Tag: depression

  • Understanding Bipolar Disorder: A Focus on Women of Color

    Understanding Bipolar Disorder: A Focus on Women of Color

    Written by: Michelle Tillman-Cureton, LCMHC, PsychoTherapist

    World Bipolar Day (WBD) serves as an essential moment to raise awareness, challenge stigma, and foster a deeper understanding of bipolar disorder. The vision of WBD is to promote global education about bipolar disorders while reducing the social stigma surrounding mental illness (International Society for Bipolar Disorders, n.d.). Through international collaboration, this day seeks to provide accurate information that increases sensitivity and compassion for those living with the condition.

    As mental health professionals, we recognize the profound impact bipolar disorder has on individuals and families. However, it is crucial to acknowledge that no two experiences with this condition are identical. For Black women and women of color, the journey is often shaped by systemic inequities, cultural influences, and the complexities of intersecting identities.

    Barriers to Diagnosis and Treatment

    Research suggests that Black individuals are less likely to receive an accurate and timely diagnosis of bipolar disorder compared to their white counterparts (Ward et al., 2013). This disparity is influenced by multiple factors, including:

    • Stigma Within Communities of Color: Mental health struggles may be viewed as a sign of weakness or a betrayal of cultural expectations. The “strong Black woman” archetype, while often framed as a symbol of resilience, can discourage vulnerability and prevent individuals from seeking support (Abrams et al., 2019).

    • Racial Bias in Mental Health Care: Studies indicate that Black individuals are more likely to be misdiagnosed with schizophrenia rather than bipolar disorder, due to biases in symptom interpretation by healthcare providers (Schwartz & Blankenship, 2014).

    • Cultural Explanations for Symptoms: In some communities, mood instability may be attributed to spiritual or supernatural causes rather than recognized as a medical condition, leading individuals to seek alternative forms of healing that may not fully address the underlying biological and psychological factors (Alvidrez et al., 2008).

    The Impact of Racial Trauma on Mental Health

    The daily realities of racial trauma, microaggressions, and systemic discrimination can contribute to emotional distress and exacerbate mood fluctuations in women of color. Studies have shown that chronic exposure to racial stressors can lead to increased vulnerability to mood disorders, including bipolar disorder (Carter et al., 2017). The emotional toll of navigating these challenges can intensify symptoms and complicate treatment, making culturally competent care essential.

    The Role of Hormonal and Physiological Factors

    Women with bipolar disorder already experience mood fluctuations influenced by hormonal shifts. For Black women and women of color, the physiological effects of chronic stress, often referred to as “weathering,” may contribute to heightened risks for mood instability (Geronimus et al., 2006). Life stages such as pregnancy, postpartum, and menopause can trigger or worsen mood episodes, necessitating specialized and culturally informed care (Viguera et al., 2018).

    Prioritizing Culturally Responsive Care

    To improve mental health outcomes for Black women and women of color with bipolar disorder, we must integrate culturally competent and trauma-informed approaches into our practice:

    ✅ Culturally Competent Care – Recognize how race, ethnicity, and culture shape mental health experiences and tailor treatment approaches accordingly.

    ✅ Addressing Racial Trauma – Create a safe therapeutic space where clients can process racial trauma, microaggressions, and identity-related stress.

    ✅ Challenging Stigma – Engage in community education to normalize conversations about mental health and encourage early intervention.

    ✅ Building Community Support – Facilitate access to peer support groups and culturally relevant mental health resources.

    ✅ Advocacy for Equitable Care – Work toward reducing healthcare disparities and increasing access to mental health services for marginalized populations.

    ✅ Intersectional Approach – Recognize that women of color have multiple intersecting identities and that treatment must address the whole person.

    Moving Forward with Awareness and Action

    On this World Bipolar Day, let us center the voices of Black women and women of color, honoring their lived experiences and advocating for a more inclusive and equitable mental health system. By fostering a culturally sensitive and trauma-informed therapeutic environment, we can empower our clients to navigate their journeys with resilience and strength.

    Let’s commit to ensuring that all individuals affected by bipolar disorder receive the understanding, care, and support they deserve.

    In health & wellness, it is vital to prioritize mental health alongside physical health. By fostering an inclusive environment where open discussions about bipolar disorder occur, we can break down stigma and promote awareness. This includes providing access to quality healthcare, educational resources, and support groups that empower individuals living with this condition. Together, we can create a community that values empathy and encourages continuous personal growth and recovery for those affected.

    References

    • Abrams, J. A., Maxwell, M., Pope, M., & Belgrave, F. Z. (2019). Carrying the world with the grace of a lady and the grit of a warrior: Deepening our understanding of the “Strong Black Woman” schema. Psychology of Women Quarterly, 43(1), 49-63.

    • Alvidrez, J., Snowden, L. R., & Kaiser, D. M. (2008). The experience of stigma among Black mental health consumers. Journal of Health Care for the Poor and Underserved, 19(3), 874-893.

    • Carter, R. T., Lau, M. Y., Johnson, V., & Kirkinis, K. (2017). Racial discrimination and health outcomes among racial/ethnic minorities: A meta-analytic review. Journal of Multicultural Counseling and Development, 45(4), 232-259.

    • Geronimus, A. T., Hicken, M. T., Keene, D., & Bound, J. (2006). “Weathering” and age patterns of allostatic load scores among Blacks and whites in the United States. American Journal of Public Health, 96(5), 826-833.

    • International Society for Bipolar Disorders. (n.d.). World Bipolar Day. Retrieved from https://www.isbd.org/world-bipolar-day

    • Schwartz, R. C., & Blankenship, D. M. (2014). Racial disparities in psychotic disorder diagnosis: A review of empirical literature. World Journal of Psychiatry, 4(4), 133-140.

    • Viguera, A. C., Whitfield, T., Baldessarini, R. J., Newport, D. J., Stowe, Z. N., & Reminick, A. M. (2018). Risk of recurrence in women with bipolar disorder during pregnancy: Prospective study of mood stabilizer discontinuation. American Journal of Psychiatry, 175(2), 175-183.

    • Ward, E. C., Wiltshire, J. C., Detry, M. A., & Brown, R. L. (2013). African American men and women’s attitude toward mental illness, perceptions of stigma, and preferred coping behaviors. Nursing Research, 62(3), 185-194.

  • Wading Through It All

    My thoughts before and after….my intimate prayers are layered: “I ask for complete healing. I pray for a good report of the mass being benign. I ask, that You, Father, Creator, to be with me in whatever I may experience and or hear Thursday.” My tears have been unstoppable on most nights upto Thursday morning, 12/23. Thursday morning, my sister picks me up and we head to my appointment. She is told she cannot wait with me in the waiting room due to the new variant. She returns to the car. I check-in and go to the furthest corner of the waiting room and I begin to cry. Well, there is just too much time between waiting and seeing the doctor so all these thoughts occur. I worry on how to do this. I worry that my prognosis is going to be the worst. I worry that I’m too young for any of this…but that’s not a new worry. I feel as if all of my life I’ve been too young for all that has happened in my lifetime. I laugh-cry reminding myself none of these thoughts sound like your prayers. I pull myself together just as my name is called.

    My nurse gives instructions to change and states she will be waiting by my door. I change. I cry some more. I exit the room and she’s waiting. Nurse: “Are you ready?” I respond, “No.” She patiently waits until I am. She smiles. We proceed. She goes over all the medical jargon, expectations and how to take care of myself after. I lay on the table, staring at the ceiling as she begins to locate the mass. Nurse: “I can’t find it. I’ve moved all the way to 12:00+.” (I pray some more, believing God has heard me, answered my prayer.) She’s trying for about 5 more minutes and she finds it. The mass moved from its initial location at 2:00-3:00+ (3 weeks ago) to 1:00+. I’m unsure what this means but I think it is a good thing the difficulty she has locating it. (They determined the location of growth/mass by clockwise direction beginning at the center of the areola.)

    Dr. comes in and states: “Your mass is in your areola. The fact that it is moving means that there is fluid inside and that usually means benign. That is not definitive you will have to wait for confirmed testing.” He begins to explain the procedure, the sounds I will hear…..he is kind, his voice comforting. I turn my head, close my eyes and practice my deep breathing as they numb the area. I think they can hear me and it bothers me that I think I am a hindrance. I grow quieter. I stay focused on my breathing and not the pain in my areola; my thoughts: it’s not in the deep parts of my breast. I’m still lost; running back and forth from faith to fear, from fear to faith. “Red Rover, Red Rover send Michelle right over.” Once all was over, I honestly can say I felt better after the procedure than I did going in. My results come Tuesday, over the phone not in person. (Coronavirus Measures 101) Deep sigh again.

    Biopsy Christmas. Grief. Loss. Another isolating round of this new variant-Pandemic-ish living. We’re not blindly going into this new year yet we’re exhausted. I pray that we will faithfully say goodbye to the fear with renewed perspectives of ourselves, of our humanity. Yes, 2022 is coming in heavier than 2021. I believe prayers, the fact that we have to be inclusive, insightful of all that is happening around us, those things occurring far away from us and within us is quite a spiritual undertaking; it is becoming traumatic, at times depressive. We turn more towards self-defeat and question our whys, neglecting our purpose. We’re not wrong. We are weary. Our souls ache, we are wounded souls.

    I hope that you find yourSelf wading through when you’re not able to stand, lean, pray nor comprehend. Our answered prayers do not always reflect what we ask yet they seem to always be what God knows is for our best, at times our betterment and more often than not what we have the capacity to receive. Trust this timing of your life….ask for what you need…love even the more. We’re not lost. We’re finding our way.

    Faith read: “Every good gift and every perfect gift is from above, and comes down from the Father of lights, with whom there is no variation or shadow of turning.” James 1:17 NKJV

    Intimately Worded,

    Michelle