A Mark of Shame: Cultural Stigma around Mental Illnesses

In Ramadan 2020, I received the most troubling email. It was from M, a then-20-year-old young woman with whom I had had a few conversations on Twitter. It was a 15-page letter with intimate, yet painfully explicit, details about her personal life. “I recently went for a mental health test and I realized I had an anxiety disorder, severe depression, bipolar disorder and PTSD [Post-Traumatic Stress Disorder],” it read from the very beginning. As I read on, I learnt that in addition to these, she had also been diagnosed with Attention Deficit Hyperactivity (ADHD) – at which point she was denied access to professional healthcare by her family. They called her mad, thought her to be an attention-seeker, said she was possessed by Jinns (spirits), and fed her all sorts of concoctions in an attempt to expel the evil spirits from her body. 

This was a young girl who had her whole life ahead of her but whose growth was being inhibited by the cultural and societal stigma around mental illness, which have been normalised in many of our communities in northern Nigeria. The region is replete with communities that dismiss mental illnesses as a sign of weakness, a mark of shame and/or an indication of faithlessness. It is especially challenging battling with mental health problems in such conservative communities but for this young woman – whose family hugely contributed to the development of all her mental illnesses – it seems to be the end of the road.

The stigma around mental illness is formed by insensitive comments such as “Depression is a white man problem; We don’t have that in Africa”, or “You’re only pretending to not be okay to get attention”. It is in belittling comments and gaslighting people by making their realities seem made up because you cannot relate to it. It is in this scenario we all know too well: the “crazy” uncle who had to be taken away to some rehabilitation center because he couldn’t function properly in society. There, he is chained and beaten and fed concoctions in an attempt to dispel the “evil spirits” taking over his body – the same spirits that convinced him he had a mental health problem. It is also in hearing that if we misbehave, we – like him – will also be banished away to such places, where we won’t have access to our toys and video games.

When someone opens up to you about mental illness, there are many things you are should never say – “It’s all in your head”; “Things could always be worse”; “It’s all part of God’s plan”; “Try not to think about it”. But there are also myriad helpful ways to handle such situations. You should allow them to speak as much or as little as they wish to; create a safe space for them to speak, while assuring them it’s okay to stop anytime they don’t feel comfortable enough to continue; and listen to understand, not to reply. It is important to know your limits and offer them professional support – be it guiding them to an affordable therapist or encouraging them to fight against their illness however they can.

As I read the letter from M that Ramadan, I had to pace myself because of how heavy it was. The emotional impact it had on me was so devasting I could only read a few pages a night, but I felt I must continue; her choosing to speak to me was a priviledge on its own. In the beginning, she said she chose to tell me – a stranger she had never met – her story because of an Instagram post by my mother. “[When] you were subjected to cyberbullying, your mom supported you,” she writes. “Your mom also talked about how you’re so good at heart and nice […] [and I] thought that perhaps you could understand me.” More than anything, people battling with mental illnesses are just trying to be understood; our only job is to listen to them.

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