But beneath the looks and persona lurks an inflicted girl silently tormented and demonized by great fear for almost six years now

TACLOBAN CITY — Sixteen-year-old senior high student Jennifer is a standout among her peers — pretty, tall with fair complexion, an achiever both in academics and athletics, and has a cheerful personality that creates a positive mood in a room.

But beneath the looks and persona lurks an inflicted girl silently tormented and demonized by great fear for almost six years now — a condition that has all the signs of a post traumatic stress disorder or PTSD.

“She is still traumatized with what happened during typhoon ‘Yolanda,’” says her mother Cathy. “I myself is also suffering still from the trauma. My body gets cold and I would shiver because of fear when it rains hard especially at night.”

Cathy said she noticed the sudden change in Jennifer’s behavior right after typhoon “Yolanda.” “She gets distressed whenever it rains hard. When she knows there is typhoon coming, I would hear her crying at night. I don’t know until when she will suffer this,” she said.

Jennifer’s behavior is very much different from the exuberant girl she used to be who loves to shower in a downspout whenever it rains. His younger brother, who also shows signs of distress during bad weather, would drown himself in loud music whenever it rains.

Cathy, who lost a brother and a daughter during typhoon “Yolanda,” believes what they have is just a simple case of trauma that is also experienced by many other in their seaside community. In the local culture, trauma is called “ugmad” and the best remedy for it is to undergo “loon,” performed by a traditional healer where a trauma victim goes through a ritual and is smoked using some herbal leaves.

Traditional community healers made a heyday after the super typhoon as thousands of people including doctors and other health practitioners went through “loon” to overcome the trauma, many were able to recover quickly, while some did not like in the case of Cathy’s household.

Cathy believes that their condition does not require them to seek the help of a psychiatrist and that the trauma will heal by itself as time goes by.

Renowned psychiatrist Dr. Cornelio Banaag, who is acknowledged as the Father of Child Psychiatry in the Philippines, says that global data on mental health of people who went through mass traumatic experience as huge as typhoon “Yolanda” shows around 10 percent of them develop PTSD.

“Everybody gets distressed, and many suffer from stress and anxiety for a whole month but beyond that 10 percent will continue to have what is termed as PTSD with all the symptoms like magugulatin, just a reminder of the event will cause a lot of panic, or they get dreams at night,” Dr. Banaag said.

Local psychiatrists Drs. Benjamin Go and Vanessa Cainghug agree that there are still many cases of PTSD in Eastern Visayas due to typhoon “Yolanda” but seldom do patients come to seek treatment.

But with over one million people living in the so-called “Yolanda” corridor in Eastern Visayas alone, PTSD cases could be at least 100,000 in the region, a big number compared to only four psychiatrists to attend to them.

“We do not have the statistics like how many of them but I personally saw the people of Tacloban who displayed symptoms of PTSD after typhoon “Yolanda” and a few months after. Even at present there are still vestiges of PTSD,” says Dr. Cainghug, who is also the president of Philippine Psychiatric Association.

Another psychiatrist, Dr. Luzviminda Katigbak of Makati Medical Center, said very few people come to seek professional help because people seldom talk about mental health. “We are trying to change that,” she said.

Dr. Banaag laments the very few researches that the mental health community can produce due to the many cases that they have attend to and the scant funding available to make big researches.

“The demand is increasing exponentially but the supply for service providers is only steadily growing,” he said.

At present PPA counts only around 600 psychiatrists all over the country, many are based in Metro Manila, to attend to a population of more than 104 million in 2017, or one doctor to attend to over 170,000 people.

The disparity is worse in the provinces like in the case of Eastern Visayas with only four psychiatrists for a population of over four million, or one doctor for every one million population.

Dr Wina Ranoy of the Medical City says the issue on mental health is not just about the pathologies like PTSD.

“If we have 10 percent who develops PTSD, there are 90 percent who did not. So it means people have the resilience to get over stress or anything that is traumatic that they experienced,” she said.

Dr. Ranoy said mental health also focuses on helping people enhance their coping and defense mechanisms so as not to develop pathology, which actually is more difficult to address.

“Our emphasis is not only on the illness but mental health as a whole. What we do is to develop more effective and healthy coping mechanism so a case will not develop illness,” she added.