A Black woman and girl sitting together with serious expressions

Out Of The Norm Depression Symptoms Leave ‘Strong Black Women’ Underdiagnosed & Untreated

A Black woman and girl sitting together with serious expressions
(Photo by Eye for Ebony” on Unsplash)

By Naja Ji Jaga

Maria Morales, 47, grew up in a time when mental health and depression were taboo topics. Because of this, she had never sought treatment for her undiagnosed depression. Then, she tried to take her own life. After her suicide attempt, she was sent to a psychiatric ward and given a second chance. A second chance at life. A second chance to feel normal again. A second chance to get the mental help she desperately needed. However, her call for help was met with a lack of concern from medical practitioners who could not offer any connection to her or her Blackness, causing her to turn away from the whole notion of mental health treatment.

Like Morales, many Black women dealing with depression symptoms struggle to get the help they need. That is partly because depression is a complex condition that often presents differently in Black women.

More than 1,500 combinations of symptoms meet the criteria for a depressive disorder, according to New York University. Consequently, standard depression screening tools may not capture depressive symptoms that Black women experience, according to a new study by researchers at NYU Rory Meyers College of Nursing and Columbia University School of Nursing.

>>>Read: We Need to Talk About Black Mental Health. We Shouldn’t Have to Die For People to Listen.

Black women with symptoms of depression more often report sleep disturbances, self-criticism, and irritability rather than stereotypical symptoms like low mood, loss of interest in activities, changes in appetite and feelings of hopelessness. These symptoms Black women experience may not be adequately assessed by standard tools used to screen for depression because they do not focus on addressing somatic and self-critical symptoms. This difference in symptoms is a significant part of why this population has missed care and suffered drastic undertreatment.

Although this new study highlights this issue, Black women’s consensus is that this is not new or shocking information. However, being misunderstood is an unfortunate reality of being a Black woman.

The screening tools are not the only reason Black women are underdiagnosed. Also part of the problem are the societal expectations placed on Black women. From a young age, many are instilled with the belief they must be strong and independent, whether it comes from family or society, and it carries over into mental health. Notions like this leave many Black women in a situation where they take their health into their own hands.

“There is a Black woman archetype of depression and how it presents itself. And I think I fall into that,” said Asianna Haughton, 19. “The high-functioning acts of dealing with school, bills and people-pleasing present themselves, and it is overlooked.”

After three years of trying to manage anxiety and depression induced by attention deficit hyperactivity disorder on her own, Haughton decided she needed outside help. Desperate to feel normal again, she found a therapist her insurance would cover, but Haughton’s concerns were initially dismissed, just like Morales’.

Given how common this is, it is no surprise to many Black women they are disproportionately untreated or that it takes so long to reach for outside help.

Physicians are supposed to care for them but don’t understand their background, and it doesn’t help that mental health is also often misunderstood in the Black community.

Like many Black women, Jayde Best, 19, didn’t know much about mental health or how to practice self-care, leaving her confused about her depression symptoms.

“Mental health care wasn’t something really talked about to me,” Best said. “So I didn’t really know what taking care of my own mental health was until I got into high school, and when I first felt like something was wrong, a lot of it was self-diagnosing.”

All the women interviewed for this story said they were not initially given the necessary help and support for their mental health and felt forced to find solace and solutions through self-diagnosis. They’re taught to believe seeking help is a last resort — if it’s a choice at all. So getting past this stigma is a pivotal first step for Black women. However, the next steps in treatment rely on the medical practitioners. They must understand or be ready to consider their backgrounds and then provide the best assistance and environments that suit these women.

Change can come by implementing screening tools that account for differences in depression symptoms and urgently addressing disparities and mental health burdens. Additionally, access to mental health services needs to expand broadly, but Black women especially need providers from the same backgrounds, from communities like theirs.

Haughton and Morales, after they finally built up the courage to ignore the stigma around seeking mental health treatments, said they get the best treatment from a woman of color.

“Now, I am in therapy with a Jamaican woman, which is the best thing ever,” Haughton said. “It makes you realize how much we hold in as Black women, especially because we’re told to be strong Black women, and you don’t realize how much you internalize it when you have a person who frequently checks in on you.”

“I found a therapist that I don’t necessarily have to over-explain everything about my existence to,” said Morales. “It wasn’t until I had finally found a woman of color therapist that I began to feel very comfortable speaking and to be my whole intention self while actually feeling like I’m getting help.”

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