Manila hostage crisis: Understanding depression

MANILA, Philippines - There are many questions on what could've driven Senior Inspector Rolando Mendoza to the edge, and sent him spiralling into a deadly shooting rampage in Manila last Monday that claimed the lives of eight Hong Kong tourists as well as his own.

"I think this person was already in a crisis to start with," said Dr. Eleanor Lacuna-Ronquillo, a psychiatrist at the Medical City, in an interview with ANC's "Dateline Philippines" on Saturday.

Dismissed from service last year over allegations he and 4 other policemen were involved in extorting money from a chef, Mendoza, armed with an automatic rifle, commandeered a bus in Manila on August 23, 2010 and engaged authorities in a 12-hour stake out at the Quirino Grandstand that came to a bloody end.

He had called for a review of his case. And yet, despite a letter from the Office of the Ombudsman offering to review his extortion case within 10 days from the hostage-taking, Mendoza had called the letter "garbage" and demanded his immediate reinstatement.

Crisis and desperation

"If the person is very emotional, we advise them not to make any drastic major decision. In his case, out of desperation, and not knowing what to do, he was very emotional. That was just what he thought was the next best thing. During the time he did that, he was very confused, very anxious, agitated, angry. And at that kind of emotional level, small things would make you lose your impulse control," Dr. Ronquillo said.

She noted that Mendoza, who may already have been vulnerable from having an uncertain future after losing his job and facing a criminal case, may have become even more vulnerable upon seeing his brother being ganged-up on by police.

"If a person is in crisis, he is in the middle of it, he is very emotional. It would only take a very small thing to trigger the impulse. And he was fully armed, so when he saw a family member being restrained, nadagdagan yun," Ronquillo said.

Ronquillo believes Mendoza entered the hostage situation knowing full well the risks of the situation, including the possibility of death.

"If you're in a situation where there will be hostages and people around you, it is still perceived as a threat. Everybody is a threat, so would I fight, flee or stick it out?" Ronquillo posited.

She added that the limited space of the bus may have made Ronquillo's world even smaller, magnifying the threat outside the bus and around him.

"He should have talked to someone whom he felt he could trust," Ronquillo said.

Coping mechanism

Ronquillo said people respond to different stimuli differently depending on their frame of mind.

"Maybe he was feeling very sad or angry at the decisions that were made, or how he has not been listened to (emotional). Maybe he was not talking to his family or people at work and nobody knew what was going on in his mind (behavioral). They cannot weigh things objectively, it affects how the mind runs," Ronquillo said, adding that physical reactions were also worth observing.

On a personal level, she said the hostage-taker would've had to cope with his situation, but, she added, so does everyone else who was witness to it and who may have been directly or indirectly affected by the incident.

"At the bigger level, the community is in crisis. Indirect victims would suffer the same effect of trauma. Ngayon, natatakot na yung iba na lumapit sa bus. They won't go on field trips, and they get very anxious when they're near the site of the hostage taking."

"Understandably, the emotions are still high specially on the net," Ronquillo said.

After a big crisis, she said it could take 4 to 6 weeks for people to recover from trauma, and those who suffer direct losses from an incident will have more acute reactions to stress.

Overseas Filipino workers (OFWs) have complained of being on the receiving end of expressions of rage and snide remarks from Hong Kong nationals.

"It's a big tragedy. We can't put the blame on people. It overwhelmed us. That was the situation. We have to see what can be done if a similar situation were to affect us in the future," she said. 

"We let it pass. This will pass. We expect Hong Kong to be angry, depressed and emotional. They have to go through the rituals of grieving, and forgiveness," Ronquillo said.

Depression unveiled

The World Health Organization says depression is a common mental health illness, affecting around 121 million people worldwide. In 2004 alone, the U.S. Census Bureau International Database recorded over 4.5 million cases of depression in the Philippines.

But despite it being common, Jean Goulbourn, president of the Natasha Goulbourn Foundation, said the stigma attached to people with depression keeps them from admitting to having some form of the condition and from seeking medical help.

"A lot of cases of depression are not reported, especially among OFWs. She mentions some people she knows just can't admit to it because it can create an epidemic," Goulburn said on ANC's "The Rundown."

Depression affects a person's body, mind and emotions, and in the most serious cases, could lead to death or suicide.

Goulburn said depression can lead to suicidal thoughts, adding some doctors say there is only 20% success of overcoming it with medication.

Factors that lead to suicide include: 1) deep/intense psychological pain; 2) [suicide] method is present and doable; and, 3) the strength and courage to do it.

On September 10, 2010, on the occasion of International Suicide Prevention Day, interested parties are invited to help raise awareness and understanding on depression by joining the "Walk and Light for Hope" at the Liwasang Aurora of the Quezon Memorial Circle, Elliptical Road Diliman, Quezon City at 5 p.m.

Losing Natasha, finding the light

Goulburn lost her own daughter Natasha to depression 8 years ago. She said her daughter went to psychiatrists and was given a cocktail of medicine, until her personality changed and they lost her.

Back then, as she grieved over her daughter's passing, Goulburn said she had asked God what losing her daughter meant, and she prayed for a sign. The sight of over 100 dolphins convinced her she had a higher calling to help people with depression.

"I prayed that if I see five dolphins, Natasha might be in hell. If I see 10 dolphins, could she be in purgatory? But God, if you show me a lot of dolphins, more than 10, I know my daughter is with you. We saw about 108 in Puerto Galera," Goulburn recalled, saying the sight was so rare it even brought the boatman to tears.

"Milagro ito," she remembered him saying. "Hindi po ito nangyayari. Bangkero ako for 40 years."

Today, the Natasha Goulburn Foundation bears the shape of a dophin with two people holding hands.

Now three years old, the foundation continues to raise funds and provide seminars to overseas Filipino workers (OFWs) abroad.

"We've gone to companies for support to treat parapsychology, to help OFWs. My biggest dream is to have our own sanctuary for those who are depressed, highly stressed or bordering on depression."

Noting a lack of understanding on depression, Goulburn hopes to help educated the public through the foundation, and show those who suffer depression that there is hope.

Goulburn said understanding and accepting one's self is the first step to healing.

"With depression, the person doesn't always knows he's depressed," said Goulburn.

She noted that it starts with a person not losing a lot of sleep, depending on sleeping tablets, having erratic mood swings, and--depending on the stress in a relationship--having difficulty with handling communication. Many things can trigger it, including chemical imbalance or hormonal change.

Goulburn warned against the perils of abruptly stopping the use of prescribed psychiatric drugs.

"One should not never stop taking it without a weaning period. It jumbles your system."

She said other modalities like hypnotism, acupuncture and exercise can also help treat depression, adding that having a spiritual center also helps.

"I think finding the light is important, the spiritual side of knowing that there is a God, somebody bigger than life who loves you."
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For inquiries on the Walk and Light for Hope or the Natasha Goulburn Foundation, call (632)897-2217 (632)505-9045
or e-mail: ngfoundation@gmail.com