Madness in Senegal

I wasn’t able to arrange any interviews. The doctors in the Senegalese mental hospitals were defensive, fearful that I would paint a bad picture of conditions, or busy. The assurances of the State Department staff who were helping me didn’t sooth this naive patriotism or persuade them to give me half an hour, but I learned a little. There’s no social security in Senegal, so the mentally ill either rely on the care of their family or begging. I didn’t see many people who struck me as being afflicted on the streets (unlike London and Paris), so I assumed that they had been assimilated into the crowd and received care of sorts from other dwellers of Dakar’s streets.

The luckier among the mentally ill receive support from their families who send them to mental institutions where they receive treatment in the form of psychotropics. These help as long as the money holds out — a familiar story to those of us who remember the dark days before Obamacare. I can’t tell you about the conditions in the hospitals; so, I don’t know if they followed the best standards of care or if they were dank prisons where patients were chained or locked into padded cells.

Mental illness is recognized even in the more remote and traditional areas, which refutes the myth that people in Africa regard people living with schizophrenia and bipolar disorder as holy. Instead, they are ostracized and feared — as they have always been.

Most of the mentally ill disappear into the mass of people walking the streets of this city. They are ignored and forgotten, their symptoms shrugged off which is not the reverence of the myth makers. There’s rumor of an American in one of the suburbs who is in episode; there is no retrieving him and taking him home, however, because he will not come into the embassy for evaluation.

If I stayed around, I might see more; time is running out, however.

The Flatland Dilemma in Interpreting Bipolar Mania.

People in mania are known for flights of fancy and the rapid association of ideas. Of all the forms of intelligence that we may possess, it is only the ability to recognize analogies and build associations that suffers when we go on mood stabilizers. I think it can be a mistake for outsiders to believe that this ability leads to wild, random, and unusable linkages in our mind. I find that my ability to write poetry — meaningful poetry — suffered after I started taking lithium; I lost insights. Of course, many other more negative traits like my irritability, grandiosity, and racing thoughts disappeared so I consider it a net gain.

The things we bring back from our adventures in mania land aren’t all rubbish. Poets such as Shelley and Byron depended on their manic states to generate compelling material. Some scientists have conceived startling new concepts. Isaac Newton is a classic example of a maniac whose insights transformed the science of his day and enabled him to revolutionize mathematics with his invention of calculus. The trouble comes when we try to bring our insights back from the fine and private place of our sickness.

William Knowland’s Flatland — which was written to explain the difficulties inherent in Faith — presents a useful allegory for our struggle to explain what we have found. Imagine a two dimensional figure, say a square. Imagine that it is you. Your perceptions are limited to two dimensions, so while you can make out one dimensional figures such as lines and points, you cannot appreciate three dimensional ones. If you were one dimensional, squares would appear as lines to you. Angles and other aspects of the square would invisible.

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