Mental health conditions that are trivialised and misunderstood

Mental health conditions can affect people from any background and manifest differently from one person to another. [iStockphoto]

A person who is neat and organised and prefers things in order is sometimes casually described as having OCD). In this way, the mental illness is viewed as a personality trait to explain tidiness, structure, and attention to detail.

Psychologist Hellen Staula says that OCD is far more complex than a preference for cleanliness and order. Clinically, OCD involves two components: obsessions and compulsions. Obsessions are intrusive, unwanted thoughts, fears or images that cause anxiety. Compulsions are repetitive behaviours or mental rituals performed to reduce that distress.

“A person with OCD is not simply organised. There is distress and anxiety attached to the behaviour. They feel compelled to repeat certain actions because they fear that if they don’t, something bad might happen,” Hellen says.

The repetitive behaviours can be excessive handwashing, repeatedly checking locks, arranging objects in a precise way or following rigid routines. Interrupting these rituals can trigger intense anxiety and conflict.

“People with OCD have a pattern which they consider is their norm. If you interfere with it, they are likely to end your friendship or turn violent. They will view you as an intruder who is interfering with their sense of order,” she says.

Hellen notes that those living with the illness aren’t aware of it unless diagnosed. In some instances, it starts in childhood when a person is punished for messing their clothes or belongings.

She says that since the condition is barely understood, people living with OCD are labelled as difficult, crazy or spiritually possessed. Some families hide affected relatives for fear of judgement, while those living with the condition struggle to maintain relationships if their symptoms are misunderstood.

Staula says that casually claiming to have OCD for liking things organised trivialises a serious mental health condition and makes it harder for people experiencing genuine distress to be recognised and treated.

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Even though mental health conversations have been more common in recent years, many conditions are misunderstood, misrepresented, dismissed, or stereotyped. Terms such as OCD, ADHD, and bipolar are regularly used casually to describe everyday behaviour which then ends up masking the reality of living with these conditions.

Social anxiety disorder is another commonly misunderstood condition that is mistaken for ordinary shyness or low self-confidence. While shy people gradually become comfortable in social situations, Hellen explains that those living with social anxiety experience overwhelming fear of being judged, embarrassed, or humiliated.

“They avoid gatherings and struggle to speak in public. Sweating, trembling, nausea, stammering, or vomiting. Some people think they are antisocial, rude or lack confidence, yet they have been traumatised as children,” she says.

She notes that early experiences such as harsh criticism, humiliation or repeated embarrassment in front of others in their childhood can cause social anxiety.

Without support, the condition can affect academic performance, careers, friendships and relationships, causing people to miss opportunities due to overwhelming fear. They may even isolate themselves.

Treatment involves therapy to help them gradually face feared situations while building self-esteem and personality.

Generalised Anxiety Disorder (GAD) is another condition that is trivialised to worrying. People living with GAD, Hellen says, experience excessive and unsettling anxiety about everyday situations, finding it difficult to control their worries.

"They worry about almost everything. They overthink, are restless, struggle to rest, develop sleeping problems and constantly worry about everything. Some may withdraw for fear of the unknown,” she describes.

In many African communities, chronic anxiety is misunderstood as a lack of faith, weakness or attention-seeking behaviour. Such assumptions can leave affected people feeling isolated and misunderstood.

She discourages dismissing anxiety as normal stress and instead recognises it as a mental health condition to encourage people to seek appropriate care before symptoms worsen.

ADHD

Attention-Deficit Hyperactivity Disorder (ADHD) is dismissed as laziness or indiscipline for their low focus and forgetfulness, while their restlessness is mistaken for stubbornness and bad behaviour.

In reality, Hellen explains, ADHD affects attention, impulsive decisions, forgetfulness, impulse control, and organisation. Those with the condition experience outbursts and anxiety. Some people struggle with inattention, while others experience hyperactivity and impulsivity. Many have a combination of both.

“People with ADHD embark on projects enthusiastically but find it difficult to complete them. They become easily distracted, emotionally overwhelmed, forget important tasks or make impulsive decisions. They appear restless or disorganised, but that doesn’t mean they are lazy,” she says.

Children with ADHD are vulnerable to stigma. Instead of receiving support, they are punished for behaviours beyond their control, thus affecting their confidence and school performance. Some of the signs of ADHD in a child are delayed speech, extreme sensitivity, and violent behaviours because they don’t feel understood. Highly processed foods and juices can trigger ADHD.

When misunderstood, people with ADHD withdraw socially, stop attempting new opportunities or develop emotional difficulties since they feel constantly criticised.

Bipolar

The term 'bipolar' is commonly used to describe someone whose mood changes quickly. However, she says that bipolar disorder involves episodes of extreme elevated or depressed mood that affect thinking, behaviour, energy levels and daily functioning. A bipolar person doesn’t have a reason to change their mood.

“During elevated periods, a person may speak rapidly, experience racing thoughts, be unusually energetic or spend money impulsively. During depressive episodes, they withdraw from others, lose hope, feel exhausted and struggle to function,” she says.

They tend to alternate between these two episodes unexpectedly. Misusing the term for ordinary mood changes, she says, diminishes public understanding of a serious disorder and can discourage people experiencing symptoms from getting medical help.

People with this disorder can be triggered by any slight level of stress.

“They feel fatigued and are withdrawn, and they can get hopeless in life and have suicidal thoughts. They can reach a point where they harm themselves or take their own life,” she says.

They also tend to have dysfunctional relationships when they go on impulse spending and when they insist they don’t need help. They can also turn violent. Due to limited awareness, families usually attribute bipolar disorder to spiritual causes.

People living with schizophrenia are highly stigmatised as violent or dangerous. Some believe that there was witchcraft involved, while others think that it is a failure in their moral life that they are paying for; therefore, they ostracise them.

The misinformation and lack of awareness perpetuate stigma which harms those living with this condition. For instance, in some local communities, the violent tag leads families and communities to isolate or restrain them when they are going through an episode.

“In reality, this is when they are more vulnerable. When they are tied, they will fight back. People think they are cursed, yet with proper medication and ongoing support, they can lead stable and productive lives,” she says.

People living with schizophrenia experience hallucinations, delusions, disorganised thinking and difficulty articulating emotions. During episodes, they withdraw socially or struggle to distinguish reality from strong false beliefs. She advises people living with schizophrenia against exposing themselves to triggering content.

She notes that the misconceptions and trivialisation of mental health conditions can result in stigma, delay diagnosis and discourage people from seeking professional help.

“Awareness can help families recognise symptoms early, replace myths with evidence-based understanding and encourage more people to seek professional support without fear of judgement,” she says.

Hellen adds that mental health conditions can affect people from any background and manifest differently from one person to another. Trauma, prolonged stress and adverse childhood experiences can all influence mental wellbeing, though each condition has its own combination of biological, psychological and environmental risk factors.

Progress has been made in Kenya through expanded mental health awareness, community-based services, county mental health councils and the decriminalisation of attempted suicide following a High Court ruling by Justice Lawrence Mugambi.

However, stigma, underfunding, shortages of mental health professionals, delayed diagnosis and limited access to specialised care continue to prevent many people from receiving treatment.

The Kenya Mental Health Investment Case 2021 estimates that mental health conditions cost the Kenyan economy approximately KSh62.2 billion in 2021. Hellen believes that increasing mental health literacy at the community level is vital.