By Daryl Moore
Naomi Osaka, the second-ranked woman in tennis, withdrew from the French Open, citing concerns for her mental health. “The truth is that I have suffered long bouts of depression since the US Open in 2018 and I have had a really hard time coping with that,” Osaka stated, breaking her silence on social media. Additionally, Osaka has since pulled out of Wimbledon.
I, too, though not a celebrity athlete, face bouts of depression and anxiety. In fact, many in the Black community do though we don’t always get the proper treatment. Addressing this very real concern, Nicole Cammack, licensed clinical psychologist and President and CEO of Black Mental Wellness, Corp., cited the National Alliance on Mental Illness (NAMI): Overall, 1 in 5 adults in the U.S. experience a mental health condition. Black adults in the U.S. are more likely than White adults to report persistent symptoms of emotional distress, such as sadness, hopelessness and feeling like everything is an effort. Despite the needs, only 1 in 3 Black adults who need mental health care receive it. According to the American Psychiatric Association’s Mental Health Facts for African Americans guide, they are also less likely to receive guideline-consistent care, (less frequently included in research), and more likely to use emergency rooms or primary care (rather than mental health specialists).
Angela Neal, Ph.D., director of Program for Research on Anxiety Disorders among African Americans (PRADAA), said we probably don’t even know full statistics because there are people who don’t recognize they are experiencing depression or anxiety. “For many, it’s generational,” said Neal, “so they think that’s just the way it’s supposed to be. Others put up the strong black man/woman image because to admit it is weakness and to be weak and black is an oxymoron. The way many of us deal with depression is to self-medicate with marijuana or alcohol, or by overeating. We don’t talk a lot about anxiety in the black community. We say we have nerves, or someone is getting on your nerves, or getting on your last nerve. We don’t talk about panic attacks.”
With those troubling facts in mind, it’s time for a change in how anxiety and depression is perceived in the black community. To that end, I submit my story here. No one’s journey through life is the same, in any aspect, and mental health issues are no different. Nevertheless, I’m going to share parts of my journey in the hopes that it may help another.
My Personal Backstory
My mother ran away from my alcoholic biological father shortly after I was born in Washington D.C. He beat my mom, so when she finally escaped, she told no one her whereabouts. Nevertheless, somehow, he found her.
And threatened my life.
So, she went back.
Around the age of 4, my father left us for good. I never saw or heard from him again. For a short time, family reluctantly took us in, but soon turned their back on us.
So that meant we were homeless, not a rare occurrence in our community. African-Americans comprise 40% of the homeless population in the United States. My mom and I, now 5, bounced around from homeless shelter to homeless shelter. In fact, my most vivid holiday memory as a child is celebrating Christmas in one of these homeless shelters. All of us kids were handed out gifts that were donated to the shelter, mine being a yellow whiffle bat and ball.
By this time, we had been forced across the country to Richmond, California – a city described as worse than Compton. It was here that my mom met my stepfather.
The good news was he didn’t beat her.
The bad news was he beat me.
My stepfather, like my biological father, was an alcoholic. He had a bad temper and when he got drunk, he would take it out on me. At least once I went to elementary school with a black eye handed out by my stepfather, which my mom tried to cover it up with make-up.
For some reason, there is even a picture of this atrocity in our family photo album.
On the plus side, my stepfather got us out of the homeless shelters by working manual labor jobs. He was physically strong and could fix any car. Problem was, he never finished past fifth grade so he found it hard to find steady employment, which in turn meant we always lived in abject poverty. I remember many days not eating at all. When we did eat, it might have only been government cheese that came in an orange-yellow block that didn’t exactly seem edible because it was the only cheese I’d ever heard of that could hardly be melted. Or we drank powdered milk, also a government handout. We lived in rat-infested apartments, surrounded by crime and despair. On more than one occasion, we went without electricity. But at least we were no longer in homeless shelters.
I relocated a lot as a child, which in itself can be traumatic. A 2010 study published in the Journal of Personality and Social Psychology looked specifically at the long-term effects repeated moves had once children reached adulthood. The study found that the more frequently a child moved, the more likely they were to report feelings of unhappiness and dissatisfaction, as well as fewer quality social relationships overall — and this was even after controlling for factors such as age, gender, and education level.
“We know that children who move frequently are more likely to perform poorly in school and have more behavioral problems,” said the study’s lead author, Shigehiro Oishi, PhD, of the University of Virginia. “Moving a lot makes it difficult for people to maintain long-term close relationships. This might not be a serious problem for outgoing people who can make friends quickly and easily. Less outgoing people have a harder time making new friends.”
Eventually we wound up back in Maryland, where when I was 10, a teacher noticed a gash in my forehead caused by my stepfather and called the police. I was taken from my mom and stepfather and placed in a foster home for a very short while. We went to court over the matter, yet soon enough I was back living with the very man who injured me.
I was beaten down mercilessly with canes, rulers, fists, or anything else my stepfather could get his hands on. One time my tooth was chipped. With everything we know now about concussions, I wonder how that sort of trauma affected my mind at such a young age, particularly while my brain was still developing. Would I have been smarter if I had been allowed to grow without blunt force trauma to my head? How did it affect me emotionally? Or chemically?
Of course, as with most cases, emotional abuse accompanied my physical abuse. My stepfather repeatedly told me how stupid I was, despite my teachers emphasizing otherwise, as evidenced by putting me in advanced and/or gifted programs.
I’m sure there are others out there who are going through or have gone through similar situations. Facing conditions like this, is it any wonder that depression among black youth is 30% higher than average for their age group? Unfortunately, the abuse worsened as I grew older, so as soon as I could, I escaped to the Army.
As a child though, my child abuse didn’t affect as much as perhaps it could have. I didn’t block it out, per se – I remembered every detail. At the same time however, I didn’t dwell on it. I guess it was just normal to me. I knew no other life after all. But when I came back from the military to go to college, it all rushed back to me like a tidal wave. It hit me so hard in fact, I was overwhelmed to the point where I dropped out of college after 2.5 years. I couldn’t sleep and when I did, I had nightmares. I was always stressed. I often felt like I couldn’t breathe. I was drowning, suffocated by my misery.
It was it this point I started having suicidal thoughts. Again, this was something I experienced in which I was not alone. Across a 15-year span, suicide rates increased 233% among African Americans aged 10-14 compared to the 120% among Caucasian Americans in the same age group across the same span of time. Though I was not in this age range when I started recognizing my suicidal thoughts, I wondered if I had had them all along, but suppressed them. Either way, the stats are startling.
But it doesn’t stop there. Sean Joe, PhD, MSW, Benjamin E. Youngdahl Professor of Social Development, said anxiety impacts everyday life and is the strongest psychiatric predictor of attempted suicide among Black Americans (Joe et al. 2006). “Addressing anxiety is critically important for women’s health, but is a more deadly serious concern for black males,” Joe said. Depending on the age group, black males account for 60 to almost 90% of all suicide among black Americans. Among Black Americans, it is those 35 and younger who die more by suicide (Joe 2008, CDC). In contrast, among White Americans, it is those over the age of 65 who account for most of their suicides. “So, we’re losing future generations,” said Joe, “while Whites are losing past generations.”
But how would I kill myself? When? Where? See, though I contemplated those questions often, I never formulated definitive answers. I never actually planned anything out. That’s when I realized I didn’t want to kill myself. I just didn’t want to be alive. Or a better way to put it is, I didn’t want the life I had.
I also worried that life could get worse. African Americans with mental health conditions – especially those with psychotic symptoms – are more likely to be incarcerated than people of other races. As such, I feared that I would soon end up dead or in jail.
Shortly after I dropped out of college, I went to Atlanta to pursue my dream of becoming a writer. Homeless yet again, I was able to sleep on the floor of a friend’s girlfriend, then when she kicked me out, I snuck in to a vacant apartment and slept there. I wasn’t quite living like an animal, but I wasn’t actually living like a human being either. I was basically just surviving. Barely existing, actually.
Eventually I found a job at a gas station and slowly but surely, finally was able to rent a room in the very apartment building I had broken into. Many heartbreaking years later, I got my first article published. Sidenote: The very first article I got published was for Essence magazine about being abused as a child, chronicling how hard it was to forgive my mother for allowing it to happen.
Eventually, my suicidal thoughts grew unbearable. Thoughts of killing myself consumed me, all day, every day. I began missing work, often weeks at a time. Luckily, my workplace allowed me to take FMLA (Family and Medical Leave Act) without losing my job. Before that, I very rarely took off any days for sickness or vacation, so I had plenty of leave built up. Thankfully, I called the veterans suicide hotline before it was too late, which enabled me to speak with a mental health professional for free. They diagnosed me with anxiety and depression, while also informing me that I have abandonment issues. Of course, they recommended continued therapy and meds, which I declined.
My reasons for declining the help offered start with my fear of being dependent on anything as a crutch. For instance, I don’t drink. Never have. I have had maybe a few sips of champagne and perhaps a half a beer in my whole life. Yet, I consider myself an acholic that just has never drank. Why do I say that? Because my biological father was an alcoholic, so I feel like I’m predisposed to be an alcoholic, genetically. My stepfather was an alcoholic, so I feel like I’m predisposed to be an alcoholic, emotionally. It goes back to the age-old question about nurture versus nature. Well, I feel like I’m down on both counts, so I don’t even risk it. Same thing for drugs. I’ve never even tried weed or any other drug. Not once, although to be honest, I believe I’d love marijuana. I feel like it would definitely calm my mind, giving me perhaps a little measure of the peace I’ve been craving all my life. Yet, that’s what scares me the most – getting that peace and never wanting to let go of what caused it. I’m so terrified in fact, I am reluctant to take even aspirin or cold meds unless absolutely needed.
So, as I said, it’s that fear of losing control and becoming dependent on a crutch that also drives me to not take prescription meds, not even for depression. After a lot of thought, I have decided I would like to try as many nonmedical methods as possible before I go that route. Same with therapy. At least that’s how I feel as of this moment. But that doesn’t mean that I won’t change my mind in the future.
Why do African-Americans Deal with Anxiety & Depression the way they do?
Dr. Alfiee M. Breland-Noble, founder of the AAKOMA Project, Inc., said psychosocial barriers such as stigmatized attitudes toward depression treatment, reliance on non-clinical faith-based supports, and concerns about the lack of cultural relevance of treatment, often play a role in the lack of treatment utilization by African Americans (Breland-Noble, 2004).
For example, Black youth report that seeking professional help for mental health can be associated with social stigma (Breland-Noble, Harb, & Williams, 2015).
In general, research suggests that an individual is less likely to endorse stereotypes about mental illness if they have had more intimate contact with a person with a severe mental illness. “In our AAKOMA Project research,” Breland-Noble said, “teens of color reported modest levels of contact with individuals with severe mental illness. We found these youth less likely to endorse negative stereotypes about mental illness, or stigmatize mental illness and stigmatize receiving help for mental illness.”
NAMI Maryland Executive Director Kate Farinholt said one of the oldest and sometimes only emotional outlet and support for African Americans has been the church. According to the Pew Research Center, 91% of Black Americans say religion is somewhat or very important to their lives and can be a critical path to healing.
Not for me though. Many a night I cried myself to sleep, begging God – no pleading with Him, to grant me a reprieve. Not only did I never get my respite, I never heard a word of reply.
One of my favorite passages is by Langston Hughes, who once upon a time, wrote for this very paper. It’s from “Salvation” from The Big Sea:
“But I was really crying because I couldn’t bear to tell her that I had lied, that I had deceived everybody in the church, that I hadn’t seen Jesus, and that now I didn’t believe there was a Jesus anymore, since he didn’t come to help me.”
Like most of America, I was raised Christian. I even studied to be a pastor at one point. However, like Hughes’ passage spoke about, no deity helped me. And it wasn’t just Christianity that let me down. I explored other religions also, but I found no answers.
Certainly though, religion and spirituality can play a piece in the healing of mental health. “People often report that engaging in spiritual or religious activities helps them cope with adverse circumstances, relieve stress, and provides a sense of meaning and purpose in their lives,” said Cammack. “Enhancing your spiritual or religious practice can improve your mood, your outlook on life, and give you a sense of inner strength.”
However, this can also be a double-edged sword. “Historically, mental health issues were deemed a ‘vice of the Devil’ and the solution was prayer and stronger faith,” Farinholt said. “Despite many advancements, this rhetoric is still echoed in churches today. Many in Black communities have heard fragments of stories like the one about the aunt with ‘bad nerves’, or the distant relative who ‘just has not been right since…’. Rarely, if ever, are their treatments discussed.”
In short, religion doesn’t have to be the sole treatment. “Some people may incorrectly believe that religion and faith should be enough to heal their mental health concerns, but this is not true,” Cammack said. “You can practice your religion and seek the help of a mental health provider, in the same way that you would seek a medical provider or dentist for other concerns. Many religious institutions are beginning to seek mental health providers for their membership and are providing programs related to mental health to help educate members of their church.”
Farinholt said ensuring that faith leaders are educated about mental health issues and know how to be transparent and inclusive is critical to shifting the narrative and breaking down stigma in Black communities.
Cammack’s tips for dealing with anxiety and depression, spiritually:
- Pray or create a prayer journal
- Sing or listen to uplifting songs
- Read devotionals or something that speaks to your spirit
- Fast from something that will challenge you
- Connect with others that have a similar belief system
- Create a personal space that is free from negative energy
Interestingly enough, a recent study from the Journal of American Medical Association showed evidence that there is less sexual activity going on than in earlier generations, according to Cammack.
Surprising, because for me, sexual release is the most effective way to treat my symptoms of anxiety and depression. It relieves tension or nervousness, releases pent up energy, and aids better sleep. Farinholt noted that sex releases endorphins and oxytocin which can improve your mood and mind.
On the flip side, Farinholt further said that mental illness can disrupt your sex life in many ways. For instance, research from National Institutes of Health (NIH) has shown that anxiety at the start of a person’s sex life is one of the most common causes of sexual dysfunction, since anxiety can override sensations of pleasure during intercourse. Depression also has a host of sexual issues, including impotence, erectile dysfunction, sexual pain, and loss of desire. Furthermore, the side effects of certain medications may event reduce your desire for sex, your ability to get aroused, and your ability to maintain an erection or achieve an orgasm.
It’s not all our fault
Breland-Noble said one of the key factors driving mental health disparities is the lack of funding at the federal level for Black researchers: “Data tells us definitively that Black researchers are penalized and unable to obtain federal monies (funded by all Americans’ tax dollars) to support our leadership of the research that will drive culturally relevant solutions for Black people.” Breland-Noble said. “This leaves significant gaps in our knowledge base and in our efforts to support Black scientists invested in this work. I have worked closely with Congresswoman Bonnie Watson Coleman of NJ to spearhead efforts to drive change to reduce systemic and structural racism in the process of securing federal funds to help Black investigators secure the money needed to create interventions to help Black people with mental health concerns. One of our recent victories is the passage of HR 1475 the Pursuing Equity in Mental Health Act of 2021 in the House with hopes that it will soon pass in the Senate and eventually become law.”
There is substantial evidence of racial and ethnic disparities in community mental health care. As documented by the U.S. surgeon general’s report on mental health, racial and ethnic minorities have less access to mental health services than white people, are less likely to receive needed care and are more likely to receive poor-quality care when they are treated.
Farinholt agreed: Although anyone can develop a mental health problem, national trends tell us that Black people in particular experience more severe forms of mental health conditions due to unmet needs and other barriers. According to the Health and Human Services Office of Minority Health, Black Americans are 10% more likely to experience serious psychological distress. And, like many minority communities, are also more likely to experience socioeconomic disparities such as exclusion from health, educational, social and economic resources. These disparities may contribute to worse mental health outcomes.
Farinholt explained that knowing the warning signs of mental illness and when to begin seeking help is one of the best ways you can start dealing with a mental health issue. “The earlier someone is diagnosed, the earlier they can get into treatment and into recovery,” said Farinholt.
Farinholt said the most common warning signs of a mental illness are:
- Feeling sad or withdrawn for more than two weeks
- Severe mood swings that cause problems in relationships
- Intense worries or fears that get in the way of daily activities
- Sudden overwhelming fear for no reason
- Seriously trying to harm or kill oneself or making plans to do so
- Not eating, throwing up, or using laxatives to lose weight
- Significant weight loss or weight gain
- Severe out-of-control risk taking behavior that can pose a serious danger to oneself or others
- Repeated use of drugs or alcohol
- Drastic changes in behavior, personality, or sleeping habits
- Extreme difficulty concentrating or staying still
General Tips and Advice for dealing with Anxiety & Depression
- Pause, take a break, meditate, and focus on things that are within your control in the present moment
- Practice healthy sleeping habits
- Write in your journal
- Write a list of things that are within your control
- Practice positive affirmations
- Write positive coping statements
- Practice gratitude
- Maintain connections to family and friends
- Get active: Get up and move, exercise, walk around your neighborhood to help improve your mood
Anxiety and depression can manifest itself in many ways. For example, I isolate myself. I can go without leaving the house for days at a time if I’m not careful. Hell, I might not even get out of bed except to go to the bathroom. Believe it or not, I’m shy and quiet. I’m sort of an introvert by nature, and my insecurities can mess with me big time. “You’re not good enough to go out in public today”, I tell myself. Or, “Stay in your office at work.” Or maybe, “If you don’t socialize, no one can see the real you and criticize you.” Or, “Don’t ask out that girl – she’s just going to reject you.”
Those debilitating thoughts and countless more force me to withdraw. Having said that, I make a conscience effort NOT to isolate myself. I will go talk to my neighbor, even if I don’t feel like it. I will go sit in a restaurant, even though that most likely means I have to go by myself. It takes all of my emotional, mental, and even physical energy to be around people for 8 hours a day at work. I have to psyche myself up to even leave the house in the morning. When I get home, I hurriedly undress, as if to shed the stress of the day, and from the moment I walk into my house after work, I take every second of that time trying to reenergize myself to get ready for work the next morning. It’s a never-ending cycle.
As bad as that is, it takes almost that same amount of energy to ask a girl out. It can be nerve wracking. What do I say? How do I say it? How do I work up the courage to walk over there? What if she rejects me? In fact, I know she’s going to reject me. But somehow, I do it. If she rejects me, man it can knock me on my butt for a long while. If by some miracle, she gives me her number, then a new kind of anxiety creeps in: when do I call her? What do I say? How do I say it, etc.?
Then if after all that the woman ghosts me, (which happens a lot nowadays), it further triggers my abandonment issues. It. Want to know what’s really crazy? Out of all the pain I’ve experienced in my life, emotional or otherwise, the worst pain I ever feel is after a break up. That sense of loss makes me feel as if my literal heart is actually breaking.
And these are all individual or “personal” issues. Add to that the overarching issues we all face such as systemic racism, police brutality, class inequality, and the myriad of other concerns that we just don’t have time to discuss, the task of living a healthy life seems daunting. Yet, somehow, some way, I pick myself up and get back on the horse again.
Why? How? I don’t have those answers. In fact, I don’t have any answers at all. In the end, my motto is the same as Nike’s: Just Do It.
But I also work to help my personal situation, such as taking every available opportunity to meet new people, exercising, practicing sexual wellness as best as I can, and so forth. And for now, I’m content with the results, though I’m constantly evaluating and looking for new ways to maximize my life.
I moved back to Maryland in July of 2018, knowing no one. That was tough enough, but then the pandemic hit, so I was on lockdown with virtually no friends and no real way to meet anyone new. It’s been rough for me, just as it has been for so many others. Yet maybe this article and the resources in it will help us all grow together. I feel that just having the conversation and continuing to have the conversation is a good start, and for that, I thank Naomi Osaka and all the others who have spoken out, for bringing this issue to the forefront of our community.
I no longer see myself as that little homeless boy with nappy hair, living in a shelter, wearing thrift store clothes, and living an impoverished life. However, I do remember it vividly and I will never forget. In fact, that period of my life will always be a part of me. That’s why I keep grinding.
Organizations that support and provide services for Black Mental Health can be found here:
Therapy for Black Girls
Therapy for Black Men
Open Path Psychotherapy Collective (Affordable Therapy)
The LoveLand Foundation (Vouchers for Therapy)
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