Robert Kinyua's mind kept flooding with thoughts of people thinking he was crazy. The 30-year-old accountant would also talk too much. He would get periods of extreme highs where he would speak rapidly, suddenly, or erratically.
"My triggers then were lack of sleep, lack of appetite, irritability and I was paranoid. My mind was flooded with thoughts of people thinking that I was crazy. I would also be overly talkative and walk around a little bit too much. When I was happy, I would be beyond excited, and if I was angry and sad I would also be on the other extreme. There was no balance between my feelings and emotions," he says.
As a newly married man, his mood swings started straining his marriage.
“We had a lot of squabbles. My wife would seek help from neighbours to get me to the hospital. You can imagine how challenging that may have been for her and the children to see me vulnerable," he says.
It took him being admitted to the Nakuru Teaching and Referral Hospital psychiatric ward for him to be diagnosed with Bipolar II disorder.
"I was in the hospital for three months. But over the years, I have been admitted to hospital frequently," says Robert.
Rampant misdiagnosis
Getting a diagnosis, he says, took a while. At first, he was treated for many other ailments before the bipolar disorder diagnosis.
Just like many other Kenyans facing mental illnesses, Robert faced stigma.
"When it comes to stigma I look at it this way, some people stigmatise because they do not know what bipolar is," he says.
His family may have also faced stigma when they had to seek help to take him to hospital, he says.
"But now I can take my medication without supervision and I also go for my appointments by myself," he says, adding "My wife and children have been my pillars. They are always keeping me in check whenever they observe I am at the edge of a manic or depressive episode."
Bipolar is a mental health disorder where a person experiences unusual shifts in mood ranging from extreme highs (mania) to extreme lows (depressive episodes).
Bipolar burden
The World Health Organisation estimates that 40 million people are living with this mental health condition globally but due to poor mental health reporting in Kenya statistics on the exact number of people suffering from bipolar disorder are not known since, previously mental illness were recorded collectively.
"I would like people to know that bipolar is like any other disease that needs lifelong management. Sometimes bipolar is hereditary and a lot of factors, like stressful situations, can trigger it," Robert says.
Many people with bipolar disorder struggle to keep jobs and employers are also not keen to support them. Robert was lucky.
"I work in a school and the headteacher has been very supportive. I am almost retiring and I look forward to my future,” he says.
Stigma hurdle
According to Lydia Nyaga, the mental health coordinator in Nakuru County, stigma is a major impediment to mental health treatment. Nakuru County hosts one of the 15 public health facilities currently taking part in a pilot programme that will see Kenya change how mental illness is reported.
“What we report at the national office as mental illness is not specific to the mental conditions. Once this pilot is adopted by the Ministry of Health, getting statistics for the various mental illnesses will be easy," says Lydia.
Nakuru has also begun training community health promoters to identify mental illness and refer patients for treatment in good time.
Bipolar Heroes Foundation
Dr Patrick Boruett, is the founder of Bipolar Heroes Foundation, and is also living with bipolar disorder.
“The thing about being a medical officer living with bipolar is that sometimes my peers in the profession think that I have a clue of what’s going on with me," he says.
His symptoms started in 2011 and he was leading a project at work.
"I invested all my energies into the assignment without knowing that I was slowly falling into this condition. I hardly slept. I was very firm with my proposals during meetings and I could not see my colleagues’ points of view and it made my boss point out that something was wrong with me. I got diagnosed in June 2011, but I was in denial until 2016," he says.
Between 2011 and 2016 a lot transpired.
"I had difficulty in going for medical appointments which affected my recovery. It cost me a lot. I could not progress with my career. I lost finances and relationships. I was feeling low but then I decided to research bipolar disorder and at that time I only got information online mostly from Europe, Australia and North America. I was encouraged by people with lived experiences of bipolar and that helped me move from denial to acceptance," Dr Boruett says.
In 2019, he founded the Bipolar Heroes Foundation.
"I believe in amplifying the voices of persons living with bipolar disorder because when we share, we help others use our lessons as survival skills to come out of the difficult situations bipolar can bring. It can be managed and our vision is a world where people living with bipolar can realise their full potential," he says.
Online support groups
They also have online support groups and physical meetings with caregivers, and people with lived experiences.
The biggest gap in bipolar management, he says, is access to doctors and psychiatrist wards.
"We do not have adequate psychiatrists and psychologists. And the few ones are in cities, so access to services in rural areas is a challenge. For instance, in the Rift Valley region where I work as the Director of Preventive and Promotive Health, in Baringo County, only two hospitals have in-patient psychiatric services.
Lack of psychiatric services
These are Nakuru Teaching and Referral Hospital and Gilgil Subcounty Hospital. Initially, there was a challenge of congestion at those two hospitals but I must appreciate the last couple of years the facilities have been expanded and there is less crowding now," Dr Boruett says.
Medicines are also a challenge.
"Some drugs are not available locally. It’s frustrating to seek services at these hospitals and not get complete treatment," he says.
