Over the last three weeks, I have been involved in multiple discussions related to stigma and mental health. The conversation always and unavoidably goes into the sub-topic of “Why is there soo much stigma in Black communities related to mental health”? It is a great question and we will sort some of that out today. Parts of this will inevitably be sensitive and perhaps controversial for some of you, but try to hang in there with me through the end.
Historically, within Black communities, we tend to shy away from openly talking about the impact mental health has on our daily lives. I see on social media more people talking about their experience with a mental health condition on a platform like Twitter, where your “following” is more likely to be made up of individuals whom are like minded. On other platforms such as Facebook, where your “friends” are people you actually know personally, people are sometimes less likely to discuss openly the state of their mental health. I have seen a few brave souls openly talk about their depression on a variety of social media sites. I have also seen that in response to them, they are often told, to pray, go to church or brush it off, as it will be fine. Not always, but a lot of the time.
Unlike a physical health condition, let’s say, asthma. If someone has asthma and symptoms emerge related to their disease they are rushed to an emergency room or some medical setting to seek medical care. It is a life-threatening disorder, so you can easily see why the urgent response would be warranted. Guess what, Depression is also a life-threatening disease. No? You think this is hyperbole? Exhibit A: The Centers for Disease Control cites, “In 2016, nearly 45,000 Americans age 10 or older died by suicide. Suicide is the 10th leading cause of death and is one of just three leading causes that are on the rise.” The difference is that with Asthma you can see or hear the distress one may be in physically. Unlike Depression, you can not always see with your eyes the level of distress an individual is in. However, it does not make the subsequent consequences any less deadly. There is a wide array of mental health disorders, but for purposes of this discussion I will focus on depression because of its prevalence.
Shame is powerful. The shame individuals carry that are suffering from a mental health condition, no matter where on the spectrum of mental health wellness – whether that be situational depression all the way through a chronic serious and persistent mental illness such as Schizophrenia – the shame is real. Pause for one brief moment and reflect back upon a time in your life when someone laughed at you, mocked you, or teased you in some way. It has absolutely happened to everyone, so seriously stop for a second and recall a time when this has happened to you. I will wait.
I really did pause for about 3 minutes so I hope you did the same. If not circle back and rejoin the conversation now. It’s important to do this because I want you to connect with how powerful the feeling of “shame” is. Nobody wants to feel it. Now imagine that you have been diagnosed with Clinical Depression, which is defined as: Depression, otherwise known as major depressive disorder or clinical depression, is a common and serious mood disorder. Those who suffer from depression experience persistent feelings of sadness and hopelessness and lose interest in activities they once enjoyed. Aside from the emotional problems caused by depression, individuals can also present with a physical symptom such as chronic pain or digestive issues. To be diagnosed with depression, symptoms must be present for at least two weeks. You become educated on the disorder and understand that this is a brain disorder, a chemical imbalance and something that you can not just “shake off”, but when you discuss it with your less informed, although well meaning friends, family or colleagues, you receive a response of “you just need to pray”…..or “you just need to shake this off”…..or “you are soo dramatic”….or “what in the world do you have to be sad about, you have everything”. Do we do this with any other physical condition? When someone is diagnosed with having a degenerative eye disease, do we say “you need to just keep your eyes closed more”? No, we would not.
In Black communities when we see someone with mental health issues we tend to be less likely to seek services or supports (therapist, psychiatrist, psychologist, support groups, etc.) because historically through generations, it is not something you would talk about. You don’t tell your business to strangers. We would seek other means, such as going to church so you could be prayed over. Or label the uncle with clear mental health needs as “Crazy Uncle Jay”, without ever understanding the actual mental health condition. Everyone would know that you just “ignore” Crazy Uncle Jay, because that’s what you were taught. This in turn leads to not understanding the role genetics play as it relates to mental health disorders and this miseducation continues to be passed down from one generation to the next, all the while never addressing the actual issue. Black families often shun someone who has attempted suicide (and failed) from a lack of understanding that this individual suffered from, in many cases, a mental health condition that may have gone untreated. I have a black colleague that disclosed she attempted to commit suicide when she was 13 or 14 years old. Her response from her father was that she was stupid. Additionally, male black adolescents statistically will be shown as having lower rates of depression than their female counterparts, but that is simply because black adolescent boys go undiagnosed or categorized as a conduct issue because their depression does not look like “sadness”. It is not internalized in the way girls often do. With black adolescent boys, depression looks aggressive, oppositional and they are disproportionally involved with Juvenile Justice systems because their underlying mental health issue has gone unaddressed.
It is true, that within our culture we often value religion at a high level. We are taught to pray, read a bible, go to church, go to the alter or whatever is in align with your religious beliefs. Leadership in churches have to understand the dynamics at hand and the role they play when religion is used as the only means for someone to get help for mental health needs. This is not the way we treat physical health. You can absolutely pray and talk to a therapist at the same time (Thanks KN for the Meme). You can pray on the way to urgent care for your emergency psychiatric care. Everyone has a path to recovery, in their own way, on their own time. We have to not laugh at Kanye West when we see him in clear mental health distress. We can not pretend to be shocked when something more serious happens to him (he has openly disclosed he struggles with mental health issues). We have to be curious about what we don’t know, seek to understand more about mental health, its impact on our society and culture. Once we know more, we do better. Once we remove one additional layer of the stigma associated with mental health in our own communities, we learn how to be better friends, family members and general citizens. Seeking treatment is also not easy because you have to find someone that is on the treatment side who is culturally component and understands these dynamics. But just like we go through a process of trial and error to find pediatricians for our kids, hair stylists/barbers, etc. the same is required to find a good match for you when seeking help.
It was a lot to unpack here. I hope if nothing else, some awareness is raised and at least 1 person acts differently the next time someone shares their struggle with a mental health condition. Let’s help to reduce the stigma of mental health by taking a look inward into our own communities and how we address mental health. For more information or support regarding suicide please visit: https://suicidepreventionlifeline.org/ or for more on understanding depression visit: https://www.nami.org/Learn-More/Mental-Health-Conditions/Depression
P.S. – Do not message me saying that I said prayer does not work for managing mental health and try to argue with me about that! Pray, fast, meditate, practice mindfulness, do YOU. But also, be informed about mental health disorders so you seek the additional treatment/care/supports that could also be warranted.