In a similar situation, an individual described the mental health clinic that I worked in as a cold and uninviting place where she felt unwelcome because of her race.
This opinion was voiced by a senior African American woman with whom I was doing an “intake.” She was clearly uncomfortable during the interview– clasping her handbag tightly in her lap. Her posture was stiff and she had been answering questions with only “yes’ or “no” responses.
With encouragement and after a cup of tea, she relaxed sufficiently to tell me that she had come only because her primary doctor wanted to “rule out” depression as the cause of her severe stomach pain before he sent her for testing.
She was, indeed, depressed , but refused counseling and said that she would “take care of it” herself. It turned out that she also had an ulcer.
Cause of Depression
The fourth issue is the cause of depression. They perceive that the predominant biologically-based view of mental illness is antagonistic to their view of mental illness as primarily because of life stress, poverty, discrimination and the violence within the African community today.
“I know a lot of black people that’s depressed. Every black person I know is depressed…We’re born into a depressed (state). What we live with and adjust to…I have nothing against white people…But what we live through and go through… a white person couldn’t handle it.” http://www.sciencedirect.com/science/article/pii/S0890406510000435
They pointed to specific causes of their depression as being relationship-based and because of problems with partners, children, grandchildren and friends. The issues that made them feel depressed were deaths through murder, drug overdose, gang violence, physical abuse, incarceration of loved ones, etc.
One participant stated:
“Uh, one of the things that affected me is the two children that died so close together and left me with the one about what I wished I’d had done and it gets to me, sometimes. And that’s really depressing.” http://www.sciencedirect.com/science/article/pii/S0890406510000435
Within this community (and other communities where poverty and marginalization take place) the environment is so harsh and hopeless that it is difficult for privileged individuals to conceptualize.
Self-care is an important part of self-esteem and emotional well-being. There is little time, money or energy for this in the Black woman’s schedule. Self-deprivation is sad and demeaning . The following quote is one that we need to hear:
“And I think another reason why people get depressed in my opinion, is we neglect ourselves. Particularly black people, black women. We don’t have any good men to rely on. We’ve had children too early in life. And we neglect ourselves. We’re so busy doin’ for and trying to do the things that we should do and make up for it, we don’t take the time to get our hair done, go to the spa, go get a facial, get a pedicure, ya know.” http://www.sciencedirect.com/science/article/pii/S0890406510000435
Living a life of deprivation and abuse that has been endured for generations is what is being described and the chemical imbalance theory simply does nothing to explain the sadness and hopelessness of these lives.
In an environment filled with the sounds of sirens, cries, gun shots and the deafening sounds of silence when someone is being abused in secret, we hear that the medical model is another form of oppression. To be informed that you have a chronic brain-based illness is just another degrading experience.
The symptoms of depression are well known to African Americans and they view these symptoms in the context of their difficult lives. They are not denying or ignoring their symptoms.
In one of the studies that used a mixed focus group to question African Americans on their perceptions of depression, their use of mental health resources and their traditions, it was made clear that the individuals are very aware of the symptoms.
They identify the following: sadness, being tired and having little energy, irritability and weight loss or gain. Many described headache and body pains and others pointed to increased cravings for drugs or alcohol.
Those interviewed believed that these symptoms were to be expected because of their difficult lifestyle.