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A 22-year-old Somali woman was brought to the emergency department by her student friends because she was complaining of chronic tiredness, loss of appetite and difficulty in concentration. She was midway through a computer studies course at a tertiary institution and said that she had "brain fag". Further exploration revealed that she was under considerable stress: she was the eldest of four children who had migrated with their mother to Australia five years previously, her father was still in Somalia involved in the civil war there, and she was conducting a surreptitious relationship with a Pakistani boy in London via the Internet, behaviour which was unknown and unacceptable to her Muslim family. Although these stresses were obvious to the interviewer this young woman maintained that all her problems were due to "brain fag", experienced as a result of her difficulty with the course.

With counselling aimed at dealing with her underlying problems the patient's symptoms gradually resolved.

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