How shock, drugs made our brother mentally ill

At the age of 18, Brian Owino was quite an accomplished young man. He had excelled in his secondary school national examinations and earned a slot at the prestigious University of Nairobi, making him the first member of his extended family to join the university.

Had everything gone to plan, he would complete his bachelor of science degree within the scheduled four years. He hoped to specialise in physics and later venture into astronomy, his dream career. But this was not to be. In 2017, Brian’s mother was diagnosed with cervical cancer.

The lastborn in a family of four was deeply troubled by his mother’s ailment. To beat his stress, he says, he secretly started smoking cannabis, tobacco, and basically any other drug he could get his hands on.

Brian got a slight respite a year later when his mother was declared cancer-free, but the drugs stayed with him. Unfortunately, the cancer had spread, and barely a year later, his mother was back in hospital. This time, the pain was more severe, sending Brian into deeper drug use.

“He used to be close with our mother. When she fell sick, it depressed him. When our mother was in Nairobi Hospital, he was there with her most of the time,” Sheila Amondi, Brian’s elder sister, tells Healthy Nation.

In 2019, the mother died, shattering Brian’s world and affecting the progress he had made towards achieving his dreams. In his secret life, drugs took the centre stage, but from the outside, he appeared composed. But slowly, the changes caused by drug use started kicking in.

His sister says that while Brian did not openly mourn their mother, he had signs of withdrawal as he stopped taking food and became abusive. Unknown to them at the time, these were the first signs that their brother was on the cusp of getting a mental condition.

After their mother was laid to rest, Brian returned to Nairobi to continue with his studies. He did not stay in school as expected. He returned home and became even bolder with his newly acquired traits of violence and abusiveness.

All this while, his family thought he was still in shock from losing his mother and that he would soon return to the soft-spoken, gentle, and kind young man he had always been. He never did.

One day, Brian showed up in their living room wearing only a bra and a skin-tight garment. His sisters tell us that he spoke excitedly, uttering things that made no sense.

That is when his family realised that he had become a new person who needed their help. They did not want to lose the only child who went to university.

The mission to save him started.

Their first stop was their pastor’s office, who, after praying for Brian, recommended that they seek medical intervention at a mental health facility. They took him to Migori County Referral Hospital, where he was referred to Mathari National Teaching and Referral Hospital in Nairobi.

Until this time, the family had not learnt that Brian had become an ardent user of cannabis and other hard drugs. But a hint from the psychologist who attended to him made them pay closer attention, and they eventually learnt the painful truth that Brian had become a drug addict.

It was at Mathari where Brian’s family got a name for what had been ailing him: bipolar disorder — a mental health condition that causes extreme mood swings and which has an impact on one’s sleep, energy, activity, judgement, behaviour and the ability to think clearly.

It wasn’t easy to have him stay at Mathari and get professional help. His family says that at some point, he tried committing suicide by jumping from a fly-over at Thika Road but he was saved by street children. He was later taken back to Mathari.

Sheila says that it was at Mathari that Brian, for the very first time since his mother’s death, wailed heartily to mourn her.

After that, he calmed down slightly and was himself again for a while.

After spending 12 days at the hospital, he was discharged and he seemed ready to proceed with his studies and fulfil his dreams. Doctors prescribed drugs to calm him down so that he could concentrate on his studies. His family even moved him from the student hostels to a rented apartment in Ngara.

Return of violence

All went well for a while and he completed a semester while sober. For the holiday, Brian went to stay with his sister in Kisumu and all still seemed well, until last year when she also fell ill. His undesirable traits of violence returned.

“It’s called a relapse,” Brian shouts in the background as his sister narrates his ordeal.

“He used to see me as the mum since our mother passed on, so when he saw me sick, on a hospital bed, he became ‘high’ again,” Sheila explains. “Since I was also sick, I asked a friend to take him to the hospital, where he was given some medication, and he was fine again for a while.”

Again, his recovery didn’t last. Earlier this year, Brian lost a cousin who had been one of the people he was closest to.

“When I told him the news that his cousin was dead, he was so shocked and again, he had a relapse,” recounts Sheila.

“It has been on-and-off like that. He is on medication, but we cannot tell any progress because sometimes he even decides to take these other illicit drugs. That’s how it has been and lately, he is not doing fine at all,” she says.

Sometimes he picks up fights with random people and often ends up being beaten and badly injured.

When we interviewed his sister, Brian had multiple bruises all over his body but was full of energy and kept interrupting the interview emphatically to stress a point or correct his sister whenever she made a mistake.

His teeth were slightly discoloured, perhaps due to the excessive use of tobacco. He was moderately well-kempt and seemed to be fully aware of what was going on.

Although we didn’t ask for it, he insisted on taking the interview after his sister, but he could barely give straight answers to the questions we asked him.

He clearly remembered his high school friends but seemed to think they are still in school or university, yet most of them finished school years ago.

Brian does not like seeing anything that reflects his image. Sheila explains that he has broken every window pane, mirror or television screen at their home, and when asked why, he only says he doesn’t like them.

To the community, Brian has become a nuisance.

“Many people around here consider him mad, and they think it’s juok (witchcraft),” says Sheila. “They don’t understand that it’s bipolar, and that it can affect anyone.”

Interestingly, Brian is aware of his ailment. At some point as we interviewed his sister, he interrupted and said, “I just want to be a normal person.”

“My problem is cigarettes,” he added and even proceeded to explain why he’d like to quit tobacco.

His sister explained that he has been able to quit nearly every drug he has been using in the past, or he has at least reduced the quantities he consumes, but tobacco remains the problem.

His willingness to stop tobacco use amazes his family, but the support they can offer him is limited as he needs to return to Mathari to help stabilise his mental condition before he is taken to a rehabilitation centre.

It will cost them a pretty penny to get Brian both the treatment he needs and the rehabilitation he desires, but they remain unsure whether it’ll be a solution that lasts this time.

Fundraising

They estimate that the price of buying their brother’s sanity back will be about Sh200, 000, an amount they have been trying to fundraise for months with little success.

Meanwhile, beyond the medication he takes, the family tries to give Brian what the doctor prescribed to help manage his condition: love, care and attention.

“If he gets his medication and eats well, he will just be fine,” says Sheila, who says doctors explained to them that Brian’s condition was basically a result of depression.

To support Brian’s medication and rehabilitation, his former high school classmates – who have been appalled by his current state –  have also been fundraising to complement his family’s efforts.

“Brian was a very bright fellow. He was among the best performers in our class. That’s why we are horrified to see him like this, and we must do all we can to ensure he is himself again,” said one of his former high schoolmates.

But for the family, it isn’t a simple wait-and-see situation, it’s a do-or-die. They consider Brian to be the brains of the family and seeing him like that is deeply troubling to them.

An expert’s view

Mr Cleopa Njiru, a clinical psychologist, explains that any type of drug that a person takes is likely to interfere with their brain and alter their thinking process.

“This is why when people are intoxicated, their usual behaviour slightly changes and they will likely feel ‘high’,” he says.

“It is the chemicals found in the drugs that come in the way of our bodies’ natural chemicals and hormones, therefore affecting how they work,” he adds.

He explains that clinicians can diagnose different mental disorders related to drugs by assessing the symptoms and by speaking to people close to the patient.

“There is a criterion used in the diagnosis for every mental illness. For substance use disorder related mental conditions, however, some people may develop it after using the drugs while others may have an underlying mental condition that had not been recognised yet. The latter are likely to start using drugs to cope with their condition,” he says.

In the case of bipolar disorder like that of Brian, Mr Njiru explains that it occurs in two ways hence the prefix “bi”.

“In one period, a person may be depressed. They may have suicidal ideation, irritability and may fail to eat. The other phase could be the manic phase where they are either overexcited, they talk too much, experience paranoia and tendencies of psychosis,” he explains.

Bipolar disorder can escalate to another disorder called the schizoaffective disorder, which Mr Njiru explains affects one’s thinking and their mood.

He explains that there are some risk factors that predispose people to getting mental health conditions like bipolar disorder.

One of them is the genetic component, where a key genetic composition becomes a missing link that predisposes someone to a mental condition especially when they are triggered by a traumatic situation.

“In other parts of the world, some scientists can identify such markers when a child is still young and they can know if they are likely to have a mental illness when they grow up,” he explains.

The other factor is the chemical imbalance in the body which can be exacerbated by drugs use.

“The neurons in our bodies act as messengers. When drugs enter our bodies with the chemicals, they interfere with the process and hence everything becomes messed up. This is why the thinking process is affected and it can escalate to a mental condition if someone continually uses the drugs,” he explains.

The good news is that mental health conditions are treatable.

“As long as the patient takes medications and frequently goes for medical review to make sure that the drugs are working, then they are likely to go back to normalcy. Therapy is an important aspect in the treatment process. The clinical psychologist who offers the therapy gives techniques that can help in managing the symptoms,” explains Mr Njiru.

He adds that an early diagnosis has better outcomes, and that some people may not even need medication.

“Immediate therapy helps one to recover faster,” he says.

Severely affected

A survey conducted by the National Authority for the Campaign Against Alcohol and Drug Abuse (Nacada) shows that there is an increasing burden of substance use disorder caused by addiction of drugs in under-age and youthful Kenyans.

More people aged between 25 to 35 years are severely affected by mental conditions caused by drugs and substance use in the country, it says.

Ms Judith Twala, the manager for counselling and rehabilitation at Nacada, told Healthy Nation that parents need to have a bond with their children to realise change in mood, eating and sleeping patterns which are symptoms of a mental disorder.

“Warm relationships with parents make it easy for the two to discuss cordially about drug experimentation and use or abuse,” she said.

Ms Twala added that Nacada has a toll-free number ,1192, through which   Kenyans can access counsellors.

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