“Many Black people believe that with the right attitude or prayer, they can get rid of mental health issues. Mental health conditions are serious health problems that a person cannot think or pray away.”
Dr. Alva Baldwin
It’s no secret that in the Black community, when it came to mental health, silence ruled as many families adopted a ‘don’t ask, don’t tell’ mentality. Black folks didn’t talk about their “touched” uncle locked in the back room, or they urged their loved ones to “suck it up because if we made it through slavery, we could make it through anything.”
But that line of thinking has led to generations of African Americans going undiagnosed and untreated when it came to mental illnesses. According to Mental Health America, mental issues are worse among African Americans, who have a 20% higher rate of serious mental health issues than other races..
While mental health issues aren’t confined to the Black community (Blacks have issues about the same or less frequency than whites), the historical Black experience in America has and continues to be characterized by trauma and violence more often than for their white counterparts and impacts emotional and mental health of both youth and adults. Historical dehumanization, oppression, and violence against Black people has evolved into present day racism – structural, institutional, and individual, which, when coupled with day-to-day stressors, chemical imbalances, and more, leads to a rising number of African Americans facing mental issues.
While a myriad of mental issues plagues those in the Black community, we looked at the top three: depression, anxiety and bipolar disorder.
Depression
“He had it all. What did he have to be depressed about?”
“He always looked so happy. Didn’t you see any signs?”
“Just take your troubles to Jesus, and everything will be alright.”
Those are just a few of the comments Evon Murray says she received after her husband of 22 years took his own life. Her husband had just received a promotion at work, they had a loving family, and six figures in the bank. But no one – including Evon – knew the depression that raged through her husband’s mind.
“I think people forget that this is a chemical imbalance,” Murray said. “My husband buried himself in his work, he was an overachiever and he always wore his strong armor for our family. But it wasn’t until after he passed, that I realized the toll life had taken on him.”
Depression is a huge mental health issue that affects African Americans. For Black women, they mask it by putting on their Superwoman cape and forging ahead. For Black men, they often bury themselves in work and won’t seek help due to stigma and pride.
Despite rates being less than the overall U.S. population, according to Mental Health America, major depressive episodes increased from 9% to 10.3% in Black youth ages 12-17, 6.1% to 9.4% in young adults 18-25, and 5.7% to 6.3% in the 26-49 age range between 2015 and 2018 (the last year data was available).
Family therapist Dr. Alva Baldwin says depression robs people of the enjoyment found in daily life and can even lead to suicide.
“Depression is more than life’s ups and downs,” Baldwin said. “Life is full of joy and pain, happiness and sorrow. It is normal to feel sad when a loved one dies, or when you are sick, going through a divorce, or having financial problems. But for some people the sadness does not go away, or keeps coming back. If your ‘blues’ last more than a few weeks or cause you to struggle with daily life, you may be suffering from depression.”
Depression is a “whole-body” illness that affects your mood, thoughts, body and behavior. Without treatment, symptoms can last for weeks, months or years.
“A common myth about depression is that it is ‘normal’ for certain people to feel depressed — older people, teenagers, new mothers, menopausal women, or those with a chronic illness,” Baldwin said. “The truth is that depression is not a normal part of life for anyone, regardless of age or life situation. Unfortunately, depression has often been misdiagnosed in the Black community. And contrary to belief, people with depression can’t just ‘snap out of it’.”
Anxiety
According to Census Bureau data, rates of depression and anxiety have increased among Blacks, following the murder of George Floyd in police custody. Research shows that anxiety may present differently in African Americans, who are more likely to develop post-traumatic stress disorder than white Americans.
Anxiety is a complex mental health issue, with many triggers. African Americans face several additional risk factors for anxiety, including racial trauma. Those risk factors include:
- exposure to racism and racist abuse
- the effects of racism, such as fewer opportunities and less safe communities
- higher rates of trauma, including sexual assault, and police violence
Anxiety can manifest in many ways, and in several related diagnoses. They include obsessive-compulsive disorder, post-traumatic stress disorder, phobias, and generalized anxiety disorder. Over time, anxiety can affect a person’s health. Some researchers argue Blacks experience weathering. This is a long-term erosion of mental and physical health due to chronic trauma, stress, and racism.
Bipolar disorder
An estimated 2.3 million Americans have bipolar disorder, also called manic-depressive illness. A person with bipolar disorder can go from feeling very, very high (called mania) to feeling very, very low (depression). With proper treatment, people can control these mood swings and lead fulfilling lives. While the rate of bipolar disorder is the same among African Americans as it is among other Americans, African Americans are less likely to receive a diagnosis and, therefore, treatment for this illness.
Most Blacks with bipolar disorder are going undiagnosed and untreated. Several factors have contributed to Black Americans not receiving help for bipolar disorder and other mental illnesses. Some of the reasons are:
- A mistrust of health professionals, based in part on historically higher-than-average institutionalization of Black Americans with mental illness; and on previous mistreatments, like such tragic events as the Tuskegee syphilis study.
- Cultural barriers between many doctors and their patients.
- Reliance on family and religious community, rather than mental health professionals, during times of emotional distress.
- A tendency to talk about physical problems, rather than discuss mental symptoms, or to mask symptoms with substance abuse or other medical conditions.
- Socioeconomic factors which can limit access to medical and mental health care. About 25% of Black Americans do not have health insurance.
- Continued misunderstanding and stigma about mental illness.
No one knows for certain what causes bipolar disorder. But its causes may include:
- Brain chemistry – There are chemical changes or imbalances in the brain during both extremes of behavior (mania and depression).
- Genetics – Close relatives of people with bipolar disorder are 10 to 20 times more likely to experience depression or bipolar disorder than other people.
- Drug and alcohol abuse – More than half of the people diagnosed with bipolar disorder have histories of substance abuse. In some cases, substance abuse precedes the development of the problem; in others, alcohol or other drugs may be used as a form of self-medication.
- Stressful or disturbing events – Both can cause mood swings.
Seeking help
All ethnicities and cultures experience mental health conditions, but according to the U.S. Department of Health and Human Services, only one in three Black adults who need mental health care actually receive it.
Health experts say this is rooted in a history of systematic racism and oppression. In the late 18th century, white physicians and mental health professionals believed Black slaves felt less pain, and if they complained about any medical procedures, it was seen as a mental illness, leading to a foundation of suffering in silence.
“Getting through some of those cultural norms is huge because they are barriers,” said Dr. Sheldon Jacobs, a family and marriage therapist.
One study showed 63% of Black people believe having a mental health condition is a sign of personal weakness.
“I think for African Americans the mentality has been that life has been rough being Black in America, so you do what you have to do to survive. You don’t have time to complain, you don’t have time to stop,” UNLV Assistant Professor of African-American Studies Tyler Parry said.
The good news is that recent studies have shown that college-aged Black people are seeking mental health help at a higher rate. The hope is that they will be more likely to care for their children’s mental health in the future.
Black facts
- Serious mental illness rose among all ages of Black and African American people between 2008 and 2018.
- 439,000 18-25-year-olds had serious thoughts of suicide (Up from 277,000 in 2008).
- 166,000 made a plan to commit suicide compared (Up from 96,000 in 2008).
- 111,000 attempted suicide (Up from 70,000 in 2008).
- Only one in three African Americans who need mental health care receive it.
- Compared with non-Hispanic whites, African Americans with any mental illness have lower rates of any mental health service use including prescriptions medications and outpatient services, but higher use of inpatient services.
- African Americans are less likely to receive guideline-consistent care; less frequently included in research; more likely to use emergency rooms or primary care (rather than mental health specialists).
- Blacks are more often diagnosed with schizophrenia and less often diagnosed with mood disorders compared to white people with the same symptoms. Additionally, they are offered medication or therapy at the lower rates than the general population.
- ·Because less than 2% of American Psychological Association members are Black, some may worry that mental health care practitioners are not culturally competent enough to treat their specific issues.
- Stigma and judgment prevent African Americans from seeking treatment for their mental illnesses. Research indicates that Blacks believe that mild depression or anxiety would be considered “crazy” in their social circles. Furthermore, many believe that discussions about mental illness would not be appropriate even among family.
*Sources: Centers for Disease Control; SAMHSA’s 2018 National Survey on Drug Use and Health; Source Psychiatry.org.
Resources
- Black Emotional and Mental Health: BEAM is a training, movement building and grant making organization dedicated to the healing, wellness, and liberation of Black communities. BEAM envisions a world where there are no barriers to Black Healing.
- The Boris Lawrence Henson Foundation: Changing the perception of mental illness in the African-American community by encouraging people to get the help they need; focuses on stigma/self-stigma reduction and building trust between Black people and the mental health field.
- borislhensonfoundation.org
- Therapy for Black Girls: online space encouraging the mental wellness of Black women and girls; referral tool to find a therapist in your area..
- The Loveland Foundation: financial assistance to Black women & girls seeking therapy
- Therapy for Black Men: primarily a therapist directory for Black men seeking therapy; includes some resources and stories.
- Safe Black Space: Safe Black Space is the umbrella under which various services are offered to address people of African ancestry’s individual and community reactions to cultural and racial trauma. Safeblackspace.org
Suicide Hotline – Phone/text 988 988lifeline.org
Depression And Bipolar Support Alliance – 800-826-3632 www.dbsalliance.org
National Institute Of Mental Health 1-866-615-6464. www.nimh.nih.gov
National Medical Association (for a list of Black doctors 1888-662-7497
www.nmanet.org
