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We call depression "the blues" in the black community. We have been taught, at least in the past, and, to a certain extent even now, to shrug off this mental state. For many of us, it is not just a fact of life; it is a way of life. When bluesmen used to sing, "Every day I have the blues" or "It ain't nothing but the blues" or similar words from hundreds of songs, they do more than mouth lyrics. They voice a cultural attitude. They state an accepted truth at the heart of their music: Having the blues goes along with being black in America. In addition, from the time we are young boys, black males have ingrained into us an idea of manhood that requires a silence about feelings, a withholding of emotion, and ability to bear burdens alone, and a refusal to appear "weak." The internal pressure to adhere to this concept of masculinity only increases as we sometimes experience various forms of racism in a society that historically has sought to deny us our manhood.

The internal wall that often keeps black men away from psychotherapy goes along with external barriers built just as high, if not higher. Mental health practitioners are overwhelmingly white, with the proportion of black psychiatrists, psychologists, and psychoanalysts estimated at less than three percent of the nation's total. This would mean that even if black men were to break through the self-imposed barriers and seek professional help for mental issues, it may be difficult to find someone with whom they can build a rapport, and whom they feel can relate to them, and they can trust. This feeling of comfort is what allows a patient to reveal his most intimate secrets. As Dr. Richard Mouzon, a prominent black clinical psychologist puts it, "Many of us grow up feeling that it is dangerous to give up too much of yourself to the white man." There's no denying that access to mental health care is restricted for Americans in general. In private health insurance policies and government medical assistance programs, psychotherapy is too often considered a luxury rather than a necessity. It has been said often times that the only people with a guaranteed right to health care are the inmates of our jails and prisons. That is even more true of mental health care.Unfortunately, this is a right that is of marginal value; while many black men receive their first treatment for mental illness behind bars, that treatment is likely to be directed at keeping them under control rather than alleviating the effects of their illness.

Our health care system assures preventative measures and early intervention for mental health problems only to the privileged, just as it does for physical health problems. The disparity is so great in minority communities that for many, mental illness receives attention only when it reaches a florid stage, in public hospitals' emergency rooms and psychiatric wards, or worse, in its aftermath, when people with mental illness may end up behind bars and in morgues.

According to a new study reported on by the " Health Behavior News Service", jobless African-American men appear to be at a greater risk of suffering from depression. While the issue of unemployment offers at least one possible explanation for why the symptoms of depression might be experienced, more puzzling is the fact that African-American men who were making more than $80,000 per year were still at a higher risk for depression.

In order to come to their conclusions, Dr. Darrell Hudson, Ph.D., and his fellow researchers carefully screened the data provided by the "National Survey of American Life." During their analysis, they took into account how much various factors such as social class, income, education, wealth, employment, and parental education level related to depressive symptoms. "After measuring depression in a very comprehensive way, the results were not very consistent. We need to figure out as a general public: Is there a cost associated with socioeconomic position or moving in an upward trajectory?" said Dr. Hudson.

For the purpose of the research 3,570 African-American men and women who experienced depressive episodes within the past year of their lives were studied. Men who made over $80,000 per year reported more symptoms of depression than those making less than $17,000 per year. However, unemployed black men were more likely to report depression during that year compared to employed men. Men who completed some college or beyond were less likely to experience depressive symptoms than those who did not complete high school. Women, on the other hand, did not appear to suffer the same rates of depression. Females who earned between $45,000 and $79,000 were less likely to report symptoms of depression than those with the least income. The study appeared in the journal "Social Psychiatry and Psychiatric Epidemiology."

According to Dr. Hudson: "One thing could be going on with African-American men with greater incomes. The more likely they are to work in integrated settings, the more likely they are to be exposed to racial discrimination. Racial discrimination can undermine some of the positive effects of socioeconomic position like the increased benefits of more income."

Some black men who suffer from depression may think suicide is the answer. It is not. Men that become suicidal don't realize that they are repeating the cycle, burdening their children with the same loneliness the father had endured. Their kids would grow up with the knowledge that theifather had taken his life.

Depression can be very paralyzing to African-Americans. This vile illness affects men from all walks of life, from the black executive to the young street hustler. In many documented cases, several socially advanced black men have suffered from depression for many years and refused to receive treatment. This is a very disturbing undercurrent. If educated, accomplished, and highly informed black men refuse to seek treatment for depression, just imagine how difficult it is for uneducated or poor black men to seek help. Some experts believe that depression is likely a key factor in a 233 percent increase in suicide in black males ages 10-14 from 1980 to 1995.

According to Dr. Satcher: "Black men feel that they have to be twice as good as other people, that you can't be weak because people will take advantage of you. Those pressures work powerfully against a black male seeking treatment for depression and other mental illnesses." About one in four African-Americans is uninsured, compared with about 16 percent of the U.S. population overall. African-Americans are less likely to receive antidepressants, and when they do, they are more likely than whites to stop taking them. Particularly troubling to those who study and treat mental illness in black men is their disproportionately higher rates of incarceration than other racial groups. Nearly half of the U.S. prison population is black, and about 40 percent of those in the juvenile justice system is black. It is a very difficult and very serious situation for these young men and for society. Psychiatrists who work with the homeless as well as with black youth say they see dozens of black males each year head to jail or juvenile justice when they should be in treatment centers.They blame,in some form or another, depression, or other related mental illnesses. "It happens all the time and it's very alarming," said Dr. Raymond J. Kotwicki, Medical Director of Community Outreach Programs, Department of Psychiatry and Behavioral Sciences, at Emory University School of Medicine, in a recent statement.

While all mental illnesses often come wrapped in some sort of stigma or negative connotation, mental illnesses in black men are even more entangled. Historical racism and current cultural biases and expectations all play a part, mental health advocates say. Nearly two-thirds of African-Americans believe that mental illness is a shortcoming that can be overcome through prayer and faith, according to a study by the National Alliance for the mentally ill. Certainly prayer and faith may be helpful to someone suffering from mental illness, but is not a replacement for treatment by a professional.

The neglect of emotional disorders among men in the black community is nothing less than racial suicide.Many experts argue that the problem of depression in black America can be traced back to the time of slavery, when it was believed that blacks were unable to feel inner pain because they had no psyche. This myth has damaged generations of African-American men and their families, creating a society that sometimes has defined black men as being violent and aggressive, without considering that depression (or other related mental illnesses) might be one root cause.

The consequences of untreated mental illness can be dire. And the tragedy of the worst outcomes can be no greater than when the disorder is depression, one of the most common and treatable mental illnesses. The disease is painful, and potentially fatal, but eighty percent of those who get treatment get better. Yet, quite sadly, only twenty-five percent of those who need help get it. African-American men are especially prone to put ourselves in mortal danger because we readily embrace the belief that we can survive depression by "riding out" the illness and allowing it to run its course. The internal walls we build to keep out the world, along with the walls that society sometimes builds to isolate us, cut us off from the help we need. So we suffer, and we suffer needlessly.

Please do not be ashamed of seeking help if you feel that you are suffering from depression, or any mental illness. There are very likely resources right in your own city or town such as a county Mental Health Center, even if you are uninsured. Those who are insured may choose a private hospital or psychiatrist, but don't hesitate to get help. One resource that is available would be to call 1-877-331-9311, or 1-877-568-6230 to talk to a specialist at any time. This could change your life immensely, and could indeed save your life.

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