Depression knows nothing of skin color, yet cultural influences shape how people of different races deal with the illness. So says Terrie M. Williams, author of Black Pain: It Just Looks Like We're Not Hurting, which arrived in bookstores this month. Williams, an African-American, is a social worker by training and a public relations professional by trade—and has herself battled depression. In the African-American community, she says, there's a tendency to hide or ignore symptoms of depression, which include sadness, energy loss, feelings of worthlessness, thoughts of death or suicide, change in weight, and oversleeping or difficulty sleeping. That tendency means missed opportunities to hit the disorder with effective treatments, including talk therapy, antidepressant medication, or both. More than 20 million people in the United States are clinically depressed.
African-Americans are less likely to have access to "comforts"—such as mental health services, massage, and yoga—that can make dealing with depression easier, Williams says. "If you don't have access to those comforts that cushion what you're going through, that in and of itself makes [dealing with depression] different and very difficult," she says. In an interview with U.S. News, Williams provided some insight into how depression affects the African-American community.
Is there more stigma tied to depression in the African-American community than in other groups?
Depression is a sign of weakness in the black community. Black people would rather say that they have a relative in jail before they will acknowledge that they have a mental illness. But many of my white friends and colleagues who are very much more open will tell you that they can't make an appointment because they are going to see their therapist. But it's a very different experience in the African-American community.
You say in the book that misdiagnosis of depression in the African-American community is common—that the "strong personal style" of African-Americans, "on top of beliefs that we can handle anything, often makes white professionals miss how much pain or anguish we're in." How so?
We're perceived to be ones who can handle our business, and so there is that tendency to not recognize depression in African-Americans. In general, I think that there's a lack of knowledge about the black experience with depression. I feel that we are in such a major crisis. We haven't really named what's ailing us. Almost any given day, at any turn, you can see that we are a people who are hurting. I hear many different kinds of reasons. What I know is that we experience life in this country in a way that makes it very difficult to be.
What symptoms of depression transcend across cultures?
You run from yourself. It's a human thing to keep things locked up inside of you. When you're working 24-7 and you don't have the energy to do anything at all, when you have difficulty concentrating, when you're not doing work that fills your spirit — those are things that mean you have unresolved issues. And you may also sleep a lot because you're afraid to get up.
How can people be more attuned to signs of depression in African-Americans?
African-Americans suppress and repress pain. [Still], there are many signs of depression that are like neon lights, but we don't really pay attention, or we don't have time to listen. With more dialogue, maybe, just maybe, there will be more sensitivity. Remember, everyone has a story. Assume that that person has a story just like you do, is just as fragile and as challenged as you are.
You went through your own personal struggle with depression and chose to share your story through this book. Why?
I've always been a very sensitive person. I feel other people's pain and have a tendency to absorb it. I have a sense of the universality of humanity. I have a sense that underneath the face that everyone wears, we all share the same thing. People speak to you on so many different levels. I often will pay more attention to a person's body language than I will to what they say. That's what speaks really loudly to me. And a lot of times, I think three of the hardest words to answer honestly are, "How are you?" We usually lie, and when we do lie, it chips away at our spirit. So when we do ask this question, really listen to the answer.