Depression Among Black Men - Finding Help and Reasons to Hope

Excerpted from
Standing In the Shadows: Understanding and Overcoming Depression in Black Men
By John Head

I've never considered myself a violent person. I'm slow to anger and sparing in shows of emotion of any kind. But at that moment, standing there on the sidewalk, I felt a white-hot rage. I saw the world bathed in that are light intensity. I wanted to kill the guy. He smirked, got into his car, and drove away. I stood there still thinking that I wanted to kill him, and fearing that if I had had a gun or some other means of doing it, I would have. This wasn't me.

But what if I were not so far removed from being that kind of person? What if I wasn't a violent person from the outset, but had grown up in an environment where violence was expected? What if I routinely carried a weapon because so many people around me did? If those things were true, and if they were compounded by the impulsiveness, the diminished emotional control, and the failure to reflect on the consequences of an action that can be symptomatic of clinical depression, I could have done something horrible and irrevocable over a parking space. I would have been fully responsible for what I did, but that wouldn't change the fact that it could have been prevented.

Don't misinterpret this story. It's not a warning that depression leads to violence. Quite the contrary, the clinically depressed person is more likely to be a danger to himself than to others. It's true that irritability, clouded thinking, loss of emotional control, and other symptoms of depression can make the sufferer more volatile and vulnerable to being provoked into confrontation. But, like people with other mental disorders, depressed people who get treatment are no more prone to violence than anyone else.

So the story isn't a cautionary tale about depression and violence. Rather, it's about race and depression, and what may happen when the twain meet.

No doubt, the run-in over the parking space was fueled by a surplus of testosterone. But there also was a racial subtext to my confrontation with the rude young man. I can only speculate about how race influenced his behavior. He was too young to remember the era when his white skin would have been enough to earn deference from any black person. I doubt that he was set off because a black person failed to act in a subservient manner toward him. He probably considered himself an equal opportunity jerk, someone who mistreats people without regard to race or national origin. Perhaps subconsciously, however, he viewed black men as inherently threatening, so he went out of his way to make it clear that he wasn't going to let a black man push him around.

For my part, I do remember a time when it would have been inconceivable for me to clash with a white person the way I did that day. I'm ever conscious that those days have passed into history-but did my memories of the era of white supremacy transform this little set-to over a parking space into a very painful and infuriating reopening of old wounds? Did the fact that a white person felt he could figuratively and literally run over my rights with impunity stir in me deep-down doubts about our progress toward racial equality and harmony over the last four decades? And did my depression have anything to do with the existence of those doubts, if those doubts existed at all?

I would answer yes to all those questions.

In physics there is the concept of the "multiplier" a device that intensifies the effect of a force or phenomenon. Similarly, in medicine, there is synergism, when the combined effect of two substances is greater than either substance alone could produce, and also greater than their effects would be when added together. The textbook Maxy-Rosenan-Last Public Health and Preventive Medicine explains this "multiplicative" effect with the example of asbestos and smoking: "Asbestos exposure increases the risk of lung cancer 5-fold over the risk of the unexposed person, while smoking increases the risk of lung cancer about 10-fold over the nonsmoker s risk. The asbestos worker who smokes has a risk of about 50 times greater than the person with neither exposure."

Even though depression falls within the realm of medicine rather than physics, I'll take the liberty of coopting the concept of the multiplier for this discussion; the term is easy to understand and clearly evokes what a black man with depression goes through. I maintain that racism is a multiplier for clinical depression. I believe that the person who is a victim of racism is more susceptible than others are to depression and is in greater danger of suffering a more severe form of the illness.

This is very different from arguing that race alone determines whether a person will suffer from depression and how severe the depression will be. The Surgeon General's Report on Mental Health says studies show no evidence that African Americans as a racial group are more prone to depression than other racial groups. I don't argue with that conclusion. I do indeed argue with the failure to take the next step, which is to determine whether the rate of depression in African Americans is higher in spite of the absence of a genetic predisposition toward depression. Are factors other than genetics at play? I believe they are, and I also believe that racism-because of the double whammy I discussed earlier-is the biggest of the X-factors contributing to depression in black men.

Whatever the cause of clinical depression, the course of the disease is influenced by how we see ourselves and how we believe others see us. The ultimate goal of any treatment is to counter the negativity the depressed person sees in those two images. Racism is about reinforcing our negative self-image and the negative light in which we believe others see us. The presence of racism in our culture and our social atmosphere increases the effect of depression on black men exponentially.

In truth, this is one of those areas in which those who anoint themselves the only ones willing to speak about race forthrightly, without being cowed by political correctness, are getting it wrong. Take, for example, the case of the former New York Times reporter Jayson Blair.

A lot was said about race in the aftermath of revelations that Blair fabricated and plagiarized many of his articles, some of which were front-page scoops. Many of those talking were opposed to affirmative action or, at best, were dubious about the value of diversity in the workplace. They charged that top editors at the Times overlooked a high rate of reporting errors and other early signs that Blair was not capable of meeting the newspaper's journalistic standards. The reason this happened, the argument goes, is that Blair is black and the editors were willing to sacrifice all else just to have another black face in the newsroom. In other words, Jayson Blair's race enabled him to do what he did.

What wasn't talked about much was the role racism played in causing Blair to do what he did. I believe racism was a factor. Here's why.

I'm not a psychotherapist, of course-if I were, I would know better than to try to diagnosis a disorder in a person I've never so much as met. But I will take Jayson Blair at his word when he told the New York television station WCBS that what happened at the Times "has to do with my own human demons, my own weaknesses, and it ranges from ... my struggles with substance abuse to my own struggles with mental illness." I take that statement to mean that Blair has been diagnosed, by a professional or by himself, as suffering from a mental disorder.

Add racism, as a multiplier of the mix of mania and depression Blair appears to have been experiencing. A better understanding of the extremes of his professional failings emerges. As a young black man given the opportunity to breathe the ratified air of The New York Times he must have felt pressure that would have pushed him hard, even if he were not contending with mental problems. He must have felt he lived in a society that didn't believe he, as an African American man, could succeed. Even as he achieved successes, he probably expected that there were people around him who felt a black man didn't deserve such successes. Going to places where he believed his race made him unwanted, even as an emissary of The New York Times, must have been daunting. Blair would have felt the symbiotic dynamic between racism and depression. If racism had instilled in him any doubts of his abilities and his worth, depression would have increased those doubts. If somewhere deep in his sub- conscious every encounter with a white person seemed to risk racial rejection, depression would have brought it to the surface.