"There's no such thing as depression."
Have you heard that statement before? What about "Aint nothing wrong with [him/her]. [He/She] just be sad all the time for no reason, but I don't have time for that." Or even, "I don't what's up with them. They went to a party then next thing you know, they started talking about they hear voices." In the black community, these are statements that we often hear. Within our community, some of the first things we're taught are to be strong, don't cry and pray through it. Crying is a sign of weakness and lack of faith. Depression, along with a multitude of other disorders, are very real. So real, that without proper care, it could lead to an early death. But, why does this stigma exist? Why is so difficult for the black community, especially the baby boomer generation, to accept that someone they know is mentally and/or emotionally struggling?
Victor Armstrong (2019) from the National Counselor's Board of Directors mentioned one possible perspective that our community shares is that if we can get through slavery, surely we can get through sadness. But, it is more than sadness. It is more than what meets the eye. According to Erica Cirino's article reviewed by Dr. Timothy Legg, "The Effect of Depression on the Brain" (2017) from healthline.com, depression can impact areas of the brain such as the hippocampus, the amygdala and the prefrontal cortex.
Why are these Areas of the Brain Important and How are they Impacted by Depression?
The hippocampus deals with memory and holds cortisol. Cortisol is often referred to as the "stress hormone." When a person is experiencing depression, increased amounts of cortisol are produced and released. If that increased amount of cortisol continues for an extensive amount of time, it could "slow the production of new neurons and cause the neurons in the hippocampus to shrink. This can lead to memory problems." (Cirino, Section: "How Does Depression Affect the Brain", 2017).
Cortisol can also shrink the prefrontal cortex if there's an excessive amount produced. Cirino (2017) stated that the prefrontal cortex "is responsible for regulating emotions, making decisions, and forming memories." Thus, if the prefrontal cortex shrinks, the person is less likely to have control over their emotions and struggle with decision making skills.
Lastly, the amygdala has your pleasures and fears sensor. In individuals with major depression, "the amygdala becomes enlarged and more active as a result of constant exposure to high levels of cortisol. An enlarged and hyperactive amygdala, along with abnormal activity in other parts of the brain, can result in disturbances in sleep and activity patterns." (Cirino, Section: "How Does Depression Affect the Brain", 2017).
Dr. Thomas Vance's article "Addressing Mental Health in the Black Community" (2019) stated, "Research suggests that the adult Black community is 20% more likely to experience serious mental health problems, such as Major Depressive Disorder or Generalized Anxiety Disorder." (Section: Research Surrounding the Black Community and Mental Health). One might as, if the black community is at higher risk, why not seek help? In addition to lack of healthcare coverage, lack healthcare support and healthcare affordability, the black community has a significant distrust with the medical field as a whole. One significant cause of that distrust is The Tuskegee Experiment; more specifically "Tuskegee Study of Untreated Syphilis in the Negro Male.” (CDC, "The Tuskegee Timeline", 2020).
Tuskegee Study of Untreated Syphilis in the Negro Male
As the name of the study states, researchers with the Public Health Service and the Tuskegee Institute, set out to study untreated syphilis in black men in 1932 (CDC, 2020). The duration of the study was expected to be 6 months. Researchers did not receive the participants' consent for the experiment and explained that participants would "[receive] free medical exams, free meals, and burial insurance." (CDC, "The Tuskegee Timeline", 2020). The study had a group of black men with syphilis and a control group who did not have syphilis. Six-hundred black men participated in the study; 399 men with syphilis and 201 without. In Elizabeth Nix's article "Tuskegee Experiment: The Infamous Syphilis Study" (2019) she stated, "In order to track the disease’s full progression, researchers provided no effective care as the men died, went blind or insane or experienced other severe health problems due to their untreated syphilis." In 1947, penicillin was the widely used drug of choice for treatment of syphilis, but researchers did not provide it to the 399 men (CDC, 2020). In 1972, the study officially ended. Thus, the distrust with the healthcare field.
Understanding the depths of distrust that the black community has with the healthcare system helps to understand why we're not the first to go to the doctor, even when we know we should, or seek mental health support when we know something is "off". But, that has shown to negatively impact us. Health services and providers are continuing to evolve, such as more inclusion of black healthcare providers and more access to healthcare*.
As time moves forward, the stigma around mental health treatment is decreasing, but there is still much work to be done. In Armstrong's 2019 article titled "Stigma Regarding Mental Illness among People of Color", he stated one way to continue moving toward progression is by "[changing] the narrative from a conversation about mental illness to a conversation about mental wellness. Mental health is, after all, more than depression, anxiety, or a bipolar disorder diagnosis. It is your overall emotional and mental wellbeing, including both positive and negative elements." Let's continue that narrative and continue respectfully challenging those who don't take mental health serious.