At that time, we lived opposite a car repair place. The owner of this business was a hard-working older man. Every morning my mother would lean out of one of the front windows and call for Mr. Cox. They would exchange a few pleasantries as they both prepared for their day. She would then fasten the window to let the morning breezes in and would start singing gaily. It was her singing that would eventually wake me up.
Whenever my mother greeted the dawn with an exchange with hard-working Mr. Cox, she would spend the rest of the day in a flurry of activity. If however, another neighbor happened to intercept her plan – just happened to be passing by as she opened her window – she would suck her teeth in irritation, especially if said passer-by was known in the village as a good-for-nothing who wasted his time. My mother was convinced that this person’s energy would influence hers. She would spend the rest of the day complaining about having gotten nothing done thanks to that so-and-so that she saw first upon arising.
I believe that my mother may have been depressed just before she died. I remember that towards the end of her life, in the last few months before she died, she became more and more desperate about seeing Mr. Cox at the crack of dawn. And she complained that she did not understand why she was still so tired, even though her day had started right.
I found myself thinking about my mother as I perused the latest issue of “Psychiatric News”. A writer, Aaron Levin – who sounds neither female nor Black – was writing about depression among women of color. He believes that there are many factors that militate against the recognition and treatment of depression among African-American women. He makes the case that the most salient of these may be cultural.
Traditionally, epidemiological studies on the prevalence of depression have suggested that African-Americans are less likely than whites to be diagnosed with major depressive episode, major depressive disorder, or dysthymia. [Dysthymia is best described as a low-grade chronic sadness, similar in symptomatology to major depression but with significantly less intensity.] African-Americans are described as more likely to develop phobias or somatization disorders.
However, in 2005, a third study by the National Health and Nutrition Examination found higher rates of dysthymia among African-Americans and higher rates of depressive disorder among Whites. In other words, Black people appear to be less likely to suffer major depression, but are more likely to sing the chronic blues.
This finding has been endorsed by other more recent studies that have noted a closing of the depression gap between Blacks and Whites. One study found that African-American women born in the US were three times more likely to report depression than immigrants from Africa or the Caribbean. Apparently it's life in America that depresses the heck out of many Black women.
Allesa English, M.D., an assistant professor of psychiatry at the University of Tennessee, Memphis Center for Health Science and director of its psychiatry residency program, believes that the problem is less diagnostic and more cultural. English maintains that African-American women simply present differently. They may be less likely to use words like ‘depressed’ or ‘sad’. They may be more likely to complain of feeling tired or to report nonspecific pain.
English believes that many Black women may be less willing to describe themselves as depressed as a result of the stigma attached to seeking help and the risk of being perceived as crazy. When some Black women summon up the nerve to seek help, they may spend more time describing aches and pains and less time labeling their condition as depression. In fact, some may feel offended if this word is used to describe their experiences.
Even when diagnosed with depression, many Black women resist or delay taking antidepressant medications, as a result of a distrust of the medical community or the fear of unknown side effects and/or drug dependence. In other words, Black women are more likely to allow themselves to suffer. And this makes sense, because many have suffered for so long, what’s a little more?
I think of all this as I think of my mother. Her desperate superstitious belief that the mere sight of Mr. Cox was enough to get her energized for the day may have served to distract her from a growing awareness of an underlying dysthymia. Her fatigue as she neared the end of her life may have been her body’s way of telling her that she was going to die unhappy. And she did.