Fighting 'the blues' in African-Americans

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Fighting 'the blues'
In African-Americans

Are you a black person in a blue funk that just won't go away?

Do the things that once gave you pleasure now seem uninspiring, and are you sleeping and eating a lot more or a lot less than is normal for you? If the answer to these questions is "Yes," you may be depressed. But you are not alone. About 17 million people a year suffer from depression, mental health experts say.

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African-Americans, Psychotherapy & Spirituality (Dr. Ivan Walks, the chief health officer for the District of Columbia, talks about the high rate of suicide among young black males. Walks says the numbers reflect the widespread availability of firearms in the African-American community, and highlight the need for better treatment facilities for black men who suffer from mental depression.)

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And if you are an average black person in America, you are more likely than an average white person to suffer depression.

You don't have to remain depressed, however. Dr. Freda Lewis-Hall, a psychiatrist who has worked extensively in the African-American community says not nearly enough blacks who are depressed seek professional help. "Most either believe that depression, or the "blues," is a necessary condition of life and must be endured, or they fear being labeled as insane and therefore do no seek professional help," says Dr. Lewis-Hall.

In addition to dramatic changes in sleeping and eating patterns, Dr. Lewis-Hall says symptoms of clinical depression include "changes in energy level, so that there is a lack of energy; not enjoying things that were previously enjoyed, like you've gone to church every Sunday, but for weeks you can't get up and go to church. You just feel so depressed."

A survey by the National Mental Health Association revealed that only one-third of all persons with major depression ever seek treatment. According to the study, African-Americans and persons over 65 years old are the least likely to seek professional help for depression.

Dr. Lewis-Hall, who is a clinical research physician at U.S. Medical Operations and is director of the Women's Health Center at Eli Lilly and Company, stresses that most depression cases are treatable. "In fact, more than 80% of people with clinical depression can successfully recover and resume normal, happy and productive lives," Dr. Lewis-Hall stated in a paper on clinical depression in the African-American community.

Dr. Lewis-Hall said the medical community could not say in every case precisely what caused depression but had identified certain factors that could either cause depression directly or predispose a person to be depressed.

"What we believe is that, number one...depression seems to run in families, and so we know that there is some predisposition, some genetic piece to it," she said. "The other piece of it is what happens in the environment. And there are certain things that we recognize as risk factors for the development of depression, and they include things like having been a victim of abuse, or violence, poverty, chronic or serious illnesses - cancer, heart disease, diabetes. We think that people with chronic illnesses have systems that are likely to develop other illness, that there is an actual change in the physiology of the person that actually leads to the development of depression."

Dr. Lewis-Hall adds that not everybody that gets diabetes also gets depression. Not everybody that's hospitalized for very serious illness gets clinical depression. "One would think that if you went into a population of people with cancer everybody would have depression, because having cancer is a depressing thing. But the reality is that only (20-35%) percent of them actually go on to develop this medical illness that we call depression. They may be sad at some point after hearing the diagnosis or after going through the treatment, but to actually develop (depression), not everybody does it."

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Nonetheless, the 20-35% percent rate of depression among persons with serious or chronic illness is likely to account for a larger portion of the black population than the white population, since African-Americans suffer conditions such as high blood pressure, heart disease, diabetes and lupus at a significantly higher rate than whites.

Additionally, some mental health experts believe that the stresses of racism and the attendant social undervaluing of the victims of racism lead to low self-esteem among those persons. Therefore, the stress of encountering racism and the low self-esteem caused by it are thought to be contributors to depression in some African-Americans, Dr. Lewis-Hall said.

To improve their chances of overcoming depression, African-Americans who are afflicted- and their friends and families - need to recognize the cultural norms and myths in the African-American community that contribute to depression and the tendency to live with it untreated, Dr. Lewis-Hall said. And sufferers need to seek professional help for their depression, she said.

Citing her own experience as an African-American and a mental health expert diagnosing and treating depression in African-Americans during an Urban Corps assignment in Washington, D.C., Dr. Lewis-Hall said "the stigma continues to be great." The relative isolation of African-Americans from the U.S. information mainstream has prevented them from being full beneficiaries of the aggressive public education campaign on depression that has been carried on in the media in recent years, Dr. Lewis-Hall said.

That campaign has helped white Americans and many other non-African members of U.S. society to improve their attitudes and approaches to depression, while African-Americans mostly have been left behind, still clinging to unhealthy beliefs about depression and the stigma of insanity.

"We don't often have an opportunity to hear depression described as the medical illness that it is," she said. "If we look at the exposure of African-Americans to things that we recognize as risk factors in developing depression, (we see that) we get exposed to those more often. What we don't think is that there is a genetic predisposition on the part of African-Americans to be depressed."

Significantly, the risk factors that predispose many African-Americans to depression frequently affect another visible group of persons in the U.S. - immigrants. Because immigrants tend to be poorer than the mainstream population, and because many of them also experience racism and are often undervalued as persons, they too experience high levels of depression.

Some immigrants feel isolation and hopelessness and slide progressively into depression under the weight of language barriers, cultural differences, poverty, racism and generally being undervalued.

"There have been number of studies that have been shown that immigrants to this country, and to other countries, are clearly at risk for the development of depression and other mental illnesses. That is because immigration is one of the toughest of all stressers," Dr. Lewis-Hall said.

The stress of immigration "includes loss of people that you love because you usually leave them behind. It changes your entire perspective. It changes everything. It changes where you live, where you work, who you socialize with. And as much as many cultures are pliable in accepting people who have immigrated there ... immigration still is an enormous stresser unto itself," she said.

some statistics on Blacks and Mental Health are included in the 1999 U.S. Surgeon General's report on mental health

Fighting 'the blues' In African-Americans

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Fighting 'the blues'
In African-Americans