CABWHP publishes issue guides with thorough analyses of health policy issues addressing mental, emotional and physical health. Our Issue Guides are distributed via mail to Policy Advisory Group members and to over 1,000 colleagues and organizational collaborators.
Healing and Wholeness During the Holidays
Black women experience rates of depression that are twice that of our male counterparts. Black women are also more likely to go without treatment, experience more severe symptoms, and seek help only at a point where their symptoms are debilitating.1 The holiday season is a time when getting "the blues" is especially common. At a time when many people are enjoying the season, celebrating with friends and family, and spending some time off of work or school to relax, others may find themselves experiencing depression, anxiety, and feeling overwhelmed. It is especially hard to take care of oneself or reach out for support when every corner and song proclaims the joys of the season and you feel just the opposite.
For many women, depression is experienced as feeling extremely irritable, sad, hopeless or guilty. Your interest in things that once made you feel happy (like spending time with friends or enjoying a hobby) may have diminished and now those things feel more like chores. During the holiday season, many women feel especially overwhelmed by multiple gatherings, gift exchanges, meals to prepare, and guests to host. 2 The expectation that women will do most (if not all) of the work of buying gifts, cooking meals, planning parties, coordinating children's activities, participating in religious celebrations-and all with a smile and in "good spirits"-- is dangerous to our mental, spiritual, and physical well-being. Many women experiencing depression find it hard to relax at all and end up feeling worried and agitated about all of the things left on the "to do" list. With all of these expectations, many of us feel worthless and hopeless about living up to the "Super Woman" image.
In her book about Black women and mental health, Dr. Marilyn Martin, describes the ways that being faithful to our past, old family patterns or ways of being can be detrimental. A Black woman may feel that because her mother and grandmother did all the things they had to do without complaining (even when times were hard), then what right do I have to complain, do less, or seek support? 3 These expectations of being the caretaker who never needs to refuel or be nurtured contribute to the myth of the "strong Black woman". After a long time of meeting multiple responsibilities and being overcommitted, especially if the family tradition is to "keep it to yourself", the impact starts to show. Instead of reaching out for support, a person experiencing depression might find that eating, sleeping, drinking alcohol or using drugs "helps"-or at least seems to dull the pain for the moment. Other people find themselves sleeping too much or too little, feeling fatigued, having a hard time concentrating, or even having thoughts of suicide. 4
The National Institute on Drug Abuse found that over 60% of people who abuse drugs and alcohol also suffer from a mental disorder. 5 Using drugs is a common survival skill for those who have experienced trauma, violence or abuse. Over 25% of Black children who are exposed to violence meet the criteria for Post-Traumatic Stress Disorder. 6 Black women experience intimate partner violence at a rate 35% higher than that of white females, and at a rate 22 times higher than other races. 7 40% of Black women report experiencing abusive or coercive sexual contact by the age of 18. 8 50% to 90% of all women who experience sexual harassment, rape, sexual abuse, coercion or molestation will develop symptoms of trauma including depression, anxiety, hopelessness, and decreased interest in enjoyable activities. 9 Holidays can trigger feelings associated with past trauma, especially if a family member that was abusive in the past will be attending celebrations or family functions. Remember that you can say "no" to some gatherings. By saying yes to only those things that will be edifying, you will feel less traumatized, resentful and overwhelmed. 10
It is important to acknowledge your own feelings and know that you do not have to force yourself to be happy just because it is the holidays. At the holidays, or any time of year, be aware that families change and grow. Traditions often change or shift from one generation to the next. A healthy way of honoring our ancestors is to acknowledge past traditions, and then keep those that are healthy for us today. Be aware that not all " traditions" may be possible or healthy to continue. 11 Take the time to continue your healthy habits during this season. Unhealthy or emotional eating and excessive drinking at this time of year can exacerbate depression and other health problems. 12
Many social factors contribute to experiencing symptoms of depression or other mental health problems. A 2001 Surgeon General's report said much of the depression and stress that women of color experience is a result of racism, gender bias, poverty, violence, large family size and social disadvantages. These social components, as well as the lack of culturally competent mental health services make getting help more difficult. Black women are often at a socioeconomic disadvantage in terms of accessing medical and mental health care. Approximately 20% of Black people are uninsured. 13 Fannie Lou Hamer's statement about "being sick and tired of being sick and tired" is quite relevant for Black women experiencing depression, since they often suffer from persistent, untreated physical and emotional symptoms. If these women consult health professionals, they are frequently told that they are hypertensive, run down, or tense and nervous. They may be prescribed anti-hypertensives, vitamins, or mood elevating pills; or they may be informed to lose weight, learn to relax, get a change of scenery, or get more exercise. While these other things can be good advice, the root of their mental health symptoms frequently is not explored. These women continue to feel tired, weary, empty, lonely and sad. 14
As a community, Black women are more likely to depend on family, religious and social organizations than on health or mental health professionals or other agencies that specialize in mental health services. 15 Other women friends and family members may say, "We all feel this way sometimes, it's just the way it is for us Black women", which often discourages our sisters from seeking the help they need and deserve to heal and start feeling better. 16 Especially at the holidays, women often feel guilty for wanting to have some time to relax and take care of themselves, when there is so much to be done. It is vital for Black women to take care of our mental health needs through the support of our families, friends or religious leaders, and sometimes with an expert. Despite our best efforts to live as "Super Women", the stress of the holidays can help give us the push we need to finally make our mental and emotional well-being a priority.
1. Black Women's Health, "Depression", www.blackwomenshealth.com
2, Health Plus, "Depression and the Holidays" by L. Axmaker, Ph.D., www.vanderbiltowc.wellsource.com
3. Martin M.D., M.P.H., Marilyn, Saving our Last Nerve: The Black Woman's Path to Mental Health, 2002
4. American Psychiatric Association, Diagnostic and Statistical Manual and Health Plus, "Depression and the Holidays" by L. Axmaker, Ph.D., www.vanderbiltowc.wellsource.com
5.National Institute on Drug Abuse (NIDA), www.nida.nih.gov
6. National Alliance on Mental Illness (NAMI) Multicultural Action Center, www.nami.org
7. Bureau of Justice Statistics, 2000
8. National Black Women's Health Project, Africana Voices Against Violence at www.ase.tufts.edu
9. California Coalition Against Sexual Assault Report 2003
10. Mayo Clinic, "Stress, Depression and the Holidays", www.mayoclinic.com
11. Mayo Clinic, "Stress, Depression and the Holidays", www.mayoclinic.com
12. Health Plus, "Depression and the Holidays" by L. Axmaker, Ph.D., www.vanderbiltowc.wellsource.com
13. National Alliance on Mental Illness (NAMI) Multicultural Action Center, www.nami.org
14. Warren, Barbara Jones, "Examining Depression Among African American women Using Womanist and Psychiatric Nursing Perspectives", www.uga.edu
15. National Alliance on Mental Illness (NAMI) Multicultural Action Center, www.nami.org
16. Warren, Barbara Jones, "Examining Depression Among African American women Using Womanist and Psychiatric Nursing Perspectives", www.uga.edu