Brain Fag Syndrome (BFS) is a culture bound syndrome found in several countries of Western and Sub-Saharan Africa such as Nigeria, Uganda, Liberia, Ivory Coast, and Malawi. This illness typically affects students in secondary school or universities or professionals who are required to take examinations to raise educational levels for their careers. The symptoms include problems concentrating and retaining information, sleep problems, pain in the head, neck, and eyes, and other cognitive and somatic impairments. There have been reports of its prevalence in West African populations of up to 53%. Some correlations found to be significant with BFS include socioeconomic status, levels of intelligence and neuroticism, and cultural orientation.
BFS is believed to be a biological reaction to stress and anxiety from studying. Most people with BFS are under a great deal of pressure and resort to spending long hours studying and using stimulants to help them stay awake longer to study. These stimulants can disrupt the circadian rhythm, which can result in several biological and psychological effects on the body such as changes in metabolism, fatigue, and inability to focus. Much of this pressure to achieve highly in school and beyond comes from the family oriented West African culture. Often families will support one of the higher order children in the family through school and towards a successful career and in return that child must provide for the rest of the family, taking a role as head of the house. It is this great pressure to succeed in order to take care of their family that many students develop BFS. In addition, students from West African cultures that aren’t as westernized as others are at greater risk for developing BFS as they feel that they are betraying their culture by receiving westernized education.
Several different approaches have been taken to evaluate and attempt to treat BFS. The biopsychological approach describes BFS as anxiety behind the drive to succeed and fear to fail. This anxiety creates a vicious cycle which leads to students trying harder and sacrificing sleep for study, that in turn causes the body and mind to not perform as well studying, which results in increased anxiety. Treatment methods for this approach are anti-anxiety pharmaceuticals including benzodiazepines and lorazepam, with lorazepam being most effective. The psychoanalytic approach attributes BFS to ego, with those effected having larger egos and the symptoms being due to the stress and effort from trying to maintain the ego. There are no effective reported treatments from this approach. The transcultural approach describes BFS as the somatization of anxiety and depressive moods, with anxiety coming from the pressure to uphold cultural standards and the depression from the failure to uphold said standards. In this case psychotherapy would be an ideal treatment for BFS.
A. O. Adewuya, O. Morakinyo, B. A. Ola, “Brain Fag Syndrome – a Myth or a Reality,” Afr J Psychiatry 12 (2009):135-143