Dream Count (2025) is a work of fiction by acclaimed writer Chimamanda Ngozi Adichie. It follows the lives of four west African women living in the USA as they navigate the promises and realities of their relationships. It is especially rich in content concerning women’s mental health.

Early in the novel a principal character, Chiamaka, encourages another character who is acutely stressed, Kadiatou, to get psychological therapy. Kadiatou has experienced sexual assault. She has intense fear and is distressed. However, she refuses psychological therapy. Here, the novel explores the dilemma that non-Caucasian populations face when they use or interact with psychological therapies that are based on Western ideologies. A sense of strangeness implies that psychotherapy environments may not be perceived as emotionally safe places. This is, in itself, the antithesis of therapy.

Later in the novel, another principal character, Omelogor, exhibits depressive symptomatology and is also encouraged to get psychological therapy. Despite her education and exposure, Omelogor is reluctant to do so. Her help-seeking behaviour is influenced by cognitions of emotional deficiency and the perception of psychotherapy as a form of emotional indulgence. The consequences of these are a lack of engagement with and limited benefit from supportive psychotherapy.

Omelogor does eventually go on to see a therapist, but it is not a good fit. She terminates therapy, her experience predominantly negative. The portrayal is of Omelogor not speaking her mind but following the agenda of another (the therapist). There is also a sense of how certain words do not quite capture the inner world of non-Caucasian populations, though they are in popular use among Caucasian populations. The ascription of qualities of blandness and invisibility limits the usefulness of psychotherapy at a time of need.

Omelogor’s condition does merit the prescribed intervention of psychotherapy. Others recognise that Omelogor is mentally unwell, though this is largely resisted by the character. Her educated cousin (Chiamaka) specifically suggests depression, but this is dismissed by Omelogor.

This is recognisable as a moderate depressive episode. The sorts of symptoms described include low and irritable mood; rage; reduced interest in previously enjoyable activities; reduced energy and motivation; reduced concentration; reduced appetite; excessive sleeping; thoughts of hopelessness; recurrent tension headaches; excessive alcohol use; and reduced functioning in education and socially. These are of unspecified duration but depicted as ongoing for a sustained period of time.

The interventions administered by the patient’s friends and support network include regular visitations, including virtual contacts; practical support such as meals; encouragement to improve self-care; and monitoring of functioning. These are appropriately psychosocial and align with lower-level interventions that may be beneficial in depression.

The depictions of psychotherapy in this novel may improve the understanding of psychotherapeutic interventions in African and Afrodiasporic women’s mental health. It can improve public knowledge of mental health interventions and contribute to reduction of stigma.