they are as a person or who they are as an African American.” She says that while the predisposition for depression is genetic, depressive symptoms may present themselves during stressful life events.
Since African American professionals usually face higher levels of scrutiny and common concerns such as the glass ceiling, stress and depression are not uncommon. “In the corporate sector, you think that people have ‘arrived,’ but they are not immune from getting the illness of depression. And if it is untreated and overlooked, there is a risk that it could end up being a fatal illness,” says Primm. She adds that black professionals often feel they have to hide their depression for fear of damaging their careers and to feel secure in their positions. “They may feel that they’ve worked so hard to get to this point. They may fear getting treatment because it may impair their upward mobility or ability to maintain their status. You don’t want to give anyone a competitive edge.”
The dangers of such behavior are great. According to Primm, it’s not uncommon for executives to try to “work through the depression,” overwork to the point of exhaustion, or begin abusing substances. “Because of the realities of racism and how we as African Americans are judged differently, the risks of admitting we are ill are very high.”
Not much is understood about the exact cause of depression, but we do know that it involves certain neurotransmitters, like dopamine and serotonin. People who are depressed often do not show enough serotonin activity, for example, and this is where antidepressant SSRI (selective serotonin reuptake inhibitor) medications might help. They include brand names like Paxil, Prozac, and Zoloft. But there are a host of other medications doctors might provide to treat varying degrees of depression.
New research is also uncovering strong links between depression and other debilitating diseases, such as cancer, heart disease, and diabetes. In fact, people with diabetes have a twofold chance of getting depressed, and people with depression are twice as likely to get diabetes. Depression and diabetes involve a common part of the brain. They also both involve the stress hormone cortisol, too much of which is damaging to brain cells.
Although depression is an equal opportunity disease, manifestation of symptoms can differ widely among ethnic groups. “It’s very unusual for an African American man to come in and say he’s ‘sad,’ because it’s not appropriate culturally for a black man to present himself that way,” says Primm.
Often, African American men and women will display their depression as anger or irritability instead of sadness. Changes in eating habits and complaints of chronic pain that no physical evidence can substantiate may also be red-flag indicators of depression in African Americans.
Large-scale studies have typically shown African Americans have a lower rate of depression than the majority population. “Non-Hispanic blacks and Hispanics both have a significantly lower lifetime risk of ever becoming clinically depressed than non-Hispanic whites, but they also have higher risks of chronicity once they become depressed,” says Kessler.