Most times, when someone asks “how are you?” I lie. It’s not that I’m a sociopath, or have a pathological aversion to the truth; it’s that, for a Black man living with depression, those three words are loaded enough to induce angst. If I answered honestly, it would result in a heavy conversation, which is generally the opposite of what someone expects in response to an autopilot pleasantry.
What motivates that heavy conversation changes day to day. Sometimes I could be fresh out of an elevator ride where a White lady instinctively clutched her purse tighter. Sometimes it’s the memory of being followed by a security guard in a grocery store. Or it could be thinking of a former roommate who, after I refused to go to a bar to be her wingman, launched into a tirade that included the veiled threat, “I am a young White woman with a big Black man in her home.” (To avoid confrontation, and assuage my fears of having to explain myself to the police, I packed my suitcases and moved out. At 4 a.m.) Or the ex who called me her “personal Mandingo.” These are but a few of the razor blades that lie within the sugar bowl of my Black brain.
To face the world, Black men have to arm themselves with various self-preservation and self-defense tools, and participate in emotional martial arts just to prove they deserve to exist. This daily battle, compounded with approximately 10 generations of inherited grief, creates severe emotional dis-ease. In media, culture, and film, Black men are frequently told to “man up,” that showing emotion is “soft,” and that “real” men don’t cry. Barry Jenkins’ Moonlight was vindication for so many of us — even if many Black people didn’t see the film because of its queer narrative. (And believe me, that’s a whole other essay.)
According to Souls of Black Men: African American Men Discuss Mental Health, a report by the Morehouse School of Medicine-affiliated organization Community Voices, 7% of African American men will develop depression during their lifetime. However, that figure is acknowledged to be an underestimate “due to lack of screening and treatment services.”
Depression is only the beginning. That same report claims that African American men have death rates that are at least twice as high as those for all women for suicide, cirrhosis of the liver, and homicide. Between 1980 and 1995, the suicide rate for Black males ages 15 to 19 increased by 146%. Alcohol abuse and its consequences also appear far more grave for African American men, especially in urban areas, than comparable statistics for African American women or White men or women.
But change is possible. Those in their thirties and forties — Black millennials and Gen Xers — are the first generations to engage in a comprehensive discussion about healing, and by extension to bring about a fundamental shift in our community. Due to this immense power, therapy has to be a part of the Black man’s arsenal.
On October 4, 2016, rapper Kid Cudi shared on Facebook that he had checked himself into a rehab facility for treatment of “depression and suicidal urges.” The post, raw and moving, resulted in the creation of the Twitter hashtag #YouGoodMan, continuing the conversation about Black men’s mental wellness.
But for me, sitting at home reading Cudi’s words — “I am not at peace. I haven’t been since you’ve known me… I simply am a damaged human swimming in a pool of emotions everyday of my life” — prompted a reaction much stronger than a hashtag.
A year before his post, a bout of severe depression had left me crippled, homebound for 26 days. My treatment included daily visits to a psychiatric hospital, where the waiting area felt like the belly of a ship, and where each time I left the intake nurse’s station to head into a session, the penal clink of locks and the buzz of doors triggered something within me. I’ve never been locked up, but the sound of those doors was unmistakable. I was seeking health, but the course of care felt undeniably punitive, penal — as much Alcatraz as Avalon.
But how did I get here?
I knew I was depressed from the age of 13. Growing up in a Jamaican evangelical household, I was taught that God is the ultimate healer. While those with physical ailments could receive medical treatment while praying and fasting, my church intimated that folks who struggled psychologically or emotionally had simply strayed from the Word — and the only treatment necessary was to recommit themselves to Christ.
At 16, while in high school, I confided in a guidance counselor whose advice boiled down to “lose weight and pray more.” When I headed to university in Toronto, my student insurance gave me access to real counseling — and as one of two Black students in the entire English program, I soon learned how integral it was to my well-being.
We’ve seen how Black folks who publicly display mental health problems, especially men, are dealt with. To be clear: They end up in the forensic unit, not the psychiatric unit.
When I returned to Jamaica on university break, I told my parents I was in therapy and on Prozac. I was immediately asked if I was sharing private family matters with strangers. My parents are loving and supportive — but like many older Black people, they’re from an era when they were conditioned to the idea that there were “proper” ways to express emotion, and speaking to a therapist wasn’t on the list.
For decades, Black communities have eschewed engaging psychotherapists. According to the Substance Abuse and Mental Health Services Administration, only 30% of African American adults with mental illness seek counseling — two-thirds of the national average. As a culture, we’ve seen how Black folks who publicly display mental health problems, especially men, are dealt with. To be clear: They end up in the forensic unit, not the psychiatric unit.
People with untreated mental illness are 16 times more likely to be killed during a police encounter than other civilians, according to a study by Virginia-based nonprofit the Treatment Advocacy Center. In September 2016, Alfred Olango, a mentally ill Ugandan refugee, was fatally shot by a police officer in El Cajon, California. The officer in question was not charged. Last year, 29-year-old Osaze Osagie was shot and killed in his home in State College, Pennsylvania, during a police-conducted wellness check. “To serve and protect” is a mission not always extended to Black men with psychological issues.
In her 2003 book, We Real Cool: Black Men and Masculinity, social activist bell hooks posits “this is a culture that does not love black males.” She continues by saying that Black men “are not loved by white men, white women, black women, girls, or boys. And especially, black men do not love themselves. How could they? How could they be expected to love, surrounded by so much envy, desire, and hate?” Whoosah!
Black people have the daily struggle of dealing with the generational trauma wrought by slavery. While navigating racial microaggressions within a cultural architecture that systematically discounts our pain. “Sadly, mental health care providers have been slow to acknowledge the deep impact of racism on psychological development, health, and well-being,” says Carla Ribeiro, a psychotherapist in Toronto. “I have heard from many of my clients that their attempts to raise these issues with mental health practitioners are often met with silence, disbelief, awkwardness, discomfort, and sometimes even denial.”
In his 2015 book Between the World and Me, Ta-Nehisi Coates observes that terms like “race relations” serve “to obscure that racism is a visceral experience, that it dislodges brains, blocks airways, rips muscle, extracts organs, cracks bones, breaks teeth.” It has been 186 years since the abolition of slavery, and a mere 54 since the end of the Jim Crow; still, our pain clings to us like a down jacket that’s one size too small.
Meanwhile, even those of us suffering are likely to avoid seeking help, invalidating our own suffering. “Our cultural discourse often tells us that therapy is only for those with severe psychological disorders,” says Sandra Jackson, a social worker and psychotherapist in Toronto. But we know that embracing this ideology inhibits the healing process. Researchers from health nonprofit Robert Wood Johnson Foundation have found that “racial and ethnic discrimination can negatively affect health across lifetimes and generations.”
Sometimes even actively seeking help doesn’t ensure healing: Though I was in and out of therapy for the better part of 17 years, it took nearly as long to find a good match with a therapist. One, who I initially held in high esteem, responding to my stories about racism and microaggressions at work, told me to “get off the plantation, it’s been closed for some time.” This statement took me aback — so far aback, in fact, that I never returned to see him.
For Dr. Nathaniel Currie, a clinical social worker and educator in Decatur, Georgia, specializing in mental health and HIV, that’s an unfortunately common occurrence. “Current disparities in therapeutic care access, community stigmas, and availability of culturally competent therapists often make mental health care a last resort for many Black and Brown men,” he says.
Luckily for us, Kid Cudi is far from the only high-profile Black man who has shared his mental health struggles publicly. In 2015, NFL free agent Brandon Marshall wrote about being diagnosed with borderline personality disorder, and called for other prominent men battling mental health issues to step forward. DeRay Mckesson, Logic, Wayne Brady, Metta World Peace, Kanye West, Dwayne Johnson, Donald Glover, Big Sean, Jay-Z, Stormzy, Trevor Noah, Kendrick Lamar, and DeMar DeRozan have all spoken up and championed the mental health of Black men.
It’s easy to feel pride, to say that Black men are so strong that we don’t need treatment, but that retrograde concept of masculinity simply steeps us in our own toxicity. Restorative self-care is vital for Black men, and that includes therapy. Each time I have a session, I think of it as personal training for my mind. Talking to someone who has no bias, no judgment, and asks incisive, challenging questions — all in support of me processing my emotions — has allowed me to work through and release mental tension.
Any shame I once possessed has long since been washed away; by now I speak openly about therapy and my mental health as one would talk about fighting allergies. So yes, my answer to “how are you?” may be heavier than people expect — but my candor is the result of a long, challenging journey, and I wouldn’t have it any other way.