The Social Life of Anxiety: COVID-19-related Emotional Distress and Anxiety in Ghana and Nigeria

Abstract

This study argues that psychological distress during the COVID-19 pandemic differed across contexts. While the pandemic's impact was global, its disruptions were experienced and perceived in diverse ways. Yet much of the literature reported a worldwide rise in mental illness, particularly depression and anxiety, reinforcing global mental health discourses of universality while overlooking ongoing debates on local contexts in mental health. Within this narrative, low- and middle-income countries such as Ghana and Nigeria were depicted as especially vulnerable, prompting calls to expand services through task-shifting strategies. Such calls marginalise the lived reality of such populations, leading to interventions that may not meet the needs of society. This study aims to examine how people in Ghana and Nigeria experienced distress and anxiety during the pandemic, considering their sociocultural factors. A multidisciplinary approach was used to collect data, including ethnography, COVID-19 case management notes, clinical records, and media reports. Thematic analysis showed that distress was shaped by international narratives echoing colonial logics, which portrayed African countries as deficient or incapable, and by structural violence arising from public health policies. These findings contribute to critical debates in global mental health, challenging universalist assumptions about the pandemic's mental health impact and questioning the sufficiency of biomedical models within task-shifting strategies. The study highlights the need for context-specific approaches that engage more deeply with the sociocultural, political, and historical factors shaping experiences of distress, and that recognise the diverse ways that mental health is understood and addressed.