According to statistics, African Americans are particularly at risk for developing major depressive disorder (MDD). Being an African American woman increases the risk of clinical depression, because this mental condition is more prevalent in women than men.
Depression is most likely caused by a combination of biologic, environmental and genetic factors. Studies have shown that close relatives of patients diagnosed with clinical depression are two to six times more likely to develop this mental disorder than people without a family history of depression.
Although major depressive disorder and other subtypes of clinical depression are treatable conditions (provided that the individuals seek professional help), several misconceptions regarding African Americans and depression often keep individuals from receiving proper treatment (psychotherapy and antidepressants if necessary) as well as emotional support.
Due to their cultural background, most African Americans associate this mental illness with weakness and frailty and the fear of being stigmatized by the society is the main reason of their reluctancy to seek medical help. Over the years, the African American community has withstood discrimination and enslavement and has continued to be a resilient and productive community with strong moral values.
Clinical Depression Subtypes
The primary subtypes include Major Depression, Dysthymia (milder yet chronic depression), and Atypical Depression. African American women are also affected by Premenstrual Dysphoric Disorder (PMDD) and Seasonal Affective Disorder (SAD) as well as by episodes of depression during pregnancy and/or following delivery.
How to Recognize Major Depressive Disorder
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), at least five of the following symptoms must occur nearly on a daily basis for a period of minimum two weeks and they must represent a conspicuous change from previous mood or behavior. Episodes of Major Depression typically last about 20 weeks.
- Depressed mood nearly every day (irritability is typically prominent in children and teens)
Overwhelming feelings of sadness, irritability and anxiety usually alternate and range in intensity from mild to severe. African American parents should also be aware of the fact that the comorbidity rate with Anxiety Disorders (such as Generalized Anxiety Disorder, Panic Disorder and various Phobias) is quite high, depression in children and adolescents usually co-existing with an anxiety disorder in up to 75% of the cases.
- Very noticeable or complete loss of pleasure for most of each day
- Sleep disorders – these include either Insomnia (the inability to sleep) or Hypersomnia (excess sleep) and especially excessive daytime sleepiness which has been exhibited for at least three months prior to diagnosis.
- Significant changes in terms of eating habits or patterns; unusual changes in appetite and weight (either losing or gaining weight) and eating disorders especially in women.
- Low levels of energy throughout the day, persistent boredom, reduced socialization and apathy (not feeling like doing anything)
- A sense of intense slowness or feelings of restlessness
- Self-deprecation, worthlessness and a sense of guilt
This refers to the tendency of individuals to undervalue themselves and it is often triggered by negative or less pleasant experiences from an early age, a constant feeling of insecurity, and even by a fear of inadequacy.
- Lack of focus nearly every day
- Recurrent thoughts of death and even suicide
Treatment Options for Clinical Depression
For most African Americans who have decided to seek proper treatment provided by mental health specialists, cognitive behavioral therapy (CBT) is typically the most effective approach, because it works as well as prescription medication in treating severe cases of clinical depression. This form of therapy focuses on identifying and changing the distorted perceptions (known as “schemas”) that the individual may have of themselves or the world. Like other psychotherapies, the success of CBT for depression depends significantly on the skills of the psychologist. Studies have shown that the benefits provided by CBT are long-lasting.
When psychotherapy is used alone, without antidepressants, benefits should be obvious within 8 weeks and symptoms should be fully relieved by 12 weeks. In severe cases of major depressive disorder when talk therapy proves to be insufficient, antidepressant drugs should also be considered. The best candidates for CBT include adults suffering from chronic or atypical depression, teens with mild symptoms of major depression, women suffering from non-psychotic post-partum depression as well as with recurrent thoughts of suicide.
Cognitive Behavioral Therapy typically lasts 12-14 weeks and patients can choose either Individual or Group Therapy sessions. Other forms of talk therapy include interpersonal therapy (IPT), which focuses on current problems that cause depression symptoms and psychodynamic therapy, which focuses on discovering unresolved issues originating in childhood.
Regarding African Americans and depression, it is crucial to understand that underestimating the impact of this mental disorder and seeking support from non-medical sources such as friends, church and family can lead to serious complications, including increased risk for suicide. More than 85% of African Americans describe themselves as religious and believe that prayers are the best way to deal with depression.
Untreated depression also affects the physical health, because it is a major risk factor for heart disease and obesity. Securing the specialized services provided by a licensed, experienced mental health professional can help African Americans suffering from depression benefit from an accurate diagnosis and proper treatment.
Marcus Hummings, Psy.D. is a Licensed Clinical Psychologist in Private Practice in Washington, DC area