I first got treatment for a mental health related issue in Rwanda in September 2016, my last year of high school. I met with a psychiatrist but the treatment was more geared towards physical issues like blood flow to the brain. I got a fancy test where they plug stuff on your head and read electrical signals. The test said I was okay. This was what I later knew to be my first hypo mania episode that was preceded by a very long depressive episode. In the doctor's defense, he didn’t have most of the information that could lead to a diagnosis of bipolar disorder. I was diagnosed with bipolar disorder at the beginning of 2018 when I was at MIT.
Freshman summer, 2018, my mental health was all over the place. It got especially worse at almost the end of summer. It was the beginning of what would be a long depressive episode. I was taken to ICYIZERE center. This was one of my worst experiences with mental health professionals. I was in a bad shape, but the person I talked with didn’t even bother to look at me while talking. She just took notes based on my appearance and dismissed my issues because they were not big enough. I went there again and they gave another “doctor” who did the exact same thing. I know my memory and judgement might have been clouded by the mental state I was in, but I really hated that place.
End of 2018, I had to take a leave of absence to get treated in a less stressful environment. In addition I wouldn’t have been able to be a student even if I wanted to. I got treated by the doctor I worked with in 2016. He was good, but this didn’t stop me from having some reservations. The treatment felt dry, we would talk for like ten minutes or less and he would prescribe my meds. Sometimes I went with my parents or he requested to meet with them which killed the privacy part. However, he was the best I could get and he did listen to me.
When Corona got serious and I had to come home from school, I needed a doctor here. I put it off because I still had meds until the beginning of July. When I called my doctor I couldn’t get hold of him. I later learnt he had left the country, I had to go to the hospital he worked at because they had a mental health clinic. It was bad. The new doctor was really nice but she didn’t want to believe me regarding medication. They had increased my mood stabilizer dosage when I stopped taking an anti-psychotic to balance out the change. I was taking 1200mg and she decided to only give me 600. I went somewhere else.
The hospital I went to specialized in neurological, psychiatric and psychological issues. I had a relatively okay time because they had the medication, tests and everything. What put me off is that people working there have a habit of mocking visibly sick people. Those who sound confused and need another person’s supervision. The hospital as a whole doesn’t try to give privacy to people who may be showing symptoms. I had a feeling that the patients were stripped of their agency which made me sad. The second time I went there, I was determined to get there early but I was the 50th person and by 9:00 am there were almost 150 people waiting. I find it ironic how people like to say that mental illnesses are not a Rwandan thing while there are this many people seeking treatment.
I also worked with a therapist since the beginning of 2019. I decided to work with her again when I came home due to the corona virus. It really is the best treatment I had, but also the most expensive. First time around MIT paid for it so I didn’t have to worry. Now I have to pocket the cost so I have way less sessions than I used to. My therapist is American but the organization she works for is Rwandan and has many Rwandan practitioners. I chose her because some of the things I deal with I don’t know how to word in Kinyarwanda. It also helps because I don’t usually feel prejudiced with her like I do with other doctors here.
My impression of the whole system is that “the good organized kind of care” is extremely expensive. The care at state owned or affiliated hospitals is questionable. The doctors are okay but the way care is given is very exhausting and confusing. I’ve considered getting off my meds so I won’t have to deal with psychiatrists and stuff but I know if I were to have a crisis I wouldn’t want to be hospitalized here. More frustrating is that I don’t really know what needs to be done to make these experiences better. I understand why the system works like this and it makes me even angrier.
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