President Kagame is showing all the signs of a person suffering from fatigue and requiring psychological help. It follows that his immediate family has a duty of care to look after and looking for the right interventions to support Paul Kagame.

It is widely accepted that in relation to people in their 40s and above who are surrounded with a lot of work get a brain breakdown and need a rest from work. A duty of care means that the immediate family like wife but also body guards needs to take such measures as are reasonable in the circumstances to ensure that people who are under their watch will be safe both in mind and in the body.

The conduct of Janet Kagame to her husband is capable of giving rise to criminal liability, conduct which consists of failing to take measures that lie within one’s power to counteract a danger that one has, if at the time of such conduct one’s state of mind is such as constitutes a necessary ingredient of understanding what he/she is doing.

A duty of care may be imposed by legislation or a moral Duty to help those who are under your watch. When your husband, children or vulnerable adults are involved in any situation and are to any extent under the care and/or control or one or more adults, the adult(s) have a duty of care to take to ensure their safety and welfare.

This occurs either as

A Legal Duty of Care, or

A Moral Duty of Care.

In addition to the matrimonial obligation a wife owes to her husband, there is a legal duty of care for Janet Kagame to take such measures as are reasonable in the circumstances to protect her husband from risks of injury or mental meltdown that as a wife should have reasonably foreseen.

According the recent retreat in which the president looked tired and aggressive to his government officials, it could be concluded that, Mr. Kagame has shown all the signs common in major mental illness or meltdown due to fatigue or chronic disease.

Below are specific symptoms associated with common mental illness disorders.  These lists are very brief – there are many and varied symptoms that can occur depending on the disorder someone is experiencing and the severity of their illness.  However, these should serve as a guide to the types of symptoms associated with many common forms of mental illness

Personality disorders are conditions in which an individual differs significantly from an average person, in terms of how they think, perceive, feel or relate to others.

Changes in how a person feels and distorted beliefs about other people can lead to odd behaviour, which can be distressing and may upset others.

Common features include

Being overwhelmed by negative feelings such as distress, anxiety, worthlessness or anger

Avoiding other people and feeling empty and emotionally disconnected

Difficulty managing negative feelings without self-harming (for example, abusing drugs and alcohol, or taking overdoses) or, in rare cases, threatening other people odd behaviour

Difficulty maintaining stable and close relationships, especially with partners, children and professional carers sometimes, periods of losing contact with reality

Symptoms typically get worse with stress.

People with personality disorders often experience other mental health problems, especially depression

When and why personality disorders occur

Personality disorders typically emerge in adolescence and continue into adulthood.

They may be mild, moderate or severe, and people may have periods of “remission” where they function well.

Personality disorders may be associated with genetic and family factors. Experiences of distress or fear during childhood, such as neglect or abuse, are common.

Types of personality disorder

Several different types of personality disorder are recognised. They have been broadly grouped into one of three clusters – A, B or C – which are summarised below.

Cluster a personality disorders

A person with a cluster a personality disorder tends to have difficulty relating to others and usually shows patterns of behaviour most people would regard as odd and eccentric. Others may describe them as living in a fantasy world of their own.

An example is paranoid personality disorder, where the person is extremely distrustful and suspicious.

Cluster B personality disorders

A person with a cluster B personality disorder struggles to regulate their feelings and often swings between positive and negative views of others. This can lead to patterns of behaviour others describe as dramatic, unpredictable and disturbing.

An example is borderline personality disorder, where the person is emotionally unstable, has impulses to self-harm, and has intense and unstable relationships with others.

Cluster C personality disorders

A person with a cluster C personality disorder struggles with persistent and overwhelming feelings of fear and anxiety. They may show patterns of behaviour most people would regard as antisocial and withdrawn.

An example is avoidant personality disorder, where the person appears painfully shy, socially inhibited, feels inadequate and is extremely sensitive to rejection. The person may want to be close to others, but lacks confidence to form a close relationship.

How many people are affected?

Personality disorders are common mental health problems.

It is estimated that around 1 in 20 people has a personality disorder. However, many people have only mild conditions so only need help at times of stress (such as bereavement). Other people with more severe problems may need specialist help for longer periods.

Outlook

Many people recover from personality disorders over time. Psychological or medical treatment is sometimes helpful; sometimes support is all that is needed. This depends on the severity of the disorder and whether there are ongoing problems.

Some mild to moderate personality disorders improve with psychotherapy.

Different types of psychological therapies have been shown to help people with personality disorders. However, there is no single approach that suits everyone and treatment should be tailored to the individual. Not all talking therapies are effective and it is essential they are delivered by a trained therapist.

Bi-Polar Disorder

Bi-Polar Disorder is characterized by extreme mood swings.  A person with Bi-Polar disorder may have periods of depression, mania, and normal mood, but must have episodes of both depression and mania to be diagnosed as having Bi-Polar Disorder.  Bi-Polar Disorder used to be called Manic-Depressive Disorder. Symptoms include those for both depression and mania.

Symptoms:

Depressive Symptoms – Sadness, anxiety, guilt, anger, lack of emotional responsiveness, helplessness, hopelessness, self-criticism, self-blame, pessimism, impaired memory and concentration, indecisiveness and confusion, thoughts of death and suicide, crying spells, withdrawal from others, worrying, neglect of responsibilities, loss of interest in personal appearance, loss of motivation, chronic fatigue, lack of energy, overeating or loss of appetite, constipation, weight loss or gain, loss of sexual desire

Manic Symptoms – Increased energy and overactivity, elated mood, needing less sleep than usual, rapid thinking and speech, lack of inhibitions, grandiose delusions, lack of insight.

Psychotic Disorders

Psychosis is a mental disorder in which a person has lost some contact with reality.  There may be severe disturbances in thinking, emotions or behavior.  Psychotic disorders are not as common as depression and anxiety disorders, affecting just over 1% of the population.  Psychotic disorders include Schizophrenia, Psychotic Mania, Psychotic Depression, Schizoaffective Disorder and Drug-Induced Psychosis.

Symptoms:

Changes in Emotion and Motivation – Depression, anxiety, irritability, suspiciousness, blunted, flat or inappropriate emotion, change in appetite, reduced energy and motivation

Changes in Thinking and Perception – Difficulties with concentration or attention, sense of alteration of self, others or the outside world (e.g. feeling that self or others have changed or are acting different in some way), strange ideas, unusual perceptual experiences (such as a reduction or greater intensity of smell, sound or color), delusions, hallucinations

Changes in Behavior – Sleep disturbance, social isolation or withdrawal, reduced ability to carry out work or other roles.

There is no doubt that President Kagame is suffering from multiple mental disorders  and he could be visibly seen on the Camera where at certain times he could lose his temper and walk in the audience with a microphone or asking repeatedly the same question.  If the family especially Janet Kagame does not act reasonably to save her husband, she will be ostensibly in breach of the Duty of Care.

Noble Marara.