Anyone can have clinical depression. However, cultural background plays a large role in how the symptoms of depression are reported and interpreted, and consequently, if and how clinical depression is recognized
and treated. But clinical depression is never normal and should not be accepted as a normal part of life for any African American regardless of age or life situation. Clinical depression is a serious medical illness
affecting more than 19 million American adults each year, but one that can be effectively treated. In fact, more than 80% of people with depression can be treated successfully with medication, psychotherapy or a combination of both.

Symptoms of Clinical Depression If you have been experiencing five or more of these symptoms for two weeks or more, you could have clinical depression and should see your doctor or a qualified mental health professional for further evaluation.

• Persistent sad, anxious or "empty" mood
• Sleeping too much or too little, middle of the night or early morning waking
• Reduced appetite and weight loss, or increased appetite and weight gain
• Loss of pleasure and interest in activities once enjoyed, including sex
• Restlessness, irritability
• Persistent physical symptoms that do not respond to treatment (such as chronic pain or digestive disorders)
• Difficulty concentrating, remembering or making decisions
• Fatigue or loss of energy
• Feeling guilty, hopeless or worthless
• Thoughts of suicide or death

Reasons for Misdiagnosis of Depression in African Americans
Depression often has been misdiagnosed in the African American community. Factors that can contribute
to fewer African Americans being diagnosed with clinical depression include:

• A mistrust of medical health professionals, based in part on historical higher-thanaverage institutionalization for African Americans with mental illness.
• Cultural barriers, influenced by language and values in the relationship between the doctor and the patient.
• Reliance on the support of family and the religious community, rather than mental health professionals, during periods of emotional distress.
• A "masking" of depressive symptoms by other medical conditions, somatic complaints, substance abuse and other psychiatric illnesses.
• Socioeconomic factors, such as limited access to medical care.

African American Attitudes Towards Depression
According to a National Mental Health Association survey on attitudes and beliefs about depression:

• Approximately 63% of African Americans believe that depression is a "personal weakness," compared to the overall survey average of 54%.
• Only 31% of African Americans said they believed depression is a "health" problem.
• Close to 30% of African Americans said they would "handle it" (depression) themselves if they were
  depressed, while close to 20% said they would seek help for depression from friends and family.
• Only one in four African Americans recognize that a change in eating habits and sleeping patterns are
  a sign of depression; only 16% recognize irritability as a sign.
• Only one-third of African Americans said they would take medication for depression, if prescribed
  by a doctor, compared to 69% of the general population.
• Almost two-thirds of respondents said they believe prayer and faith alone will successfully treat
  depression "almost all of the time" or "some of the time."

For more information about the National Mental Health Association or additional resources, please
call 1-800-969-NMHA or visit our website at www.nmha.org.

To access care, call 937-734-8333 or if suicidal, call CrisisCare at 937-224-4646

Sources:
Leo RJ, Sherry C, Jones AW: "Referral Patterns and Recognition Among African-American and Caucasian Patients." General Hospital Psychiatry 1998; 20:175-182.

National Institute of Mental Health: "Depression: Treat It. Defeat It." Accessed June 1999.

National Institute of Mental Health: "The Numbers Count: Mental Illness in America." Science on Our Minds Fact Sheet Series. Accessed August 1999.