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.
This article explores anxiety in Black Americans, including the causes, common myths and stigmas, treatments, and coping methods.
- 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
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.
Mental health is worse among Black Americans, who have a 20% higher rate of serious mental health issues than people in the general population.
Certain mental health conditions, such as PTSD, are more prevalent in the Black community. Because PTSD cannot exist without trauma, this suggests that high rates of racial trauma may play a key role in Black mental health.
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.
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can call 800-799-4889.
Myths about Black mental health may uphold racist ideology and prevent people in need from seeking care. Some common myths include:
- Anxiety is a choice or a personal problem: Many Black people believe that with the right attitude or prayer, they can get rid of mental health issues. Mental health conditions are serious health problems that a person cannot think or pray away.
- Psychological differences are natural: For centuries, racist scientists have claimed that apparent racial differences are innate, because of different brains, hormones, or genes. Race is a cultural construct, not a biological fact. Racial determinism ignores the role of racism and discrimination in Black mental health.
- Black children do not experience mental health problems: Children can and do face mental health issues. Among Black children, the problem is especially acute, with suicide rates rising.
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 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.
The right treatment for anxiety demands a personal and collaborative approach. Not every technique works for everyone, so a person should work with a mental health provider they trust, and be open to different interventions. The most effective treatments for anxiety include:
- Therapy: Therapy can help a person better understand their anxiety, identify triggers, develop coping skills, and gain an outlet for their pain. Techniques that help a person better control their thoughts and emotions, such as cognitive behavioral therapy, may prove helpful.
- Medication: Medications that may help include anti-anxiety drugs, antidepressants, and sleeping remedies.
- Residential treatment: People with severe anxiety or mental health problems that endanger their life may get the most help from residential treatment.
Some other strategies may also offer some relief. They include:
- Good self-care: Regular exercise, quality sleep, and a balanced diet may ease anxiety and help someone remain in good health.
- Activism: People who experience anxiety because of racial trauma may find an outlet in activism.
- Supportive community: A support network can prove invaluable. Connect with people who understand the intersection of race and anxiety, and treat anxiety as a serious challenge.
- Alternative and complementary remedies: Meditation, acupuncture, and yoga may help ease an anxious mind.
Anxiety can be overwhelming, and make it difficult to concentrate on anything else.
For Black Americans, racial trauma is an additional risk factor that can lead to strong symptoms of anxiety.
Various fears and stigmas around mental health and access may make finding help more difficult for Black Americans.
When anxiety is physical, it can trigger immense fear about a person’s health, and make daily existence very uncomfortable. The right treatment does work.
A Black person should find a therapist specializing in Black people with anxiety, who understands the role that race and racial trauma can play in this condition.
Treatment can take time, so they should choose someone they trust.