What to know about depression in Black communities

Share on Pinterest

Depression is a complex illness that can affect someone’s relationships, mental wellbeing, and physical health. Researchers have not identified a single cause that triggers this condition. Instead, several risk factors may predispose people to depression.

Regardless of race, the most common causes of depression include:

• Genetic factors: Depression seems to run in families, which suggests there might be a genetic link.
• Biological factors: Physical changes in the body may increase the risk of depression. Certain medications or medical conditions may alter a person’s brain chemistry.
• Environmental factors: Stress, trauma, and abuse may increase a person’s risk of depression. The risk may also rise in difficult situations, such as following the loss of a job or relationship.
• Psychological factors: A person’s temperament, psychological makeup, and worldview may increase their risk of depression. For example, people with a negative outlook may be more vulnerable.

Some Black people may face unique risk factors for depression, including:

• exposure to racial trauma
• difficult life circumstances due to racism
• racial barriers to access care, including racism from care providers and mental health stigma

A 2014 study of Black women in a primary care setting found that 49% had symptoms of depression, and 10% experienced suicidal thoughts. Participants who had higher resiliency scores had fewer symptoms of the condition. Depression correlated strongly with unemployment, having a prior mental health condition, and having a chronic disease.

Another 2014 paper emphasizes that Black people have higher exposure to numerous forms of violence, including domestic violence. This increases their risk of depression alongside another mental health disorder.

Symptoms of depression are the same in Black and non-Black people, though symptom profiles can differ from person to person. Because Black people may struggle to access treatment, their symptoms may become more serious in the meantime.

Additionally, stigma may cause some Black people to conceal their depression symptoms.

Some signs of depression include:

• feeling sad or depressed all or most of the time
• losing interest in activities a person used to enjoy
• changing sleep patterns, such as sleeping too little or too much
• changing appetite, such as eating too much or too little
• unintended weight loss or weight gain
• feelings of hopelessness
• feelings of worthlessness
• low energy and fatigue
• loss of motivation
• feeling agitated or struggling to concentrate
• unexplained physical complaints, such as headache, muscle pain, or nausea
• relationship problems due to depression symptoms

Depression symptoms may also color someone’s perceptions. They may cause people to believe that treatment will not work, or the problem is because of personal failings, not a mental health diagnosis.

Healthcare providers sometimes fail to notice and treat depression in Black people. Some studies suggest clinicians are less likely to recognize or take a wide range of health symptoms seriously, when they involve Black people.

Racial stereotypes continue to exist within medical care, so Black people who think they may have depression should advocate for themselves and seek treatment from a culturally competent provider. Ideally, this should be someone who routinely treats depression in Black individuals.

Research generally suggests that depression rates in Black people are similar to or slightly lower than those of whites. One study found a lifetime depression rate of 10.4% among Black people and 17.9% among white people.

However, most studies find that when Black people do develop depression, the condition lasts longer. They may also be more likely to have co-occurring diagnoses, such as addiction, post-traumatic stress disorder, and generalized anxiety disorder.

Racism and stigma within the mental health profession may intensify the effects of depression. Doctors and other care providers provide lower rates of treatment for Black people with depression than their white peers.

Black mental health consumers may not get culturally sensitive care, particularly when white clinicians fail to recognize racism and racial trauma.

Many people with depression have thoughts of suicide. Suicide rates are rising among some groups of Black Americans. Black high schoolers report suicidal thoughts at a rate of 9.8%, compared to 6.1% among white students. And while suicide attempts declined among white teens between 1991 and 2017, it rose 73% in the same period among Black teens.

Depression is a serious illness. Like any physical ailment, it requires the right treatment, and finding this can take time. Yet people with depression routinely encounter myths about the disease.

Some of the most common myths include:

• If depression treatment does not work immediately, it will not work: Many people need to try several treatments or combinations of techniques to get results.
• Medication is the only way to treat depression: There are many treatment options, and people who wish to avoid drugs may find relief from therapy.
• People should be strong enough to overcome depression: Someone cannot think or pray their way out of this condition. Depression changes the brain and body.
• Depression is sadness: While many people with depression feel sad, it can also cause anger, physical pain, and changes in the way they think.
• Black people are inherently resilient, and do not need therapy: While Black Americans have faced much adversity, a person cannot think their way out of depression, any more than they can think their way out of heart failure or diabetes.

Mental health stigma is prevalent everywhere. Some research shows it is more influential in the Black community, particularly among Black men. Stigma might affect a person with depression by:

• Deterring them from seeking treatment because they are afraid to admit they need help.
• Making them think that their depression is their fault or the product of personal weakness.
• Feeling embarrassed to lean on others for support.
• Worrying about how racism may affect their experience of mental healthcare. Several studies suggest that many healthcare providers believe in racist myths about Black patients.

Depression is treatable, even if sometimes it does not feel that way. Most people have to try different treatments to get the best relief. The most effective treatments for depression include:

• Medication: A wide range of drugs help with depression. Some people might need to try a combination of medications, or different doses of a single drug.
• Therapy: Therapy can help a person process negative emotions, cultivate coping skills, heal their relationships, and understand the connection between their thoughts and feelings.
• Lifestyle changes: Many people with depression find that more exercise, healthful changes in diet, and quality sleep can help.
• Residential treatment: People with severe depression may need residential treatment.
• Alternative therapies: Some people find additional support from acupuncture, meditation, and other alternative remedies.

Depression can cause intense sadness, but it can trigger a complex blend of other symptoms.

Many people with this condition believe their case is hopeless, which can deter them from seeking treatment. With the right care, even people with severe depression can feel better.

Black people may get the most effective treatment from culturally competent therapists who specialize in Black mental health.