African Americans and Depression

African Americans and Depression - Julia Hastings, Lani Jones, Pamela Martin

What's the angle?
Hastings, Jones, and Martin - all three psychological researchers and all three African American - share some of their thoughts and research on depression in the African American community - a topic understudied and undertaught. They also provide a lot of encouragement to those suffering from depression, some advice on how to seek help, and a brief guide to America's health care (and mental health care) system.

What is depression?
They basically stick with the DSM definition, but also describe depression in case histories and examples.

What causes depression?
They don't specifically identify one cause or another, but simply say that depression has many causes - genetic, psychological, social, and/or environmental. They do, however, highlight a bewildering array of socio-economic stressors facing the African American community, not to place the root of depression in that sphere, but to demand that we understand depression in that context. For African Americans, social struggle is woven into in depression's cause and cure.

Religion and depression
They all mention spirituality and religion, in a positive way, and they explain that faith has been a key element in African American survival and mental resilience. They also note that, in the church, seeking psychological help can be seen as a lack of faith. Mental and emotional health are often thought to be the domain of spirituality.

Strength-building
Another refrain in the book is "encourage your strengths," or "play to your strengths," I'm paraphrasing. In the author's experiences, that seems to be a particularly important or effective.

Rates of Depression
They mention statistics of significantly higher levels of major depression in the White population than in the Black population. They suspect that some of that discrepancy has to do with the African American community being underdiagnosed for depression. I'm curious to know what more recent studies have shown.

notes

• Throughout American history the mental health status of African Americans has always been in question, and, according to Professor James S. Jackson, a noted researcher on Black mental health, has been 'used to justify slavery, enforce racial segregation, and reinforce the idea that blacks were inferior to whites.'
• Our strength as a people has always been discovering ways to maintain personhood against many adversities.
• With this daily assault on self-respect, the right to exist truly becomes an ordeal.
• John Henryism - working to exhaustion with little reward
• higher rate for major depression in Whites than African-American, but data may not be quite accurate
• the question as to whether African Americans, and Black people overall, exhibit different behavioral cues of depression remains debatable
• African American women are recognized as the most undertreated group for depression in the United States
• Men are more likely to report being very tired, exhibit irritability, lost interest in once pleasurable activities, and have difficulty sleeping
• although women are more likely to attempt suicide, a higher number of men die by violent suicide in the u.s.
• more than half of people suffering from depression cannot function well in meeting social obligations as a result of their mental illness
• the economically disadvantaged and the uninsured most particularly rely extensively on emergency medical services
• African Americans are overrepresented among emergency medial service users
• Af-Am are more likely to be considered gravely disabled or a danger to themselves or others and to be subject to involuntary commitment
• several factors may contribute to Af-Am's being properly diagnosed and treated
• mistrust, based on higher-than-average institutioalization
• cultural and language barriers
• reliance on family and religion
• the masking of depression by other medical conditions
• socio-economic factors, limited access
• only 1/3 of Af-Am with mental health difficulties use professional services
• a 2009 study found that 2/3rds of primary care physicians were unable to obtain mental health care for their patients who needed it
• Africentricity is both theory and practice that is rooted in a cultural orientation toward spirituality, interpersonal relationships, communalism, and expressive communication.
• bioecological theory
• microsystem - person to person interactions
• mesosystem - interconnectedness of microsystems
• exosystem - social environments not directly relevant, but involved
• macrosystem - cultural patterns and values
• chronosystem - periods of time or developmental stages
• the neglectful treatment of police brutality by the legal sectors of the u.s. expecially adds emphasis to the attack on the african american psyche.
• ...attempting to alleviate low feelings transforms into a search for a higher purpose and understanding
• experiencing depression tempts the mind to create suffering
• actually care for yourself
• ...there is something about discussing depression among African Americans that calls for hushed tones. We believe that no one needs to suffer unnecessarily when there are treatment options