ALL THAT discussion should have stressed you by now, and made you wonder: given the deteriorating economic and political situation in the Philippines, are we about to see an epidemic of stress-related ailments?

I think we're already in that epidemic, and too little is being done to help Filipinos tackle stress.

I've intentionally used the verb "tackle" rather than "treat" because there is a tendency to medicalize stress, to look for drug treatments that could lead to new dependencies. The drug companies push all kinds of "antidepressants" to doctors, who are then quick to prescribe them to stressed patients.

Sessions with psychiatrists or psychologists are more effective than drug treatments, but again, low incomes may prevent many Filipinos from getting the "talking therapy" they need. That is why we need to be able to tap what we already have in culture, looking into how families and communities can be mobilized to help people with their stress.

I feel community health workers are under-utilized for mental health. Given some training, they can learn to help their barangay residents with stress. That includes essentials about counseling, for example, not resorting to that notorious sulsol ("Oh yes, your husband is really terrible, and mare, you know I just didn't want to tell you but we've all known all this time that. . .")

In the United States, studies are showing that somatization syndrome is best handled with what's called cognitive restructuring, helping patients to take on new lenses as they revisit their problems. Instead of wallowing in self-pity as a victim, cognitive restructuring helps people regain some sense of control.

We have that in our folk therapies — note how, in bangungot, we're supposed to try to move a finger, a toe, any part of the body. It's not a symbolic act; it actually means taking control of one's own body, and the failing spirit. It's a powerful metaphor that can be used to explain other stress-related ailments and syndromes.

I'm ambivalent about New Age therapies such as meditation and aromatherapy, but mainly because the type offered by spas and health resorts are just totally inappropriate. Since we're a very olfactory people, I think there is a place for aromatherapy. Sadly, we're importing expensive aromatic oils when there are local plants that can be used; in fact, some of the most expensive aromatic oils are extracted from local plants we take for granted, like ylang-ylang.

But I do see a place for many traditional therapies being rechanneled toward stress management. The manghihilot can be "reinvented" so his or her skills with therapeutic massage can be applied not just for sprains, but also for broken hearts and weary spirits.

Massage and aromatherapy, however, are only the externals. Stress management is really helping people to dissect their own feelings, to understand where their distress is coming from. The solutions may not always be easy — all the aromatherapy and meditation in the world will not raise low wages.

But community action can help to make the stress more tolerable. Communities should be urged to create their own safe spaces where people can seek some refuge. Filipino-style, such spaces need not be totally quiet, but they do need to give some sense of safety, of sanity in a mad world. Filipino-style, too, we need to think of how these therapeutic spaces might work out as places where people can engage in social activities, without becoming more agitated. Alternatives could be offered: gardening, cross-stitching, bingo…anything that calms the mind. You don't need to be in the lotus position to meditate.

Ultimately, stress management is a matter of helping people to recognize that the world, which seems so stressful, can also be a source of joy and pleasure, fulfillment and renewal. The therapies being dangled around are really meant as appetizers, ways of inducing the depressed the person to garner enough strength and courage to re-engage not just the world, but life itself.

Michael L. Tan is a medical anthropologist. He is currently chair of the anthropology at UP Diliman, Quezon City. He also writes an op-ed column, "Pinoy Kasi," for the Philippine Daily Inquirer.