would continue to affect and create
people to be in flux because of the scarcities of experience this traumatic event that causes isolation, a
treatment. great feeling of loneliness and distress that adds to being
- The more economically unprivileged the paranoid and the fact that we have little knowledge on how
people are, the more they suffer. to survive in this pandemic.
- Hence, they are longer exposed to those
illicit acts w/c stems also from other nature Lack of income and opportunities, insufficient food supply
of mental illnesses such as trauma caused and health sanitation, nutritional issues, increased poverty
by different types of abuse and
rate, weak health care infrastructure, underpaid and
exploitations just to alleviate the
impending problem. overworked of every front liner and many more factors that
- It is also added from the numbers that take a toll on our mental health that worsened the situation
there are approximately 2.0 psychiatrists while we are facing the Covid - 19 pandemic.
per 100, 000 people, making it even more
difficult for mental illnesses to combat. Types of Mental Illness
f. Statistics- In the worst case, the feature of mental
illnesses may end the life of a human being. The According to PCTC (Philippine Center on
fatalities of mental illnesses keep on increasing, Transnational Crime, 2022) Heroin, Marijuana, and
w/c adds to other nature Shabu are the most used, preferred, and expensive
- The alarming rate of this nature may
drugs in the Philippines. There are several reasons why
continue to disrupt other people's lives.
The numbers say that one for every five people resort to using drugs and alcohol. According to the
Filipinos aging from 15-24 considered research made by Ozeylem, De la Torre-Luque, and Essau
in 2021, there are two reasons why people use drugs and Brain Anatomy
alcohol, personal and interpersonal risk factors.
(1) Impacts of the environment
● Peer pressure
● Curiosity (2) Changes in the brain
● Stress
● Environment These environmental factors include

Drug addiction ● Abnormal fetal development and low birth weight;

● Gestational diabetes;
● also called substance use disorder, is a disease ● Preeclampsia;
that affects a person's brain and behavior and leads ● Emergency cesarean section and other birthing
to an inability to control the use of a legal or illegal complications;
drug or medicine. ● Maternal malnutrition and vitamin D deficiency;
● Substances such as alcohol, marijuana, and ● and Urban residence.
nicotine also are considered drugs. When you're
addicted, you may continue using the drug Changes found in the brain:
despite the harm it causes.
● Enlargement of the lateral ventricles, areas of
When under the influence of drugs a person feels libido or the brain that allow brain fluid to flow through
intense euphoria. Drug use affects our brain that creates ● Decreased volume of the temporal lobe cortex,
dopamine, therefore stopping the brain from producing the area of the brain that helps us understand the
them making the person dependent on drugs. information we hear
● Damage to neurons or nerve cells, which are
A person is said to have alcohol use disorder (AUD) if broken or torn apart due to repeated or prolonged
they have trouble cutting back or limiting their alcohol stress
consumption despite its detrimental effects on their health, ● Decreasing brain activity due to reduced gray and
employment, or social life. It covers a wide range of issues white matter volume, the parts of the brain that
associated with alcohol, including abuse, dependency, and play a role in our behavior and thought process
addiction.
Chronic mental illness schizophrenia typically first
Alcohol use disorder manifests between the ages of 16 and 30. Its symptoms are
categorized as positive (psychotic acts not usually seen in
● is believed to arise from alterations in the brain's individuals in good health, such as hallucinations,
reward circuit following repeated alcohol delusions, and bodily agitation), negative (disturbances to
consumption since this causes a positive reaction normal feelings and actions, such as reduced facial
in the brain. expressions, emotions, and speaking) and cognitive (issues
● It is also believed that changes in the brain itself with memory, attention, and executive function), make it
develop as a result of frequent alcohol one of the more severe and crippling disorders.
consumption.
- Numerous environmental, psychological, There are five different kinds of schizophrenia:
and hereditary factors, as well as
genetic ones, can raise the likelihood of 1. Catatonic - rigidity, odd postures, speechlessness,
developing the illness. 2. Paranoid - theme-based delusions and
hallucinations,
Schizophrenia and Other Psychoses 3. Disorganized - disorganized speech and behavior,
flattened affect,
Here are the three most common mental health illnesses in 4. Undifferentiated - symptomatic but not prominent
the country (Department of Health); enough to be categorized into the aforementioned,
and
● Depression (154 M) 5. Remaining Material - positive symptoms have
● Substance Use Disorder (15.3M) subsided sufficiently to allow regular daily
● Schizophrenia (1 M) activities but adverse symptoms persist.
●
According to estimates, there were 14.4 million
As of today (Department of Health, 2023), Schizophrenia presenteeism days and 26.3 million absence days overall
is the second-highest mental health disorder in the in 2019. This resulted in a total expenditure of 56.0 billion
Philippines, but not many people are informed about what PHP (US$ 1.1 billion) in 2019.
Schizophrenia really looks like
Bipolar disorder and alcoholism are the most expensive
Hallucinations, delusions, and issues with thought, psychological disorders in terms of early death. The high
perception, and behavior are all symptoms of mortality rate among those with trouble with alcohol was
schizophrenia. According to the research made by Lally, J., brought on by a variety of illnesses and injuries, such as
Tully, J., & Samaniego, R. (2019), 15 out of every cancer and falls, and traffic accidents. Although anxiety
100,000 persons have schizophrenia. In younger groups, disorders can not cause death, they are, as previously said,
it is more prevalent in males, whereas in elderly ones, it linked to a significant economic burden because of
is more prevalent in females. presenteeism and absenteeism.
Being diagnosed with these mental health illnesses also Dementia cannot be inherited, but those rare
triggers something within the patients to execute self-harm. types of Dementia have a small amount of
In an article published by Lally, J., Tully, J., & Samaniego, possibility of being passed on to another
R. (2019), research shows that the overall suicide rate of generation.
3.2% in 100,000. A huge percentage of this data was from ● According to a study on Genetic Mutation in
males. Being informed and aware of illnesses such as Southeast Asian (2023) countries regarding the
Schizophrenia, Depression, and Substance abuse can be of Disease of Dementia, it can be passed on
help and can be used to disseminate to raise more genetically, it can be mutated, or through
awareness and end the stigma going around these diseases. pathogenic expansion.
1. people with Dementia sleep a lot is
The most commonly used antipsychotics in clinical because parts of their brain neurons are
practice are chlorpromazine and haloperidol; being damaged by the disease
escitalopram and fluoxetine are the most commonly used 2. people with Dementia tend to hallucinate
antidepressants. 3. people who are diagnosed with Dementia
show symptoms of visual loss
First-generation/typical antipsychotics 4. they also lose the ability to smell things
like peppermint and oranges
● Chlorpromazine,
5. Craving sugary foods because this illness
● haloperidol (oral and long-acting injectable),
affects the serotonin system of the brain
● fluphenazine decanoate
making them crave sweets.
Second-generation/atypical antipsychotics 6. patient's ability to speak, their inability to
verbally express themselves
● clozapine, 7. sense of direction can be distorted. They
● olanzapine, also have
● quetiapine, 8. difficulties with emotional control,
● risperidone 9. social behavior, and
10. physical imbalance (malnutrition)
Antidepressants 11. memory loss

● fluoxetine, Mild Cognitive Impairment (MCI) can be found (using

● sertraline, MRI) in a person that can later develop as Dementia or
● escitalopram there’s another illness that is confused with Dementia
which is Alzheimer’s. They have distinct differences
Mood stabilizers though, Dementia can be helped with proper guidance and
valuable medication while Alzheimer’s cannot be reversed
● lithium carbonate and is a terminal disease.
● valproic acid
● carbamazepine Depressive disorder (also known as depression) is a
● lamotrigine common mental disorder. It involves a depressed mood or
loss of pleasure or interest in activities for long periods of
Anticholinergics time.
● biperiden, Depression is different from regular mood changes and
● diphenhydramine feelings about everyday life. It can affect all aspects of life,
including relationships with family, friends and
Benzodiazepine
community. It can result from or lead to problems at school
● clonazepam and at work.

Cholinesterase inhibitor Depression can happen to anyone. People who have lived
through abuse, severe losses or other stressful events are
● donepezil more likely to develop depression. Women are more
likely to have depression than men.
NMDA receptor antagonist
An estimated 3.8% of the population experience
● memantine depression, including 5% of adults (4%among men and
6% among women), and 5.7% of adults older than 60
Dementia years. Approximately

Dementia 280 million people in the world have depression.

Depression is about 50% more common among women
● This disease is mostly diagnosed among the aged
than among men. Worldwide, more than 10% of pregnant
ones for when we reach 60 years old and above,
women and women who have just given birth experience
our chance of having this illness advances.
depression (2). More than 700 000 people die due to
● At the moment there is still nothing that can come
suicide every year. Suicide is the fourth leading cause of
to cure or at least prevent this disease, but there are
death in 15–29-year-olds.
medications that can help with this illness.
Clinical Symptoms of Major Depressive Disorder based on known risk factors for diseases such as cardiovascular
Diagnostic and Statistical Manual of Mental Disorders V - disease, cancer, diabetes and respiratory diseases. In
Text Revision turn, people with these diseases may also find themselves
experiencing depression due to the difficulties associated
Five (or more) of the following symptoms have been with managing their condition.
present during the same 2-week period and represent a
change from previous functioning; at least one of the Psychological treatments are the first treatments for
symptoms is either (1) depressed mood or (2) loss of depression. They can be combined with antidepressant
interest or pleasure. medications in moderate and severe depression.
Antidepressant medications are not needed for mild
1. Depressed mood most of the day, nearly every depression. Psychological treatments can teach new ways
day, as indicated by either subjec tive report or of thinking, coping or relating to others. They may include
observation made by others talk therapy with professionals and supervised lay
2. Markedly diminished interest or pleasure in all, or therapists. Talk therapy can happen in person or online.
almost all, activities most of the day,nearly every Psychological treatments may be accessed through self-
day help manuals, websites and apps.
3. Significant weight loss when not dieting or weight
gain (e.g., a change of more than 5% of body Effective psychological treatments for depression include:
weight in a month), or decrease or increase in
appetite nearly every day. ● I. behavioral activation
4. Insomnia or hypersomnia nearly every day. ● II. cognitive behavioral therapy
5. Psychomotor agitation or retardation nearly every ● III. interpersonal psychotherapy
day (observable by others, not merely subjective ● IV. problem-solving therapy.
feelings of restlessness or being slowed down).
6. Fatigue or loss of energy nearly every day. Antidepressant medications include selective serotonin
7. Feelings of worthlessness or excessive or reuptake inhibitors (SSRIs), such as fluoxetine.
inappropriate guilt (which may be delusional)
● Up to 8.9% of young Filipino adults experience
nearly every day (not merely self-reproach or guilt
moderate to severe depressive symptoms.
about being sick).
● Prevalence is higher in females (10.2%) compared
8. Diminished ability to think or concentrate, or
to males (7.6%).
indecisiveness, nearly every day (either by
● The most common symptom in the general
subjective account or as observed by others).
population is "not enjoying life."
9. Recurrent thoughts of death (not just fear of
● "Loneliness" is the most frequently reported
dying), recurrent suicidal ideation with out a
symptom among those with moderate to severe
specific plan, or a suicide attempt or a specific
depressive symptoms.
plan for committing suicide.
● The prevalence of these symptoms is higher
A depressive episode can be categorized as mild, among individuals with less education,
moderate, or severe depending on the number and separated/widowed/divorced individuals, and
severity of symptoms, as well as the impact on the urban residents.
individual’s functioning. ● Those with moderate to severe depressive
symptoms are about twice as likely to experience
There are different patterns of depressive episodes suicidal ideation.
including: ● Prevalence of these symptoms is up to 40 times
higher in females than males.
● Single episode depressive disorder: The ● Urgent need for policies and mental health
individual experiences their first and only resources to support young adults experiencing
depressive episode. depressive symptoms is highlighted.
● Recurrent depressive disorder: The person has a
history of at least two depressive episodes. Mania
● Bipolar disorder: Depressive episodes alternate
with periods of manic symptoms, which include Mania
euphoria, increased activity, racing thoughts, and
● A manic episode is a period of at least one week
other related symptoms.
when a person is extremely high-spirited or
Depression results from a complex interaction of social, irritable most of the day for most days, possesses
psychological, and biological factors. People who have more energy than usual, and experiences at least
gone through adverse life events (unemployment, three of the following changes in behavior:
bereavement, traumatic events) are more likely to I. Decreased need for sleep (e.g., feeling
develop depression. Depression can, in turn, lead to more energetic despite significantly less sleep
stress and dysfunction and worsen the affected person’s than usual
life situation and the depression itself. II. Increased or faster speech
III. Uncontrollable racing thoughts or quickly
Depression is closely related to and affected by physical changing ideas or topics when speaking
health. Many of the factors that influence depression (such IV. Distractibility
as physical inactivity or harmful use of alcohol) are also
 V. Increased activity (e.g., restlessness, Medications for bipolar disorder often include mood
working on several projects at once) stabilizers and atypical antipsychotics. You may also be
VI. Increased risky behavior (e.g., reckless prescribed meds to help with sleep or anxiety. Sometimes,
driving, spending sprees) you may be prescribed an antidepressant to help with
depressive symptoms, along with a mood stabilizer to
These behaviors must represent a change from the person’s prevent the antidepressants from triggering mania.
usual behavior and be clear to friends and family.
Symptoms must be severe enough to cause dysfunction in The National Institute of Mental Health also recommends
work, family, or social activities and responsibilities. regular exercise to help reduce depression and anxiety and
Symptoms of a manic episode commonly require a person to promote better sleep. Getting quality sleep can
to receive hospital care to stay safe. significantly boost mental well-being

Some people experiencing manic episodes also experience

disorganized thinking, false beliefs, and/or
hallucinations, known as psychotic features. Dyslexia

Symptoms Dyslexia is an alternative term used to refer to a pattern of

learning difficulties characterized by problems with
The Diagnostic and Statistical Manual of Mental Disorders accurate or fluent word recognition, poor decoding,
(DSM-5) states that an episode of mania involves at least 3 and poor spelling abilities. If dyslexia is used to specify
of the following behavior changes: this particular pattern of difficulties, it is important also to
specify any additional difficulties that are present, such as
1. elevated self-esteem, high self-confidence, or difficulties with reading comprehension or math reasoning.
feelings of grandiosity (DSM-V TR)
2. less need for sleep, such as feeling rested after
only 3 hours of sleep Dyslexia is a learning disability that makes reading and
3. fast, loud, and sometimes disorganized speech, or language-related tasks harder. It happens because of
feeling a pressure to keep talking disruptions in how your brain processes writing so you can
4. racing thoughts or quickly-changing ideas understand it. Most people learn they have dyslexia during
5. feeling easily distracted or unable to pay attention childhood, and it’s typically a lifelong issue. This form of
to one thing for long dyslexia is also known as “developmental dyslexia.”
6. doing many activities at once, such as work tasks,
organizing social events, or seemingly purposeless Dyslexia falls under the umbrella of “specific learning
movements disorder.” That disorder has three main
7. engaging in activities on an impulse that can lead
to harmful consequences, ● Reading (dyslexia).
- such as overspending money, heavy ● Writing (dysgraphia).
alcohol or drug use, or dangerous driving ● Math (dyscalculia).

These behaviors aren’t typical for you, so your friends and Reading starts with spoken language. In early childhood,
family are able to recognize the change. By definition, the speaking starts with making simple sounds. As you learn
symptoms of mania are severe enough to get in the way of more sounds, you also learn how to use sounds to form
your life and functioning. They might, for example, cause: words, phrases and sentences. Learning to read involves
connecting sounds to different written symbols (letters).
● I. problems at work
● II. job loss This is where dyslexia enters the picture. It interferes with
● III. financial losses how your brain uses spoken language to “decode” writing.
● IV. difficulties in your relationships Your brain has trouble processing what you read,
especially breaking words into sounds or relating letters to
The symptoms can be severe enough to require hospital sounds when reading.
care to stay safe. To diagnose a manic episode, your doctor
will rule out other causes of these symptoms, including That slowdown in processing can affect everything that
drug or medication use and other medical conditions. follows. That includes:

An effective treatment plan for bipolar disorder is often a ● I. Slow reading because you have trouble
combo of medication and psychotherapy. Psychotherapy, processing and understanding words.
aka talk therapy, can help you identify and change ● II. Difficulties with writing and spelling.
troubling emotions, thoughts, and behaviors. ● III. Problems with how you store words and their
meanings in your memory.
Depending on the person and their situation, therapy ● IV. Trouble forming sentences to communicate
options for bipolar disorder might include: more complex ideas

I. psychoeducation Dyslexia is uncommon overall but widespread enough to

II. cognitive behavioral therapy (CBT) be well-known. Experts estimate it affects about 7% of
III. interpersonal and social rhythm therapy (IPSRT) people worldwide. It affects people equally regardless of
IV. family focused therapy sex and race. However, many people have symptoms that
V. dialectical behavioral therapy (DBT) aren’t severe enough for diagnosis. Including people with
symptoms but without a diagnosis, dyslexia may affect up an unfamiliar situation and it goes beyond the normal
to 20% of people worldwide. experience of anxiety

The exact cause of dyslexia isn’t clear. However, several Anxiety disorder is one of the most common mental
clues hint at how and why most cases happen. disorders and it has different types according to its
symptoms and effect on an individual.
● I. Genetics. Dyslexia is highly genetic and runs in
families. A child with one parent with dyslexia has Some of the types of anxiety disorders are;
a 30% to 50% chance of inheriting it. Genetic
conditions like Down syndrome can also make ● Generalized Anxiety Disorder
dyslexia more likely to happen. ● Panic Disorder
● II. Differences in brain development and ● Social Anxiety Disorder
function. If you have dyslexia, you’re ● Obsessive Compulsive Disorder
neurodivergent. That means your brain is formed ● Selective Mutism
or works differently than expected. Research ● Specific Phobias, etc.
shows people with dyslexia have differences in
brain structure, function and chemistry. Anxiety Prevalence in the Philippines
● III. Disruptions in brain development and
39% out of 1,200 people have anxiety, it shows that
function. Infections, toxic exposures and other
anxiety is prevalent in Filipinos from low-income
events can disrupt fetal development and increase
communities or lower quality of life, and are also
the odds of later development of dyslexia.
associated with younger ages

In a recent study about the psychological impact of

Anxiety COVID-19 pandemic in the Philippines, 29% out of 1,879
people had moderate-to-severe anxiety levels.
It a common mental health concern that is characterized by
excessive and uncontrollable worry According to the data of World Health Organization, there
are about 3 million cases of anxiety disorders or 3.1
Signs and symptoms percent of the population were affected by the anxiety
disorder in 2017
● Excessive worry
● Irritability Coping with Anxiety
● Sleep disturbance
● Poor concentration ● Psychotherapeutic approaches or medications
● Restlessness ● Meditation
● Muscle tension ● Stress management
● Fatigue ● Seeking help with professionals
● Tense, sweat, tremble, nervousness ● Talking with other people
● Hyperventilate, rapid heartbeat. ● Exercise regularly
● Reduce alcohol, caffeine, and drug use
Common Causes ● Improving diet
● Getting enough sleep
● Childhood or past experiences
● Genes Intellectual disability
● Diet
● Physical or Mental Health Problems ● a mental health condition where the cognitive
● Change or negative life events function and adaptive behavior of an individual are
● Drug or alcohol abuse impacted.
● Intellectual Disability was previously termed as
Anxiety as a Response to Stressors Mental Retardation. It is a term used when a
person has certain limitations in their abilities and
An individual might experience this kind of emotion cognitive function
whenever they are in a different situation where their ● It is characterized as having inadequate intellectual
mental state becomes uncertain or challenged, since it capacity from birth or early infancy of an
could be a normal reaction to a stress they are individual. It is difficult for them to adapt various
experiencing. behaviors and skills in their environment

Anxiety Disorder Possible Causes

The anxiety and anxiety disorder may differ since anxiety ● Biological or Sociological Factors.
disorders involve excessive fear or anxiety, which is ● Pregnancy Complications
different from regular feelings of nervousness or anxiety. ● Iodine Deficiency
● Teratogens
An individual experiences such symptoms that differ from
the typical feeling of anxiousness that an individual feels in Exposure of a child to the environment while they are in a
development stage is one of the factors to be considered
because it has a significant impact and influence on a ● It could be environmental
child's sociological and psychological development ● Teratogens
● (Alcohol, Smoking, and Other Substances)
The challenges and their problems
It is estimated that 3-5% people worldwide suffer from
People with Intellectual Disability face different challenges ADHD in the year of 2022, and 60% of adults and 80%
in their life and they still struggle with various irrational of adolescents in the Philippines alone have admitted that
stereotypes such as discrimination, stigma, isolation, they experience ADHD symptoms
neglect, and some were abused because of their
disability. They also stated the concern that 40-50% of children with
ADHD also have difficulty in learning, and 30-50% of
They also face with different challenges related to these kids have engaged in disruptive behavior and shown
education, employment, environmental, and societal signs of antisocial behavior.
challenges.
-ADHD Society of the Philippines
What can we do?
These individuals experience various problems such
● Social inclusion has numerous benefits for those as…
with intellectual disabilities. They do not deserve
to treat them like they are different or not belong ● Keeping up with their daily activities
to us as a normal human being ● Frustrated with themselves and have low self
● Be emphatic, be inclusive, and understanding esteem
● Encourage, support, and protect them ● Difficulty in meeting the expectations
● Difficulty in controlling and managing their
emotions

Stigmas in the Philippines

Attention-deficit Hyperactivity Disorder ● Some Filipinos who are struggling and dealing
with these conditions are having a hard time, and it
● It is characterized by a pattern of difficulties is harder for them since they live in a society
paying attention and a tendency to be impulsive where they don’t get enough patience and
and overactive, which interferes with daily tasks understanding
and personal development. ● The social and economic burdens also worsens her
● This mental health condition is characterized as a state and their expenses since they spend a lot of
neurodevelopmental disorder that requires proper money for her medications.
assessment. ● Philippines is not totally ADHD friendly since
● A neurodevelopmental disorder is a category of there are still discriminations and stigma regarding
disorders that are characterized by impairments in ADHD.
brain function and central nervous system growth
and development. These conditions consist of What can we do?
various conditions that commonly affect the brain
and development of an individual ● Everyone should not only just be educated and
understand their situation, they should also treat
People with ADHD experience an ongoing pattern of the them equally
following types of symptoms: ● People should be aware that having ADHD is not
being lazy and stubborn; be compassionate, show
Inattention empathy, and help them to appreciate their
progress no matter how small it is.
● It is defined as a person who may have trouble
staying on task, focused, and organized. Golden Questions to Detect Mental Illness in General
Health Care Settings
Hyperactivity
A. Nature and Definition of Mental Illness
● A person with hyperactivity is seen to move
around all the time even when inappropriate, or Mental Illnesses are medical conditions characterized by
fidgets, taps, and talks too much. shifts in emotion, thinking, or behavior.
Impulsivity These conditions may lead to feelings of distress and
difficulties in effectively participating in social, work, or
● Impulsivity is defined as acting without thinking or
family activities
having difficulty with self-control. Impulsive
people interrupt others or make big decisions one in five Filipino adolescents aged 15 to 24 have
without thinking long-term. contemplated terminating their lives
Possible Causes of ADHD The number of fatalities attributed to mental illness among
young individuals in the Filipino community continues to
● It is a genetic mental illness.
show an alarming upward trend.
This distressing situation underscores a pressing concern Anxiety
within the nation's mental health landscape, signaling the
need for enhanced awareness, support, and is often defined by excessive worry, fear, and restlessness
interventions to address this growing crisis. considered a future-oriented, long-acting response broadly
focused on a diffuse threat.
B. Screening tools for diagnosis and evaluation of
Mental Illness’ Depression

In a collaborative effort, Dr. Robert L. Spitzer, Dr. Janet encompasses extreme sadness, loss of interest, and feelings
B.W. Williams, Dr. Kurt Kroenke, and their associates of hopelessness and considered a past-oriented.
have formulated the Patient Health Questionnaire
(PHQ-9) and Generalized Anxiety Disorder (GAD-7) A. Sociodemographic Profile

it is an assessment instruments designed to aid medical Research has shown that both disorders (Anxiety &
professionals in evaluating and screening the intensity of Depression) are more prevalent among women compared
depression (PHQ-9) and generalized anxiety disorder to men, with women experiencing higher rates of
(GAD-7) among patients. depression according to (Puyat, 2021).

PHQ-9 and GAD-7, are commonly employed in both Additionally, according to (Flores, 2018)
clinical practice and research settings, suggesting their
there is a higher prevalence of anxiety and depression
potential efficacy as screening tools for detecting
among individuals belonging to lower socioeconomic
depression and anxiety in individuals working as domestic
status, indicating that economic factors may play a role in
helpers (Sauders et al., 2023)
the development of these mental health disorders.
Patient Health Questionnaire (PHQ)
B. Symptoms
consisting of nine questions assess the existence and
Children who are depressed, for instance, may express
intensity of depression.
symptoms of irritability rather than sadness. They may also
The outcomes of the PHQ-9 can guide the determination of fail to make expected weight gains rather than lose weight.
a depression diagnosis based on DSM-IV criteria, and it On the other end of the age continuum, older adults are
requires under three minutes to finish. more likely than younger adults to experience symptoms
such as loss of appetite, loss of interest, and thoughts of
Scores correspond to various levels: death.

0-5 indicates mild In some cultures, individuals may be more likely to report
physical symptoms such as headaches or stomach aches
6-10 signifies moderate rather than emotional symptoms like sadness or
hopelessness. Additionally, cultural norms and beliefs
11-15 indicates moderately severe anxiety surrounding mental health can influence the way
individuals express and interpret their depressive
15-21 represents moderately severe to severe symptoms, further highlighting the importance of
depression. considering cultural context in understanding depression.
Generalized Anxiety Disorder 7 (GAD-7) III. Philippine Guideline for the Treatment of Mental
Illness
The GAD-7 is a self-administered questionnaire crafted to
identify and measure the intensity of generalized anxiety a. Clinical Assessment:
disorder (GAD).
Trained mental health professionals, such as
● Consisting of seven elements psychiatrists, psychologists, or clinical counselors, play a
● Evaluates Generalized Anxiety Disorder indicators key role in conducting clinical interviews. They
● Frequently employed in outpatient and primary
care contexts, this sensitive test can prompt engage individuals in open conversations to understand
referrals to psychiatrists. their emotional experiences,
● The GAD-7 score is computed by attributing
values to response options and totaling them across symptoms, and the impact on their daily lives. These
the seven inquiries, indicating varying degrees of professionals assess the duration, frequency, and intensity
anxiety severity. of symptoms.

Scores correspond to various levels: b. Use of Standardized Assessment Tools:

● 0-5 indicates mild The DOH recommends utilizing standardized

● 6-10 signifies moderate assessment tools that have been validated and adapted for
● 11-15 indicates moderately severe anxiety the local context. These tools help quantify the severity of
● 15-21 represents moderately severe to severe anxiety and depression symptoms. Examples include the
anxiety Generalized Anxiety Disorder-7 (GAD-7) questionnaire
for anxiety and the Patient Health Questionnaire-9 (PHQ-
9) for depression. These tools can be administered by Alcohol, Smoking and Substance Involvement
trained professionals and may be available in both English Screening Test (ASSIST)
and local languages.
a five-to-ten-minute test that can be completed with pen
c. Cultural Sensitivity: and paper or through online with the assistance of an e-
ASSIST. An eight-question test used to screen for all
The DOH emphasizes the importance of culturally levels of dangerous substances such as alcohol, cannabis,
sensitive approaches. Mental health professionals should alcohol, and other drugs, which in turn determines the risk-
be attentive to cultural nuances and local expressions of score for substance use and related problems
distress. They should create an environment where
individuals feel comfortable sharing their feelings and CAGE (Cut, Annoyed, Guilty and Eye) assessment-
experiences, taking cultural factors into consideration.
a screening tool used for alcohol use problems that can be
Alcohol dependence accomplished in a minute and scored by adding the number
of YES.
is a behavioral disorder marked by recurring and
compulsive alcohol consumption accompanied by negative Scores of 2 and higher are indication of harmful level of
outcomes. A loss of regulation in alcohol consumption and alcohol consumption and a need for further assessment
persistence despite negative repercussions are prevalent and/or referrals.
markers.
Alcohol Use Disorders Identification Test (AUDIT)
Tolerance, withdrawal symptoms, and frequent usage may
also play a role in this dependence. is a reliable screening tool for detecting drinking problems,
focusing on risky and excessive consumption, and suitable
Symptoms typically emerge over an extended 12 month for diverse cultures and nationalities. It may be used if
period, yet a diagnosis can be established if issues related CAGE assessments raise concerns.
to drinking persist for a minimum 3 month interval
High scores on the AUDIT suggest hazardous drinking and
Drug dependence harmful consequences. A score of 8 or more is associated
with risky drinking and a score of 13 or more in women
sometimes referred to as substance use disorder, is a and 15 or more in men suggests a probable diagnosis of
complex health condition defined by cognitive, behavioral, alcohol dependence
and physiological symptoms caused by an intense desire to
use psychoactive drugs. International Classifications of disease (ICD) ICD-10

The condition is not directly tied to excessive drug use, but A criteria is utilized in order to diagnose drug dependence,
rather, is driven by psychological and social factors that the test can be accomplished by answering a “yes” or
affect an individual's health and functioning. “no”table.

Addiction develops overtime as a result of frequent drug Three “yes” in the previous 12 months may denote that the
use, and is influenced by factors such as dosage, person can be diagnosed with drug dependence.
frequency, administration, and individual vulnerability.
Diagnostic and Statistical Manual of Mental Disorders
How do substance dependence develop? (DSM-IV)

● The development of dependence on substances A person can be diagnose as “dependent” to substance if a

share common characteristics, including frequent person has a certain pattern of using the substance that
daily or almost daily use resulting in physical and caused clinical impairment or distress manifested by three
psychological changes in the body. or more of the following during the last 12 months.
● The body can adapt to the substance, requiring
higher doses to function normally. Tolerance, as defined by either of the following:
● Stopping or reducing use can be challenging, with
withdrawal symptoms arising as a result. ■ a need for markedly increased amounts of opioids to
● A person with dependence may feel intense achieve
impulses and compulsions to use, even when faced
intoxication or desired effect;
with potential consequences such as financial,
legal, relationship, employment, and psychological ■ markedly diminished effect with continued use of the
challenges. same amount of opioids.

DRUG DEPENDENCY TEST Withdrawal, as manifested by either of the following:

a medical examination that will be conducted by a DOH ● the characteristic withdrawal syndrome for
accredited physician in order to evaluate the extent of drug opioids;
dependency, history taking, medical and psychological ● opioids or a closely related substance are taken to
complications, and the presence of comorbidities, as well relieve or avoid withdrawal symptoms.
as a recommendation for an appropriate intervention. ● Opioids are often taken in larger amounts or over
a longer period than was intended.
 ● There is a persistent desire or unsuccessful Psychological treatment is an essential component of
attempts to cut down or control opioid use. medication-assisted therapy, aiding treatment compliance
● A great deal of time is spent in activities necessary and decreasing drug use.
to obtain opioids, use opioids, or recover from
their effects. Psychotherapists identify the reasons for drug use and
● Important social, occupational, or recreational focus on its negative repercussions and the benefits of
activities are given up or reduced because of quitting.
opioid use.
● The opioid use is continued despite knowledge of MEDICAL AND PHARMACOTHERAPY
having a persistent or recurrent physical or
Pharmacotherapy is the treatment of health conditions by
psychological problem that is likely to have been
using pharmaceutical products (drugs) as medication.
caused or exacerbated by opioids.
Withdrawal is the bodily response to the termination of a
substance with dependency. It ranges in nature and severity
depending on the drug taken and individual background.

Three Phases of Withdrawal

Crash is felt by users and can begin 12 to 24 hours after

their last drug use. It typically last for several days and
reduce gradually over 2 to 4 days.

The symptoms include fatigue, agitation, and irritability,

followed by depression and muscle aches. Other common
sleep disruptions such as increased sleep, insomnia, and
restless sleep can also occur.

Withdrawal typically happens 2 to 4 days after a person

Severity of Dependence Scale (SDS) stops using drugs, with the worst of the symptoms
occurring around the 7-to 10-day mark. Symptoms
The SDS is a 5-item questionnaire that evaluates substance gradually lessen during the following 2 to 4 weeks.
dependency on a 4-point scale (0-3). The overall score is
calculated by combining ratings, the higher the rating the Common withdrawal symptoms are intense cravings,
higher the dependency. One administration is performed changing energy levels, alternating between irritability,
for each substance the person is suspected to be dependent. restlessness, anxiety, agitation, fatigue, and low energy.

Extinction is the gradual return to normal mood over

weeks or months, during which individuals' energy and
mood fluctuate while experiencing alternating irritability,
restlessness, anxiety, agitation, fatigue, low energy,
Treatment and Rehabilitation
cravings, and disturbed sleep.
ASSESSMENT
SUSTAINED RECOVERY MANAGEMENT
An assessment of drug dependence is essential in treatment
A sustained recovery management approach focuses on
planning, and it should include detailed information on the
aiding individuals affected by substance use disorder in
individual's disease stage and severity, mental and physical
attaining sustainable and productive lives in their
health status, personal characteristics, job, and social
communities.
status, family relationships and legal history, childhood
and adolescent experience, social and cultural It targets the individual's relationship with drugs in the
circumstances, and previous treatment involvement. context of their self-concept, personal strengths, and
relationship with the larger community.
CASE MANAGEMENTS
Steps towards building recovery capital
Case management includes the tracking of progress in the
treatment of the patient and making treatment or care plans Domain 1: Physical and mental health supports
that have taken into consideration the beliefs and
motivations of the client and their personal and societal Domain 2: Family, social support, and leisure activities
support and issues.
Domain 3: Safe housing and environments conducive to
The treatment plan includes the client's current problems, health and recovery
the current social, legal, and economic status, and their
goals and milestones. Domain 4: Peer-based support

COUNSELING Domain 5: (Self-) employment and resolution of legal

issues
Domain 6: Vocational skills and educational development ● This assistance should include psychological or
psychiatric supports for people with severe mental
Domain 7: Community integration and cultural renewal disorders whenever their needs exceed the
capacities of existing primary/general health
Domain 8: Meaning and purpose in life services.
● Such problems require either (a) referral to
specialized services if they exist, or (b) initiation
of longer-term training and supervision of
primary/general health care providers.
● Although specialized services are needed only for
a small percentage of the population, in most large
emergencies this group amounts to thousands of
individuals.
_______________________________________________
Do: Provide which levels in the Intervention Pyramid
Chapter 5: Psychological Intervention Pyramid corresponds to the given statements:
_______________________________________________ 1. Provision of food packs and hygiene kits
2. Psychosocial Processing
Basic services and security. 3. Establishment of child-friendly space and women-
friendly space
● The wellbeing of all people should be protected 4. Basic mental health care by primary health care workers
through the (re)establishment of security, adequate 5. "Libreng Ligo", "Libreng Laba", "Libreng Tawag"
governance and services that address basic 6. Management of a drug dependent
physical needs (food, shelter, water, basic health 7. Providing basic health care services (Health Caravan)
care, control of communicable diseases). 8. Controlling communicable diseases and preventing
● In most emergencies, specialists in sectors such as disease outbreaks
9. Family Tracing and Reunification
food, health and shelter provide basic services.
10. Cash for work
11. Psychotherapy
Community and family supports. 12. Provision of a prayer room
13. Activation of social networks, such as through
● The second layer represents the emergency women's groups and youth clubs
response for a smaller number of people who are 14. Use of antipsychotics
able to maintain their mental health and 15. Advocating that these services are put in place with
psychosocial wellbeing if they receive help in responsible actors
accessing key community and family supports. In
most emergencies, there are significant disruptions
of family and community networks due to loss,
displacement, family separation, community fears
and distrust.
● Moreover, even when family and community
networks remain intact, people in emergencies will
benefit from help in accessing greater community
and family supports.

Focused, non-specialized supports.

● The third layer represents the supports necessary

for the still smaller number of people who
additionally require more focused individual,
family or group interventions by trained and
supervised workers (but who may not have had
years of training in specialized care).
● For example, survivors of gender-based violence
might need a mixture of emotional and livelihood
support from community workers. This layer also
includes psychological first aid (PFA) and basic
mental health care by primary health care workers.

Specialized services.

● The top layer of the pyramid represents the

additional support required for the small
percentage of the population whose suffering,
despite the supports already mentioned, is
intolerable and who may have significant
difficulties in basic daily functioning.