After over ten years of listening, one thing became increasingly clear: psychological distress in Nigeria rarely exists in isolation. It is deeply intertwined with economic uncertainty, caregiving responsibilities, insecurity, unemployment, family conflict and the daily pressures of survival.
Trigger Warning: This article contains discussions of mental health, emotional distress, and related experiences that some readers may find sensitive.
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When Kalu lost his father to cancer, he knew the weight of his family’s demands would now rest solely on his shoulders. He fought back tears as his father was lowered into the ground, unsure whether he was mourning the love he barely received or the burdens he now had to carry as the first son.
“Look at the casket,” he thought.
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He had borrowed money to give his father a somewhat decent burial; perhaps a final act of love. His ₦200,000 salary meant that almost 40 per cent of this went into commuting to and from work. Between keeping his siblings in school and paying out of pocket for his mother’s arthritis medication, another 40 per cent disappeared.
What did that leave him?
“It is well,” Aunty Ify said quietly, as though she could hear his thoughts.
He nodded.
It is well.
Is it?
In Nigeria, “it is well” has become more than a prayer. It has become our national coping mechanism.
We say it after kidnappings. We say it after job losses. We say it when hospitals fail us, salaries disappear and another young Nigerian quietly reaches breaking point.
Perhaps that is why “it is well” has become one of the most dangerous phrases in our national vocabulary. Not because it lacks faith, but because it too often allows us to stop asking harder questions.
Somewhere along the way, “it is well” stopped being an expression of hope and quietly became a substitute for confronting our reality.
Yet our understanding of mental health has remained surprisingly narrow.
Mental health is often spoken about as though it begins and ends with biology; as though it is something that happens to other people.
“Not in this family.”
“Not my portion.”
But after ten years of answering calls from Nigerians in distress, we have learnt that “it is well” often sounds very different on the other end of the phone.
For a decade, She Writes Woman’s 24-hour mental health free helpline has quietly become one of the clearest windows into what it means to survive modern Nigeria.
Over that period, more than 25,000 Nigerians reached out to us. More than 80 per cent were between the ages of 18 and 30.
Here’s the reality: We answered more than 25,000 calls, but what we were really listening to was the sound of survival.
Very few callers begin by saying,
“I have depression.”
Instead, they say:
“I’m tired.”
“I’m overwhelmed.”
“I don’t want to be a burden.”
“I just need someone to listen.”
Their stories are different, but their language of distress is remarkably consistent: isolation, overwhelmed, exhaustion, loneliness and fatigue.
By the time they call us, they are not looking for a diagnosis, but for relief.
Behind every statistic in this report is someone who reached a point in which carrying life alone no longer felt possible.
Kalu is one of them.
So are the thousands of Nigerians whose experiences shape the Decade of Impact report.
According to this report, nearly 55 per cent of callers reported suicidal ideation, while one in four crisis calls related to depression.
These numbers are not abstract.
They are your neighbours.
They are in your office.
They are in your church.
They are in your family WhatsApp group.
And they are not inevitable.
After over ten years of listening, one thing became increasingly clear: psychological distress in Nigeria rarely exists in isolation. It is deeply intertwined with economic uncertainty, caregiving responsibilities, insecurity, unemployment, family conflict and the daily pressures of survival.
The Decade of Impact report is not simply telling us how many Nigerians are struggling. It is asking why so many Nigerians are being pushed to the point of struggle in the first place.
The answer begins to emerge when we look beyond the statistics and into the conditions Nigerians are expected to survive.
Nigeria is one of the youngest countries in the world. More than 60 per cent of its population is under the age of 30. Yet over half of young Nigerians are unemployed or underemployed. Even for those who earn, the minimum wage struggles to cover transportation, food and other basic necessities.
According to the 2022 Nigeria Multidimensional Poverty Index Survey, 63 per cent of Nigerians are multidimensionally poor — not just income-poor, but deprived across healthcare, education, basic living standards and social safety nets all at once.
Roughly two in every three Nigerians are living with no meaningful safety net.
Millions are one emergency away from total collapse.
In 2026, about ₦2.48 trillion of Nigeria’s budget was allocated to healthcare; that is around 6 per cent of the national budget.
Less than 5 per cent of that went to mental health, leaving hundreds of millions of Nigerians with little access to affordable mental healthcare.
And perhaps that is the most uncomfortable finding of all.
Whilst SWW continues the urgent and important work of responding to hundreds of Nigerians in distress each day, the Decade of Impact report forces us to confront a much bigger question: how much therapy can a person receive before it begins to lose its impact, if they must continually return to the very conditions that produced the distress in the first place?
Therapy can help people process trauma, develop healthier coping mechanisms and rediscover hope.
But therapy alone cannot lower the price of food, create decent jobs, make communities safer or repair broken social systems.
We cannot continue treating distress, while ignoring the conditions that manufacture it.
The problems are not merely economic; they are also embedded within the culture — familial conflicts and romantic relationship breakdowns are ranked second and third in the top sources of distress in Nigeria.
So what then must we confront?
First, we must acknowledge that mental health is shaped by the conditions people live in.
They show up every day in sleepless nights, anger in traffic, violence within families, substance dependence, declining productivity and the quiet erosion of hope.
Second, mental health is not simply a healthcare problem.
It is a social problem that calls on the government as much as it calls on the private sector.
It requires both financial investment and cultural shifts.
Above all, it must ensure that the shifts that occur in therapeutic spaces must not be undone by the stagnation, or even worse, regression of the lived realities of Nigerians.
Thirdly, we must collectively shape a culture that sees help-seeking and vulnerability as valid options.
For too long, we have celebrated silence as strength and endurance as resilience.
Neither should be confused for wellbeing.
The culture that produces “it is well” is the same culture that makes seeking help feel like weakness, especially for men.
Shame and stigma as active barriers, Kalu didn’t call 0800 800 2000 until he began experiencing thoughts of taking his own life.
“It is well” can be a beautiful expression of resilience.
Faith should give us hope.
It should never become permission to look away.
The Decade of Impact report is not simply documenting a mental health crisis.
It is documenting the emotional cost of surviving Nigeria.
Nigeria must stop performing resilience and start building the infrastructure that allows people to move beyond survival.
Until then, it is not well.
If you or someone you know is dealing with any form of mental health distress, self-harm or thoughts of taking their life, please call SWW’s national 24/7 toll-free helpline on 0800 800 2000. It is confidential, multilingual and offers faith-based counselling and disability-sensitive options.
To support the work SWW does in providing free mental health support and advocacy, visit www.shewriteswoman.org or email [email protected]. Find SWW across social media @SheWritesWoman
Hauwa Ojeifo is a human rights activist, mental health advocate, and executive director of She Writes Woman (SWW), an award-winning movement giving mental health a voice in Nigeria.
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