Bad Nerves...
And other things we say about mental health
My grandmother used to sigh and say her nerves were bad. And that was all she would say. As a child, I knew that meant she wasn’t feeling happy.
I did not understand until years later, once I was practicing family medicine, how many Black women used some version of the same sentence. Stressed. Tired. Nerves. These are the words we reach for instead of the real ones. Anxiety. Depression. PTSD. We were taught those words meant weakness and were dangerous to say out loud.
July is Bebe Moore Campbell National Minority Mental Health Awareness Month. She was a journalist and novelist who fought for awareness of Black and brown mental health struggles. Her daughter experienced mental illness, so her advocacy grew out of her personal frustration of getting her child the care she needed.
The rates of depression, anxiety, and serious psychological distress for Black Americans are not very different from those of the general population. But the rate of seeking and receiving care is much lower. That gap, among other things, is about historical mistrust of the healthcare system, lack of culturally competent providers, barriers to access, and cultural stigma in our communities.
My grandmother’s silence was not weakness. It was an inheritance. Racial trauma and intergenerational trauma shape how we regulate emotion, how we trust, and how we ask or don’t ask for help.
Many of us seek solace in our faith communities when we are distressed; however, for serious mental health problems, prayer and church are supports, not substitutes for adequate care.
Where to Start:
Start by naming it, even just to yourself. Anxious, depressed, grieving, overwhelmed. Seek help without shame or guilt. Find a provider, and remember fit matters as much as credentials. Ask a potential therapist whether they have worked with Black clients before. Check out melanin and mental health for a list of providers. If you are struggling with your mental health and are in crisis, seek help here.
Writing Desk:
Think of the word someone in your family used instead of the real one. My grandmother's was “nerves” for anxiety. Write what that word was standing in for.
Odds & Ends:
This week I’m recommending Nadia Owusu’s Aftershocks, a memoir built around the metaphor of earthquakes, the way trauma keeps arriving in waves long after the initial rupture. Owusu writes through abandonment, a father’s death, and her own mental breakdown.
It is July hot here on the East Coast. I am wearing breathable cotton, trying to do less, and staying in the air conditioning. Stay hydrated, keep the blinds closed during peak sun, and check on anyone elderly or alone near you.
Hey, I’m going to be watching the FIFA World Cup in Philly on Saturday. France is expected to dominate, but I’m excited to be a part of the action and see the once-in-a-generation talent Kylian Mbappé.
This week, I got to do my virtual launch event for Brother Epistles with Split/Lip Press. Wonderful to be in conversation with my brilliant editor, Athena Dixon, and fellow SplitLip author Sean Enfield. And celebrate with my whole wonderful publishing team at SplitLip.
Here are some upcoming events. Join me! More to Come!
References
Anglin DM, Alberti PM, Link BG, Phelan JC. Racial differences in beliefs about the effectiveness and necessity of mental health treatment. Am J Community Psychol. 2008;42(1-2):17-24.
Lee AT, Chin P, Nambiar A, Hill Haskins N. Addressing intergenerational trauma in Black families: trauma-informed socioculturally attuned family therapy. J Marital Fam Ther. 2023;49(2):447-462.
Hankerson SH, Moise N, Wilson D, et al. The intergenerational impact of structural racism and cumulative trauma on depression. Am J Psychiatry. 2022;179(6):434-440.
Mongelli F, Georgakopoulos P, Pato MT. Challenges and opportunities to meet the mental health needs of underserved and disenfranchised populations in the United States. Focus (Am Psychiatr Publ). 2020;18(1):16-24.
Cogburn CD, Roberts SK, Ransome Y, Addy N, Hansen H, Jordan A. The impact of racism on Black American mental health. Lancet Psychiatry. 2024;11(1):56-64.
Hudson DL, Collins-Anderson A, Hutson W. Understanding the impact of contemporary racism on the mental health of middle class Black Americans. Int J Environ Res Public Health. 2023;20(3):1660.
Geronimus AT, Hicken M, Keene D, Bound J. Weathering and age patterns of allostatic load scores among Blacks and whites in the United States. Am J Public Health. 2006;96(5):826-833.