“African Americans Face Unique Mental Health Risks”

When Demetrius Minor left the Army after 12 years in 2013, he went through a standard medical review. Physically fit and seemingly healthy, he breezed through. Nobody caught that he was depressed.

Minor says he “passed through [the mental health system] because I looked healthy. They are looking for broken bones and ask you the easy questions, like, ‘Do you feel like hurting yourself or others?’ No. So the help was technically there, but there was no real deep dive.”

Minor, now 41, who is African American, is just one example of a much larger problem. According to the U.S. Health and Human Services Office of Minority Health, African Americans are less likely to have their mental health problems addressed.

“I’d come home, go outside, do my thing, sit on my couch for days and weeks on end. And then you just disappear. People would say, ‘Hey I haven’t heard from you, what’s going on?’ and the response would be, ‘I’m good, I’m out here grinding,’ ‘I’m hustling.’ We say those words that people in our community use to make it sound like we’re doing something. You say all the clichés, but inside, you’re hurting and you don’t know why or how.”

Minor isn’t sure African American communities and society at large are ready to deal with the challenges of mental health.

“I don’t think we are ‘woke’ enough yet to understand that mental health doesn’t mean we’re crazy. You can have a functioning life outside that door of your house. Just how there are functioning alcoholics, I was a functioning depressant.”

The issues and challenges are ingrained in families, neighborhoods, and society, he says.

“Growing up, we never used the words ‘mental health.’ If we had a problem, we just had to accept it and roll on. Looking back at my childhood, I see a lot of issues where people were suffering from [poor] mental health, but there’s no diagnosis, there’s no help and no treatment, so families were broken up.”

Sobering Statistics:

While African Americans are just as likely to report serious psychological distress, they are less likely to get behavioral treatment. But adult African Americans are more likely to report feelings of sadness, hopelessness, and worthlessness than are adult whites. Still, in 2018, 18.6% of white Americans received mental health services, compared to less than 9% of African Americans.

When it comes to a specific diagnosis and treatment for depression, the gap narrows but still exists. More than 68% of white Americans received treatment after a major depressive episode in 2018, compared to 61% of black Americans.

Having a mental illness significantly increases suicide risk among black teens and adults. One of the most common mental health issues that leads to suicide is anxiety. African Americans who have a connection to organizations, like church, have a lower suicide risk, according to the Suicide Prevention Resource Center.

African Americans, who are more likely to be impoverished, incarcerated, homeless, and fighting substance abuse, are all at higher risk for poor mental health. While poverty, homelessness, drug abuse, etc., are often signs of mental illness across all ethnicities, racism is an added part of poor mental health in African Americans. While negative stereotypes and attitudes of rejection might be less openly displayed today, examples of racism are many, and it has consequences, although research on the connection between racism and mental health is limited.

The recent tension between police and some African Americans has not helped how the community is perceived in society. African Americans are more likely to be victims of serious violent crimes, making them more likely to qualify as having posttraumatic stress disorder (PTSD). 

The Stigma:

 

A 2008 study showed a stigma within the African American community against receiving treatment for mental illness. Some people felt that sitting down and talking to a “stranger,” a therapist, was the same as airing their “dirty laundry.” Talking about your mental health problems was just not done. African Americans skirt away from conversations dealing with therapy as a solution to struggles with depression, posttraumatic stress disorder, parenting issues, and marriage problems.

Another reason African Americans may resist seeking treatment is a fear that it might reflect poorly on their families and could be an admission that something within the family or home is broken.

In 2018, music mogul Jay-Z sat down with CNN’s Van Jones to discuss mental health representation in African American communities. Jones, at the beginning, said, “As scared as black folks are of cops, we’re even more scared of therapy.” Jay-Z responded, “It should be in our schools. Children have the most going on, their minds are not fully developed, and teenagers and drinking and these things are happening to you, and you don’t know how social anxiety […] and you don’t how to navigate it.”

There is a need for trained counselors in schools for children of color, he said. Introducing them to the idea and benefits of therapy from a young age might combat the stigma in the African American community.

Sitting Down With the Experts:

Gail Mattox, MD, a professor of psychiatry and behavioral sciences at Morehouse School of Medicine in Atlanta, has been working for more than 30 years as a psychiatrist.

She has gotten grant funding to take a deeper look into behavioral health in a university setting, particularly at historical black universities like Morehouse.

Kisha Holden, PhD, is a psychologist who worked with Mattox to address health disparities and health issues that may be problems in various communities.

“We both believe that the mental health of the African American community is important,” Holden says. “We try to look at our students from a holistic and comprehensive perspective.”

Because primary care doctors may not recognize or know how to diagnose mental health issues, Holden says it’s important to get beyond the initial clinical setting.

They look to find out what is happening to the whole self, “and not exclusively at what their presenting problem may be at a medical facility.”

“We want to look deeper into the issues that contribute to or prompt some of the health problems they see. We’re pulling the Band-Aid back and looking at what may be some of the underlying problems,” she says.

Getting out of the clinical setting is key, Holden says. It’s difficult enough to get people to voluntarily come in for an appointment.

“Try and meet the patient or potential patient where they are,” she says. “Go into the community and have trust. Have stakeholders important in that community, and respecting them is certainly a part of how we build the trust and subsequently connect them to care.”

“We would go out to the community church and school and be part of the community to be aware of the signs and symptoms of psychological illness and the importance of overall health.”

Grady Hospital in downtown Atlanta is one of the Southeast’s largest behavioral health centers. Morehouse works with Grady to embed psychiatrists in the neighborhoods that Grady serves. Morehouse is also working with local school systems and colleges to beef up counseling and access to mental health care.

“We’re approaching it both from community education and cultural competency,” Mattox says.

Part of what Morehouse is trying to teach communities and health care providers is to consider a patient’s mental health as part of their overall health.

“There is a relationship with chronic diseases, like diabetes and cardiovascular disorders and depression,” Holden says. “Disentangling those risk factors allows us to treat the overall patient.

“There’s really no health without mental health.”

Article by: Shari Celestine

WebMD Health News Reviewed by: Arefa Cassoobhoy, MD, MPH

Sources:

Article: African Americans Face Unique Mental Health Risks

census.gov: “U.S. Census Bureau QuickFacts: United States.”

mentalhealthamerica.net: “Black & African-American Communities and Mental Health.”

familiesusa.org: “Barriers Faced by African-Americans in Receiving Mental Health Care.”

minorityhealth.hhs.gov: “Mental Health and African-Americans.”

sprc.org: “Addressing Suicide among Black Americans.”

mentalhealthamerica.net: “Depression And African-Americans.”

news.rutgers.edu: “African-Americans More Likely to Be Misdiagnosed with Schizophrenia, Rutgers Study Finds.”

inquirer.com: “African-Americans more likely to be misdiagnosed with schizophrenia, Rutgers study finds.”

cnn.com: “Jay-Z: Therapists should be in schools.”

nami.org: “Schizophrenia.”

nimh.nih.gov: “Depression.”

therapyforblackgirls.com: “Therapy for Black Girls.”

psychologytoday.com: “Access Counseling and Coaching.”

Gail Mattox, MD, professor and chairperson, department of psychiatry and behavioral sciences, Morehouse School of Medicine.

Kisha Holden, PhD, interim director, Satcher Health Leadership Institute, and professor in the departments of psychiatry and behavioral sciences and community health and preventive medicine, Morehouse School of Medicine.

REFERENCES:

Association for Behavioral and Cognitive Therapies: "What is Cognitive Behavior Therapy (CBT)?"
Parinda Khatri, PhD, psychologist; director of integrated care, Cherokee Health Systems.
National Institute of Mental Health: "Psychotherapies."
NAMI: "Treatment and Services."
Substance Abouse and Mental Health Services Administration: "Acceptance and Commitment Therapy."
National Institute of Mental Health: "How is Depression Diagnosed and Treated?"

Much Love, Dr.Shermaine, #InformativeRead #PleaseShare #HealthyBodySoulAndSpirit #IWantYou2LiveWell

The Goal is to Always Make You Aware of What Concerns Your Body, Soul and Spirit, So You Can Have Open, Honest and Frequent Discussions With Your Physicians and Counselors. You Can’t Treat or Cure What You Don’t Know is Sick.

"It's Not Selfish to Love Yourself, Take Care of Yourself and to Make Your Happiness a Priority. It's a Necessity." (Mandy Hale)

"Self-Care is Not Selfish. You Cannot Serve From an Empty Vessel." (Eleanor Brown)

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“12 Signs of Depression in Men”

More than 5 Million Men in the U.S. Experience Depression Each Year!

Clinical Depression—in women or men—can cause sadness and a loss of interest in once pleasurable activities. But depression can sometimes manifest in different ways in different people.

"While the symptoms used to diagnose depression are the same regardless of gender, often the chief complaint can be different among men and women," says Ian A. Cook, MD, the Miller Family professor of psychiatry at the University of California–Los Angeles.

With that said, here are 12 Signs of Depression in Men:

FATIGUE: People who are depressed undergo a series of physical and emotional changes. They can experience fatigue, as well as psychomotor retardation, or a slowing down of physical movements, speech, and thought processes. According to Josh Klapow, PhD, a clinical psychologist with the University of Alabama at Birmingham's School of Public Health, men are more likely than women to report fatigue and other physical symptoms of depression as their chief complaints.

SLEEPING TOO MUCH OR TOO LITTLE: Sleep problems—such as insomnia, waking up very early in the morning, or excessive sleeping—are common depression symptoms. "[Some people] sleep 12 hours a day and still feel exhausted or toss and turn and wake up every two hours," says Dr. Cook. Like fatigue, sleep troubles are one of the main symptoms that depressed men may discuss with their doctor, experts say.

STOMACHACHE OR BACKACHE: Health problems such as constipation or diarrhea, as well as headaches and back pain, are common in people who are depressed. But men often don't realize that chronic pain and digestive disorders go hand in hand with depression, according to focus groups conducted by the National Institute of Mental Health. Norman Sussman, MD, a professor of psychiatry at the NYU Langone Medical Center, says people who are depressed do genuinely feel bad physically. "It is a medical disorder," says Dr. Sussman.

IRRITABILITY: Instead of seeming down, men who are depressed often show signs of irritability. "If they talk about an emotional component, it could be sadness with irritability," says Dr. Cook. In addition, says Klapow, negative thoughts are a common aspect of depression. "Men will report feeling irritable because they are having negative thoughts constantly," he says.

DIFFICULTY CONCENTRATING: Psychomotor Retardation can slow down a man's ability to process information, thereby impairing concentration on work or other tasks. "Depression fills one with negative thoughts, almost like an intrusion," Klapow says. "You're slowed down and constantly thinking about negative things in your world. As a result it makes it very difficult to focus on anything." "I describe depression as a form of reversible brain failure, Dr. Sussman says.  "When you're depressed, it's like your CPU [central processing unit] isn't working properly."

ANGER OR HOSTILITY: Some men manifest depression by being hostile, angry, or aggressive, says. Dr. Sussman. "A man who realizes something is wrong may need to compensate by demonstrating that he is still strong or capable," he says.  Anger and hostility are different than irritability. "Anger tends to be a stronger emotion," Klapow says. "Irritability is a crankiness."  Dr. Sussman says he's also seen men become hostile when they have withdrawn as a result of their depression and feel under pressure by friends or family to rejoin society.

STRESS: "Men might be more likely to report symptoms of depression as stress. It's not that they have more stress; it's that it's more socially acceptable to report it," Klapow says. According to Dr. Cook, stress and depression can also travel a two-way street. "It's accurate to say that feeling stressed can be an indicator of having clinical depression but also be part of the cause," he says. Research has shown that prolonged exposure to stress can lead to changes both in the body and brain, which can in turn lead to depression.

ANXIETY: Research has shown a strong link between anxiety disorders and depression. Men may be no more likely than women to experience anxiety—in fact, anxiety disorders are about twice as prevalent in women—but it's often easier for men to talk about feeling anxious rather than sad, Dr. Cook says. Men may discuss concerns about work and whether the loss of a job will impede their ability to provide for themselves and their family. "It may be easier to put words to worries and fears," Dr. Cook says.

SUBSTANCE ABUSE: Substance abuse frequently accompanies depression. Research has shown that alcoholics are almost twice as likely to suffer from major depression as people without a drinking problem. "It can happen for both men and women, but using drugs or alcohol to mask uncomfortable feelings is a strategy many men will employ instead of seeking health care," says Dr. Cook. "There's a cultural bias of, 'I should be able to fix this myself and so I'll use what chemicals I have available to me to do that,'" Dr. Cook says.

SEXUAL DYSFUNCTION: Depression is a common reason for loss of desire and erectile dysfunction (ED), and it's one symptom that men are inclined not to report. "Performance problems can come from depression and make depression worse," Dr. Cook says. However, ED can be the result of other medical conditions or medications (including antidepressants), and ED by itself does not signal depression. "My strong recommendation...is that you can't go after one symptom; it's a group of symptoms," Klapow says. 

INDECISION: "I can't count the number of people who have said, 'I had money in the bank but the phone got shut off because I couldn't bring myself to [pay the bill] or decide what to do and when.' It gets overwhelming," Dr. Cook says. Some people naturally have a hard time making decisions, so an inability to make choices is usually worrisome only if it's a new behavior. "It's an information-processing issue," and depression slows down your ability to decide, Klapow says.

SUICIDAL THOUGHTS: Women are more likely to attempt suicide, but men are more than four times as likely to die if they do attempt suicide. One reason is that men tend to choose more lethal methods. "They more often use firearms and kill themselves the first time they try," Dr. Cook says. Older men are at highest risk for suicide, and doctors may miss depression symptoms in this group. In fact, more than 70% of older suicide victims saw their primary care physician within the month of their death. Depression is not a normal part of aging in men or women.

{www.health.com} “What depression looks like?” By Lisa Zamosky

Much Love, Dr.Shermaine #InformativeRead #PleaseShare #HealthyBodySoulAndSpirit #IWantYou2Live

"It's Not Selfish to Love Yourself, Take Care of Yourself and to Make Your Happiness a Priority. It's a Necessity." (Mandy Hale)

"Self-Care is Not Selfish. You Cannot Serve From an Empty Vessel." (Eleanor Brown)

The contents of the Health Magazine and Self-Care With Dr. Shermaine Sites, such as text, graphics, images, and other material contained on the Health Magazine and Self-Care With Dr. Shermaine Sites ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the Health Magazine and Self-Care With Dr. Shermaine Sites!

If you think you may have a medical emergency, call your doctor or 911 immediately. Health Magazine and Self-Care With Dr. Shermaine does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Sites. Reliance on any information provided by Health Magazine, Health Magazine employees, others appearing on the Site at the invitation of Health Magazine, and Self-Care With Dr. Shermaine or other visitors to the Sites is solely at your own risk.