Brain fag syndrome (BFS) describes a set of symptoms including difficulty in concentrating and retaining information, head and or neck pains, and eye pain. Brain fag is believed to be most common in adolescents and young adults due to the pressure occurring in life during these years. The term, now outdated, was first used in 19th-century Britain before becoming a colonial description of

Nigerian Nigerians or the Nigerian people are citizens of Nigeria or people with ancestry from Nigeria. The name Nigeria was derived from the Niger River running through the country. This name was allegedly coined in the late 19th century by British jo ...

high school and university students in the 1960s. Its consideration as a

culture-bound syndrome In medicine and medical anthropology, a culture-bound syndrome, culture-specific syndrome, or folk illness is a combination of psychiatric and somatic symptoms that are considered to be a recognizable disease only within a specific society or c ...

caused by excessive pressure to be successful among the young is disputed by Ayonrinde (2020)

Etymology

The term 'brain fag' presumably stems from the verb meaning of the word "fag", ''"To cause (a person, animal, or part of the body) to become tired; to fatigue, wear out"'' chiefly found in

British English British English is the set of Variety (linguistics), varieties of the English language native to the United Kingdom, especially Great Britain. More narrowly, it can refer specifically to the English language in England, or, more broadly, to ...

Classification

BFS was classified in the fourth revision of the ''

Diagnostic and Statistical Manual of Mental Disorders The ''Diagnostic and Statistical Manual of Mental Disorders'' (''DSM''; latest edition: ''DSM-5-TR'', published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a com ...

'' (DSM-IV) as a

. Individuals with ''symptoms'' of brain fag must be differentiated from those with the ''syndrome'' according to the Brain Fag Syndrome Scale (BFSS); Ola ''et al'' said it would not be "surpris ngif BFS was called an equivalent of either depression or anxiety".

Causes

Brain fag is typically driven in people with high anxiety and people with high stress levels. Morakinyo found in 20 people with BFS an achievement drive that was

anxiety Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...

-related that led to the use of

psychostimulant Stimulants (also known as central nervous system stimulants, or psychostimulants, or colloquially as uppers) are a class of drugs that increase alertness. They are used for various purposes, such as enhancing attention, motivation, cognition ...

s and consequent

sleep deprivation Sleep deprivation, also known as sleep insufficiency or sleeplessness, is the condition of not having adequate duration and/or quality of sleep to support decent alertness, performance, and health. It can be either Chronic (medicine), chronic ...

which contributed to cognitive disruption. Omoluabi related BFS to test anxiety.

Treatment

In a 1975 uncontrolled study of 60 male Nigerian students, Anumonye reported treatment success with

lorazepam Lorazepam, sold under the brand name Ativan, Tavor among others, is a benzodiazepine medication. It is used to treat anxiety (including anxiety disorders), insomnia, severe agitation, active seizures including status epilepticus, alcoh ...

. Others found benefits from antidepressants and relaxation exercises.

Epidemiology

BFS has been reported in other

Africa Africa is the world's second-largest and second-most populous continent after Asia. At about 30.3 million km2 (11.7 million square miles) including adjacent islands, it covers 20% of Earth's land area and 6% of its total surfac ...

n cultures, and in Brazil, Argentina, and

Ethiopian Jews Beta Israel, or Ethiopian Jews, is a Jewish group originating from the territory of the Amhara and Tigray regions in northern Ethiopia, where they are spread out across more than 500 small villages over a wide territory, alongside predominant ...

. Historic higher reported prevalence among males may be due to more males being present in higher education in African countries. Studies since the 1990s have not verified gender differences. Other studies found a possible association with low

socioeconomic status Socioeconomic status (SES) is a measurement used by economics, economists and sociology, sociologsts. The measurement combines a person's work experience and their or their family's access to economic resources and social position in relation t ...

, an association with average or higher intelligence, and a high association with

neuroticism Neuroticism is a personality trait associated with negative emotions. It is one of the Big Five traits. Individuals with high scores on neuroticism are more likely than average to experience such feelings as anxiety, worry, fear, anger, shame ...

. Individuals with BFS have been found to have problems with isolation, poor study habits, and the use of

s as well as physical changes including in muscle tension and heart rate.

History

The condition was first described by R. H. Prince who named the condition based on the term ''brain fag'' used by students who believed their symptoms were attributed to "brain fatigue". However, this term was used in Europe dating back to 1839. In a detailed historical account, Ayonrinde (2020) illustrates that contrary to widely held and published belief in diagnostic manuals, psychiatric, social science and educational text, the term "brain fag" and associated syndromes of anxiety, affective and somatoform symptoms in student and "brain worker" populations were first described in nineteenth century Britain (Tunstall, 1850) with dissemination across the British Empire. Ayonrinde concludes that the time has come for the decolonization of brain fag and its African syndromization in the true spirit of ethical scientific rigor in the twenty-first century.

References

{{Use dmy dates, date=January 2021 Syndromes of unknown causes Culture-bound syndromes Culture of Nigeria Health in Nigeria