According to Raymond DePaulo, Jr. M.D., Professor of Psychiatry at Johns Hopkins University School of Medicine, African-American populations do not have higher rates of depression in the U.S. However, the statistics may be skewed because African Americans are much less likely to report their symptoms of depression.
The stigma and prejudice toward mental health issues in black communities is especially thick, making it very difficult for persons suffering from depression or anxiety (or any mood disorder) to acknowledge it, let alone seek treatment. When I participated in a six-week outpatient program at Laurel Hospital, half the group was African-American. The stories horrified me. Most of the African Americans could not reveal to any member in their family what they were doing (the outpatient program) because the stigma was so deep and tall and wide.
A while back I interviewed professor and blogger writer Monica Coleman, Ph.D., on Beyond Blue. She described the stigma in this way:
In many ways, I do think that there is a greater stigma among African American culture than among white cultures. I live in southern California, and many white people will freely reference "seeing a therapist" in normal conversation. Black people don't do that. Seeing a therapist is generally seen as a sign of weakness or a lack of faith. There is still an active mythos of "the strong black woman," who is supposed to be strong and present and capable for everyone in her family -- and neglects her own needs. In the midst of a depressive episode, I had a friend say to me, "We are the descendants of those who survived the Middle Passage and slavery. Whatever you're going through cannot be that bad." I was so hurt and angry by that statement. No, depression isn't human trafficking, genocide or slavery, but it is real death-threatening pain to me. And of course, there are those who did not survive those travesties. But that comment just made me feel small and selfish and far worse than before. It made me wish I had never said anything at all.
So without support from the community, or at least family and friends, how does a person begin to recover?
Monica has found strength, healing and affirmation through speaking and writing candidly about her own depression -- her attempts to penetrate the stigma for others. She says:
I am just now learning that vulnerability is strength. I am learning to speak and write boldly about the reality of living with a depressive condition. Even when it's hard and I don't have it all figured out and it's actively kicking my butt. It's the most terrifying thing I've ever done. It feels like running naked across the front lawn.
But I also feel a lot of affirmation when people respond -- especially other black women -- and let me know that their processes and challenges are made lighter by hearing their experience reflected from a pulpit, leadership, the classroom or wherever I am. That confirms what I've felt is a calling from God. It encourages me, and helps my health.
A few other African-American voices have joined her in coming forward with their stories. In becoming vulnerable, they free others from a different kind of oppression from the kind that blacks have experienced in the past, but an oppression just as real. Among them is Terri Williams, who participated in a panel discussion at the Mental Health America conference last year. She gave me a copy of her provocative and insightful book, "Black Pain: It Just Looks Like We're Not Hurting." In it, she writes:
For much of my career I have spoken to diverse groups of thousands of people around the country about achieving success in business and in the field of public relations. In the last two years, I've begun dealing with major depression in my life, and when I give talks now, they're less about business than they are about this misunderstood disease. First I talk about how depression almost killed me; in other words, I stand in front of audiences of hundreds of people, naked and transparent, with my arms flung open. Then I talk about depression and Black people -- how it is crushing our youth and destroying lives -- those who suffer from depression along with those who care about them. It is then that I think of Queen Esther, because she was called upon to reveal herself to save the lives of her people, and she was scared to do it, but she couldn't stand to watch her people be destroyed -- she had to save them. I think of Queen Esther because depression is killing Black people by the thousands, and I have to talk about it no matter how much it scares me.
As more voices join the chorus, may there be more dialogue in African-American communities about mental illness so that those inflicted with mood disorders have a chance to recover.
A version of this piece was originally published on Psych Central.