Growing up between Ogun State and Lagos State, southwestern Nigeria, Suhayla Yusuf* still remembers the exact moment her Obsessive-compulsive Disorder (OCD) symptoms started. It was in her first year at the University in 2013- she had just performed the Muslim pre-prayer ablution and was heading to the mosque when a blasphemous thought came to her head.
Shocked and jilted, she desperately tried to brush it away. But every attempt just increased its intensity, leaving her feeling like a mess. As it persisted, she tried to use sleep to escape those thoughts, but they would be waiting the minute she woke up. For a while, she believed she had been cursed by God.
“I was going through a very mentally stressful period at school. I had failed a course, and it wasn’t my fault. I was ill and admitted for a week at the hospital because of the stress. I wasn’t used to academic failure at all, I had always been a straight-A student,” she explained.
Suhayla had always been a lover of words and learning, occasionally dabbling in poetry and spoken words. The thoughts grew more intense after she dropped out of school by choice after failing a pre-med course. She chose to study another course at the university, but she couldn’t go for two reasons: the intense shame of failure and a family member who was a lecturer at that same school.
“This family member was abusive, and I lived with them. I was under a lot of verbal abuse from them, and they confirmed that God was angry with me and that was why I failed,” she told HumAngle.
OCD is a mental disorder that is accompanied by intrusive thoughts known as obsessions. It can lead to repetitive behaviours causing distress and interfering with their everyday lives. OCD has different sub-types, and in Islam, Suhayla’s religious OCD is known as ‘Waswas’, which translates to ‘whisperings of the devil.’ Muslims who experience this version of OCD suffer from repetitive and compulsive behaviour in relation to acts of worship and cleanliness.
It affects an estimated two per cent to three per cent of people globally, with women having a 1.6 per cent higher prevalence rate than men. Hormonal differences and higher treatment-seeking rates in women contribute to this, leading to social isolation, physical health problems, emotional distress, and damage to relationships.
Those vicious thoughts then led to what she would later learn were compulsions. She would perform ablution multiple times before praying and would even pause in the middle of praying to do so again because she was unsure if she had done it right the first time. She would also do a cleansing bath every day for up to an hour in the bathroom, repeating the steps she believed she got wrong.
Suhayla would take pills that would force her to sleep because she constantly felt exhausted. Some days, she would wash buckets, bathroom slippers, door handles, and her hands in the bathroom over and over again to purify them. Her mother noticed something was amiss after she discovered that the soap she was buying kept disappearing rapidly because Suhayla had to ‘wash the impurities’ off the soap before washing her hands. It got so intense that during the harmattan season, her skin would become flaky and dry.
“Daily prayers were hard for me. I would be praying and then would imagine bowing to something else. I would get so afraid that I’ve ruined my religion. I avoided watching movies a whole lot, especially Yoruba movies with idols, because my brain would capture them and use them to torture me. Sometimes my thoughts were sexual and very random. I would shut my eyes so tight at how disgusting they were, and would feel shame for having them,” she told HumAngle.
OCD subtypes include contamination obsessions, violent or sexual obsessions, relationship obsessions, sensorimotor obsessions, and sexual orientation obsessions. These subtypes can overlap for some people.
The 29-year-old Quality Analyst’s days are filled with intense, disturbing thoughts, many of which she can’t bring herself to speak out loud. The thoughts sometimes slip into her dreams, evoking nightmares leading to insomnia.
There are moments when she believes she can “see” germs moving on surfaces, her brain constantly creates these vivid images like a film. Though this symptom has eased up over the years, if something she deemed “impure” isn’t “purified,” she can’t bring herself to stop thinking about it. She would even find herself dreaming about cleaning it.
“I spend a long time in the bathroom just cleaning up after peeing, and I don’t touch things in the fridge or freezer without washing my hands after. I sometimes have to count the number of times I clean something before it’s “pure.” People have to ask my permission before touching my things because I need to see their hands most of the time.”
Suhayla believes she is getting better over the years, and her symptoms have eased up in severity. It can still sometimes be very hard for her to distinguish between what is true and what is not.
Seeking help
Concerned about her situation, she asked her mother to accompany her to the Yaba Neuropsychiatric Hospital, where she was diagnosed with OCD, BPD, anxiety, and severe depression. The psychologist who attended to her started by shooting intense, uncomfortable questions at her, asking if she had experienced sexual abuse, especially by a close family member.
The psychologist insisted that he believed she might not have been telling the truth, even though she was. He later told her that if she used the little blue and yellow pills he would prescribe for her, it would work instantaneously.
With time, Suhayla was forced to learn that the pills did not perform magic, and that realisation made things worse for her. “I was self-harming at that point. I feel I didn’t have real therapy work done and was just downed with anxiolytics and anti-depressants. He [the psychologist] kept asking me to bring that abusive family member to one of these sessions, but I was not comfortable. So I decided to end therapy when I felt it wasn’t helping. He told me to resume sessions at school, but I didn’t, and just sought help through Islamic platforms and clerics,” she told HumAngle.
Suhayla focused on seeking help through the Islamic way since her OCD was majorly religious. She messaged an Islamic platform and told them about her condition. Instead of offering the help she needed, they insisted that her thoughts were from the devil.
According to Chioma Onyemaobi, a clinical psychologist, mental health issues are highly stigmatised. “Many people will view those having these problems as having spiritual problems, being weak, and more. This leads to shame and people being forced to keep things to themselves- due to this stigma, mental health professionals may not have the liberty to reach out to them,” the psychologist said.
Suhayla’s OCD tends to flare up during the muslim fasting period, and it was one of those intense periods that she dropped out of the university again. She could not get out of bed or cook and would only sleep. It was torturous to be unable to function even when she had examinations. She could only cry and curl into a ball on her bed, plagued by horrible nightmares.
When it persisted, one of her mother’s friends, a psychiatrist, put her on some medications for nine months. The side effect was very severe depression, so she eventually stopped that, too. Suhayla eventually dropped out of school and was later forced to go for what she described as a spiritual exorcism.
“I still have OCD, but it isn’t as bad as it used to be. Mentally, I feel altered, like there is a bit of fog that never goes away. I wouldn’t even know it’s there, but there are some days I feel a ‘light breeze’ in my head, like how my head used to feel before it all started.
“The fog clears, and I settle into the feeling because it’s so rare…I still feel like my failures are a reflection of God’s anger, but I’m trying to police my thoughts better,” she said.
Also, stress is a huge trigger for her sometimes, especially if the “nightmare period” starts. She currently sees an online therapist as a result of her workplace’s mental health benefits.
While the therapist had repeatedly advised Suhayla to file for leave at work, she is sceptical about opening up about her condition to anyone. The stigma for people with mental health struggles she witnesses prevents her from speaking up, and she believes that is one of the many reasons she hasn’t met anyone with her condition yet.
A similar story
For Rumi Wutoh*, her symptoms have always been lurking in the corners of her life for as long as she could remember. When she was in primary three, she couldn’t eat for a day and a half after a classmate, about four desks away, vomited in class. The smell stayed with her, causing her to spit continuously all day.
Now 36, she still can’t stand anything dirty. “I get very uncomfortable when I sweat, I hardly hug or shake people because I don’t like being that close to people, but the few people I love. I abhor public transportation, touching door handles or people’s phones, and shaking hands. I don’t share utensils, even when I was a child,” Rumi told HumAngle.
Genes, personality types, the structure of the brain, as well as dysfunctional environments, can increase the risk of developing OCD.
The biggest impact Rumi’s life has is on how it impacts her relationships and interactions with her family, friends, and the world in general. She has to try not to nitpick and overanalyse people. Many situations also seem to leave deeper impacts on her life than is normal, and she is also working on getting less bothered by situations outside her control.
“I came across the story on Instagram about three years ago about a dog being fed illicit drugs, and I still feel a profound sadness and sometimes an almost unbearable urge to know what happened after, because then I can sleep better knowing the dog is now in safe hands. I would pull out my hair, not only because I am empathising with the dog, but also because I hate that I can’t fix it.”
Rumi had always been interested in people and scientifically dissecting things. Sometimes, she would find herself mentally dissecting the people around her, fixing their eyes, noses, or aspects of their behaviour. Her memory is also incredibly sharp, making it hard to forget anything.
“I can still say word for word what certain people said around me when I was as young as 3 years old, and it has been proven to be accurate.” This has caused her to drift away from people over the years, as she can’t stand when people talk ignorantly. She believed this created distance in her relationships with those around her. So, she learnt to stop calling them out.
Rumi finds herself to be a walking contradiction. On one hand, she can’t stand being touched by others, but she may willingly hug her loved ones. Even though she can’t stand anything filthy, her room can be left unswept for a week when she is having intense moments of sadness, which she suspects may be depressive episodes.
Studies show that 25 per cent to 50 per cent of people with OCD can also experience severe depression. For some, the two conditions begin simultaneously, with more people showing up with symptoms of OCD first.
“I have never been diagnosed medically. I am not so keen on having people understand me as long as my loved ones do. Because would the world stop my pet peeves even if they understand how it makes me feel?” she explained.
Though depression can be an accompanying illness to conditions like OCD and BPD, depression itself is a mental health disorder that is very common in Nigeria. A study in Kano State shows a 70 per cent to 90 per cent depression prevalence in two specialist hospitals, with many left undiagnosed and untreated. This condition causes persistent feelings of emptiness, sadness, loss of pleasure in activities and feelings of worthlessness.
Speaking with HumAngle, Janet Peter*, said her diagnosis for chronic depression happened accidentally in November 2024, when she went to a psychiatrist for an Attention Deficit Hyperactivity Disorder (ADHD) analysis. Prior to that, she had struggled with a lack of energy, a lack of motivation, a lack of self-worth, constant sadness and the nagging feeling that she had nothing to live for.
The Fashion Design Intern assumed she had ADHD because she seemed to resonate with many of the symptoms she came across on social media and wanted to confirm that for herself.
“I’m not exactly sure when the symptoms started for me, but I believe my first major episode was in 2014. I was in my final year at the university, and I pretty much skipped school for most of the year. I would lock myself in, numb myself with binge eating and binge watching movies,” she recalled.
It led to her failing her finals woefully, and she had to make up for it for a year and a half. Her future looked very bleak for a long time, and she struggled to find her footing for 8 years after that.
Her diagnosis came at the Federal Neuropsychiatric Hospital, Yaba, Lagos, southwestern Nigeria, where she was based. She found the appointment days very stressful and struggled with the lack of order and nonchalance of the staff, making her feel like they had forgotten the patients were humans like them.
Another issue she had was with the length of the therapy sessions. Sometimes, a session can be as short as 5 minutes, and she always leaves feeling that more could have been done. In addition to the fact that there are only eight Federal Neuropsychiatric hospitals in Nigeria, only 3.3 per cent of the country’s budget is allocated to mental health services. Beyond the inadequate facilities, mentally ill patients are also treated badly in hospitals, and societal stigma makes it harder for people to seek help.
Janet finds the general situation of the country to be very triggering. Her medication helps her not to dwell too much on them. “I hope that one day I will be able to function without having to rely on medication. My doctor says I may have to use them for at least 5 years. That’s such a long time to be popping pills every morning, but what choice do I have?”
She added that if she knew 11 years ago what she now knows, she would have sought help much earlier and not tried to “pray” her troubles away.
In the same vein, 21-year-old Miracle Jacob* has struggled with numbness, dissociation from people and low self-esteem since she was 12 years old. Sometimes, she feels she has no real reaction to things, even when something very traumatic happens to her.
Her current financial situation is why she never sought help in Port Harcourt, Rivers State, southern Nigeria, where she is currently based. She does not have the privilege to spend money on mental health support, she said.
Studies show that Nigeria does not have a free psychiatric treatment program, causing a huge barrier in seeking help for many people.
“Mental health practitioners are also being cut out of health insurance, and because of that, people can’t really afford the services, and the high cost of mental health services makes it harder for people to access care. Mental health policies are also not being implemented as they should be,” Chioma, the clinical psychologist, says.
“Mentally, my condition puts me on a delayed reaction and makes me react to something months or years later. It makes me feel dead sometimes, and I have low self-esteem. Physically, I don’t really get to take care of myself,” Miracle explained.
Miracle constantly neglects herself, struggles to clean, do her laundry, repeats underwater because she is unable to wash them, and sometimes, goes days without being able to brush her teeth. This impacts her relationship with those around her.
“My mum and sister always complain, and I tend to attract people who just don’t have knowledge about proper hygiene or people who look down on me for it and shout at me all the time, especially male partners.” Sometimes, she is able to deep clean when things get very bad, allowing her to feel clean and refreshed for a little while.
Data shows that 1 in 4 Nigerians struggles with a mental illness and 15 million Nigerians die from suicide annually, ranking Nigeria as the most depressed country in Africa. But despite these, understanding and social acceptance of the condition remain poor.
Miracle currently copes by watching psychology videos and reading about depression online, and in her interpersonal relationships, she tries to be someone she is not in order to accommodate the people around her.
Chioma believes that updating and implementing the policies will go a long way in making mental health accessible. She also believes cultural norms and values in communities, shortage of mental health professionals, high cost of mental health services, domestic violence, political instability, and poor mental health policies in the country also affect access to mental health in Nigeria.
“Inflation, high cost of living crisis, unstable political crisis, lack of access to healthcare, emotional distress, and poverty contribute to the mental health crisis in Nigeria. Due to the high rate of unemployment, people are stressed, anxious, hopeless and are slipping into depression, which can lead to a high rate of substance abuse, crime and suicide,” she argued.
*The asterisked names are pseudonyms we have used at the request of the sources to protect them from stigma.