Mental distress among freelancers working from home is unusually high. Unfortunately, not many of them seek intervention. Cost is one reason, while the availability of professionals and facilities is another. But by and large, the hesitance is due to Filipinos regarding mental health issues, including anxiety and depression, as “taboo.”
To the uninitiated, working from home seems easy and more relaxing. Consider these benefits:
- Live and work anywhere there is a data connection
- Freedom to choose clients
- No more long commutes and horrendous traffic
- Flexible time
- More than one source of income
Online freelancers are very much like Overseas Filipino Workers (OFW). Many of them work with foreign clients earning dollars. But one fundamental difference is that they do not have to leave their family.
Of the estimated 10 million OFWs, most would not choose to go if they could have decent local jobs. Being away from home, most of them experience mild to severe loneliness. Even more troubling is the impact of distance on families. For instance, Judge Francis Buliyat Sr. of the Regional Trial Court (RTC) Branch 9 of La Trinidad estimates that 3 out of 4 couples resort to annulment when one works as an OFW.
Online freelancers do not share the same burden. Compared to OFWs and traditional employees, working from home is a holiday. Sure, there are disadvantages, such as the lack of government benefits. Be that as it may, the advantages far outweigh the cons.
Despite enviable perks, the truth is that the prevalence of mental distress is high. One can say that stress, anxiety, and depression are the dark sides of working from home.
What Is the Mental Health Situation in the Philippines?
Even before the pandemic, mental health has already reached alarming levels. Yet, most Filipinos continue to ignore this issue. One reason is the stigma attached to mental illness (Rivera and Antonio).
Some of the negative perceptions Filipinos attach to mental illness are:
- Ruined family reputation
- Social isolation and prejudice
- Loss of face
- Sense of shame or being a disgrace
- Sign of personal weakness
- Failure of character
Consider, too, that Filipinos are Asians who generally deem mental illness as unacceptable. This shame, and more reasons (Martinez et al.), dissuades them from seeking help. Instead of consulting with experts, they would rather rely on family and friends.
Even if intervention becomes an absolute necessity, professional help is not always available. The cost of treatment, for instance, is prohibitive. Plus, most communities lack adequate mental health facilities.
Mental health in the Philippines, unfortunately, is not a priority. A proposed mental healthcare bill, for example, sat in congress for 20 years (Poblacion). Fortunately, Pres. Duterte signed the Philippine Mental Health Law (Republic Act No. 11036, or RA 11036) on June 20, 2018.
Despite the initial optimism, the impact of the new bill remains unknown (Lally et al.). One obstacle is the lack of funding, which hinders:
- Establishment of mental healthcare facilities in communities outside the main urban areas
- Training and recruitment of psychiatrists, psychologists, and other professionals
An estimated 3.6 million Filipinos suffer from mental health disorders (Crisostomo). Over the coming years, one can only hope that the numbers will decrease.
Prevalence of Stress in the Philippines
Before the pandemic, 6 of 10 Filipinos were already experiencing stress. Overall, the Philippines has the second most stressed population in the world.
Table 1. The Top 10 Most Stressed Out Countries in the World in 2018
(“Gallup 2019 Global Emotions Report”)
Among millennials globally, 44% admitted feeling anxious or stressed all or most of the time. In the Philippines, the number is much higher at 57% (Cahiles-Magkilat).
Table 2. Filipino Millennials’ Top Stressors in 2020
|Long-term Financial Future||53%|
(“Deloitte Global Millennial Survey 2020”)
All the figures above were results of surveys conducted before the pandemic. During these troubled times, stress levels among the Filipinos increased.
Table 3. The Magnitude of Stress Caused by COVID-19 in the Philippines in 2020
|Period||Great Stress||Much Stress||A Little Stress||No Stress|
(“SWS September 17-20, 2020 National Mobile Phone Survey – Report No. 7: Filipinos Stressed by the COVID-19 Crisis Remain High at 86%”)
A little stress is good. But too much and for a prolonged period may lead to anxiety or depression, or both. The SWS survey shows that nearly 9 of 10 Filipinos suffer from much stress and great stress.
Prevalence of Anxiety and Depression in the Philippines
Filipinos are no stranger to anxiety disorders and depression.
Table 4. Percentage of Filipinos Experiencing Stress, Anxiety, and Depression in 2018
(Flores et al.)
From these figures, there is only one conclusion. The prevalence of stress correlates to the incidence of anxiety and depression.
Table 5. Psychological Impact of COVID-19 in the Philippines
|Severe to extremely severe||3.9%||11.1%||4.2%|
(Tee et al.)
Surveys do have limitations. For example, the stress levels in Table 5 deviate from the numbers shown in Table 3. At any rate, they do indicate that 4 of 10 Filipinos suffer from anxiety, and 3 of 10 suffer from depression.
Tee and his team conducted their research (Table 5) from 28 March to 12 April 2020. 60% of Filipinos did not feel stressed despite the initial lockdown because they treated it as a vacation. Accuracy is not critical, as the use of these surveys is to show that mental health is a growing concern.
Table 6. National Center for Mental Health Average Daily Calls
|May 2019 to Feb. 2020||April 2020 to July 2020|
|Average daily calls||13 to 15||32 to 37|
(“DOH Reports Spikes in Mental Health-Related Calls Due to COVID-19 Crisis”)
The Philippines first imposed a total lockdown during the second half of March 2020. A month after, the pandemic started taking a toll on mental health. The National Center for Mental Health, for example, reported a record number of calls from April to July. These calls, incidentally, also include 1 to 2 suicide-related concerns daily.
What Causes Work from Home Stress, Anxiety, and Depression?
There are many causes of mental distress in work from home arrangements, six of the top reasons are as follows:
- Job insecurity
- Loss of sense of control
- Lack of boundaries
- Social isolation and loneliness
- Sedentary lifestyle
As the pandemic continues, its negative impact on mental health keeps worsening. This notion of WFM-associated stress is unfathomable for anyone who has never worked from home for a period.
Premier Value Provider (PVP) – an insight, solutions, and training company – surveyed their employees from 5 May to 15, 2020. Of 420 participants – 83% worked at home, 9% worked both at home and on-site, and 8% worked on-site.
Table 7. PVP Internal Survey on Employee’s Mental Health Working from Home and On-site
|Work from home||16%||31%||22%|
|Combined WFM and WOS||3%||23%||10%|
(“Community Quarantine: Its Mental Health Toll on Our Younger Workforce”)
The sample size is tiny and confined to one company. Nonetheless, the results are revealing. For instance, consider the percentage of employees experiencing stress and anxiety. The prevalence rate is higher among those working from home than on-site.
In Singapore, the Mind Science Centre of the National University Health System surveyed mental health resilience.
Table 8. Stress Levels of Working from Home Compared to Frontliners
|Work from Home||Frontliners|
|Feeling stressed working at home||61%||53%|
|Feeling stressed at home||51%||32%|
(“Mental Health Resilience Survey on COVID-19”)
More people feel stressed working from home than on-site (Table 7). Furthermore, the stress level of people working from home can also be higher than frontliners (Table 8).
1. Job Insecurity
The threat of losing a job can motivate a person to work harder. Such belief is pervasive among clients who hire work-from-home workers. In the Philippines, there are an estimated 1 to 2 million online freelancers. So, the impression is that it is easy to replace a freelancer who leaves.
Aside from being replaced, restructuring, downsizing, and other cost-saving measures is also a concern. If the business is not doing well, a client may drop a freelancer. Hence, losing their livelihood remains one of the top worries of online workers.
Job insecurity, in some ways, is a disease that not only results in loss of productivity. It might as well be a contributing factor to the political unrest in the country. One plausible explanation for extremism could be its impact on social identity (Selenko et al.). The constant psychological distress can also change the personality of affected individuals (Wu et al.).
The five personality traits negatively impacted include:
- Emotional stability
Fear of uncertainty fuels job insecurity. As a result, employees, including online freelancers, lose motivation. Instead of focusing on tasks and goals, their minds get hooked on negative sentiments. Eventually, many freelancers become tense, irritable, anxious, or depressed.
2. Loss of Sense of Control
A low perceived sense of control reduces cognitive performance (Robinson and Lachman). Unfortunately, it is one of the challenges encountered by employees – and much more so by online freelancers.
- Distractions. The lack of space makes it impossible to have a physical barrier. As such, chores and activities performed by other household members can be distracting. Breaking the boundaries in a work-from-home arrangement can only add to the frustration.
- Family dynamics. Relationships between spouses, partners, and other family members play a significant role. An imperfect marriage or partnership, for example, causes emotional distress. Seeing that person – the stressor – while working can make one feel trapped and bound. All these negativities spill over to work, adding to the job-related pressure. Likewise, work stress can also spill over to the home, eroding work-life balance.
- Poor time management. Some online freelancers juggle between tasks and chores. As a result, they end up confused or submitting unsatisfactory performance. Failing to deliver on expectations or completing tasks can erode confidence.
- Unreasonable expectations. While striving for excellence is laudable and a much-desired trait, it can also be stressful. Under normal circumstances, it is not a problem as long as one can complete each chore or task. Failing to reach the desired outcome, however, leads to frustrations.
Any of the factors cited above, and others more, that cause a low level of control is psychologically distressful (Griffin et al.). Unless there are changes, it may lead to chronic stress, anxiety, or depression.
An employee switches tasks or gets interrupted every 3 minutes 5 seconds (Mark et al.). Once distracted, it takes 23 minutes and 15 seconds to get back on track. Imagine how difficult it is for knowledge workers to lose their train of thought. Before getting back to where they left off, another interruption comes.
Compounding this problem is the need to complete tasks. The natural reaction to losing time is to compensate by working faster. As a result, stress level builds up while the quality of work degrades. At home, managing distractions is even more difficult.
- Uncontrollable distractions. An example would be living in a noisy neighborhood – random noises from neighbors talking loudly, dogs barking, or non-stop traffic. Unfortunately, every person working from home has to deal with distractions that they cannot control – and that is frustrating.
- Household distractions. Members of the family, especially young children, can interrupt work from time to time. They can also do it indirectly – such as watching TV, listening to music or singing, and being generally noisy. It gets incredibly stressful when some people in the house willfully disregard boundaries. Incidentally, pets belong to this category too.
- Work-related distractions. Even in relative silence, messages from colleagues take the mind away from the task at hand. Each interruption makes completing a job difficult. It gets worse when the interruptions include requests for more time-sensitive tasks. As a result, frustration mounts as each interruption stops an online freelancer from completing a job while the workload piles up.
- Lack of self-discipline. Most online freelancers are not accountable to anyone. Instead of working, some of them sneak in time to watch movies or check social media messages. They multitask by reading the news, chatting with friends, and doing chores.
4. Lack of Boundaries
For many online freelancers, the line between professional and personal life is a blur. Ideally, employees do not bring personal issues to work. At the end of a stressful day, they can go home and spend quality time with the family. Such delineation barely exists in a work-from-home arrangement.
- Lack of boundaries at work. Being home-based also means working, even when it is family time. An example would be employers or colleagues sending messages outside working time. Instead of waiting for office hours, most online freelancers feel compelled to reply. As a result, they have to sacrifice personal or family time to complete tasks. And to make matters worse, some employers do not appreciate or compensate their remote workers for the extra time.
- Lack of boundaries at home. Creating physical, social, and temporal boundaries is easier said than done. Almost all Filipinos live with their families, with an average of five people in a household. Privacy is non-existent compared to western standards. As such, distractions occur here and there, now and then.
5. Social Isolation and Loneliness
Working from home can make a person feel socially isolated. As studies and surveys showed, many have also been dealing with loneliness.
Table 9. The Biggest Struggles of Working from Home
|Unplugging after work||27%||18%||22%|
|Difficulties with collaboration and communication||16%||20%||17%|
|Distractions at home||15%||12%||10%|
(“2021 State of Remote Work”)
Social isolation is consistently one of the top three concerns of online freelancers. And with social deficit comes loneliness.
15% to 30% of the general population suffers from chronic loneliness (Hawkley and Capitanio). Moreover, being lonely for prolonged periods can lead to cognitive decline and depression. Actual or perceived, it can increase the risk of early mortality (Holt-Lunstad et al.). One reason is that loneliness affects the immune system, which increases the risk of getting ill (Cole et al.). In essence, the health risks of social isolation on well-being are comparable to obesity and smoking (Novotney).
Isolated and lonely, what do online freelancers do?
Of course, log in to Facebook and other social media platforms. The Philippines, after all, has among the most Facebook users worldwide. At 92,200,000 – that is equivalent to 82.2% of the population (“Facebook Users in Philippines – February 2022”).
Scrolling through the timeline, commenting, and messaging might be fun and a means to stay connected with family and friends. But then again, it may also cause or worsen depression.
One research, for instance, found a correlation between depression level and Facebook usage frequency and duration (Pauline and Dy). Some possible reasons for the negative emotions could be envy and social comparison. Staying connected, as it is, may make one feel even more lonely.
6. Loneliness or Hopelessness
Foreigners often describe the Philippines as a nation of happy people. In times of calamities, they still manage to find humor. A portion of the population, though, does feel lonely.
Table 10. Mental Health of Filipino High School Students
|Felt Lonely Almost or All the Time||16.1%||12.4%||19.7%|
|Felt Worried Almost or All the Time||11.0%||9.4%||12.6%|
(“2015 Global School-Based Student Health Survey (GSHS) Country Report”)
The table above also indicates that more females than males tend to feel lonely.
Table 11. Filipino Who Thought They Would Feel Lonely Most of the Time
(“Global Predictions for 2020”)
Between 26 Nov. to 6 Dec. 2019, a survey showed more than a third of the population do not think they are or will get lonely. Although the sample size is small, it does indicate that the rate of loneliness increased.
Table 12. Social and Emotional Loneliness among College Students During the COVID-19 Pandemic
|Not Lonely||Moderately Lonely||Severely Lonely|
(“Labrague et al.”)
During the pandemic, the number of moderately and severely lonely Filipinos shot up to 90%. Quarantine helped prevent the spread of COVID-19. But it also increased social and emotional loneliness.
The universal definition of loneliness is solitude or a state of being alone. It is a destructive state of mind, which leaves one feeling empty, alone, and abandoned. There is no single cause, and other factors may worsen the condition – social isolation being one.
Do note that loneliness and solitude are not the same:
- Lonely people do have the desire to have social connections. Even if they are in the company of others, they still feel an emptiness.
- Solitude is a voluntary action of people who choose to stay alone. At any given time, they can have positive social relationships.
Prolonged loneliness can dramatically affect cognitive functions and promote negative behaviors. Lonely people tend to have:
- Poorer memory retention
- Higher stress levels
- Increased risk of substance abuse
- Increased risk of cardiovascular disease
Loneliness affects people in any profession. In other words, a portion of the people working from home already has this issue.
7. Sedentary Lifestyle
In Asia-Pacific, 67% of employees spend 6 to 9 hours at a desk (“Herbalife’s Nutrition at Work Survey Reveals Majority of Asia-Pacific’s Workforce Lead Largely Sedentary Lifestyles, Putting Them at Risk of Lifestyle Disorders”). Filipinos should not be far behind on the prevalence of insufficient physical activity. As of 2016, 4 in 10 Filipinos live a sedentary lifestyle (Guthold et al.).
Sedentary behavior is a serious threat to long-term health (“Risks of Physical Inactivity”). It is a leading risk factor for non-communicable diseases, including but not limited to:
- Coronary heart disease
- Mental illness
As it is, several other factors compound the problem of mental distress. The ongoing pandemic, for sure, made conditions worse. For instance, quarantine measures kept many who want to live a more active lifestyle at home. There is no debate on doing physical activities indoors because it is doable. The question is if online freelancers find the motivation.
Incidentally, online freelancers who were not active in the last two years should be mindful of health protocols. The lack of physical activity ranks third as a risk factor for severe COVID-19, behind advanced age and history of organ transplant (Sallis et al.). Once infected, the chances of dying are higher than for people with an active lifestyle.
Anxiety and Depression Is Real for Online Freelancers
The Philippines is a nation of warm and fun-loving people. Beneath the smiles and laughter, though, are endless worries. Although hard to believe, the country ranks second with the most stressed population globally.
Unfortunately, most people neglect the gravity of mental health distress. Even if one were to seek professional help, it is either prohibitive or unavailable.
At the national level, the government needs to do two things:
- Educate the people on mental health
- Build more clinics and hire more professionals
As an individual suffering from mental anguish, accept that it is a problem. Disregard concerns, such as the shame or stigma attached to mental illness. Get educated and seek help.
Sources and Further Reading
“2015 Global School-Based Student Health Survey (GSHS) Country Report.” Department of Health, 27 Oct. 2015. Accessed 20 Oct. 2021.
“2021 State of Remote Work.” Buffer, 2021. Accessed 20 Oct. 2021.
Cahiles-Magkilat, Bernie. “Pinoy Millennials More Stressed, Anxious than Global Peers – Study.” Manila Bulletin, 4 July 2020. Accessed 20 Oct. 2021.
Cole, Steven W., et al. “Myeloid Differentiation Architecture of Leukocyte Transcriptome Dynamics in Perceived Social Isolation.” Proceedings of the National Academy of Sciences, vol. 112, no. 49, 23 Nov. 2015, pp. 15142–15147. Accessed 20 Oct. 2021.
“Community Quarantine: Its Mental Health Toll on Our Younger Workforce.” Premier Value Provider, 21 May 2020. Accessed 20 Oct. 2021.
Crisostomo, Sheila. “3.6 Million Pinoys Suffer from Mental Disorders – DOH Survey.” PhilStar, 14 Oct. 2020. Accessed 20 Oct. 2021.
“Deloitte Global Millennial Survey 2020.” Deloitte Philippines, 2020. Accessed 20 Oct. 2021.
“DOH Reports Spikes in Mental Health-Related Calls due to COVID-19 Crisis.” CNN Philippines, 26 Aug. 2020. Accessed 20 Oct. 2021.
“Facebook Users in Philippines – February 2022.” NapoleonCat, 2022. Accessed 17 Mar. 2022.
Flores, Jo Leah, et al. “Abstract 17228: Prevalence and Correlates of Depression, Anxiety and Stress among Filipinos in the Philippines.” American Heart Association, 9 June 2018. Accessed 20 Oct. 2021.
Gallup, Inc. “Gallup 2019 Global Emotions Report.” Gallup, 18 Apr. 2019. Accessed 20 Oct. 2021.
“Global Predictions for 2020.” Ipsos, 16 Jan. 2020. Accessed 20 Oct. 2021.
Griffin, Joan M, et al. “The Importance of Low Control at Work and Home on Depression and Anxiety: Do These Effects Vary by Gender and Social Class?” Social Science & Medicine, vol. 54, no. 5, Mar. 2002, pp. 783–798. Accessed 20 Oct. 2021.
Guthold, Regina, et al. “Worldwide Trends in Insufficient Physical Activity from 2001 to 2016: A Pooled Analysis of 358 Population-Based Surveys with 1·9 Million Participants.” The Lancet Global Health, vol. 6, no. 10, Oct. 2018, pp. e1077–e1086. Accessed 20 Oct. 2021.
Hawkley, Louise C., and John P. Capitanio. “Perceived Social Isolation, Evolutionary Fitness and Health Outcomes: A Lifespan Approach.” Philosophical Transactions of the Royal Society B: Biological Sciences, vol. 370, no. 1669, 26 May 2015. Accessed 20 Oct. 2021.
“Herbalife’s Nutrition at Work Survey Reveals Majority of Asia-Pacific’s Workforce Lead Largely Sedentary Lifestyles, Putting Them at Risk of Lifestyle Disorders.” The Financial Express, 12 May 2016. Accessed 20 Oct. 2021.
Holt-Lunstad, Julianne, et al. “Loneliness and Social Isolation as Risk Factors for Mortality.” Perspectives on Psychological Science, vol. 10, no. 2, Mar. 2015, pp. 227–237. Accessed 20 Oct. 2021.
Labrague, Leodoro J., et al. “Social and Emotional Loneliness among College Students during the COVID‐19 Pandemic: The Predictive Role of Coping Behaviors, Social Support, and Personal Resilience.” Perspectives in Psychiatric Care, vol. 57, no. 4, 6 Jan. 2021, pp. 1–7. Accessed 20 Oct. 2021.
Lally, John, et al. “Mental Health Services in the Philippines.” BJPsych International, vol. 16, no. 03, 14 Jan. 2019, pp. 62–64. Accessed 20 Oct. 2021.
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Martinez, Andrea B., et al. “Filipino Help-Seeking for Mental Health Problems and Associated Barriers and Facilitators: A Systematic Review.” Social Psychiatry and Psychiatric Epidemiology, 20 Aug. 2020. Accessed 20 Oct. 2021.
“Mental Health Resilience Survey on COVID-19.” Mind Science Centre, National University of Singapore, 2020. Accessed 20 Oct. 2021.
Novotney, Amy. “The Risks of Social Isolation.” American Psychological Association, vol. 50, no. 5, May 2019, p. 32. Accessed 20 Oct. 2021.
Pauline, Grace, and Marison R Dy. “Facebook Usage and Depressıon Levels of Selected Filipino College Students.” ResearchGate, Kiperonline Academic, 26 Jan. 2019. Accessed 20 Oct. 2021.
Poblacion, Samantha. “Mental Health in the Philippines.” The Manila Times, 12 July 2018. Accessed 20 Oct. 2021.
“Risks of Physical Inactivity.” Johns Hopkins Medicine Health Library, 2019. Accessed 20 Oct. 2021.
Rivera, Ana Kriselda B., and Carl Abelardo T. Antonio. “Mental Health Stigma among Filipinos: Time for a Paradigm Shift.” ResearchGate, Jan. 2017. Accessed 20 Oct. 2021.
Robinson, Stephanie A., and Margie E. Lachman. “Perceived Control and Cognition in Adulthood: The Mediating Role of Physical Activity.” Psychology and Aging, vol. 33, no. 5, 1 Aug. 2018, pp. 769–781. Accessed 20 Oct. 2021.
Sallis, Robert, et al. “Physical Inactivity Is Associated with a Higher Risk for Severe COVID-19 Outcomes: A Study in 48 440 Adult Patients.” British Journal of Sports Medicine, vol. 55, no. 19, 8 Apr. 2021. Accessed 20 Oct. 2021.
Selenko, Eva, et al. “Does Job Insecurity Threaten Who You Are? Introducing a Social Identity Perspective to Explain Well-Being and Performance Consequences of Job Insecurity.” Journal of Organizational Behavior, vol. 38, no. 6, 22 Jan. 2017, pp. 856–875. Accessed 20 Oct. 2021.
“SWS September 17-20, 2020 National Mobile Phone Survey – Report No. 7: Filipinos Stressed by the Covid-19 Crisis Remain High at 86%.” Social Weather Stations, 8 Oct. 2020. Accessed 20 Oct. 2021.
Tee, Michael L., et al. “Psychological Impact of COVID-19 Pandemic in the Philippines.” Journal of Affective Disorders, vol. 277, Aug. 2020, pp. 379–391. Accessed 20 Oct. 2021.
Wu, Chia-Huei, et al. “Effects of Chronic Job Insecurity on Big Five Personality Change.” Journal of Applied Psychology, vol. 5, no. 11, 24 Feb. 2020, pp. 1308–1326. Accessed 20 Oct. 2021.