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. 2022 Jan 16;61(1):618–643. doi: 10.1007/s10943-021-01476-3
Original Transcript Exploratory Notes / Comments Emerging Themes Clustered Themes
Participant # 1:
There was a time where I needed the guidance of God. It was from the start of the pandemic, wherein my mental health started to decline due to the circumstances. Maybe it could be because of the stress from academics, the current situation caused by the pandemic, how the government has been handling the situation, losing friends, etc. The stress from academics where my parents have high expectations from me to receive a high grade despite everything that has been going on. The current situation caused by the pandemic where I am worried for my family and my loved ones being infected by COVID-19. How the government has been handling the situation where people are dying and losing their source of incomeLosing friends where we were slowly drifting apart caused by the pandemic and not being able to talk due to our reasons and problems that we are currently facing.

Recognizes God’s guidance during crisis

Refers to the pandemic as the cause of mental health decline

Point to the pandemic as the source of stress from academics, poor government response, and losing friends

Identifies parents’ high expectation to excel in academics despite the pandemic

Feels worried about the effects of the virus on family and loved ones

Expects the government to manage well the situation especially the many cases of deaths and financial burden

Expresses sadness for causing separation from friends who give support

Attributing God’s support during the current pandemic

Referring to the pandemic as the source of mental health problem, poor government response, stress, separation from friends

Expressing being pressured by parents’ expectations to do well in academics amid the crisis

Showing concern for family and loved ones

Hoping for an effective response from the government in handling the crisis

Longing for support from friends amid the pandemic

Major Themes

Mental Health problems such as anxiety/depression as a serious effect of the pandemic

God/Higher Being as the first and/or last source of support/guidance

Self-awareness/Self-acceptance helps improve mental health

Minor Themes

Family support (Parents and/or siblings)

Government’s response to the pandemic

Parental pressure to perform well in academics

Friends/peer support

My mental health deteriorated so badly that it has led me to the point that I wanted to consult a psychiatrist but could not do so. To be honest, I find it hard to open up to anyone; however, I decided to talk to God and ask for guidance: what to do, how can I cope, how to ease the burden, etc. Through these, I realized that opening up to someone somehow lessens the burden in your heart. God was always with me from the beginning. Even before the pandemic, God has always been by my side quietly looking out for me and listening to my problems; and I know that He has guided me and has been listening to my concerns. From the start of this year, 2021, my mental health is slowly becoming stable again. I’ve been doing well in my academics, opened up to a few trusted friends, met new friends, and more. I knew I was more than blessed to have these things come into my life despite how bad my mental health was last year. For that, I thank God for helping me through my toughest times and has been with me whenever I needed someone to open up and talk to. More importantly, I thank God for the guidance He has provided me and answered my prayers.

Acknowledges mental health decline brought by the pandemic

Feels ashamed of opening up regarding the mental health issue

Points to God as the source of guidance and support since the start and during this pandemic

Regains mental health

Expresses gratitude for doing well in academics and having trusted friends

Thank God again for being there always

Identifying again the pandemic as the source of mental health problem

Showing lack of self-acceptance for the condition which prevents getting professional help

Acknowledging God as the initial and last source of support

Expressing gratitude for regaining strength and getting help from friends

Being thankful for God’s guidance

Participant # 2:
I think I struggled with this whole pandemic lifestyle, especially during online classes. At first, it was okay, professors were very lenient as everyone was adjusting and we were just finishing up Term 2… The next term was again okay. People got the hang of online classes, the workload varied depending on the class, but it was manageable. I passed off the struggles as simply an adjustment phase. The next terms, however, hit me hard… we had case studies almost every week. I felt so burnt out. I faced my laptop first thing in the morning, and it was the last thing I saw at night. For 20 years, my home was my ‘relax place’; it was a place where I could chill and decompress after the stresses of the day. Now with online classes, there’s no separation between work and home. I would relax after a class, but I would feel guilty because I could’ve been working on another requirement. When I would 'relax', I wasn't relaxing because the work is still in my face. I felt pressured to do things but there was no motivation to do anything at all. The continued days of online classes affected me a lot. There became points where I would lose focus during synchronous meetings... My attention span couldn’t handle all the dead air, the professors asking questions that no one replies too, and I couldn’t focus at all. There became a point where I would simply not attend class at all.

Acknowledges hardship during the pandemic

Cites understanding professors

Points out the difficulty in complying with the requirements of online class as time passes by

Feels disappointed about the integration of home with work activities

Maximizes time to finish all requirements without actually feeling relaxed

Feels pressured and stressed so much by requirements

Admits the loss of focus during synchronous classes; short attention span

Emphasizing the negative effects of the pandemic most especially in shifting to online classes

Acknowledging understanding professors

Stressing the difficulty of attending online class most especially the many requirements

Missing the old routine of having a healthy home and schedule

Utilizing the allotted time to complete all tasks

Expressing too much pressure and stress from the academic requirement

Emphasizing inattentiveness in the online class

Major Themes

Mental Health problems such as anxiety/depression as a serious effect of the pandemic

Stressed out in academics (online class requirements)

Self-awareness/Self-acceptance helps improve mental health

Minor Themes

Difficulty in dealing with online classes

Family support (Parents and/or siblings)

Friends/peer support

Professor’s concern and understanding

Separation of home and work activities

Self-relaxation as a must for self-care

Low self-esteem and unmotivated

Canvas notifications made me feel anxious because it usually meant a new output. It was hard to continue learning this way. I distinctly remember a night where I left the house around midnight to stroll around our driveway. We had clear skies that night, the breeze was cool, and the air smelled fresh. I cried. I didn’t know if I could continue to do well in school. I wanted to do well, but I didn’t have the motivation to do so. The pressure to perform was eating me up inside. As I was emoting it out on the driveway, I was thinking, when was the last time I stepped out of the house? When was the last time I appreciated nature and the outside world since the pandemic? My life since then has been a series of waking up, opening the laptop, and working until I fell asleep at some ungodly hour in the morning. Somewhere along the way, I lost faith. I lost faith in myself and everything. I was lost. The stresses of the past terms caught up to me and I just broke down. When I went back inside, dad was in the kitchen cooking a midnight snack. I opened up to him about my struggles and I felt so thankful because he was very supportive. He encouraged me to take breaks, eat well, and even told me that taking a leave of absence was okay. I haven’t been a firm believer in a while but moments like these make me thankful and blessed that I have people there to support me when everything seemed so difficult. My family and friends have faith in me, and that restored my faith in myself that I can go on because they’ll always be there to support me.

Anticipates anxiety because of another task

Stresses again over the difficulty of attending an online class

Tries to relax oneself and breathe fresh air

Describes the uncertainty of finishing the academic tasks

Feels unmotivated and pressured to excel in academics

Reminisces about the last time when there was no pressure yet

Blames the pandemic for ruining a healthy schedule

Feels being lost in everything

Finds the timely support of a father

Expresses gratitude for the father’s encouragement and advice

Acknowledges too the support of friends for the restored faith

Asserting the feeling of anxiety and being stressed out for another given task

Finding a way to be in control of the difficult situation

Doubting one’s capability to continue the online class

Claiming the need for motivation to proceed with the academic requirements

Missing the old routine of not feeling pressured

Pointing again to the pandemic as the source of hardship

Manifesting low level of self-esteem

Acknowledging parental support

Adding the necessity of support from friends

Participant # 3:
Major Themes

As a third-year college engineering student, third-year subjects are the core of my course, hence the pressure is tripled compared to other years. Lately, I've been having anxiety and depression due to the quantity of workload handed out to us with also the added weight of the pandemic. Since we're mobile in our own homes, it's easier for us to get into depression due to isolation. Being inside my room all day, doing all of the school works and requirements handed out to us with a lack of human contact and connections has taken a toll on me. I've been feeling so drained and burnt out like I cannot continue with this term anymore. The two weeks break before the start of this term isn't just really enough for us to detoxify and rest. On top of that, I also miss hanging out with my friend during break times and after classes.

Human contact is important and is a significant part of college life. I'm also not as privileged as the other students, my family is experiencing a financial crisis right now hence we are unsure if I will be able to finish my degree. However, despite all of these struggles and uncertainties, I know that I still have that one person that I can talk with. God has always been there for me through the good and bad times in my life in the past. I believe that He will still be with me right now. For quite some time now, He has gone quiet and lately, I don't feel Him in me anymore, but despite that, I just remember the saying, "When God is quiet, He is working". So this reassures me that even though everything is going down and into shambles in my life, He will still be there to pick me up. I still constantly pray to Him and ask Him for guidance and strength just to go through my day. I'm grateful that I have a God that I can run to when everything gets too much for me. I need His guidance the most right now at this stage of my life as I've never felt this lonely and stressed out through the course of my life so far. Hence, I always pray at night and just talk with Him, sharing how my day was and what were my activities. I also believe that I've developed some kind of mental illness ever since the pandemic happened due to isolation and lacking the usual environment that I am exposed to when I'm outside. Despite all of this, I know that God is still holding my hand and I know that soon, these will all pass and everything is going to be okay.

Feels a lot of pressure during the current academic level

Identifies directly being anxious and depressed due to the volume of academic requirements

Points to isolation at home given the voluminous tasks as the cause of depression

Signifies losing hope to proceed with the online class set up

Longs for the physical presence of friends for support

Points out the importance of human contact to college life

Admits one’s financial shortage which brings uncertainty to finish the degree

Expresses the presence of God for support since the beginning

Believes that God is still there to support despite moments of doubting His intervention

Reiterates the loving care of God and still hopes for His support during this crisis

Admits experiencing mental challenges due to the isolation and change of environment as brought by the pandemic

Hopes that this trial will end with God’s continuous support

Expressing feelings of pressure, anxiety, and depression from many academic requirements especially during this pandemic

Reiterating ‘isolation’ brought by the pandemic as the cause of depression

Running out of motivation to continue participating in the online class

Confirming the necessity of direct communication from friends as a source of support

Affirming the necessity of human interaction during college life

Facing the reality of family’s financial problem which doubts finishing the degree

Conveying the loving support of God at all times from the beginning despite occasional feelings of doubt

Acknowledging the effect of the pandemic on one's mental health

Never losing hope for the end of these challenges

Mental Health problems such as anxiety/depression as a serious effect of the pandemic

Pressured/Stressed out in academics (online class requirements)

God/Higher Being as the first and/or last source of support/guidance

Self-awareness/Self-acceptance helps improve mental health

Minor Themes

Isolation and change in environment as causes of depression

Friends/peer support as a source of motivation

Family’s financial inadequacy to support one’s needs

Human interaction is a necessity to college life

A temporary feeling of God's absence in trying times

Participant # 4:
Major Themes

I was considering physical self-harm to the point of even entertaining suicidal thoughts. I was alone and desperate. I had nobody to contact. I didn’t reach out to my family and friends. I didn’t want to burden my parents with problems and disappoint them with failures… My stress and desperation accumulated to what I thought was insurmountable. I began avoiding people. Despite everything, I always do one thing to allay my fears and anxieties that drove me to mental breakdowns… I sat silently, cried out to God until tears ran dry, and enjoyed the solemn silence. Then and there, I asked silently and internally. Why am I suffering? Why do I have to suffer? My internal outburst manifested into tears once more as I cried again, but I felt suddenly a wave of calm and comfort. I didn’t have anyone there to comfort me, but I felt it, a presence pushing me to move forward and find out. It was like someone saying to recognize my thoughts but do not succumb to their temptations, telling me to think about my family and friends even though I think I don’t have anyone to reach and that these people care despite what I think.

Afterward that faithful day, I came forward to my parents, and I was prepared to take anything that they had to say whether positive or not. Surprisingly, they listened and even asked me how I was doing. My parents comforted me even after I began crying in front of them, and I cry rarely in front of them. I felt there the same warmth and comfort... It was like God manifested Himself in my parents to affirm my feelings. I feel a deeper personal connection to Him. I may have been broken, but I now realize that while painful, it was necessary to make myself stronger and better than before. I bettered myself and have rekindled my relationships with both family and friends. My experience felt something that was beyond an abstract that I cannot explain in simple words, but it is there, and I firmly believe in it. So now, in face of challenges, I move forward to see beyond my perspective.

Admits having negative thoughts of doing self-harm amid the pandemic

Thinks of not involving one’s family and friends in sharing about the unfortunate condition

Manifests a lot of stress but prefers not to share it with anybody

Pointing out to God as the only confidant in what is going on

Questions the presence of suffering in life

Feels the gentle presence of God that brings calmness, relaxation, and clarity of thoughts

Decides to approach parents for whatever words will be spoken

Feels happy for the parents’ reaction and encouragement/support

Compares the show of comfort from parents and God

Realizes that pain is necessary to become stronger

Self-examination to study oneself

Renews one’s open communication to family and friends

Determined to move forward and start a new beginning in life

Manifesting a feeling of hopelessness during the crisis

Deciding on the exclusion of support from family and friends for them not to be affected

Stressing having mixed feelings of anxiety and depression that greatly affect mental health

Singling out God as the source of lone strength and support

Conveying weary/confused mind

Expressing great awe in the healing presence of God during crisis

Building up one’s confidence in opening up to parents

Appreciating with gladness the support of parents, as well as of God

Developing a feeling of acceptance of the reality of pain as part of life

Reflecting on one’s internal struggles

Understanding the importance of family and friends as sources of support

Preparing oneself to have a fresh start in facing life’s challenges

God/Higher Being as the first and/or last source of support/guidance

Mental Health problems such as anxiety/depression as a serious effect of the pandemic

Pressured/Stressed out due to numerous trials

Lack of communication to parents/friends for support

Minor Themes

Hopelessness during crisis

Hesitancy to reach out to family and friends for support

Doubting the presence of suffering in life

Pain is necessary to become stronger in battling challenges in life

Self-examination to determine a possible solution in addressing one’s problems

Participant # 5:

In the early days of the lockdown, being one of the leading places when it comes to COVID-19 cases, my heart was filled with worry, anxiety, and fear. I remembered holding my breath for 15 seconds every morning just to check if I was already infected since my dad goes out twice a week for market day. We’re not as strong as other people since we inherited our mom’s asthma, and that heightened my fear. I was so scared every day but I tried my best to distract myself by playing games and immersing myself in the world of social media. However, at the end of the day, there was this lingering fear that I just couldn’t escape, it made my stomach churn. Yes, I do pray every night but in retrospect, I can't pinpoint how important God was for me back then. I prayed to him every night, asking for healing of the world and for the pandemic to end, but that was it.

As time passed by, the cases in our barangay skyrocketed and I just thought maybe getting infected would just take away the fear of getting infected. Of course, that was absurd, I was so scared and I knew there was no way out with just me using my brain cells, and so I opened my “untouched” bible application in my phone and started a “reading plan.” It was a feature of the application wherein there are sets of plans for people encountering difficulties in life, whether it be family problems, anxiety, jealousy, toxicity, etc. I clicked on a 22-day reading plan and reading the reassuring words of God was the ONLY thing that alleviated the fear I felt. I made it a point to read the bible every day, and that somehow helped me communicate more with God. I was able to talk to him even during the day not only at night. When I was alone, I sometimes just prayed and talked to Him. Undoubtedly, He has become my best friend. He became my anchor, He was, still is, and will always be there for me. This pandemic drew me closer to God. I’m not saying that the pandemic was a good thing, but rather in every bad event, there will always be something good to come out. Some people say “cheer up, it’s just a bad day, not a bad life” but I do think that we can turn every perceived bad day into a good one when we learn to see the blessings that God continues to give us, such as the gift of life, and when we learn to completely trust Him.

Develops worry, anxiety, and fear during the pandemic

Feels anxious about getting infected with the virus

Confirms being vulnerable to any disease due to family history

Expresses fear of getting sick but turns to social media for distraction

Calls out to God for healing

Tries to calm oneself to lessen anxiety

Considers the bible as the main source of guidance and healing at the same time

Makes a habit of reading the Bible

Reiterates God as a best friend who never leaves our side

Accepts the fact that personal effort is not enough to maintain a good life but it comes from trusting God

Admitting having mental health disturbances during the pandemic

Getting anxious as the lockdown progresses

Adding the heredity factor which resulted in being immunocompromised

Turning to social media to divert one’s fear from the virus

Finding God as a source of healing

Making fun of the situation as a way of distracting oneself to manage anxiety

Directing one’s attention to the role of the bible as an effective guide to handle mental health problems

Finding the habitual reading of the Bible as a solution to alleviate fear

Highlighting one’s relationship to God as the ultimate source of support

Positing the role of God as the one that completely turns a bad life into a good one

Major Themes

Mental Health problems such as anxiety/depression as a serious effect of the pandemic

God/Higher Being as the first and/or last source of support/guidance

Praying using the bible as the tool for alleviating fear

Minor Themes

Worry due to being immunocompromised

Social media as a distraction from fear from the virus

Jokes as a means to manage anxiety

Bible as the most effective source of strength in dealing with the crisis

Participant # 6:

It started when the pandemic hit the Philippines. At that time, my classmates and even my professors are not taking things seriously because to us, it’s just a flu virus and nothing too harmful. Although we had that mindset, of course, we take precautionary measures like wearing masks and limiting contact. When the cases started rising, so did our anxiety. My mental health started dwindling, it almost reached the point where it’s hard to process thoughts, much more my lessons. Everything inside my head is a mess, and my productivity is almost non-existent. I know the cause is the lack of connection with others but it’s really hard to address that given that I can’t meet my friends and even go outside. The way I express my love to others is by physical contact, particularly through hugs, and having quality time with them. Bonding time with my friends has always been a part of my everyday life since I could remember and for it to be taken away so suddenly brought a lot of stress to me.

A few months after the first announcement of lockdown, I just felt heavy. I do not function well, I cannot do the same amount of tasks I can normally do, I also lost my appetite even for my favorite foods, I'm pressured every day from my requirements which were piling up at that time. In general, I just hate waking up at that time because I know I'll face the same amount of chaos, maybe even doubled, and it makes me even madder that I couldn't fight it. I don't like it when I’m awake and conscious during those times because I’m already drained and tired and I don’t want to succumb to the darkness by being awake so I tend to sleep when I can. At one point, I realized I can’t keep running from the things that stress me out because I’m afraid they will become my nightmares. I started accepting the fact that I can’t run from those things every day for the remainder of my quarantine life since we're uncertain until when this will last. I don’t have a religion but I do believe that there is a Higher Being than us and that being resembles us, maybe even resides in us. With that thought in mind, I started having the courage to acknowledge the situation, and one step at a time, I started to open up to myself and others. I started accepting myself, recognizing my new strengths and weaknesses, working on myself. I also dared to fight against the sadness and day by day, I’m getting better at completing tasks and reconnecting with my friends. I was really glad when the time came that I no longer resent waking up in the morning. Although I didn't go back to my old self, I’m still proud of the current version of myself and I’m thankful for that moment that pushed me to end my suffering and allowed me to regain at least some parts of myself.

Takes lightly the effect of the virus but still practices precautionary measures to protect oneself

Acknowledges anxiety as a result of the rising cases of people infected with the virus

Sees the lack of face-to-face connection with friends as also a factor that causes a lot of stress during the pandemic

Enumerates the serious effects of the lockdown on academics, schedule, and physical health

Confesses incapability to battle against the effects of the lockdown

Resorts to sleep to avoid facing the challenges posed by the lockdown

Realizes that “sleep” is not a permanent solution to the negative effects of lockdown

Acknowledges the essential presence of a Higher Being in one’s life

Accepts the difficulty of dealing with the current situation

Becomes aware or conscious of oneself

Connects with friends for support

Feels happy for being able to cope with the situation despite one’s limitations

Taking an initial light treatment of the virus until it is proven serious, thus, exercising safety protocols

Pointing out the pandemic as the cause of anxiety and dwindling mental health

Highlighting the importance of physical contact and communication with friends as a stress reliever

Concluding that the lockdown has ruined the everyday schedule and affecting much of one's general wellbeing

Exhibiting having not enough confidence to face the effects of lockdown

Treating “sleep” as a way to forget the challenges temporarily

Believing in the existence of a Higher Being despite not being affiliated with any religion

Being able to accept the current situation

Manifesting an adequate level of self-acceptance and self-awareness

Emphasizing the importance of connecting with friends during this crisis

Building up enough self-confidence to be in control of the difficult situation

Major Themes

Mental Health problems such as anxiety/depression as a serious effect of the pandemic

Physical contact and communication with friends as a stress reliever

Pressured/Stressed out due to numerous trials

Higher Being as a source of support/guidance during this pandemic

Self-awareness/Self-acceptance helps improve mental health

Minor Themes

Bonding time with friends is an important factor for mental health

Lockdown disrupts the overall well-being of the person

Sleep is a way to temporarily escape the effects of lockdown

Friends/peer support

Belief in a personal capacity to handle difficult situations