In 2011, while in college in the US, I was diagnosed with bipolar disorder. It was a new label, for things I had always felt, as far back as I can remember: my changing moods, my insomnia, my endless anxieties…
I was lucky enough to be in a country with a mental health care system: medication and therapists and psychiatrists, a whole system set up to take care of me and people like me.
Most Gambians living with mental illness do not have this privilege.
The earliest “doff” I remember is the toubab “doff”.
In primary school, standing at the gates of the national library, I saw him. Stark naked, his skin sunburnt almost brown, a distracted look on his face, muttering to himself as he walked slowly down the street.
And behind him: a train of children, holding long branches which they used to poke his butt from a safe distance, giggling at this impossible sight suddenly appeared in their day. I ran into the library, and by the time I came out again they had all gone: the toubab, the children, the crowd that had begun to gather.
I’ve always wondered where he ended up. If he ever got help, if his family ever found out, and took him home. Or if he died on the streets of Banjul, alone and far from anyone who loved him.
It is hard to explain depression to someone who has never experienced it. They have no frame of reference; all they can do is compare it to their own emotions: to sadness, to grief, too bad moods, to “bad hair” days.
But it is nothing like any of those things. And so you strain for metaphor and analogies. But none of them quite capture what you’re feeling.
Depression teaches you things about yourself, that you never knew before. That your brain is a thing separate from yourself, and not always your ally. That your mind is not a wide, expansive field, the infinite space you always thought; but a prison, in which you’re trapped; one you’ve been in so long you cannot remember ever being on the outside. That the stability you’ve always felt at your core is an illusion because there is only chaos and uncertainty at your center.
Depression takes away things, that you never knew could be taken away. The cord that once connected you to everyone around you, severed so even your closest friends feel like strangers. Your sense of self-worth, replaced completely by self-loathing. Your sense of Time, as you slog through days so long you do not even notice them becoming weeks and months. Your sense of self-preservation, so death seems like just another option.
And, in its wake, depression leaves behind a series of anxieties, one cascading into the next… the anxiety of conversation, so you cannot talk to anyone for long anymore, everything you say cringe-worthy in retrospect; the anxiety of waiting for a response, so great it’s easier to just stop calling and texting; the anxiety of knowing you are slowly losing people because no one wants a friend who never picks up or calls back; the anxiety of being alone; the anxiety of being with others; the anxiety of knowing you’re not good enough, and will never be… On and on, until all you are is a bundle of anxieties, frozen in time…
There was the rock-throwing “doff”. He roamed the streets of Banjul, his beard and hair a fierce, dirty white, his face contorted with rage. Each street he walked down immediately cleared of all people; as with a bellow, he would pick up the nearest rock on the ground and violently smash it into someone’s fence, against someone’s gate.
I saw him a few times in my neighborhood and then stopped seeing him. I’ve always wondered where his rage took him, if he ever found solace before he died, whether there was anyone with him at the end…
There was the slapping “doff”. He had been normal once, people said, had traveled to Europe and returned, before he lost his sanity. The toubab injects them with something before they deport them, people said, that is what turns their minds.
And now he roamed the streets talking to himself, his eyes bloodshot, his face grizzled. One moonless night, NAWEC gone and the heat feeling oppressive, I stood outside our gate to catch the breeze, when I suddenly heard a commotion. A man taking a stroll with a friend had come upon the slapper, who walked up to him and gave him a resounding slap.
And now the man was being held back as he swore he would kill him on the spot, people pleading with him that he was a “doff”, that he had not meant it; as the man tried to get at him, screaming “Doff beh si lan?!? Doff beh si lann?!”.
Five years later, living abroad, I heard that he had died. Through all his illness he had lived with his mother, who took care of him as best she could, as he had taken care of her, once, when he lived and worked abroad and sent her money to subsist on.
And then there was Huja “doff”, as she was called. She wandered the streets with a pile of possessions on her head, saying disconnected things that made people laugh.
Every once in a while she would get pregnant, and the baby would be taken away; amongst her possessions were dolls that she carried with her, wherever she went; it was rumored that there were shopkeepers who lured her into their bitiks at night, with promises of food and money, and then used her before casting her out.
I’ve always wondered where she ended up; how she spent her last days; how she died. What happened to all her children, and what they knew of their mother.
These are the “doff” that I have known.
And you all have memories of your own, too, “doff” you have seen or heard about. And most of those memories end in punchlines because that is what the “doff” are to us, as a society: a source of amusement; inspiration for our saaga.
But behind each of those punchlines is our fellow Gambian who suffers, unnoticed, unheard, and with no relief in sight. Each of those saaga is like a mental blow, one that forces Gambians living with mental illness further into the shadows, showing them clearly how everyone around them would treat them if they reached out for help.
And it doesn’t end there. Because “doff” is such a pejorative term, one meant only to denigrate, it also excludes.
Most mental illnesses do not manifest as violence or a complete lack of ability to function in society. There are in fact hundreds of different diagnoses, things we do not traditionally think of as “doff”, and therefore judge as personal faults.
The housewife suffering from postpartum depression after her third child in three years, being exhorted to “stop being lazy” and get on with the housework. The primary school student with dyslexia, derided as “stupid” by both other kids and her teachers, held back multiple grades because she “cannot even read”. The rape survivor with PTSD, being told to get on with it and “leave all that behind now it’s past”. The child with a behavioral disorder, punished over and over to get him to “stop misbehaving”. The young woman with epilepsy, being told her seizures are “daanu rabb”, caused by an evil spirit that resides within her and needs to be exorcised. And on and on.
If we include all these different diagnoses, with a population of almost two million, if only 10% of us are afflicted – a conservative estimate – that’s 200,000 Gambians.
How could we have left that many behinds, for so long, paid barely any attention to their suffering, treated them as second-class citizens, government after government doing the bare minimum, unconcerned with their plight? What does that say about us, as a society?
What does that say about us, as a people?
But what could we do, to change the state of things?
Any long-term solution will have to begin with the Government. It needs to integrate mental health care into our current system and treat it with the same priority it does other illnesses.
It will have to conduct studies to determine the exact extent of the problem; bring in outside professionals to help fill the gap, while it trains young Gambians as mental health professionals; and, when they are done, pay them competitive salaries so they stay; and carry out sensitization campaigns educating people about mental illnesses and removing the stigma attached.
In short, it will have to get serious about mental health care and extend its protection to those who live with it.
But these are solutions that will take time to plan, fund, and implement. In the meantime what can we do to help those who suffer, while we wait for our Government to act?
We can build them a net.
Eventually, your anxiety is realized: they stop calling, stop inviting you to things… and you withdraw even further into yourself; you cannot read or write now, the two things that were once your lifelines – words are heavy, jarring things you cannot stand. You can barely get out of bed in the morning, or care for yourself… behind every action hangs a thought so heavy it seems impossible to bridge the gap between the two…
And there is no escape because it is your own self that has turned against you, in complete control, taunting you. All that it will let you remember now are your failures and regrets, all the things you would change if only you could go back, your whole life reduced to the sum of your mistakes, and nothing else…
And then your anxiety dissipates and is replaced by something else, something different but somehow much worse: a deadening of all emotion, a flatness that spreads like rust, meticulously corroding everything in your life, stripping it of all pleasure and enjoyment, until there is nothing left. Until there is only one thing left to do, a single choice left for you…
One day in college, returning home, I looked at the road on which I was on, stretched out to the horizon, and then dipping beyond sight, seemingly never-ending. And I saw my life laid out beside it, the same tar-black, monotonous and long, days piled upon days, all the same in their lack of joy and color; becoming decades piled upon decades, all monochrome, all barren; nothing to look forward to ever again; everything behind me – and everything ahead – only a waste of breath.
And it seemed the only way to get off this road was to get off the road of life itself, to shrug off the yoke of being – a final, freeing time. To fade back into the nothingness from which I came, to un-exist once more…
In the end, I stayed, because the people who love me built me a net: its ropes their affection for me; the knots joining them their unrelenting determination to save me.
None of them are trained psychiatrists or therapists. But they listen and are kind. They do not use my illness as a slur against me, in anger or in jest. They are tactful, and quick to forgive and overlook my transgressions. They make me feel like I belong here, and have every right to stay; they give me more and more good days, to add to my growing tally.
And that is what we must do, as a society, for all Gambians living with mental illness. We must collectively build them a net, one that protects every single one of them, and makes them equals in this new Gambia we are imagining into being.
Because they are all around us: they are our aunties and uncles, our parents and cousins and neighbors and best friends. They are our work colleagues, and the strangers we pass on the street; the people we interact with online, and the ones we admire.
This is how you build your rope: reach out to the ones close to you, the ones you love, the ones who matter to you; listen, and be patient, and be kind; do not be too quick to pass judgment, remember that each of us carries our own burden; press your representatives in Government to act and treat this as a priority; insist on it as part of the platform of whichever party you support; stop thinking of mental illness as a black mark against someone and their family, but as just another illness, and nothing to be shamed for; and stop using the word “doff”, in hassteh or in jest, so we can finally remove it from our vocabulary and end its dehumanizing and discriminatory effects.
And then from all our ropes, we will build our net…
This is the most difficult piece I have ever had to write. My mental illness is a part of myself that I have until now shown only to a very few, because it is the most vulnerable part, the part that has been at the center of my daily existential struggle for decades now; a part I long thought of as a deep flaw, and resented in myself; but have now come to understand and accept as part of what makes me me, for better and for worse.
My greatest fear is that, after reading this, you will think less of me, reflexively retreat back into the old and familiar categories, draw a line in your mind and place me with the “doff”, and yourself on the other side with the sane.
But I thought if I showed myself in this way to you, it might spark a much-needed national conversation; and reduce the shame attached to talking about mental illness in our society, perhaps allowing more people to seek help; and signal to the ones who suffer: stop being so hard on yourself, it is not your fault. It can get better, it WILL get better.
Because if there’s one thing I’m sure about, it is that the Gambian character always bends, in the end, towards yirrmaandeh: empathy and kindness towards those less fortunate than us; a recognition of our shared Gambianness that makes us perform great acts of altruism to help each other; and a deep generosity that has always defined us as a people, and been our national armor through all our trials.
So I decided to show this part of me to you, to place myself in your hands, and trust you: my rope, a first rope, a beginning.
Will you tie your own rope, and join it to mine?
Will you build the net with me?