Depression is as prevalent a problem as it is for the population as a
whole, affecting 6% in any year. Within the black community there are
groups whose experience or environment makes them especially vulnerable
to depression and other mental health disorders.
By
Hara Estroff Marano, published on September 30, 2003 - last reviewed on April 13, 2007
She sees anger especially among women struggling with a sense of loss and abandonment over not having had a male presence in their early life. "It sets women up to feel negative about themselves, especially if they are not in a relationship," she says. And it leads to difficulty in relationships, playing out powerfully in relationship conflict, a common source of depression among all women.
The high mortality rates for heart disease and stroke and the prevalence of high blood pressure, obesity and diabetes are also traceable to depression, points out Bell. "Stress shows up not only as depression," says Bell. "It also shows up in obesity, hypertension and anxiety disorders."
What's more, it's become clear over the past several years that depression and heart disease don't just frequently co-exist, each leads to the other. Depression makes existing heart disease especially deadly; it also actually spurs the development of coronary artery disease.
African Americans are over-represented in populations that are particularly at risk for mental health problems. A disproportionate number of blacks live in poverty, a potent stressor in itself.
But poverty also contributes to toxic living conditions that supply both adults and children, the most vulnerable members of the population, with multiple forms of adversity. Blacks witness and experience more violence. They require more childhood protective services. "The adverse childhood experiences of blacks lead in adulthood to alcoholism, drug abuse, depression and suicide," says Bell, as well as hypertension, heart disease and obesity.
Mental health problems are definitely not confined to those of low-income status. As African Americans climb the socioeconomic ladder, the stresses on them often shift from more visible external ones to more subtle internal ones, taking their toll on mental health nonetheless.
On the basis of reports from her clients and her own experience, Morrow contends there are huge sources of stress in the workplace, especially for blacks in the upper middle class. Often, they are treated as if they do not deserve to be there. As a result, they feel intense pressure to outperform colleagues, just to gain acceptance.
"Clients are not always aware that these situations of subtle discrimination lie behind depression," says Morrow. "Providers need to be aware."
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