Lee Kok Leong, executive editor, interviews Gisa Paredes, a Philippine board-certified psychologist and chief operating officer at WellAtSea, on how to recognize symptoms of mental illness and ways to help seafarers improve mental well-being.
Gisa Paredes
Philippine board-certified psychologist and COO, WellAtSea.
Understanding Seafarers' Mental Health
Why are seafarers likely to develop mental health problems?
Mental pathology can often be triggered by chronic high stress in human beings – whether they are at sea or on shore. Each of us has a cognitive disposition and a set of behavioral aspects that may or may not react well to a given environment or situation.
So, you can imagine if one person has the disposition and strength of a piece of tissue versus someone whose disposition is the strength of three sheets of tissue, and if you pile rocks on each one, your one sheet of tissue may likely break faster than the three sheets. This is what we call the diathesis-stress model.
The leading causes of stress for seafarers are often shown as, but not limited to, the ship operations, people on board, being away from family, and concerns on their own well-being. When the environment on board inhibits the using of skills to promote well-being or the seafarers’ capacity to incorporate/learn new skills, this can be detrimental.
What are the symptoms of mental health problems?
Mental disorders can be identified by the four Ds:
• Distress – This is described as having unpleasant feelings and thoughts that may seem overwhelming. These emotions become distressing when they get in the way of your daily living and how you react to other people.
- Physical symptoms (shaking, headaches, feeling very tired, loss of appetite, aches and pains)
- Excessive crying, sadness, depressed mood, grief
- Being “on guard” or “jumpy”
- Worry that something really bad is going to happen
- Insomnia, nightmares
- Irritability, anger
- Guilt, shame
- Confused, emotionally numb, or feeling unreal or in a daze
- Appearing withdrawn or very still (not moving)
- Not responding to others, not speaking at all
- Disorientation (for example, not knowing their name or what happened)
- Not being able to care for themselves (not eating, drinking, not able to make simple decisions)
• Dysfunction – Defined as “abnormal or impaired functioning” on the bio-psycho-social aspects of an individual.
For some people, dysfunction can manifest in the body, our inability to sleep, unexplained pain, severe stiffening of the muscles or a nervous twitch. These not-so-subtle signs tell us that there is an obvious misfire in our brain, thus the body function may not be optimum.
Another way to understand dysfunction is through the possibility that distress or paralysis may be a cause of chemical imbalance. It is important that we notice what is happening to our bodies, because from these signs, we can find what can look like a panic attack, catatonia and a nervous tick, to name a few, and then we can seek help immediately.
• Deviance – This refers to any behavior that may differ from what is considered appropriate or typical. Deviant behavior may be seen in anti-social tendencies that may have them rebelling or breaking rules. It may also be observed in thoughts and behaviors of individuals with clear physical disabilities.
• Danger – This involves violent behavior that may be directed towards the self or others. In this case, it is absolutely crucial to take the person to a licensed professional for immediate help.
If left untreated, what can mental health problems lead to?
One thing you need to know about episodes like depression and anxiety are that once they have happened, they will likely happen again. Some people may say that they managed to get through it and they coped in the way that they knew best, but these coping styles and methods may not be the most suited to their unique situation.
As shared above, we know that mental disorders can involve deviance and danger. And when we leave it untreated, this may cause harm to the person and the people around them as the experience of the episode becomes more and more distressing.
It is best to consult with both a psychologist and a psychiatrist for treatment. The psychologist will work with you through talk therapy to help you manage the reactions, notice when an episode is coming up, and encourage you to find new ways to cope and deal with similar situations. Talk therapy is meant to help you identify the stressors and become better equipped at responding to them.
Psychiatry on the other hand, offers you proper medication that your body needs to return to a state of equilibrium. There may be several reasons why a mental episode occurs, and one of them being a chemical imbalance in the brain. It is crucial to follow the prescription from your doctor while working it out in therapy with your psychologist.
For seafarers, what can they do to improve mental health?
If we take a look at the socio-economical model of health, we know that seafarers are part of a larger system. They are therefore recipients of the effects of this system. For a seafarer to improve his well-being, there are concrete action steps they can take towards better physical health.
But in order to safeguard mental health on board means involving the system. This means that management needs to be directly involved and leaders on board need to be open to the experience of well-being programs that may teach seafarers ways to socialize and achieve mental resiliency through activities.
Mental health is best improved when the environment and situation that the seafarer find themselves in match their cognitive disposition. Leaders need to ask themselves how they can provide an environment of psychological safety and care.
What can companies do to help seafarers?
Health can be taught systematically. This means that having a dedicated team or implementation partner that caters towards the well-being of your employees is important.
In order to help seafarers, the environment they are in needs to change. An environment can change when psychological safety becomes present. Having psychological safety is described as being able to express oneself without fear of judgment, criticism or mockery that may affect status, career or self-image.
In psychologically safe teams, members feel mutual respect. In a study by Kim and Jang (2018) on Seafarers’ Quality of Life, we learn that organizational culture has a direct effect on a person’s self-efficacy, which may in turn affect the quality of work life.
