Steve Khalid Shema, a 26-year-old artist, filmmaker, poet, and writer-director based in Kigali, was clinically diagnosed last year with bipolar disorder and depression. Following his diagnosis, he spent nearly a month in a mental health institution, after it was established that his condition developed through a series of interconnected challenges.

Before he was diagnosed, he had been battling symptoms for years, long before he fully understood what was happening to him. Through his art, he began noticing patterns in his emotional state. His writing, once a space of creative expression, grew darker, revealing deep feelings of loneliness, neglect, and inner pain.

"I caught myself many times when I was writing, I wasn’t writing jolly stuff, I was writing only dark things, things about feeling neglected and lonely and not seen and hurting myself, it was overwhelming. I couldn’t sleep for two days, I didn’t know what day it was, that is when I decided to go to the hospital for help,” he recalls.

As Shema’s mental health declined, the reactions from those around him were mixed. While some close to him tried to understand, many misinterpreted his behaviour as personal flaws rather than symptoms of a deeper issue.

This lack of awareness made it harder for him to recognise the seriousness of what he was going through.

"People thought I was just being difficult or dramatic. They assumed it was attitude, not illness. But I wasn’t choosing to be that way. I didn’t control it. You think you’re fine, and then something small triggers you, and everything shifts. You don’t even see it coming.”

ALSO READ : How mental health contributes to male mortality rates

Long before his bipolar diagnosis, he had already endured a difficult path of addiction. He was once dependent on heroin and crack cocaine substances he used to escape pain he couldn’t yet name.

However, he’s now been clean from those drugs for nearly six years. But as he explains, recovery is not a moment; it’s a lifetime process.

"Once you go off a certain drug because you think it’s bad, you don’t realise alcohol is becoming a problem too. It’s more accepted. But I was using it as a defence mechanism, to avoid reality.”

This shift from opioids to alcohol is what’s known as cross-addiction, and for Shema, it masked the deeper issue for a time. But even sobriety didn’t immediately bring peace. His internal world, impacted by years of trauma, loneliness, and chemical imbalance, remained unstable.

He was eventually diagnosed with bipolar disorder around the same time he had just completed a campaign against drug abuse through his organisation, a painful irony not lost on him. Behind the scenes, things had already begun to unravel again.

ALSO READ : Recovering from drug abuse is possible – former addicts

"When I went to the hospital, I was suicidal. I actually don’t know myself when I’m not suicidal. That thought has been part of me since I got off drugs.”

Despite years of sobriety, the residue of addiction and untreated mental illness lingered. Even now, he acknowledges that recovery is ongoing—a daily, conscious effort to stay grounded in a life that can feel unbalanced, overwhelming, and, at times, unbearable.

How can society help men psychologically?

Chantal Mudahogora, a therapist from Solid Minds, says the first step in helping men with their mental health is encouraging them to recognise when they are unwell, something society makes incredibly difficult.

"Men often go undiagnosed not because they’re healthier, but because they don’t seek help, unlike women, who are more likely to talk about their emotions and access clinical care. Men are taught from childhood to suppress their feelings and appear strong, even in distress,” she explains.

The emotional repression starts early—with boys being told not to cry, not to show weakness—which creates long-term psychological harm. To effectively support men, Mudahogora emphasises that society must first change how it treats them.

"We have to stop oppressing men emotionally. Let them know their feelings are valid. We need to reduce the stigma, raise awareness, and create a safe space where men can express vulnerability without judgment. Encouraging them to see therapists, visit hospitals, or simply talk openly is important,” she said.

Without this support, mental distress often manifests in damaging ways—through sleeplessness, addiction, anger issues, or physical symptoms like stomach pain—long before men realise they are suffering from depression or anxiety.

ALSO READ: Why are men reluctant to seek help for mental health issues?

Mudahogora highlighted that mental healthcare must be holistic, though finding help is still the hardest part for many men. Building community support systems and removing the pressure to always appear resilient is essential.

"We have to help men care for their mind, body, and soul—not just fix what’s broken. I know that to find help for most men is the hardest part, but as the society around them, we need to let them rest. Let them not be strong all the time. There’s a difference between resilience and silent suffering.”

According to the Division Manager of Mental Health at Rwanda Biomedical Centre (RBC), Darious Gishoma, men often respond to psychological distress through externalising behaviours rather than seeking help or expressing emotional pain.

This includes risky alcohol use, substance abuse, anger, and impulsive decision-making—strategies that may temporarily mask distress but are ultimately harmful.

"We need to discourage the use of alcohol as a way of coping. There is a need for men to learn more adaptive coping approaches long before they reach a crisis point, such as physical exercise, talking to a trusted person, etc.”

ALSO READ: The silence of men suffering from mental health issues

Despite some mental health conditions like epilepsy showing equal care-seeking between men and women, significant disparities appear with disorders like depression. To address this, Dr Gishoma calls for a targeted response from the health system.

"We must develop specific strategies to reach men, especially before they’re in crisis, like integrating virtual consultations and tech-based tools to make access easier and more discreet.”

He also highlights the importance of preventive mental health programmes that focus on young men and adolescents in schools or youth centres, promoting healthier coping methods from an early age.

Where to get help

In Rwanda, mental health services are available for both men and women across all levels of the health system. Support can be accessed through specialised mental health centres, national referral and teaching hospitals such as CHUK, CHUB, Rwanda Military Hospital, and King Faisal Hospital, as well as in district hospitals and health centres.

In addition, Kigali hosts several private mental health clinics offering professional care. Importantly, mental health services are included under Mutuelle de Santé, making them more accessible to the general population.