Lifting the lid on the state of our minds

Phyllis Nyambura looks at why more women are being diagnosed with mental illnesses, and what we need to do about it.

BREAKDOWN

When Phyllis Mwangi had her first meltdown, she was not ready for the outcome. On that fateful September, 2017 morning, Phyllis had confronted her business partner, in Kasarani, Nairobi, and given her a verbal showdown for no apparent reason.

Then she walked more than five kilometres back to her house and sat on her couch. She did not even close the door. She was in a trance.

This is the same position that her family found her many hours later when they travelled from Murang'a, when her business partner called them.

“I could only recognise my son. I thought my brother and mum were strangers and I refused to speak to them,” the 38-year-old single mother of one says.

Unknown to her then, Phyllis had been suffering from manic-depressive mental illness known as bipolar disorder. This is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.

Before her breakdown, she recalls a period of more than two weeks where she would not get out of bed, eat, shower or even draw the curtains or put on the lights. She was engulfed in darkness, loneliness and extreme sadness.

“My house was a mess. There was rotting food, dishes piled in the sink and everything was upside down. When my mum looked around, she knew there was a big problem,” the administrator and IT tutor says.

DIAGNOSIS

With great resistance, the family got Phyllis to their rural home. But not even the calmness of the countryside nor the support of her family could bring the once cheerful Phyllis back to form.

She was far too gone. One night, everything in her head went berserk. “I was hearing voices, and they were threatening. I started running and talking non-stop,” she says. That’s when the family rushed her to a nearby hospital and she was given a cocktail of drugs to contain her.

“I slept for a month. I was a zombie,” Phyllis says. Her family could only watch helplessly. With her condition still undiagnosed, they were at a loss as to what plagued her.

In February, this year, Phyllis now back in Nairobi decided to get to the root of her problem.

By then she was prone to extreme mood changes which brought bouts of extreme hyperactivity, paranoia, irritability, anxiety, lack of sleep, racing thoughts and hopelessness.

“I was diagnosed with bipolar, I got medication and I was introduced to therapy sessions,” Phyllis, who discovered that her condition was triggered by a job loss and business failure, says.

“I was surprised to learn that my affinity to start many things, and then half-way through lose motivation was a sign.

“I am an introvert and I keep things in a lot. I piled too much over the years, and there was no outlet. I was also a people pleaser. But deep down my world was crumbling. I am having to confront these issues now and be forthright with where I am at my life,” says Phyllis.

DENIAL

Her family though is still in denial. “They don’t understand that I am sick. They tell me it’s moods and I need not think too hard about it. It will go away. This really hurts me.”

Mental illnesses among women in Kenya is on the rise. Though data is scanty on mental illness in the country, studies conducted by Africa Mental Health Foundation (AMHF) show depression in the lead at 42.3 per cent in health facilities, 37.7 per cent in primary schools and 25 per cent in community settings. Others mental disorders prevalent among women are perinatal depression, anxiety, schizophrenia, eating disorders and postpartum psychosis.

Two organisations that deal with mental illness, Kamili Mental Health Organisation and The Reason to Hope Organisation, back this figure up. Their daily visits statistics stand at 60 per cent female and 40 per cent male, majority in their 20’s to 40’s. Untreated depression could lead to suicide. It also lowers our body immunity.

The World Health Organisation puts depression as the leading mental illness among women, with 300 million people of all ages suffering from depression worldwide. That is 1 in every four people.

But despite the critical role that our mind plays in our general well-being, mental health is not considered vital by many of us. Stigma, cultural misconceptions, lack of information on detection and where to get help, discrimination and general neglect at government level exacerbates fatalities.

HELP

Lilian Kibanya is able to live a full life today thanks to early intervention. The 27-year-old is back to university after a hiatus interrupted by her diagnosis with bipolar disorder.

“I dropped out of school and would be out partying most times and unable to control my urges. I ended up falling into depression. I would have very high highs followed by very low lows,” the psychology student at USIU says. 

While her moods were in a constant pendulum, her personality would swing from being a vixen in the night-club to worship leader.

“I came from being a worship leader and public speaker to being someone who sometimes was too afraid to get out of the house. It made school and my relationships harder because most days I would just hide in the house for weeks,” shares Lilian, who says her issues stems from sexual abuse as a child which made her ‘secretive’.

Eventually, her parents took her to a psychiatrist and she was given medication and psychological help.

“I am on regular medication and have adjusted my life. Eating healthy and exercise is known to combat symptoms of bipolar. I also meditate and do yoga. Most of the therapy for this condition is self-care. You really need to be aware of yourself at all times and listen to yourself.”

REACTIONS

Attitudes towards mental illness irks Lilian and to shed more light on the illness she started a Facebook page, @It’sjustavibe, and speaks on the topic freely wherever she goes.

She has had to deal with her share of misconceptions.

“‘You just need to pray about it,’ people will tell you. If I told you I had diabetes, would you tell me to just pray about it? No. You’d tell me to go to hospital. People suffering from psychiatric conditions live relatively normal lives when they seek medical attention. Don’t just pray about it, ask God to lead you to someone who can help you. Pray for healing, but be pro-active,” Lilian asserts.

“I’ve been told that I can’t be depressed because I smile and I’m happy all the time, I don’t act like I’m bipolar because I don’t act mad," she talks of the absurdities. 

Modern pressures, breakdown of traditional support structures, economic downturn and our affinity to keep up with the Mungai’s and Kerubo’s are driving most women out of their heads.

TRIGGERS

“Women today are pressurising themselves. There is competition to be the greatest mother, perfect wife, best performing employee and this is overwhelming and can trigger depression,” says Melanie Blake, the founder and psychiatrist nurse at Kamili Mental Health facility.

“I would like to call it status-chasing triggers,” says Mary Wahome, who runs The Reason to Hope Mental Health Centre. “This is where people are living often beyond their means to project the right image. So they have a pile of loans, they are cut out of meaningful social interactions as everything is about money and are forever worried about a job loss and auctioneers appearing at their doorstep,” Wahome adds.

The biggest trigger for women is that of breakdown of relationships whether with spouses, children, parents, siblings or friends. “They blame themselves, fear societal judgement, are afraid of their future and that of their kids and feel unloved and neglected,” agrees the experts.

Others contributors are genetic where the condition runs in the family, failure of their children, loss and grief of a close family member, dysfunctional families, sexual abuse, pregnancy and birth, and chronic illnesses such as diabetes, hypertension, HIV/Aids which involve a change in lifestyle.

DEPRESSION

Peris Njeri Wachira has suffered three bouts of depression and mania, in 2005, 2010 and 2014. She was consequently diagnosed with bipolar 1 & 2 disorders.

“I lost my job and despite being married, it was very hard to get by. I hated having to borrow and while away the boredom. Then I was experiencing major marital problems as a newlywed. It reached a point I did not see the point in living,” the 45-year-old, married mother of three says.

Despite being genetically susceptible—several family members from the family tree exhibited undiagnosed mental illness—Peris also came from a dysfunctional family in which her mother left her to be raised by an older sister.

“I didn’t know that my sister was not my real mother until much later. This left me feeling abandoned and unloved,” Peris says. “My mother was disillusioned when my father married a second wife and she never recovered.”

When she hit rock bottom, Peris ran away from her marital home. Then she suffered her first crash.

“I had no appetite, so I wasn’t eating, I couldn’t sleep and I was talking of imaginary things,” she says.

Despite being medicated, relapses were common and she had to be constantly admitted at Mathari Hospital.

“I was in a bad state. I felt empty, I couldn’t work and I didn’t want to talk to anyone. I felt like a stone. Just sitting there,” Peris, who also had her depression worsened by medication before she changed doctors says.

UNDERSTANDING THE PROBLEM

However, it was not until she understood the illness and her triggers that she was able to manage her mental state. It has now been four years since she got a relapse.

“I realised that I needed to get busy and get a source of income. I enrolled for an Early Childhood Development (ECD) course and it has allowed me to have an outlet and source of income. When I meet people I forget my problems,” Peris, who teaches a primary school in Juja and is pursuing her degree in ECD, says.

Also keeping Peris busy is her work with Users and Survivors of Psychiatry in Kenya (USPKenya), made up of survivors and caregivers. The organisation, which has an active WhatsApp group of more than 190, provides mental health support and a community where members can talk freely.

The community has an emergency kitty, a saving fund in which members can get easy loans, contacts to mental health practitioners, suicide hotlines and hold monthly offline meetings.

But like many mental health patients Peris still faces a number of challenges. Top among her list is expensive medication, scarce and pricey specialists, lack of mental health facilities and lack of support from her own family.

Lydia believes that if we understood our bodies and in turn our minds we will be able to deal with mental illnesses.

“We need to understand that we are made of four parts. The physical, social, spiritual and emotional. If one part is not working or is below par, we will not be balanced. We need them to work together,” she says.

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IMPORTANT CONTACTS:

Kamili Health Organisation:

http://kamilimentalhealth.org/

African Mental Health Foundation:

http://www.africamentalhealthfoundation.org/

The Reason to Hope:

http://reasontohope.or.ke

Users and Survivors of Psychiatry in Kenya (USPKenya)

http://www.uspkenya.org