It took Imade Nibokun Borha years to recognize that depression wasn’t just “a white person’s disease.”
The San Francisco-based writer, 31, first realized she struggled with depression during a bout of unemployment around 2008. Another episode of depression and suicidal thoughts during her 2012 University of Southern California grad-school stint, including a reckless hurtle down a Los Angeles highway, finally spurred her to seek help. “I wasn’t proactive. I waited way too long to get treatment,” Borha told Moneyish.
After all, the overall message she’d received growing up in a religious household was that mental health treatment was “for white people”: “Black folks don’t need it — we’re strong,” she summed up the argument. “We’ve been through slavery; we don’t need all that.” Borha’s mental-health journey would inspire the blog “Depressed While Black,” which she has since expanded into an in-progress memoir and online community that shares mental health stories through an African-American lens.
African Americans are 20% more likely than the general population to experience serious mental health issues, according to the Health and Human Services Department’s Office of Minority Health. They are also more likely to experience conditions like homelessness and exposure to violence, both of which can heighten the risk of developing a mental health condition.
And a host of other stressors weigh on black women. For one, they “face more in terms of barriers and bias” with respect to both gender and race, board-certified psychiatrist Dion Metzger, co-author of “The Modern Trophy Wife: How to Achieve Your Life Goals While Thriving at Home,” told Moneyish. Those include workplace microaggressions, harassment from both police and non-police (think “BBQ Becky”) and “your normal, everyday garden-variety racism,” licensed psychologist Joy Harden Bradford said. Moreover, police killings of unarmed black people “have adverse effects on mental health among black American adults in the general population,” a June study in The Lancet found.
Black women often serve as “the therapists of their families,” Metzger added, and also take on the breadwinner role. (Upwards of 80% of black mothers serve as breadwinners, compared to 50% of white mothers. Meanwhile, black women experience higher rates of poverty than black men and all other groups of women aside from Native Americans, and make an average 63 cents on a non-Hispanic white man’s dollar.)
“For the most part, we have been the ones that are holding our families together and holding our communities together — the nurturers, the supporters — but at the same time not necessarily being nurtured or being supported in the roles that we’re carrying out,” Association of Black Psychologists president Huberta Jackson-Lowman said.
But a variety of factors keep some within the black community from seeking mental health treatment, experts say. For starters, Bradford said, the tense history between the black community and medical institutions (the unethical Tuskegee syphilis experiment, for example) can complicate the notion of wanting to speak with a therapist. “Historically, many of us come from families and homes where talking to a stranger about personal stuff is not OK,” she added.
People can also be made to feel like their faith relationship is not strong enough if they’re struggling with a mental health disorder, Bradford said. “Something that’s very common in the black community, in terms of when you say you’re stressed or you’re worried, is you either get told to pray about it or you’re told to get over it, basically,” agreed Brooklyn-based freelance writer Ashley Simpo, 34, who was raised in a religious household. “That’s kind of been the first response: ‘Well, give it to God, talk to Jesus, pray about it.’”
Jackson-Lowman added that the mental health stigma seen in broader society is “very entrenched” in the black community. The issue can be viewed as a weakness, she said, “in part because it’s judged against the history that we’ve led — and that is that if our ancestors have been able to survive the harsh and horrific conditions that existed through our enslavement, then why is it I can’t just address these issues that I’m facing now?”
“Our parents and our grandparents have come from such unimaginable trauma. We have grandparents who lived in the South when there were people being lynched,” Simpo said. “There’s a lot of ‘Just be thankful that you have a job,’ or ‘Just be thankful that you’re alive.’”
A relative scarcity of black mental health professionals may also pose a barrier: Just 5.3% of the active psychology workforce in 2013 was black or African American, according to the American Psychological Association. “Of course, the way that translates: If black people are looking for black therapists to go to, then there are not enough of us to go around,” Bradford said. Metzger, for her part, said many of her black female patients had sought her out because they wanted to talk to someone who understood their experience. (Of course, Bradford added, people should make sure their therapist has the relevant experience and specialization for their needs.)
“It is helpful to see a black woman therapist, just because there’s already an understanding (of) what societal stressors already exist most likely in your life,” Simpo said, citing by way of example “the whole bucket of emotions” that accompanies raising a black son in America. Borha recalled some non-black therapists second-guessing her accounts of racist incidents she’d experienced. “The challenge for me as a black woman,” she said, “is finding a therapist that affirms my perspective and then helps me to navigate (a) world that doesn’t value black women.”
So these mental health professionals are working to encourage black women to get whatever help they may need. Bradford operates a national directory of 1,000-plus therapists, mostly black women, who provide “high quality, culturally competent services” for black girls and women; she also hosts a weekly “Therapy for Black Girls” podcast. Metzger uses her public platform to urge people within the black community to seek out mental health services. She warns of potential consequences of untreated mental health symptoms, including suicide, substance use and physical illness. “If we don’t treat it, it may kill us — literally,” she said.
Bradford urged the therapy-reluctant to “get rid of the notion that therapy is only for crisis situations” and poke around therapists’ websites, social media profiles and video content to see who might be a good fit — and not to be discouraged if they have to date around a bit before finding the right one. Metzger suggested calling or sending an email to just one therapist’s office to get the ball rolling.
After all, she pointed out, “depression is really, really common.” (Nearly 7% of the U.S. adult population had at least one major depressive episode in 2016.) “A lot of people think it’s something that just ‘crazy’ people have or just weak people have, and that just couldn’t be more wrong,” Metzger said. “This is something that a lot of people get, and it’s something that can be treated — there’s no reason to continue to suffer for years when it can be treated now.”