Therapy session – PEXELSAt 42,
Samuel Boiyo has walked a path few understand.
Diagnosed
with bipolar disorder at 21, he has spent nearly two decades navigating a life
punctuated by extremes, from euphoric highs that lift him to unimagined
heights, to crushing lows that leave him incapacitated.
His story is
one of endurance, resilience and the quiet battle of millions living with
mental illness in Kenya.
“I have lived
with bipolar for over 20 years,” Boiyo begins, his voice steady but laced with
exhaustion.
“It began
with a manic episode during my final year in college. When the episode was
over, I had ‘donated’ my possessions. I was left confused and depressed.”
The condition
has been very tough on him and his family, and very costly.
“Every coin
I earned went into medication. Sometimes I could not even develop myself
financially because the medicine is expensive.”
His journey
is echoed by many Kenyans living with the condition, including 24-year-old Patience Kyalo, who was diagnosed with
bipolar disorder in 2024.
Together,
their stories paint a vivid picture of what it means to live between highs and
lows, to fight stigma and to seek dignity in a society still grappling with the
realities of mental health.
WEIGHT OF DIAGNOSIS
For Samuel
Boiyo, the first challenge was understanding the illness itself. In the early
2000s, mental health was widely misunderstood in Kenya.
Depression
and mania were often explained away as curses, witchcraft or spiritual
possession.
“In my
village, people didn’t know about intervention,” he recalls.
“Even when I
was sent to prison, they said I could have stolen someone’s possessions and
they did some juju to me. Or that I had been bewitched.”
Samuel
was arrested a few months after arriving in Nairobi, where he ran his jewellery
business.
It was
during what would have been a normal day at the CBD when he got an attack. He
went to sit down, having confused another trader’s stall with his, when he was
accused of intention to steal.
The
public landed on him, despite pleas, only to be rescued by police, who took him
to Industrial Area, Nairobi Remand.
“In
prison, they said I must have been bewitched. Even some officers mocked me,
saying I was pretending. At times they beat me for the fun of it,” he says.
“But the
truth is, without medication, my brain was not stable. I was a danger to
myself, not to others.”
Confusion,
stigma and fear defined those early years. Relatives whispered. Neighbours
avoided him.
“Mental illness isolates you, even from your own
family,” he says solemnly.
In moments
of mania, when his energy surged, he was dismissed as “possessed”.
During
depressive episodes, when he would lock himself away for weeks, people assumed
he was lazy or bewitched.
“It took
education and persistence before I realised bipolar disorder is a medical
condition,” he says.
“Finally, I
came to see it as a medical case. I had to take my medication and listen to the
doctors at Mathari Teaching and Training Referral Hospital. That education
helped me start improving.”
For Patience Kyalo, the journey to
diagnosis came two decades later but with similar confusion.
In 2023, she
began experiencing dramatic mood swings. Some days, she would feel invincible,
staying up all night studying and planning projects. Other times, she could not
get out of bed.
“At first I
thought I was just stressed,” she recalls. “But then the patterns became too
obvious. My family noticed I was either too high or too low. There was no
in-between.”
It was only
after she sought psychiatric help in Nairobi that she received a diagnosis of
bipolar disorder.
“Hearing the
doctor say it was bipolar felt like a relief but also a weight. Mostly though,
it was like being handed a death sentence,” she says.
“Finally,
there was an explanation. But I also knew it was not something that would just
go away.”
COST OF
SURVIVAL
Both Samuel
and Patience quickly discovered that managing bipolar disorder comes with
financial strain.
“The
first-generation drugs were cheap but had so many side effects. I was always
drowsy and weak,” Samuel says.
“The
newer ones are better, but they cost me more.”
Samuel
spends nearly Sh10,000 a month
on medication alone.
“Treating
mental illness is not like malaria or something simple,” he says. “You borrow,
you are given, and many people miss medication because of cost. It is a lot.”
He
explains that missing medication is not an option due to the risk of relapse.
For
Patience, the financial challenge is compounded by therapy sessions.
“I take mood
stabilisers, and I also go for psychotherapy.
Each session
costs about Sh3,000, and you need it regularly. Sometimes I skip sessions because
I just don’t have the money.”
Both
highlight the gaps in Kenya’s health system. While the National Health
Insurance Fund previously supported some medication, recent policy shifts have
left patients struggling.
“The
government needs to create value for mental health, give medication at a good
price and follow up with patients regularly,” Samuel urges.
Bipolar
disorder is often described as a pendulum between two extremes: mania and
depression.
For Samuel,
these swings once dictated every aspect of his life.
On some
days, he opens his shop only to find himself giving away goods to strangers by
evening.
“During
mania, I feel overly generous, invincible,” he says. “But the consequences come
later.”
Depression,
on the other hand, leaves him paralysed.
“There are
times I cannot even step out of the house,” he admits. “Even basic things like
bathing, brushing my teeth or eating feel impossible.”
Relationships
bore the brunt. For years, he avoided visiting neighbours or relatives out of
fear his erratic behaviour might harm them.
His marriage
nearly collapsed.
“At some
point, my marriage got so close to an end. My wife left with the kids because
she could not handle the highs and lows. I don’t blame her,” he says.
“It was
until my therapist encouraged me to attend sessions with her that things stated
getting better. We have been stable for the last decade. Today, she even helps
me monitor my medication.”
Patience
shares a similar battle. “When I am high, I take on too much,” she says. “I
start projects I can’t finish, I talk too much, I spend recklessly. But when I
crash, I feel like the world has ended. I can’t answer calls. I can’t face
people.”
Her
friendships have suffered. “Some people think I am unreliable. They don’t
understand it’s the illness. I’ve lost friends but I’ve also gained a few who
are patient and supportive.”
Samuel and
Patience credit therapy for helping them regain balance.
“Before
psychotherapy, I could not come out of the house or face people. Cognitive Behavioural
Therapy gave me the tools to stop destructive thoughts,” Samuel recalls.
“Now, it
balances me. It gives me insight into life. I accept myself, my illness and I
live positively with it.”
Patience
describes therapy as a safe space.
“My
therapist helps me recognise my triggers,” she says.
“For
example, I now know lack of sleep can push me into mania. I keep a sleep
schedule and I write a mood journal. These small things keep me grounded.”
TREATMENT
Dr Evans Oloo, a psychologist, says bipolar disorder is a mental condition that
affects mood regulation.
An
individual experiences rapid shifts, from sadness to euphoric highs.
He says people
tend to think bipolar disorder is just about mood swings, but it is more
complex.
“A manic
episode can push someone into risky behaviour, including overspending, unsafe
sex or even giving away properties,” Oloo says.
“A
depressive episode can leave someone in bed for weeks. Families often interpret
this as laziness or stubbornness, when in reality it is a medical crisis.”
He advocates
both medication and therapy, adding that medication stabilises the
neurochemical imbalances in the brain, allowing individuals to function.
Therapy, on
the other hand, provides coping mechanisms to handle stigma, family dynamics
and social pressures.
“Therapy is
not about curing bipolar; it is about giving patients’ tools,” Oloo says.
“For
example, teaching them to identify triggers, develop daily routines and build
support systems. Without therapy, even with medication, relapse is very common.”
Dr Nelly Kamwale, a consultant psychiatrist, says there are different
types of bipolar disorder.
“There is bipolar
1, bipolar 2 and cyclothymia, each with varying severity,” she says.
Kamwale says
bipolar disorder arises from a combination of genetic and neurochemical
factors.
“If a parent
has bipolar, the child has a higher risk,” she says.
“But
environmental stress like trauma, poverty or substance abuse can trigger onset.
That is why many people experience their first episode in early adulthood.”
She says treatment
involves careful monitoring, medication and psychotherapy.
“With proper
management, people can live fully functional lives,” she assures.
The
doctor advises against skipping doses, noting that “it is very dangerous. A
single relapse can erase months of stability”.
“Treatment
involves medication, mood stabilisers, antidepressants, antipsychotics and
psychotherapy. Both are necessary,” she says.
“We use
mood stabilisers, such as lithium or valproate, sometimes antipsychotics during
severe mania and antidepressants during depression.
“But
every patient responds differently, so constant monitoring is necessary.
Skipping medication can cause a relapse.”
Cautioning
against stigma, Dr Kamwale warns that “it kills faster than the illness”.
“Many
patients stop taking medication because their families believe they are
bewitched,” she adds.
“Others
lose jobs because employers don’t understand. It is clear that education is our
most powerful medicine.”
She also
notes that the country has a shortage of psychiatrists and most are in urban
areas, disadvantaging patients in rural areas.
“Kenya has a
severe shortage of psychiatrists. Most are in Nairobi. Patients in rural areas
rarely access proper care,” she says.
MENTAL
HEALTH LANDSCAPE
According to
the Kenya Psychiatric Association, one in every four Kenyans is likely to
experience mental illness at some point in their lives.
Bipolar
disorder, though less common than depression and anxiety, remains significantly
underdiagnosed.
With fewer
than 200 practising psychiatrists serving a population of more than 50 million,
access to care is a daily struggle.
According
to Ministry of Health guidelines, Kenya needs 1,400 more psychiatrists, 7,000
more psychiatric nurses and 3,000 more psychologists.
In March, a detailed report forwarded to the UN ahead
of the fourth cycle of the peer review mechanism showed that the government
only allocates 0.001 per cent of the national health budget towards mental
health annually.
The globally
recommended level is $1.16 (Sh150) per capita, but Kenya is spending $0.0012
(less than a cent), the report sent to Geneva showed.
Families
often bear the burden, with patients relying on relatives for financial,
emotional and physical support.
Despite the
hardships, both Samuel and Patience insist on hope.
Samuel
maintains a steady routine of medication, therapy, exercise and healthy living.
He is raising two daughters with his wife and does advocacy work to support
others.
“For anyone
diagnosed with bipolar or any mental illness, take care of yourself. Follow the
doctor’s instructions,” he says.
“Surround
yourself with supportive people. There is hope. Recovery is possible.”
Patience
echoes this message. “At first I thought my life was over,” she says.
“But now I
know it’s just a part of me. I am still me. I can work, I can love, I can
dream. I just have to manage it. And I want others to know it’s possible.”
Samuel Boiyo
and Patience Kyalo’s stories highlight both the challenges and the
possibilities of living with bipolar disorder in Kenya.
Their
journeys convey one truth: bipolar disorder is not the end of life’s story. It
is a chapter that, with courage, care and community, can be managed.
As Samuel
puts it: “Everyone has a mental illness to some degree. It is only the severity
that differs. You are not alone. And you can live well. There is hope for
tomorrow.”