Black May Not Crack, but We’re Aging Faster Inside

by Lottie L. Joiner

African-American women are 7.5 years biologically “older” than white women because of extreme stress, health experts say.

You’ve probably heard the expression “Black don’t crack,” a reference to black women’s ageless beauty. But though their skin may be smooth and wrinkle-free on the outside, black women are aging faster than white women on the inside, health experts say.

Dr. Michelle Gourdine, a former deputy secretary of health and chief public health physician for Maryland, explains that extreme stress causes wear and tear on our internal organs, contributing to heart disease, high blood pressure and stroke in black women - all diseases of aging.

“The cells that make up your heart, your blood vessels, whatever else, begin to age prematurely because of all the stress, and that predisposes you to disease,” says Gourdine, author of Reclaiming Our Health: A Guide to African American Wellness.

She points to a 2010 National Institutes of Health study titled “Do US Black Women Experience Stress-Related Accelerated Biological Aging?” The study’s authors analyzed data from the Study of Women’s Health Across the Nation and found that black women between the ages of 49 and 55 are 7.5 years biologically “older” than white women.

“US blacks are more likely to experience stressful situations, such as material hardship, interpersonal discrimination, structural discrimination in housing and employment, and multiple caregiving roles than whites,” the authors wrote.

According to the study, this cumulative impact of overexposure to stress hormones takes a toll on the body and contributes to the development or progression of such ailments as “cardiovascular disease, obesity, diabetes, susceptibility to infection, carcinogenesis, and accelerated aging.”

“What the article seems to imply is that we just have a heavier load to carry, bottom line,” says Gourdine, currently a clinical assistant professor in the departments of pediatrics and of epidemiology and public health at the University of Maryland School of Medicine, and a senior associate at Johns Hopkins Bloomberg School of Public Health.

“When you think about black women and how we’re all raised to be strong and that’s what we expect each other to be as African-American women, what comes with that is a set of added responsibilities.”

Gourdine points to how black women are often the primary breadwinners in their families and have to juggle multiple roles sometimes navigating a culturally insensitive workplace while also acting as caregivers for children, grandchildren and ailing parents. And for black women in high-powered positions, there’s an even greater risk, she says.

“In meetings where you’re the only woman or only African American, you feel like all eyes are on you,” Gourdine says. “You feel that pressure to perform, of proving that you’re good enough and that you do work hard. There is stress from always having to be ‘on.’”

Those expectations are compounded by our cultural expectations of “strong black women,” she continues. “We are expected to be independent and not ask for help, keep our needs inside and not admit that we need help,” she says.

Dr. Gayle Porter, a clinical psychologist and co-director of the Gaston & Porter Health Improvement Center, says she is amazed at how reluctant black women are to acknowledge that they’re stressed. “Strength means being able to acknowledge that you need help and support. That’s part of being strong,” she says.

Instead, black women tend to deal with stress through destructive behaviors such as overspending, which can cause financial stress, or overeating, which can lead to obesity and diabetes.

“These are some of our brightest, hardworking, most intelligent, most loving women,” notes Porter. “We are dying at rates that are greater than any other group of women from heart disease, cancer, diabetes and stroke, so whatever it is that we’re doing is not working.”

Indeed. Black women develop high blood pressure which could lead to strokes or heart attacks at an earlier age than white women and have higher rates than their white counterparts.

Although heart disease is the No. 1 killer of women in general, black women are more likely to die from the disease than women of other races. Breast cancer and diabetes also affect black women at higher rates.

Porter is a co-founder, along with Dr. Marilyn Gaston, of the Prime Time Sister Circles a 12-week program that helps black women between the ages of 40 and 75 improve their health and deal with stress.

The major stressors that women in the group have identified are health, financial stress and caregiving responsibilities, says Porter. “We give sisters a safe space where they can learn how to identify stress, how to appropriately cope with it, how to reduce it if they can’t eliminate it, and learn how to function in an assertive way that will teach them how to take care of themselves and take care of other people,” she says.

The group teaches participants stress-management techniques such as deep breathing and encourages daily exercise. The women also have to keep a daily log of stressors.

“As black women, we have to look at the relationships between how we are dealing with stress and the fact that we are dying,” says Porter. “Our folks don’t want to acknowledge how stressed they are, but it’s evident, and it impacts our entire community.”

Post-Traumatic Slave Syndrome and Intergenerational Trauma: Slavery is Like a Curse Passing Through the DNA of Black People

By David Love

The new reboot of the miniseries “Roots” reminds us of the physical toll that slavery has taken on Black people. Slavery was an exploitative system that built global capitalism through the theft, kidnapping, torture, and prison labor of millions of Africans.

However, that process is and continues to be an intergenerational one, in which Black people have suffered psychic damage. The experiences of the dreaded slave ship dungeons of the Middle Passage in which millions of souls still rest at the bottom of the Atlantic - the auction blocks, the rapes, whippings and lynchings, the slave patrols, the backbreaking and life-ending labor at gunpoint, the separation of families all inflicted psychological damage on the victims and their descendants. 

Though their trauma was profound, enslaved Black people had no mental health therapists available to them, no counselors to help them cope and heal. And the sickness was passed down to subsequent generations who to this day have not received the treatment they so desperately require.

Monnica Williams, Ph.D., director of the Center for Mental Health Disparities at the University of Louisville says Black people have post-traumatic stress disorder, or PTSD, and they may not even know it. “PTSD symptoms typically include intrusive thoughts about the trauma, avoidance of thoughts or reminders of the trauma, anxiety, concerns about safety, feeling constantly on guard, fears of being judged because of the trauma, and depression.  

Individuals may also have flashbacks and feelings of dissociation.

Very severe PTSD can result in psychosis, and PTSD can be temporarily or permanently disabling,” Dr. Monnica Williams, clinical psychologist and director of the University of Louisville’s Center for Mental Health Disparities, told Atlanta Black Star. 

According to Williams who is also a professor in the Department of Psychological & Brain Sciences and writes the “Culturally Speaking“ blog at Psychology Today - PTSD has particular significance in the Black community. “Symptoms specific to race-based trauma in African-Americans may include avoidance of white people, fears and anxiety in the presence of law enforcement, paranoia and suspicion, and excessive worries about the safety of family and friends.”

In a society in denial, racism is proclaimed dead and an historical phenomenon.  Yet it is very much alive, as manifested in the behavior of Black folk. In her book, Post Traumatic Slave Syndrome: America’s Legacy of Enduring Injury and Healing, Dr. Joy DeGruy discusses the condition that serves as the title of her book:

Dr. DeGruy argues that typically society does not address the role of history in producing these negative behaviors and perceptions. African-Americans she contends adapted their behavior in order to survive chattel slavery, an example of “transgenerational adaptations associated with the past traumas of slavery and ongoing oppression.”

“I think there is too much emphasis placed on racist individuals as opposed to the social forces that create racists. Everyone behaving a slightly racist way has a much more deleterious effect on Black people than a few people being very racist,” Dr. Williams said. “Racism is built into the power structures and institutions in our society, and White people are taught to propagate racism and not to see it. This process is maintained by pathological stereotypes and misinformation about Black people. White supremacy is a reaction to feeling one’s social status threatened by the advancement of African Americans.”

And while racial oppression has a psychological, multigenerational impact on Black people, it also leaves a biological and genetic imprint in its victims. In other words, research suggests the trauma is embedded in the DNA, changing one’s genetic makeup and becoming transferrable to subsequent generations.

According to the National Institutes of Health, chronic stress and exposure to stress hormones alter our DNA not the gene sequence but rather gene expression. When we are under stress, we produce steroid hormones called glucocorticoids, which affect various bodily systems. 

Past studies have shown that these glucocorticoids alter the genes that control the HPA axis, which includes the hypothalamus and pituitary glands of the brain, and the adrenal glands near the kidneys. When the Fkbp5 gene is modified, this leads to PTSD, depression and mood disorders. Studies involving the descendants of Jewish Holocaust survivors under Nazi Germany found that these individuals had an altered Fkbp5 gene, along with PTSD, hypertension and obesity.

A 2008 study in the National Academy of Sciences found that people who were prenatally exposed to the Dutch famine of 1944-5 had an altered IFG2 gene which plays an important role in human growth 60 years later. Children of mothers who were pregnant during that famine developed a number of health problems such as obesity, diabetes, kidney damage and heart disease.

The implications for other inter-generationally traumatized groups who have endured genocide and racial oppression, such as Native Americans and African-Americans including Hurricane Katrina survivors are blatantly clear. When racism is understood not merely as a system of discrimination for a particular generation, but also a curse that is passed through generations and affecting our health like the DNA, this helps to shape the discussion on the full extent of the damages created by racism, and the need for remedies, repair and recompense.

Dr. Farah D. Lubin–Associate Professor in the Department of Neurobiology at the University of Alabama at Birmingham told Atlanta Black Star that genetics is a matter of nature vs. nurture. “Nature is what you get from your parents, while nurture is how your environment shapes you as an individual,” she said, noting that an individual might have a predisposition to developing a certain condition such as bipolar disorder, schizophrenia or suicide. Lubin’s primary research is focused on investigating the molecular and genetic basis of learning, memory and its disorders.

 “You can experience stress early on or later on in life,” said Lubin, who is also Co-Director of the NINDS Neuroscience Roadmap Scholar Program, whose goal is to “enhance engagement and retention of underrepresented graduate trainees in the neuroscience workforce.” “Your gene sequence changes as you age, and stress can distort that trajectory for the rest of your life,” she noted, adding that there are different types of stress, such as acute, chronic and moderate levels. And if you are exposed to chronic, unpredictable stress, that could have an impact on how you respond to your environment.

Farah D. Lubin, Ph.D., Department of Neurobiology, University of Alabama at Birmingham says Epigenetics acts as an interface between your environmental experiences and how your DNA will be interpreted in response to those experiences,” Lubin said. “Sometimes these are extreme and destabilize you to your experiences". 

In cases on extreme stress, you can have long term effects.  The Bible refers to generational curses and influences, and interestingly nature actually supports what The Bible says, which is, there is an effect on the molecular epigenetic information that is affected by stress that is transgenerational and passed on to your offspring.”

What are the solutions?  “It is difficult because we are just beginning to understand these mechanisms and how they are triggered,” according to Dr. Lubin, noting all the complexities involved in the science of trauma. “Behavior therapy, environmental enrichment has been shown to cure a number of disorders. Exposing yourself to new, novel things is good for you, but we don’t do enough of it. In animals and humans we know enrichment helps to cure and alleviate disorders. The problem with enrichment and proper diet is that it takes more than taking a pill,” she said.

“As a science I know that diet changes your epigenetics and how you deal with stress. It helps you deal effectively and appropriately to stress.  It reduces cortisol levels so you are not as fearful. I think awareness first and foremost is most important,” Lubin added, noting that Black people are beginning to take matters into their own hands. “African-American society is embracing more of who they are. You see that with women wearing their hair naturally” she said.  Lubin also noted that attitudes about race are evolving among millenials, including Black young people. “But that’s not to say they do not have some of the residual effects of slavery,” she said.

In addition, Lubin says, we can learn from those who are resilient, and attempt to mimic what is present in resilient people in order to seek treatments for trauma. “There is a resilient population and a susceptible population. Whether they are disabled, have a background as slaves, suffer from the Holocaust, you can separate them into two groups. What make the resilient (bounce back) and what makes the susceptible stay stuck. The genes that encode are different in the resilient and susceptible groups.”

Interestingly, these generational effects of trauma are not believed to last forever, according to Dr. Lubin. “I believe it is six to seven generations (with 25 years a generation). Technically we are beyond these numbers, but we were re-inoculated with Jim Crow and the civil rights movement,” she offered.

“I think we as a culture need to make some major changes in the way we think about harm caused by historical trauma,” said Dr. Williams. “We now know it’s not simply ‘in the past’ but continues to influence descendants through both social and genetic (epigenetic) mechanisms. Reparations need to be meaningful and not simply symbolic to have any real impact,” she added.

Meanwhile, in the Black Lives Matter era, more attention is paid to the legacy of slavery and its significance in the present day. “Police have been killing and abusing our people with impunity for centuries, and now thanks to  dash-cams, cell phone videos, and public outrage (Black Lives Matter), this problem is now getting the attention it deserves.”

Williams said “These images can contribute to a sense of community/cultural trauma if nothing is done, but with continued attention I think we can bring about change.  These problems go back to the slavery where force of law was used to intimidate slaves and then after the Civil War to exterminate and neutralize Black males.”

Finally, Dr. Lubin responds to those who say that Black people should “get over” the trauma of slavery. “It’s a naive sentiment to say get over it, but they don’t even know what they are getting over. There are symptoms and they don’t even know why they are there. It is hard to say to a Holocaust survivor, ‘Get over it.’ They are having the same generational effect from their experiences as well.”

Report: Too Few School Counselors for Traumatized Black Children But Plenty of Punishment

By David Love

As the nation grapples with the problems of the school-to-prison pipeline and the intersection of racial justice, the criminal justice system, law enforcement and education, the need for new priorities for children comes to light. For example, in a national public school system that is now majority children of color, students are suffering from trauma.

And while there is a shortage of support staff to service public school children — including counselors, psychologists and social workers — children of color are hit especially hard.  Black and brown children, who are most likely to live with trauma, run a much greater risk of facing harsh punishment and school discipline rather than receiving the crucial mental health counseling they need.

A new research report from the Center for American Progress (CAP), “Counsel or Criminalize? Why Students of Color Need Supports, not Suspensions,” tells the story with the first-of-its-kind, state-level analysis on the shortage of counselors, psychologists and social workers in America’s public schools.

Consider, for example, that 35 million children in the U.S. are suffering from trauma, yet only 8 million (22 percent) have a school psychologist at their disposal.  Only 63 percent of public schools have a counselor, and a mere 18 percent have a social worker. 

Also the challenges facing children of color place the extent of the problem in full view.  African-American, Latino and Native American children, who are most likely to experience traumatic events, are also disproportionately poor, which in itself is a risk factor for psychological distress.

Moreover, nearly 3 million children are suspended from school each year, reflecting zero-tolerance policies that are racially discriminatory in nature.  Those students who face draconian disciplinary measures are also those who risk dropping out and going to prison traumatized children.

According to the report, 90 percent of juvenile detainees are living with trauma.  Further, Black children are three times as likely to suffer from abuse or neglect than white children, and are also three times less likely to receive mental health care.  And because of institutional racism and the perception that their behavior is disruptive, Black children also have a fourfold risk of suspensions over their white counterparts.  Meanwhile, Native American youth face the greatest barriers to mental health, as they have double the risk of committing suicide as other groups.

Delving into the statistics on a state-by-state basis reveals the extent of the crisis, which CAP says amounts to a “silent epidemic.”  While it is not surprising that the states of the South suffer from the most dire shortages of social workers and psychologists, it is shocking that the bottom is so low.

For example, the seven states accounting for 90 percent of the cases of corporal punishment of Black children in 2011-2012 — Mississippi, Alabama, Georgia, Arkansas, Texas, Louisiana, and Tennessee — had psychologists in only 10 percent of their schools. 

Only 24 percent of Georgia schools have a full-time psychologist, while Alabama, Mississippi and Texas have the lowest supply of such professionals.  Alabama, which suspended 20 percent of its Black children, has almost no in-house psychologists.  In Mississippi, the schools have a student-to-counselor ratio of 436-to-1, nearly double the recommended ratio, while only 3 percent of schools have a psychologist.

And in Wisconsin, where more than one fourth of Black students were subjected to out-of-school suspensions, only 59 percent of public schools employed a counselor.

“The numbers are sobering,” said Perpetual Baffour, Research Assistant for Education Policy at CAP and author of the brief, in a press release.  “When millions of children live in poverty, experience physical or sexual abuse, witness tragedy in their communities, lose a parent to incarceration, and/or lack access to safe and clean drinking water, it should be no surprise when they experience challenges in the classroom. Children cannot learn when they lack adequate and meaningful supports for their well-being.”

The national issue of traumatized Black children receiving severe punishment rather than beneficial support services was on display in Spring Valley High School in 2015, when a recently orphaned girl named Shakara was assaulted by a police officer in her classroom for failing to comply with an unfair punishment, and then was arrested along with a classmate.  Atlanta Black Star has reported on the ways in which violence causes PTSD-like symptoms in Black people, and has examined the neuroscience of poverty and the impact of racism on the mental well-being of African-American children and adults.

The trauma facing Black people is hereditary and intergenerational, passing through the DNA and reflecting a legacy of oppression from the Middle Passage, though enslavement and Jim Crow to the present day.

Regarding the unaddressed trauma among public school children, CAP offers several recommendations, including making school-based counseling and mental health programs a funding priority, crafting an approach to school discipline that is restorative rather than punitive, and developing culturally sensitive policies for emotional and behavioral support services.

Trauma and Poverty Alters the Brains of Black People, and It Will Take Black Institutions to Stop It

By David Love 

The shame is not ours. That holds true of the horrors and the trauma of the Middle Passage, and the toll it exacted on the bodies and psyches of African people. And that applies to the continued racial oppression, the deprivation and the economic, physical and mental violence to which Black people are subjected every day. 

While white society has told Black people that their “problems” are of their own making, a result of their moral failures and lack of work ethic, white America promoted this false narrative by punishing Black folks through public policy.

What if the shame is indeed not ours? What if neuroscience, the study of the brain, can make sense of the effect of trauma on the very minds and behaviors of Black families, adults and children?  What if white supremacy takes its toll on the health and development of our minds, not just in a philosophical, political or cultural sense, but from a medical and scientific standpoint?

If the problem is one that Black people face, then Black institutions will solve it. For the first time, two African-American organizations — a health services agency and a fraternity — are teaming up to address the neuroscience of poverty and the impact of trauma on the Black mind and behavior.

The Columbus (Ohio) Area Integrated Health Services, Inc. (CAIHS) and the Columbus Kappa Foundation, Inc. — part of the Kappa Alpha Psi fraternity — have formed a partnership called the Global Life Chances Initiative.

The project will provide services, education and outreach to Black families hit the hardest by infant mortality, educational under-performance and economic dislocation. Further, through a concept known as the neuroscience of poverty, the initiative will address prevention and repair of Black people traumatized and damaged by economic deprivation and exploitation and the toll poverty has on the brain.

The concept represents a bold and innovative research approach.  Past studies have examined intergenerational trauma and post-traumatic slave syndrome, and the ways in which the psychic damage of enslavement, genocide and other forms of oppression can be passed down through generations.

A recent Newsweek article addressed how poverty impacts the brain.  Specifically, it said that “poverty, and the conditions that often accompany it — violence, excessive noise, chaos at home, pollution, malnutrition, abuse and parents without jobs — can affect the interactions, formation and pruning of connections in the young brain.”

Anthony Penn, President/CEO of Columbus Area Integrated Health Services, Inc. (CAIHS). Anthony Penn, President/CEO of CAIHS, told Atlanta Black Star that by focusing on the Black community, what the initiative learns ultimately will benefit all communities.

“This is an important initiative for this historically African-American mental health organization. For decades, we have witnessed clients that our agency has provided services for suffer from trauma and issues that professionals have found difficult to treat,” Penn told Atlanta Black Star.  “When you look at the high rate of infant mortality in Columbus, the parents that are impacted by high infant mortality, there is a large [amount of] depression and need for support to those families.”

Penn added that it is important for the African-American community to move beyond these long-term issues that hold our community back. As Nate Jordan II, President of the Columbus Kappa Foundation, Inc. noted, the new initiative will be based in the Mount Vernon section of Columbus, where the Kappa House is located.  Jordan told Atlanta Black Star that Mount Vernon is “one of the most economically depressed areas from redlining. A lot of abandoned housing, all of the detrimental things are exemplified in these housing areas.”

“In Ohio, the Black infant mortality rate is 48th in the country. In Columbus, the Kappa House is in [an area with] one of the highest infant mortality rates in Ohio, where there are seven hot zones” for infant mortality, he added.  Jordan noted that the Kappas became involved in the Global Life Chances Initiative through their engagement in infant mortality, safe sleeping issues and matters concerning Black fatherhood.

“We also looked at the father missing out of the family unit and how the father can make a big difference from an infant mortality standpoint…even when the baby is still in the placenta, having the father acting from a nurturing standpoint,” he said.

Jordan also mentioned the Kappa’s Nurturing Fathers program, an evidence-based, 13-week program in California that improves life chances for children and puts fathers back into the lives of their families. A group of 10-16 fathers receives services and education around their relationships with their child, the roots of fathering, nurturing, discipline without violence, anger management, nutrition, housing and other issues.

Nate Jordan II, President of the Columbus Kappa Foundation, Inc. “We’re Black men showing leadership, and we already have a tremendous following. We’re politically in position, and people are looking for our leadership. So this is another example of the Kappas being on the front burner, and this model we’re putting together will be going nationwide,” Jordan noted.

For Dr. Stacy Scott, a consultant with the National Kappa Foundation’s Healthy Kappas/Healthy Communities National Initiative says this new partnership makes sense. “I work in the infant mortality field, and we know the impact of stress on African-American women and the impact on their outcomes. We know African-American women have the highest rate of infant mortality, with 14 African-American babies dying for every 1,000 — 6 for white babies, so that is double,” Dr. Scott told Atlanta Black Star.

“We see a lot of babies who die because they are in unsafe sleeping environments,” she noted. “We are in the process of training Kappa membership to go out in the community to target specifically men on safe sleep practices for infants.  It is growing; it is amazing when you start teaching men.  When men are involved in prenatal care, especially in the first 3 to 4 weeks, we see how infants thrive,” Scott added.

Two issues that concern the participants in the Global Life Chances Initiative are the trust of the Black community, and the stigma over mental illness among African-Americans. “That whole trust issue, that’s why it is so important that the partners look like the community we’re servicing,” Dr. Scott said “A predominantly African-American membership is important because there is that mistrust.  We know because of the Tuskegee fiasco,“ she noted, adding it is important “to have key people and key researchers who look like our community and build that trust so that people will not be exploited.

There is such a disproportional representation of communities of color with health disparities, and it turns into an indictment of a particular group.  And it is not an indictment, but reflects discrimination and segregation, and so I think it is going to be a slow-moving train” she said, noting that it all adds up to getting the message out one person at a time.

“It is a fresh new phenomenon. and the community is ready. And we are tired of ‘pull yourself up by your bootstraps,’ ” Scott added.  “Maybe it is not something wrong with me, and I am a victim of racism.”

Dr. Stacy Scott, National Kappa Foundation’s Healthy Kappas/Healthy Communities National Initiative says “On a national level, 1 in 5 people are impacted by a mental health condition, and we know that stigma and overcoming the stigma is real. But this is an awareness campaign we are launching to understand how to reach our community, how to make service delivery culturally sensitive, to take into consideration the historic stigma our community has faced with mental health issues, and neuroscience.  

So, that is part of our relationship with the Kappa Foundation, a fraternity that is well respected, and we go to the grassroots and find ways to be more effective,” Penn noted.  “Through education, through door-to-door outreach and having culturally competent delivery providers, we know we’re going to have more of an impact than what has been historically done.”

According to Penn, often there is a lack of understanding of how to work with the Black community.  The Global Life Chances Initiative hopes to provide a blueprint for upliftment though outreach to the community and addressing a serious condition.  

Given “the stigma that is associated with mental health issues, I personally want to see our organization and the Kappa Foundation be the institutions that lead this movement to make it easy for families, for individuals, for people of color, so that it is easy to come in and get help when I need it, to seek treatment when I need it. I don’t need to mask and hide the symptoms; I can come in. The same way you feel comfortable calling the doctor when you have a headache, people with mental health issues can find it easy to come in and ask for help,” he said.

“When you say ‘I am not quite right,’ I can give you a reason why I am not quite right,” Dr. Scott noted of this planned research.  “It does give you another tool, and if we put it out there right, people begin to get a better understanding in regards to why we are the way we are.

For example, why do so many African-Americans have high blood pressure?  It gives some foundations as to why the community has such plights,” she said.  “If you look at the brain and things of that nature, they want to blame the victim, and the idea that if we give you a pill and some job training, you’ll be OK.”

Meanwhile, the undertaking has serious implications in the public policy realm, with the potential to change the status quo. According to Dr. Linda James Myers, Professor of Psychology, Psychiatry and African-American Studies at The Ohio State University and Director of The Ohio State University Black Studies Extension Center in Columbus, Ohio, the neuroscience of poverty provides a social context for what is affecting the Black community.  She argues that Western science, for instance, is not holistic, and fails to make the necessary connections between one’s environment and physical and mental well-being.

“A more African-centered perspective assumes that what happens in my physical environment will affect my behavior and my chemistry, and that constant stress will affect every aspect of my physiology, including the brain,” Dr. Myers told Atlanta Black Star.  She added that this more holistic and integrated African-centered perspective is nothing new.  Further, a holistic world view and a cultural frame of reference that was previously missing will allow us to counter the notion that poverty is the result of Black people making bad decisions.

Dr. Linda James Myers, Professor of Psychology, Psychiatry and African American Studies at The Ohio State University and Director of The Ohio State University Black Studies Extension Center in Columbus, Ohio says “One of the big things that we want to concentrate on in the first phase is to educate the decision makers that make policy, allocate funding, educate them on this work that we are undertaking,” Penn said “What is different about this partnership that does not exist anywhere else in the country is that you have a unique partnership, with an integrated strategic approach on how to lay out a plan of dealing with the history of trauma that African-Americans have dealt with for decades. We have a strategy to begin to ask the questions and explore the research on how to better serve our community,” he noted.

“We know the issues exist, and there has been a system of a continued way of treating the problem, continuing to fund a certain model, but we’re looking at how do you, with scientific data, change the direction that we find many of our young people, many of our adults, living in poverty? How do we change the infection and change the cycle? 

We don’t want to lead by emotion, but we want our emotion to be inspired by research. It will benefit not only our community but all communities,” Penn added, as the program will be emulated nationwide. “White folks won’t believe it unless it is researched,” Dr. Scott suggested, offering that the program has the potential to upend policies such as the welfare system, which is based on the premise of a work ethic.  People in welfare-to-work programs are set up to fail, she noted, and people are punished as if it is a reflection on them. What happens, for example, when it is discovered they cannot perform certain work functions because of trauma.

“If there is long-term impact of trauma on the brain, that debunks the whole argument,” she concluded.  “It is really going to challenge the status quo, and looking at all these acts and the welfare system, you can make an impact because what they’re doing is not working, and there is going to be a lot of fallout, because people don’t like change,” Scott said.  “You don’t hear them talk about research and African-Americans with regard to this theory. This might be on purpose, because we would have another tool to say we want our 40 acres and a mule.”

Once the word spreads about this new initiative, Dr. Scott believes, it is going to be phenomenal.  However, she provides a warning: “We have to be very, very careful to make sure they don’t use this against us. We have to advocate, because if they think we have a brain dysfunction they will write us off. It is important to make sure advocacy groups are on the case, because it is not our fault.”

“One of the advantages with this initiative is trying to get the powers that be to see that what is different about what young Black people are experiencing in poverty today from what young Black people experienced back in the day with chattel enslavement and sharecropping is the role of the community, despite the poverty,” said Dr. Myers.

“Now we have urban renewal, our community has been fractured and displaced, our people were placed in public housing which is not good for our community as it produces anger and frustrationand now without the community to support and without the educational system you have complete disenfranchisement.  You have dislocation and generalized depression. Instead of asking what is wrong with these young people, we should ask: What is happening and how can we change it?”

“The fact that we see the physiological change because now we have the technology to monitor it has principal benefits and also great costs. The benefits mean that Western researchers must concede that these children are in a demeaning, disenfranchising environment that affects their brain. Maybe that means we not only need early literacy but to be more holistic in what children are experiencing.  That awareness is coming is a good thing. Unfortunately, it has taken a long time to come to that realization,” Dr. Myers offered. 

“The downside is, ‘Oh my God, these Black children are deficient.’ They are open to being stigmatized, and the Black community is going to be further disenfranchised.  We have to make sure that the people engaged in the research will not go that route,” she added, noting the evidence that the condition is not irreversible. “The evidence is the 250 years Black people spent in enslavement.  I can’t think of a more hostile environment.  Then you see Black people emerging out of chattel slavery making all the contributions to the industrial and technological revolution,” she added.

Meanwhile, Jordan reflected on the importance of having Black organizations step up to tackle this issue in the Black community, rather than rely on white society. “No longer can we depend on them to solve our problems.  We have the expertise, the talent, the facilities and the ideas. We live this. We are the ones who have been here 400 years, and we are going to get it solved.”

Broken Heart Syndrome and Older Black Women

by Kenny Anderson

“Long before the term Broken Heart Syndrome was coined my mother suffered from it! She watched her three year old son hit by a car and killed and many years later she found her oldest son in the bed dead. My mother was grief stricken most of her life; she suffered silently and often had crying spells. I believe the impact of the Broken Heart Syndrome along with the daily stress of racism over the years was the major cause of my Black mother’s death” – Kenny Anderson, Founder of Black Hearts Matter

Broken Heart Syndrome also known as stress-induced 'cardiomyopathy’ or ‘takotsubo cardiomyopathy’, is a condition triggered by an onset of emotional distress. The symptoms of broken heart syndrome are very similar to those of a heart attack, and they can include angina (chest pain), shortness of breath, low blood pressure, and temporary heart failure.

The John Hopkins Heart and Vascular Institute describes stress-induced cardiomyopathy as a condition in which intense emotional or physical stress can cause rapid and severe heart muscle weakness (cardiomyopathy). This condition can occur following a variety of emotional stressors such as grief (e.g., death of a loved one), fear, extreme anger, and surprise. It can also occur following numerous physical stressors to the body such as stroke, seizure, difficulty breathing (such as a flare of asthma or emphysema), or significant bleeding.

Broken Heart Syndrome is more prevalent in postmenopausal women; these women often have a history of emotional or physical stress. Older Black women are at a much greater risk of Broken Heart Syndrome due to a greater accumulation of emotional distress over the years thus being more vulnerable to heart failure. The higher incidences of Broken Heart syndrome among Black women makes them more vulnerable to heart disease and a contributing factor of Black women having the highest heart disease rates in America.

Older Black women have experienced a lot of deaths over the years particular the premature deaths of the Black men in their lives (fathers, brothers, sons, husbands, friends, etc.). Generally older Black women have never had grief counseling and suffer more emotional sadness (depression) from prolonged unresolved ‘compounded grief’.

The most harmful aspect of heartbreak is that it is incredibly stressful, and when we are stressed, our bodies produce an excess of the hormones adrenaline and cortisol. In small doses these hormones raise the heart rate, which is not such a bad thing, but high levels can overwhelm the heart and in some cases actually result in heart failure.

Studies show that emotional distress does indeed affect the physical body in a number of different ways. First of all, emotional pain causes blood to flow to regions of the brain that are also responsible for producing physical pain. This is why many people may feel what psychologists call ‘somatosensory representations’ of pain after a hurtful experience such as rejection. Secondly, heartbreak can interfere with your immune system, which in turn can cause inflammation and a weakening of defenses against illness and infection.

Frequently Asked Questions:

1. What is “Broken Heart Syndrome?” 

Broken Heart Syndrome, also referred to as 'stress cardiomyopathy', is a condition in which intense emotional or physical stress can cause rapid and severe heart muscle weakness (cardiomyopathy). This condition can occur following a variety of emotional stressors such as grief (e.g. death of a loved one), fear, extreme anger, and surprise. It can also occur following numerous physical stressors to the body such as stroke, seizure, difficulty breathing (such as a flare of asthma or emphysema), or significant bleeding.

2. What are the symptoms of stress cardiomyopathy?
Patients with stress cardiomyopathy can have similar symptoms to patients with a heart attack including chest pain, shortness of breath, congestive heart failure, and low blood pressure. Typically these symptoms begin just minutes to hours after the person has been exposed to a severe, and usually unexpected, stress.

3. Is stress cardiomyopathy dangerous?
Stress cardiomyopathy can definitely be life threatening in some cases. Because the syndrome involves severe heart muscle weakness, patients can have congestive heart failure, low blood pressure, shock, and potentially life-threatening heart rhythm abnormalities. The good news is that this condition improves very quickly, so if patients are under the care of physicians familiar with this syndrome, even the most critically ill tend to make a quick and complete recovery.

4. How does sudden stress lead to heart muscle weakness?
First, it is important to understand what “stress” is. “Stress” refers to the body’s response to things it perceives as abnormal. These abnormalities can be physical such as high body temperature, dehydration, or low blood sugar, or can be emotional, such as receiving news that a loved one has passed away. When these abnormalities occur, the body produces various hormones and proteins such as adrenaline and noradrenaline which are meant to help cope with the stress. For example, if a person is suddenly threatened and fears physical harm, the body produces large amounts of adrenaline to help that person either defend himself/herself or run faster to escape the danger. With stress cardiomyopathy, we believe that the heart muscle is overwhelmed by a massive amount of adrenaline that is suddenly produced in response to stress. The precise way in which adrenaline affects the heart is unknown. It may cause narrowing of the arteries that supply the heart with blood, causing a temporary decrease in blood flow to the heart. Alternatively, the adrenaline may bind to the heart cells directly causing large amounts of calcium to enter the cells which renders them temporarily dysfunctional. Whichever the mechanism, it appears that the effects of adrenaline on the heart in this syndrome are temporary and completely reversible. As will be discussed further in question 5, one of the main features of this syndrome is that the heart is only weakened for a brief period of time and there tends to be no permanent or long-term damage.

​5. How does stress cardiomyopathy differ from a heart attack?Stress cardiomyopathy can easily be mistaken for heart attack. Patients with this syndrome can have many of the same symptoms that heart attack patients have including chest pain, shortness of breath, congestive heart failure, and low blood pressure. With a closer look, however, there are some major differences between the two conditions. First, most heart attacks occur due to blockages and blood clots forming in the coronary arteries, the arteries that supply the heart with blood. If these clots cut off the blood supply to the heart for a long enough period of time, heart muscle cells can die, leaving the heart with permanent and irreversible damage. This is completely different from what is seen with stress cardiomyopathy. First, most of the patients with stress cardiomyopathy that both we and others have seen appear to have fairly normal coronary arteries and do not have severe blockages or clots. Secondly, the heart cells of patients with stress cardiomyopathy are “stunned” by the adrenaline and other stress hormones but not killed as they are in heart attack. Fortunately, this stunning gets better very quickly, often within just a few days. So even though a person with stress cardiomyopathy can have severe heart muscle weakness at the time of admission to the hospital, the heart completely recovers within a couple of weeks in most cases and there is no permanent damage.

6. I am under a great deal of stress every day. Is it possible that I have been walking around with stress cardiomyopathy and did not even know it?
While there is no debate that chronic stress can have effects on human health, stress cardiomyopathy appears to be a condition that comes on suddenly and unexpectedly and resolves quite quickly. If you are a person who frequently has symptoms of chest pain or shortness of breath when under significant stress, you should be evaluated by your doctor. He or she may want to perform some basic tests to make sure you are in god health. It is unlikely, however, if your symptoms have been going on for a while that you have stress cardiomyopathy.

​7. Who is at risk for getting stress cardiomyopathy?
Because stress cardiomyopathy is a relatively newly appreciated syndrome, we are only beginning to understand why it happens and who is most likely to get it. Most of the patients we have seen with it do not have a previous history of heart disease. It is quite clear from the available medical literature so far, however, that stress cardiomyopathy affects primarily women. In addition, it tends to occur most frequently in middle aged or elderly women (average age about 60). While it can also occur in young women and even in men, the vast majority of the patients we have seen with this are post-menopausal women. The exact reason for this is unknown, and further research will be necessary to help explain this observation.

8. Once a person has had stress cardiomyopathy, will they get it again the next time they are under severe stress.
From what we have seen so far, the answer to this question appears to be no. While it is possible that the syndrome could recur, this is not what we have observed at our hospital. In the five years that we have been following patients with stress cardiomyopathy, none have experienced the syndrome a second time. Further, several of our patients went on to have other stressful events in their lives and none developed the syndrome again.

9. If I have had stress cardiomyopathy, what is my long-term prognosis?
Because the heart muscle is not permanently damaged with this syndrome, patients typically make a rapid and complete recovery. From our experience and from what has been published by other groups, the long-term prognosis for patients with stress cardiomyopathy appears to be excellent.

Post-Traumatic Stress Disorder Black America's Invisible Crisis

By Lois Beckett

Last October, Aireana and her boyfriend were driving through Oakland when a man on the street opened fire on their car. Her two children, ages 6 and 1, were in the backseat.

Aireana remembers feeling something slam into her jaw and hearing a sound like a firecracker popping in her head. Her boyfriend hit the accelerator and swerved down the street. He and Aireana turned at the same moment to check on the kids. They were safe. Then her boyfriend looked at her and saw blood spurting from her neck. “Oh, my God,” he said, panicking, and crashed into a parked car. 

In the shock after the crash, Aireana had only one coherent thought: I cannot die in front of my kids. They cannot see me die. She unbuckled her seat belt and pushed herself out of the car. As she stood, she felt dizzy and closed her eyes. But the thought of her children propelled her forward. They can’t see my body lying here dead. Still dazed, she walked away from the car. She could hear her daughter screaming behind her, “My mom’s dying!”

Earlier that afternoon, Aireana had gotten her kids ready to go to the park. She had taken meat out of the freezer to thaw for dinner. Her life, at 24, finally felt on track. That year had been hard: She had been unemployed for the first half of 2013 with no stable place to live. After scoring a new office job that summer, she moved into a two-bedroom apartment with her kids. She remembers feeling pretty as she looked at herself in the mirror on the way to the car.

A bullet had smashed through her front teeth, grazed her tongue and broken her jaw. In the emergency room, the surgeons repaired her tongue. Later, they wired her jaw shut so that it could heal. Aireana stayed in the hospital for more than a month. When she went home, her face was still puffy and swollen, and she had a hard time talking. Fragments of the bullet were still lodged in the side of her neck.

“You’re so lucky,” her friends kept telling her. “Why are you still so sad? You’re okay—you’re alive.” But Aireana couldn’t stop thinking about the shooting. She felt guilty, as if it were her fault that she had been hit. Why hadn’t she lifted her arm to block the bullet? Why hadn’t she ducked? The shooting played over and over in her dreams. Sometimes, reliving it, she remembered to duck, and then the bullet passed over her and hit one of her children. She’d wake up in a panic, soaked in sweat.

Every day at 3 p.m., Aireana paused at her front door. She knew she should go out and meet her daughter, who would be walking back home from school just around the corner. But the busy street overwhelmed her. Sometimes she would make it down to the end of the driveway in front of their apartment and then turn back.

In the aftermath of the shooting, she struggled to pay her bills. The phone company cut off her cell phone, but she didn’t care. She didn’t want to talk to anyone. Instead, she spent most of the day asleep. When she became tired of lying in bed, she’d curl up on the living room floor.

In America, violent crime is down significantly since 1993, when the nation’s gun homicide rate hit its peak. But there are still neighborhoods in majority Black cities like Oakland, Detroit, New Orleans, and Newark, New Jersey, where shootings are a constant occurrence and where the per capita murder rates are drastically higher than the rest of the country.

3,500 American troops were killed during the eight-year war in Iraq. Within the same time period, 3,113 people were killed on the streets of Philadelphia. According to FBI data, between 2002 and 2012 Chicago lost more than 5,000 people to homicide—that’s nearly three times the number of Americans killed in action in Afghanistan.

Over the past 20 years, medical researchers have found new ways to quantify the effects of the relentless violence on America’s inner cities. They surveyed residents who had been exposed to violence in cities such as Detroit and Baltimore and noticed symptoms of post-traumatic stress disorder (PTSD): nightmares, obsessive thoughts, a constant sense of danger.

In a series of federally funded studies in Atlanta, researchers interviewed more than 8,000 inner-city residents, most of them African-American. Two thirds of respondents said they had been violently attacked at some point in their lives. Half knew someone who had been murdered. Of the women interviewed, a third had been sexually assaulted. Roughly 30 percent of respondents had had symptoms consistent with PTSD a rate as high or higher than that of veterans of wars in Vietnam, Iraq and Afghanistan.

Experts are only now beginning to trace the effects of untreated PTSD on neighborhoods that are already struggling with unemployment, poverty and the devastating impact of the war on drugs. Women—who are twice as likely as men to develop PTSD, according to the National Center for Post-Traumatic Stress Disorder are more likely to show signs of anxiety and depression and to avoid places that remind them of the trauma.

In children, PTSD symptoms can sometimes be misdiagnosed as attention deficit hyperactivity disorder (ADHD). Kids with PTSD may compulsively repeat some part of the trauma while playing games or drawing, have trouble in their relationships with family members, and struggle in school. “School districts are trying to educate kids whose brains are not working the way they should be working because of trauma,” says Marleen Wong, Ph.D., the former director of mental health services, crisis intervention, and suicide prevention for the Los Angeles Unified School District.

Men with PTSD are more likely to have trouble controlling their anger, and to try to repress their trauma symptoms with alcohol or drugs. Though most people with post-traumatic stress are not violent, PTSD is also associated with an increased risk of aggression and violent behavior, including domestic violence.

The Atlanta researchers found that civilians they interviewed who had PTSD were more likely to have been charged with a violent crime and incarcerated than other people of similar backgrounds without PTSD—but the cause and effect behind this wasn’t clear. For some people, PTSD symptoms may have contributed to their involvement in the criminal justice system, while others may have developed PTSD later. “Neglect of civilian PTSD as a public health concern may be compromising public safety,” the researchers wrote.

Despite the growing evidence of PTSD in civilians, little is being done to address the problem. Hospital trauma centers often provide adequate care for physical wounds, but do almost nothing to help patients cope with the mental and emotional aftermath of trauma.

A 2014 ProPublica survey of 21 trauma centers in the nation’s most violent cities found that only three—in New Orleans, Detroit and Richmond—routinely screened victims of violence for the disorder. Trauma surgeons said they were aware of the burden of post-traumatic stress on their patients, but it was hard to get hospitals to spend money on new programs or staff to deal with PTSD.

Even Chicago’s Cook County Hospital, where researchers found that 43 percent of injured patients showed signs of the condition, has struggled to raise funds to support a new program. Doctors said they also worried about the scarcity of mental health providers, especially for low-income patients without insurance. Some said they were reluctant to screen patients for PTSD because they could not be sure they would get treatment.

What’s more, many doctors and nurses assume that shooting victims especially young Black men are responsible for what happened to them, says John Porter, M.D., a trauma surgeon in Jackson, Mississippi, which has a higher per capita homicide rate than Chicago’s.

The line of thinking is it’s their own fault, so who cares? We’ll save their life, but who cares? But post-traumatic stress doesn’t distinguish between “innocent” and “not innocent” victims. Researchers have found gang members are just as likely to suffer from post- traumatic stress as anyone else.

The burden of post-traumatic stress on low-income communities of color gets very little attention. What public recognition it does receive is often sensationalized: A TV reporter apologized this spring after a segment on young people dealing with trauma in Oakland referred to PTSD as “hood disease.”

“Someone in the community has to stand up and say, ‘Because of all the gun violence, we have a lot of traumatized people—and it’s not just the people who are being shot and shot at, it’s the people who are witnessing it, the vicarious trauma,’” says Arthur C. Evans, Jr., Ph.D., the commissioner of Philadelphia’s Department of Behavioral Health and Intellectual Disability Services.

With the support of Mayor Michael Nutter, Evans has pushed Philadelphia to treat trauma as a major public health issue and to develop a comprehensive approach to PTSD. Over the past eight years, city officials have worked with hospitals, community mental health clinics, pediatricians, schoolteachers and police officers to increase awareness of the disorder and make sure residents are connected with treatment professionals.

“We have to stop telling our kids they just have to live with this,” Evans says. The city has paid to train local therapists in evidence-based PTSD treatments and has launched a Web site—healthymindsphilly.org, which allows people to screen themselves for the symptoms of PTSD anonymously as a way of reaching people who might be reluctant to visit a mental health clinic.

Philly has also partnered with local faith groups to train leaders about mental health resources, because “in the African-American community, people often go to their faith leaders before they will come to a treatment professional,” Evans says. Philadelphia’s police department is educating its officers about mental health and the effects of trauma. “People who have untreated trauma are highly reactive, and it doesn’t take much to set them off,” Evans says.

Crisis intervention training helps officers discern between someone who is being obstinate and someone who “might have some other issues that are driving the behavior,” Evans says. The training also helps officers learn how to de-escalate a situation, rather than react with force. Philadelphia’s broad approach to PTSD includes a technique that’s already being tried in other cities: reaching out to victims of violence in the immediate aftermath of a shooting and bringing trauma education right to their hospital bedsides.

When Aireana was lying in Oakland's Highland Hospital last fall with her jaw wired shut, one of her visitors was Rafael Vasquez, an intervention specialist with Youth Alive!, the nonprofit group that founded the nation’s first hospital-based violence intervention program in 1994. Tall and solidly built, Vasquez sometimes has to reassure patients he’s not an undercover cop. His goal is to ensure that victims of violence stay safe after they leave the hospital and that they never come back under similar circumstances.

Over the winter, Youth Alive!’s licensed marriage and family therapist, Nicky MacCallum, visited Aireana at home to conduct therapy with her daughter. For people who have grown up in violent neighborhoods, the traditional 50-minute therapy session is not always right for them.

“Many times young people would walk out not having connected with the therapists, not feeling they could relate to them,” Vasquez says. “They were overwhelmed by the whole experience.” MacCallum has held sessions in coffee shops and parking lots and even on basketball courts while clients shot hoops.

By bringing therapy out of the clinic and into the community, Youth Alive! has seen an increase in the number of patients engaged in active therapy: from about 5 percent of its clients to 35 percent. MacCallum taught Aireana’s 6-year-old how to calm herself down with deep belly breaths. She talked to the girl about trauma in age-appropriate ways, asking if she ever felt like a turtle, hiding in her shell, or a prickly porcupine.

Sometimes MacCallum and Aireana’s daughter would sit on the living room floor and draw together as a way to express emotions difficult to put into words. Aireana started by sitting off to one side and watching the sessions. When the therapist told her, “Adults can draw too,” she then picked up a marker herself. This led to Aireana finally sitting down with MacCallum for a session of her own. They started by talking through a list of trauma symptoms: sleep problems, anxiety, fear of going outside. “I’ve got that,” Aireana remembers saying. “That too.”

MacCallum diagnosed Aireana with PTSD. “Nicky helped me,” Aireana says. “She was the first person I actually talked to who believed it was real, that my feelings were real.” MacCallum and other therapists say PTSD is the best diagnosis they can give in these instances—but that it’s not a perfect fit. For clients who live in violent neighborhoods, the trauma that they’re dealing with isn’t really “post.” “People in our community are constantly re-traumatized,” MacCallum says.

The street where Aireana was shot was only minutes away from the place where she had witnessed her first drive-by shooting when she was 8. She had been at a block party near her aunt’s house in East Oakland and thought she heard fireworks. She has a vivid memory of what she found instead: a car, in the middle of the road, with the driver slumped over, already dead, and blood running out of the car.

A few weeks after Aireana came home from the hospital last winter, a young man was murdered on the street in front of her house. She remembers seeing his last heaving breaths and his friends yelling and no one around to help. She broke down. This is happening all over again, she thought.

There’s no Department of Veterans Affairs to coordinate care for Americans repeatedly exposed to violence and trauma in their own neighborhoods. One of the first steps in addressing community PTSD, says Evans, who is leading Philadelphia’s trauma response, is to “get people to come around the table. Get a few mental health professionals, a few pastors and a few human services people who are seeing the impact of this to come together and have a conversation. That’s what we did.”

Community members who want to learn how they can help loved ones struggling with PTSD or other mental health issues can sign up for Mental Health First Aid, an eight-hour course run by the National Council for Behavioral Health that can also assist community groups with setting up their own training programs. The National Center for Post-Traumatic Stress Disorder and the National Child Traumatic Stress Network also offer resources for PTSD caused by community violence.

Over the summer in Oakland, Aireana’s children were terrified by the sound of fireworks. They kept thinking they were hearing gunshots. This past Fourth of July, Aireana decided she would try to help her kids adjust to the sound, rather than shutting it out. As her neighbors set off firecrackers in the street, she kept her kids at a distance.

She pointed to the lights: “That one’s cool.” A purple explosion: “Oooh, nice.” Gradually, they walked closer. Later, she gave her kids sparklers and watched them run around making glowing scribbles in the dark. She had always loved fireworks. It was good to see her kids not being afraid and enjoying them, too.

Depression & Stress: Faking It Until You Make It Can Hurt In The Long Run

By Dr. Wizdom Powell

‘Fake it until you make it’, how often have we received and heeded this advice when we are seriously stressed? It is hard to ignore since it almost always comes from the people who love us the most. 

Sometimes, we heed this advice without being fully aware of it because masking stress or pain is so deeply embedded in our ‘survival tactic DNA’. Many of our Black ancestors practiced masking or hiding pain because their day-to-day survival depended on it. So we learned to mask our stress and pain in similar ways. Some of us also watched our mothers, fathers and grandparents cope with stress by using this tactic.

The urge to fake it until we make it may be even stronger when we experience stress stemming from discrimination and unfairness since they are difficult to validate. We go to great lengths to hide any rip in our emotional vests because doing so helps us feel safer and in control.

But, the truth of the matter is that these survival tactics only provide temporary pain relief and may set us up to feel mental distress. And ironically, we may even feel more mental distress when we routinely try to push stress out of our awareness. Bottom line – We can only fake it for so long until we realize that we are not really making it at all.

Depression, one of the most commonly diagnosed mental health conditions, is one sign that despite faking it, you may not be really making it. The most recent estimates from National Institutes of Mental Health indicate that 10.4 million adults in the US (those 18 and older) had one episode of depression that led to significant impairment.

Far fewer Blacks are diagnosed with depression than Whites. But, this does not mean that stress is not taking a toll on our health. In fact, researchers at Virginia Commonwealth University and the University of Michigan suggest that Blacks use other kinds of behaviors (like overeating and substance use) to mask stress and depression.  These behaviors have their own set of consequences and are another sign that ‘faking it ‘can have even broader impacts on our health.

Some common symptoms of depression include:

*Difficulty falling or staying asleep

*Irritability

*Frequent crying

*Trouble concentrating

*Feeling hopeless, helpless, sad, or empty

*Loss of interest in activities

There are different forms of depression and the symptoms described above can range from mild to severe.  Some forms of depression can also be treated with therapy alone and some might indicate the need for medication. But, you won’t know where you stand if you don’t take off the mask and seek help.

help for depression often runs counter to all the survival advice and social messages we receive. Black women are urged to be superwomen while Black men are instructed to ‘take stress like a man’.  But masks and capes are for cartoon characters and masquerade balls.  It’s time we all retire them from use in our day-to-day lives.

So how do you stop faking it and begin really making it?

Step 1. Take your emotional temperature and honor where you are. Expressing emotions are not a sign of weakness. Getting angry, especially in response to unjust behavior, is legitimate.

Step 2. Ventilate don’t isolate. It is important that you find someone you trust to share your stress experiences with. Use your village of family and friends to both check your emotional temperature and get support.

Step 3. Take off the masks and capes. Seek professional help if you notice that your emotional temperature constantly runs high or the weight of your stress is leading to the depression symptoms described earlier. Social workers, psychologists and pastors can provide counseling and support.

Remember, those who love you the most want you to be healthy, happy and really whole. Faking it is no longer an option.