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Culture-bound syndromes
Brain fag
Have you ever done so much studying that you felt that your brain had become tired and that you could not cope with any more studying? Stress from studying can cause various symptoms.

Some of these may be difficulty in concentrating and remembering, watering or painful eyes, blurring of vision, pain or feelings of pressure in the head and neck and dizziness or weakness. Students in West Africa believed that these symptoms resulted from the brain being tired and this gave rise to the term brain fag (American Psychiatric Association, 1994; Anumonye, 1982; Harris, 1981; Ilechukwu, 1991).

 
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A case of brain fag?

A 27-year-old male third-year student at an Eastern Cape university experienced brain fag. He reported dizziness, headaches, difficulties in concentration, difficulty falling asleep, shaking hands, rapidly beating heart, body weakness and vomiting and falling asleep at his books. He had several symptoms of depression.

A few years earlier he had made a suicide attempt after getting a girl pregnant. He also had anxiety symptoms, and was phobic about speaking in tutorial classes. Like many brain fag sufferers, he believed that he had been bewitched. He told the researcher:

Intlanga – the thing that is done by witches. They cut the skin and they put something in. I have these things in my neck. They have to be taken out if you want to be a normal person, because with them I cannot read any books. Others were put underneath my tongue so that whatever I say to a person becomes worthless, so that they would not listen to me (Cunningham, 1995, p.29).

From the standpoint of the DSM, he could have been diagnosed as having generalised anxiety disorder, a depressive disorder or a somatoform disorder. However, the symptoms of watering eyes, blurred vision, crawling sensations on the scalp and headaches seem to occur together often in Africa and are distinctive features of brain fag.

Extract from Psychology: An Introduction for Students in Southern Africa by Louw, DA and Edwards, DJA (1997) Heinemann: Johannesburg

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