“You’re being weak! Why don’t you pull yourself together? Snap out of it! Why don’t you pull yourself up from your bootstraps?”
Sometimes that’s the reaction people face when they admit that they are suffering from depression. Depression is a highly common medical condition affecting nearly one out of 10 adults each year, and twice as many women as men. African Americans are no exception and although depression is a common and treatable condition, it often goes unrecognized and untreated in the black community.
“The stigma of depression in the African American community is prevalent and it has been quite prevalent for a long time — historically and present day,” says Dr. Earlise Ward, who is currently conducting research that focuses on treatment of depression in the African American community. “When the community is small, the stigma becomes even more prevalent because people are not willing to share about it or talk about it because they don’t want other people to know what’s going on with them.
“Of course, in the [black] community we don’t think of mental illness as an illness, we just go, ‘Oh, well. He’s crazy’ or ‘She’s a little bit off’ instead of realizing and recognizing that this is an illness,” Ward says. “It’s not a whole lot different from cancer or diabetes ... People die from mental illness. Part of [the] stigma comes from not being informed about what mental illness really is. We need to address the stigma by increasing awareness and increasing knowledge about mental illness.”
The Madison Times caught up with Dr. Ward at Mt. Zion Church on April 4 while she was hosting a community luncheon with food catered by Melly Mel’s. Ward is a licensed psychologist, assistant professor in the School of Nursing at the University of Wisconsin-Madison, and a member of Mount Zion Baptist Church. She is actively recruiting individuals to participate in her African American Depression Intervention (AADI) Project where she is the principal investigator.
“This luncheon was a great opportunity to connect with the community and informing them of this study that we are doing,” Ward says. “We really want to get their support and endorsement to publicize the study in the community. As you know, within the African American community there is quite a bit of silence around mental illness —particularly depression.”
Due to barriers, including limited access to mental health services and the stigma associated with mental illness, Ward says that they have struggled to get African-Americans into treatment. “Nevertheless, it was a tremendous opportunity today to connect with stakeholders in the community so they have a better understanding of what we are doing and then they can take the message into the community,” Ward says.
Depression can cause long-standing changes in feelings, self-esteem, activity level, and even sleep and appetite. Depression is treatable with medication, psychotherapy, and other treatments, which result in a very high percentage of people eventually responding well and gaining some relief from their symptoms. However, African Americans carry a heavy burden when it comes to depression because they are less likely than Caucasians to seek mental health services or to receive proper diagnosis and treatment. They are also more likely to have depression for longer periods, resulting in greater disability.
“One of my pet peeves is that if somebody is riding a bicycle and they fall off the bike and get up and their arm is hurting, they are thinking, “Well, maybe I broke my arm. Maybe I should go in to see a doctor,’” Ward says. “Why don’t we think the same way when we can’t sleep at night or when we’re crying a lot or when we’re feeling sadness and hopelessness? Why isn’t that internal voice not saying, ‘maybe I need to get some help?’”
Ward says there is a syndrome in the African American community called “strong black woman syndrome.”
“You gotta be strong ... You gotta keep your head up,” she says. “No matter what might be going on, you have to keep your head up and keep it going because you have to support the family. But if you’re not well, how are you able to take care of the family? At the end of the day, you are doing your family a disservice by not taking care of yourself.”
The AADI Project is seeking self-identified African American men and women in the Madison and Milwaukee communities between the ages of 30 to 60 with symptoms of depression as evidenced by data. This is Ward’s third year doing the study. She has two more years left. “We need 200 people and we’re a long ways from there,” she says.
Ward is the principle investigator and has a team of 10 people working with her in both Madison and Milwaukee. “It started in Milwaukee and we’ve moved into Madison. It’s a little harder to recruit in Madison because of the smaller African American population,” she says.
For the participants, the study involves 12 weeks of group counseling classes designed to treat depression. “We usually have between 8-10 people in a class. We meet every week. The groups are led by two professional mental health clinicians,” Ward says. “They talk about depression, help people recognize symptoms, develop healthy coping strategies, and then, hopefully, reduce the symptoms of depression and improve the quality of their lives.
“There is research indicating that seeking professional treatment for depression can make a huge difference and that people actually do recover from depression,” Ward continues. “Depression is certainly treatable and a lot of people in our community are not aware of that. They think that it’s sort of a death sentence, if you will. But depression is very treatable and it’s manageable and once it is under control people can have very normal and healthy lives.”
For taking part in the study, participants can get up to $140 plus transportation costs.
“It’s talk therapy. It’s all confidential,” Ward says. “What a luxury to have a place to come in and talk and tell the person about your day, the things that you’ve been worried about, the things that you are being stressed about, and the things that you’ve been doing to cope that are working and things that aren’t working. And, of course, you get to learn new strategies.”
So, how do I know if I am depressed?
“For our specific flier, we’ve listed some of the symptoms of depression: Are you feeling sad? Are you crying a lot? Are you feeling a sense of hopelessness? Are you feeling like life is not worth living anymore?” Ward says. “We use that on the flier, but when individuals come in to work with us for our study as well as if they went in to seek treatment at a mental health center, a complete assessment is done and they are then able to look at the symptoms and the individual behavior that people are engaging in. They are able to accurately diagnose if it is, indeed, depression.”
African Americans with mental illness are one of the country's most underserved and undertreated groups, Ward says. But it doesn’t have to be that way.
“You don’t have to live this way. It doesn’t have to be this way,” Ward says. “It’s so unnecessary. It’s quietly killing people, but help is available. Depression is treatable. That’s the message that we want to convey. If you can get treatment, usually within 3-6 months people are able to resume their normal lives.
“I’m hoping that we find that the treatment from the study is effective in reducing symptoms of depression and that people are able to have improvement in the quality of their life and that people are satisfied with the care that they receive,” Ward adds. “For people that need treatment, I hope that they are open and willing to continue to receive treatment [after the study is over].”
Ward quoted Dr. David Satcher in his first Surgeon General's report on mental health: “There is no health without mental health.”
“It is the core of who you are,” she says. “And if you’re not attending to your mental health needs, then what do you have?”
For more information about the AADI study, please call 1-800-346-5147 or e-mail EwardResearchTeam@gmail.com.