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.
Dealing with Trauma, Depression and Stress
(When everyone else is celebrating!)
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
Studies indicate that Black women experience high rates of sexual and domestic violence. The California Black Women's Health Project has been speaking out about the link between depression and sexual violence because sexual violence is a health issue, a reproductive justice issue, and a mental health issue.
Black women are suffering because of the silence and denial around the prevalence of sexual abuse and assault in our communities. Rape victims are more likely than non-victims interviewed to be in poor health, have frequent health problems, use drugs and alcohol, express low satisfaction with life, experience depression, and think about suicide.2 Approximately 40% of Black women report coerced or forced sexual contact by the age of 18. 3
The holiday season is a time when getting "the blues" is especially common. For survivors of trauma and abuse, this time of year can be an extremely painful and difficult time. As many people are enjoying the season, celebrating with friends and family, and spending some time off of work or school to relax, survivors may find themselves experiencing depression, anxiety, and feeling overwhelmed. It is especially hard to take care of oneself or reach out for support when "joys of the season" are everywhere and you feel just the opposite.
For many survivors, the pain and trauma of sexual abuse or assault can overshadow the positive aspects of the season. Often, the depression and anxiety associated with trauma 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. Many Black women find themselves struggling to get by financially, not able to meet their goals, not enjoying any fun activities, or often feel completely overwhelmed by work, family or school responsibilities. For these sisters, reaching out for help in dealing with the impact of sexual violence can feel like too much to tackle or seem "selfish" when there is so much to do for others. During the holiday season, many women feel especially overwhelmed by multiple gatherings, gift exchanges, meals to prepare, and guests to host.4 The expectation that women will do most (if not all) of the work (e.g., buying gifts, cooking meals, planning parties, coordinating children's activities, participating in religious celebrations) is dangerous to our mental, spiritual, and physical well-being. Many women experiencing depression and trauma 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. CABWHP is urging women to advocate for ourselves and our sisters. We must break free of being the "Super Woman" and understand that our physical and mental health depend on prioritizing ourselves.
In practice, clinical depression tends to be defined by symptoms such as:
- Feeling helpless, hopeless, worthless;
- Experiencing anxiety, forgetfulness, and poor concentration;
- Sleeping too much or developing insomnia;
- Losing your appetite or overeating; and
- General fatigue. 5
Being a survivor of past trauma can make these symptoms even worse. Abuse and feelings of depression can make people expect the worst from life, magnify failures and minimize successes. Black women are often taught to be caregivers and to be self sufficient. 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?6 We tend to blame ourselves for anything that goes wrong, even events over which we have no control. Healing from trauma and depression means knowing that being abused or assaulted is never your fault. You must find ways to take back your power.
One of the significant stressors for survivors at the holidays is having to see family members or others who abused you, or unsupportive family who blamed you or did not protect you from the abuse or assault. In the Black community, large extended family gatherings and religious and cultural celebrations occur this time of year-usually with Black women doing the planning, cooking, and hosting. Many survivors are revictimized year after year by being made to "act as if" everything is alright when they are sharing a meal or holiday function with the perpetrator of the sexual violence. Supportive friends and family should not make you feel obligated. You deserve to have your boundaries respected. If you might see a perpetrator at a family or social event, make a safety plan. Bring a supportive friend, give yourself permission to leave the gathering, or make other plans. 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.7 You can start a new, healthy tradition of taking care of your needs.
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.8 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". Often, this discourages our sisters from seeking the help they need and deserve to heal and start to feeling better.9 We need our "village" to help heal the trauma of sexual violence and the depression and stress it often causes for years to come.
Community, religious leaders and loved ones of survivors of trauma can provide an opportunity for a Black woman struggling with depression to find hope. Loved ones can help by believing the survivor, listening when the person is ready to talk, and by never saying things like "get over it" or "that's in the past"-your loved one is dealing with the depression, pain, and impact on her life now.10 Pay attention to clues such as irritability, silence or withdrawal, as it can mean your loved one needs support but can't ask for it. Support is empathy, not problem-solving. Focus on understanding feelings rather than giving solutions or advice. What works for one person, may not work for another individual. Acknowledge that your loved one will need to find her own way to heal. Allow the survivor to make her own decisions about who to be around and how to feel safe. Let the survivor make the decision about who to tell about the assault and when to tell about it.
Help the survivor by supporting her in the healing process and by respecting options such as seeking counseling, group therapy, or medication in addition to other support. Allow the survivor to decide when she is ready for counseling, telling others in the family, or resuming any sexual contact with an intimate partner. The survivor had her power taken away by the sexual assault. Be a part of helping her feel empowered, not forcing her to do things she is not ready to do.11 It may also be very important to get support for yourself and to learn more about what your loved one is going through in order to be of help.
For many Black women who have survived sexual or domestic violence, finding healing at the holidays starts with the understanding that you are having a normal reaction to an abnormal amount of stress. You are not going crazy. You won't feel this way forever. You can heal. Take this holiday season to start habits that will nurture and care for your mind, body and soul. Practice being gentle and kind to yourself. Take a deep breath, listen to your favorite music, journal about your feelings-find healthy coping skills that help you feel safe. You do not deserve to be hurt anymore.
Many survivors have developed survival skills to deal with the pain of being violated. If you are using gambling, shopping, sex, food, isolation, drugs, alcohol, or hurting yourself to cope, please reach out for help. For others, the holiday stress can pull us away from our healthy habits. 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, trauma, and other health problems.12 There are mental health professionals and hotlines that specialize in supporting you while you heal from the past and shape a brighter future-one where you can enjoy the holidays.
If you or someone you love is the survivor of sexual or domestic violence, please reach out for help:
Rape, Abuse, Incest National Network (RAINN): 1(800) 656-HOPE or www.RAINN.org/
National Domestic Violence Hotline: 1(800) 799-7233 or www.ndvh.org
California Coalition Against Sexual Assault (CALCASA): www.calcasa.org
Statewide California Coalition of Battered Women (SCCBW) www.sccbw.org
Verbal Abuse Support Resources www.verbalabuse.org
Institute on Domestic Violence in the African American Community www.dvinstitute.org
Faith Trust Inc. (Faith and domestic and sexual violence) www.faithtrustinstitute.org
The Black Church and Domestic Violence www.bcdvi.org
National Coalition Against Domestic Violence www.ncadv.org
Mental Health Services Act:
Stakeholders Meetings and Statewide Conference Calls
Feb. 1-9, 2007
Let your voice be heard!
Help determine how Prop 63 funds will be used to improve prevention and early intervention outreach for the state of California
To register, visit http://www.dmh.ca.gov/MHSA/meetings.asp
Click for more info
1 Black Women's Health, "Depression", www.blackwomenshealth.com
2 Harris, Louis, and Associates, "The Health of American Women Survey", www.actabuse.com
3 Africana Voices Against Violence, Statistics, www.ase.tufts.edu/womenscenter/peace/africana
4 Health Plus, "Depression and the Holidays" by L. Axmaker, Ph.D., www.vanderbiltowc.wellsource.com
5 American Psychiatric Association, Diagnostic and Statistical Manual and Health Plus, "Depression and the Holidays" by L. Axmaker, Ph.D., www.vanderbiltowc.wellsource.com
6 Martin M.D., M.P.H., Marilyn, Saving our Last Nerve: The Black Woman's Path to Mental Health, 2002
7 Mayo Clinic, "Stress, Depression and the Holidays", www.mayoclinic.com
8 National Alliance on Mental Illness (NAMI) Multicultural Action Center, www.nami.org
9 Warren, Barbara Jones, "Examining Depression Among African American women Using Womanist and Psychiatric Nursing Perspectives", www.uga.edu
10 Sexual Assault Crisis Agency, Rape Trauma Syndrome Packet, Tips for Loved Ones
11 YWCA Sexual Assault Crisis Services Program Newsletter 2005, "Finding Healing"
12 Health Plus, "Depression and the Holidays" by L. Axmaker, Ph.D., www.vanderbiltowc.wellsource.com