Anxiety is among the most common mental health conditions. Yet many Black people fear mental health stigma, and avoid treatment. And those who seek care may encounter clinicians who do not recognize the impact of racial trauma.
According to Census Bureau data, rates of depression and anxiety have increased among Black Americans, following the murder of George Floyd in police custody.
Research shows that anxiety may present differently in Black Americans, who are more likely to develop post-traumatic stress disorder (PTSD) than white Americans.
This article explores anxiety in Black Americans, including the causes, common myths and stigmas, treatments, and coping methods.
Causes
Anxiety is a complex mental health issue, with many triggers. Some common causes across racial groups include:
- early trauma or abuse
- family history, including genetic and early environment
- shy or inhibited temperament
- certain medical conditions, including heart arrhythmias and thyroid disease
Black Americans face several additional risk factors for anxiety, including racial trauma. Those risk factors include:
- exposure to racism and racist abuse
- the effects of racism, such as fewer opportunities and less safe communities
- higher rates of trauma, including sexual assault, and police violence
Symptoms
Anxiety can manifest in many ways, and in several related diagnoses. They include obsessive-compulsive disorder (OCD), post-traumatic stress disorder, phobias, and generalized anxiety disorder. The common symptoms include:
- physical anxiety, such as a racing heart, tension in the chest, or butterflies in the stomach
- feeling anxious or afraid
- feeling irritable or on edge
- engaging in compulsions, such as washing hands, to ease anxiety
- avoiding people or places that remind someone of trauma
- experiencing intrusive nightmares, memories, or flashbacks
- having trouble concentrating because of distracting anxiety
- having specific fears or phobias
- developing anxiety and tension-related ailments, such as tension headaches or chronic muscle pain
Over time, anxiety can affect a person’s health. Some researchers argue that Black Americans experience weathering. This is a long-term erosion of mental and physical health due to chronic trauma, stress, and racism.
Across every age and gender, on average, Black people live shorter lives than white people.
Statistics
Mental health is worse among Black Americans, who have a 20% higher rate of serious mental health issues than people in the general population.
Suicide rates are rapidly rising in the Black community, particularly among children. Among high schoolers, 9.8% of Black students report attempting suicide, compared with 6.1% of their white peers.
Suicide attempts among white teens decreased between 1991 and 2017, but the rate rose in Black teens in the same period.
Suicide was the leading cause of death among Black young people aged 15–24 years in 2017.
Common stigmas
Some research shows more stigma against those who seek mental health care in Black communities.
In many families, being Black means they should be resilient and triumph against the odds. If they have a mental health condition or seek mental health care, it may feel like a sign of weakness.
Racism may also play a more direct role in mental health stigma. Some Black people worry that if they seek mental health care, people will see them as crazy or dangerous. This could intensify the effects of systemic racism.
In other cases, white therapists may use racist norms in therapy, or fail to acknowledge racial trauma in Black mental health.
For many Black people, mental health support is less accessible than it is for their white peers. Black people might not seek help because of stigma, or because they fear racism in therapy or medicine. Others may be unable to find a culturally competent therapist, especially if they live in a predominantly white area.
In 2018, 11.5% of Black people were without private health insurance. This can make it extremely difficult to afford therapy. Even with coverage, it is a challenge to find a quality therapist who insurers will cover.
