Silent Treatment
Many Black Women Struggle With Depression on Their Own

By Cherie Black

Sixteen years ago, Sherry Morton's sister suggested she see a psychiatrist. One of 12 children, the then-29-year-old black woman from Flatbush in Brooklyn had seen two of her siblings die in two years. She was crying constantly, but thought it was just grief that would eventually pass.

"My brother died when I was 15, then my sister died when I was 17," Morton said. "I thought I could handle it."

She realized she couldn't handle it after another of her brothers, a paraplegic after falling in a basketball game, was set on fire and killed by his home nurse, Morton said, for $10,000 worth of insurance money. It was then that she took her sister's advice.

"I thought I was crazy," she said. "I asked the psychiatrist if it was too late to get help."

Morton represents a segment of the black female population who don't readily seek professional help for depression, and often deny symptoms of depression exist. In a survey conducted by the National Mental Health Association on African-American attitudes toward depression, 63 percent of blacks believed depression was a personal weakness, and 31 percent said they would handle depressive feelings on their own. Recent statistics show less than 10 percent of the tens of thousands of black women suffering from depression seek help, compared with 60 percent of whites.

"Most people have someone in their family who was seen as a little nutty and there was a stigma around them," Morton said. "People are scared to be seen as crazy."

Morton, now 45, has been a fitness trainer for 15 years and works at Bally's Fitness Center in the Flatbush section of Brooklyn, where she lives with her husband, Dennis, and their four children. She said she saw a psychiatrist three times a week on and off for nine years to treat her depression, and it was her sister's insisting that she get well that changed her mind about the stigma attached to seeking professional help.

"Black people say, 'We have too many other things to do than be depressed,' " said Dr. Janice Bennett, a black psychologist at Columbia University. "What they don't realize is depression is a serious mental illness that needs to be treated -- and there's nothing shameful about needing help during a rough time in your life."

Depression is described by psychiatrists as a numb empty feeling or no awareness of any feelings at all. People often see a noticeable loss of feelings of pleasure, and a marked change in mood. There is also excessive weight loss or gain, and an inability to sleep. Some types of depression include post-traumatic stress disorder, which occurs after witnessing or experiencing a traumatic event and causes nightmares or flashbacks. Seasonal affective disorder is triggered by the darkness of winter, while melancholic depression is a hyperanxious type of depression whose symptoms include not eating or sleeping, and difficulty turning the brain off. Manic or bipolar depression is characterized by extreme mood swings and possible thoughts of suicide.

Stressful living conditions because of poverty, discrimination, racism, abuse, and rejection from American society contribute to the thoughts of suicide by many black women, according to a study by Black Women's Health on suicide and depression in the black community.

The National Mental Health Association, the country's oldest and largest nonprofit organization addressing all aspects of mental health, also conducted a study in conjunction with Surgeon General David Satcher on suicidal thoughts.

"In the majority of cases, suicide is the most tragic result from common and treatable mental illness," said Michael Faenza, president and chief executive of the association.

But, while suicide isn't the result of all depression, just as depression isn't the cause of all suicide, without proper treatment and diagnosis of depressive symptoms serious consequences can result.

"Because of the lingering stigma of mental illness and discriminatory insurance practices, too many Americans are not seeking and receiving the treatment they deserve," Faenza said. "Our society is in denial, and business practices, insurance policies, schools and governments too often contribute to this denial. The effect of the stigma and discrimination against mental illness not only leads to needless death, it leads to wounded families, businesses, and communities."

Yet many black women who experience these symptoms refuse to seek medical attention, and say depression is "a white thing."

"My white friends go to therapists like the dentist," Morton said. "But for some reason it's different with us."

Bennett said there's often a stigma associated with mental illness in the black community. Women feel guilty and don't want their families to see them as weak.

She said some symptoms of depression -- not eating, not sleeping, lack of motivation -- are seen as more reasons for whites to confirm the stereotype that blacks are lazy and shiftless, so blacks deny they suffer from these ills. She said religious and cultural beliefs also keep black women from seeking professional help.

"They think all they need to do is pray and keep the problems within the black community," she said. "They think they're not being the strong black woman they should be if they admit to having problems, let alone telling those problems to a stranger."

Cheryl Bartlette, 27, a hairstyling assistant from Harlem, was diagnosed with depression last year, but believes seeing a therapist shows her lack of strength.

"Black women define their households," she said. "They've always taken care of everyone and everything that involves the family, the home, and many times the finances. I can't be seen as weak in front of my husband, my brother or my daughter no matter what I'm going through inside."

Bartlette said she started seeing a therapist last May because of problems in her marriage. But after only two sessions, she stopped, deciding she could better handle her depression on her own by focusing on work and writing poetry, which she said "has helped get her mind off of her feelings." She said she also didn't want to show her 15-year-old brother, who lives with her, or her 2-year-old daughter she couldn't handle her problems on her own. She said she would like to try marriage counseling, but her husband told her "black people don't have problems they need to go to counselors for."

The National Mental Health Association survey said black women are often misdiagnosed because of this mistrust of medical health professionals, based in part, on the historical institutionalization of blacks with mental illness; they will mask depressive symptoms by other more physical medical conditions, even substance abuse, not wanting to link them to mental illness.

Another reason for misdiagnosis is the socioeconomic factor and lack of proper access to medical care. The association also said many doctors and nurses will look at the outward appearance of many black women and think they're not sick, because instead of looking stereotypically disheveled, they will look good and well put together, and not "mental" at all.

Bennett said the role and reaction of psychologists and psychiatrists -- whether black or white -- play a big part in effective treatment. And she said a white therapist can effectively treat a black patient.

"As long as they are open to discuss any discomfort, and asks questions, race shouldn't be an issue," she said. "Just because we're both black doesn't mean I necessarily understand what you're going through."

Morton agreed. She said color was never a factor in choosing a therapist. She said she has had both black and white, men and women therapists and as long as she felt comfortable and got along with them, that was what she was looking for.

Morton said as a fitness trainer, she sees many depressed black women who eat or drink heavily to overcome their emotions and are now exercising to break the habit of using food or alcohol as a comforter. She said none of them have admitted they are depressed, but they will open up about the reasons why they are so sad.

She said although she's not a therapist, she believes many of the women who visit her at Bally's need to talk to a professional.

"I asked one woman who was drinking heavily late at night if she thought she had a problem," Morton said. "She told me no, that she just needed support from her friends, so I just listened to her problems, and most of the time that's all they want. But I also tell them they shouldn't be embarrassed about getting help. It's about letting them know it's okay. It's okay to need someone's help in feeling better."

She said it was through her years of therapy, and the support she received from her husband, that she learned it wasn't shameful to need someone's help.

"Family and friends always have an opinion," she said. "Sometimes just focusing on you with an unbiased person helps with handling the problems better."