Photo courtesy of Lee Jeffries
Mental Health and Wellness

The Mad Man: Myth or Fact

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Image courtesy of Lee Jeffries

‘The single story creates stereotypes, and the problem with stereotypes is not that they are untrue, but that they are incomplete. They make one story become the only story.’ – Chimamanda Ngozi Adichie.

In her now infamous TED talk, ‘The Danger of a Single Story’, Nigerian author Adichie, discourages the culture of using single narratives as the sole descriptor of a people or a place.

 For a long time in our society, the single story of mental illness has been riddled with many false narratives thereby creating stereotypes of what mental illness is and whom it can affect.

Despite cultural beliefs on who can be affected by a mental illness, the World Health Organization (WHO) estimates that globally, 450 million people suffer from a type of mental disorder.

Translating to 1 in every 4 people, mental illness does not discriminate based on race, gender, age or social status; anyone can be susceptible to it (WHO).

The stereotype of the abject ‘mad’ man, described locally as mwenda wazimu, has for a long time been the poster child for mental illness in our society.

In this popular narrative, this individual exhibits unusual behaviour such as talking to oneself, confused thinking and generally disturbing behaviour that is highly divergent of society’s agreed set of norms.

Examples of this stereotype include, the professor who became mad by reading too many books or the individual who was normal the day before and woke up mad the next and both have been in that state ever since.

How true are these stereotypes and how do they hold up against scientific evidence on mental illness?

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I sought the opinion of Professor Otieno Omollo, consultant psychiatrist at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) to offer some insight on this issue.

‘Mad is an English term often used by lay men to describe what mental we call disturbed or abnormal behaviour. These are individuals who suffer from serious mental illnesses and the symptoms of their conditions are often exhibited through their behaviour,’ he says.

He went on to explain that when these individuals exhibit abnormal behaviour they are in a state of psychosis in which two processes are ongoing; delusions and hallucinations.

‘When they are hallucinating, there is perception without stimuli. For example, you could see them arguing with a non-existent person. There mind is convinced that there is someone in front of them, yet you can see there’s nobody around,’ he explains.

‘In a state of delirium, false perceptions are firmly held despite evidence to the contrary and which are not consistent with one’s socio-cultural background. A person will believe they are the president of the country, and you can’t convince them otherwise,’ he adds.

Professor Omollo alludes to the fact that conditions such as schizophrenia and bipolar disorder, which tend to present with such symptoms are not curses neither do they occur abruptly, usually there are some tell-tale signs before the onset of the illnesses.

‘Mistrust of friends and family, avoidance, anxiety and restlessness, lack of empathy, paranoia and delusional beliefs are some of the signs one should look out for in an individual they suspect to be suffering from psychosis,’ he explains.

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He also debunks the myth that such individuals will always be in a permanent state of psychosis. With treatment, he says, though previously learned skills will have diminished after the onset of the illness, these individuals can still be productive members of society.

The stereotype of the mad man has not only painted a skewed picture of mental illness, feeding into the stigma around mental health, it has also contributed to the exclusion of those suffering from other types of mental illnesses.

People who suffer from mental disorders such as depression and anxiety are largely able to fit into society’s expected norms. As is, their conditions do not affect their behaviour as much as those who suffer from psychosis.

‘You can’t tell from just looking at a person whether they’re suffering from anxiety or depression. This stereotype of the ‘mad man’ as the ultimate expression of mental illness, affects access to care for such individuals,’ he adds.

Depression the most common mental illness affects over 300 million people with anxiety coming at a close second, affecting about 260 million people worldwide. Depression is also the leading cause of disability worldwide (WHO).

Countries like the UK and US have over the years revised the terms used in their mental health policies from lunatic, idiot and insane to more sensitive and socially conscious terms such as mentally ill and person adjudicated incompetent.

In Kenya, the Mental Health Act 2013 says a person with mental illness means a person diagnosed as suffering from a mental illness. There is no mention of mad, lunatic or insane. Referring to a mentally ill person with these terms surmounts to discrimination.

In conclusion, Professor Omollo believes there’s still a long way to go in regards to access and availability of treatment for the mentally ill and that it’s not just an issue for the medical fraternity but the society as a whole.

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