For many of these Black women, like Cheslie, it’s hard to see the hurt because the smiles are so radiant. It’s hard to sense the pain when they’re so energetic and exuberant, and for many Black women who struggle with high-functioning depression and anxiety, it's hard to tell that this feeling and heaviness is actually the result of a deeper issue connected to their mental health, and it’s even harder for people on the outside to see what’s going on with them within.
The concept of "high-functioning anxiety and depression" is not commonly known because it is not a classified diagnosis in the DSM-5. However, it is a term that was developed to describe people who struggle with these mental health disorders but are able to function well in different aspects of their lives—creating an illusion that they are coping with their mental health—when, in reality, they are just managing as they go but deeply struggling day-to-day and remaining productive allows them to avoid their pain.
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Research indicates that after the death of George Floyd, anxiety and depression among African Americans skyrocketed from 36 percent to 46 percent which equates to more than 1.4 million people who reported a debilitating difference in their mental health to the Census Bureau.
Black people have to carry the burden of racial stress, pandemic stress, and day-to-day stress, and often, must do so while trying to operate and function at their best ability in order to move through the world without falling apart. The issue is, that many Black people truly are falling apart, and in particular, Black women are "1.8 times more likely than Black men to report sadness most or all the time and are 2.4 times more likely than Black men to report feeling hopeless more or all the time.”
The feeling of sadness and hopelessness is a direct symptom of dealing with major depression and anxiety, and in our society, the world does not stop when there is racial injustice, white supremacist attacks, pandemics, and global trauma. Instead, we are required to keep going, and Black women are required to push through despite it all and show up in all aspects of their lives including as mothers, caretakers, and within leadership in the workplace, a space that can almost often be a breeding ground for microaggressions and subtle acts of racism that impact Black women daily.
To further understand the impact anxiety and depression have on Black women’s health, let’s unpack these two terms.
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Generalized anxiety disorder (GAD) is a mental health disorder where a person experiences consistent worry, fear, and feelings of anxiousness in their everyday lives, and it is not tied to a particular reason. People who have high-functioning anxiety may experience this kind of anxiety, but what makes them different is that people with GAD experience symptoms that are debilitating to the point where it impacts their ability to function, meet tasks, and perform certain obligations.
High-functioning depression is clinically known as persistent depressive disorder. This is when someone experiences symptoms of depression such as feelings of sadness and hopelessness, changes in mood and appetite, low energy, sleep disturbances, and other issues in a less severe manner that still allows them to function and manage their obligations and responsibilities.
People with high-functioning anxiety and depression may use their feelings of worry, anxiousness, and sadness as a catalyst for productivity and managing success. Black women may carry this trait by being high achievers, operating in roles of leadership, are helpful, and often seen as the “strong friend,” they often appear happy and seem to have their life in order and are often looked up to and revered by others because of how great their lives seem to be unfolding.
Some may look at these characteristics and think this seems healthy and unproblematic, but the issue here is that this is what we see on the surface. On the inside, the Black women we know who are experiencing issues may also be silently dealing with:
- Low self-esteem and low self-worth, and channel this through overachieving
- People-pleasing and living in constant fear of rejection, driving people away, being unavailable to others, and not being seen as good enough
- Chronic feelings of sadness, hopelessness, and a lack of relief from self-debilitating thoughts
- Poor boundaries and an inability to say no out of fear of other people’s reactions or the fear of missing out on something good
- Constant overthinking and self-sabotaging thoughts
- Poor relationships and no social life from an inability to create genuine connections that are not tied to achievements or what they can do for someone
- Imposter syndrome or constant comparing to others that causes them to suffer
- Problems with alcohol and drug abuse
- Thoughts of suicide ideation and/or self-harm
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All the success, accolades, and achievements, can be distracting to those on the outside because many of us know that in order to obtain these things, hard work and dedication are requirements and we are used to the narrative around those who suffer from mental health issues looking a particular way. They appear sad, dejected, lonely, isolated, and unable to do basic things for their own personal and mental hygiene when in reality, that is not how everyone copes with their mental health.
Black women are aware that the world does not stop for their pain, so when we are wounded and need healing, we have taught ourselves that strength is to be found in propelling forward instead of seeking help, learning to rest, saying "no," and being at peace with our existence without tying it to the things we can achieve or how well we can perform in the midst of chaos.
Getting help can be scary when it’s not something you’ve ever done before, but wellness means learning to prioritize the things that enhance your well-being, increase your lifespan and benefit your mental health. Black women must be reminded that they do not have to earn their rest, nor do they have to wait until they're struggling before rewarding themselves with life pleasures and do what they need to care for themselves.
Take control of your mental health. Here are everyday tools that you can use to manage high-functioning depression and anxiety:
- Better boundaries with yourself: Take inventory of the things you say yes to and then get to the root of your, ‘why.’ Do you say 'yes' in order to please people? Is it because you think you’ll be missing out? Because you fear people’s reactions if you say 'no'? This is a sign that you have poor boundaries and this is actually exasperating your mental health issues rather than healing them. Make a list of five things you want to commit to doing for yourself daily, and define what boundaries you need to put in place to ensure you commit to doing what you need for yourself.
- Practice mindfulness/meditation: When people are severely anxious, they are trapped in a spiral of their thoughts and it can be hard to get out of their heads. Mindfulness is a form of meditation that teaches us to be present at the moment and to be grounded in reality, rather than in our heads tangled up in our thoughts that most of the time are not real and are things we made up in our minds as a form of catastrophic thinking that stems from anxiety. Practicing mindfulness can look like engaging in tasks and being in tune with your senses. Consider the work of cooking. During this task, you may focus on what you feel as you use your hands, what you smell as you use ingredients, and focus on what’s right in front of you. Think of a practice that makes you feel grounded and commit to practicing mindfulness daily.
- Journaling: Sometimes you will need to get out of your head. Studies have shown that journaling is a beneficial tool for managing mental health issues. During this practice, you can follow two themes. 1: Free-form journaling is when you write out your thoughts and express yourself through your writing. 2: Theme-based journaling is when you focus on a particular theme such as gratitude journaling, intention setting journaling, affirmation journaling, etc. Consider which options are most appropriate for you and commit to this practice a few times a week or daily.
There are going to be times when our mental health is suffering to the point where we need additional care and assistance outside of what we’ve cultivated in our self-care toolbox, and seeing a mental health professional may be the best option for your well-being.
Consider finding a therapist by visiting the following directories:
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When finding a therapist, make a list of at least five questions that you want to ask during your consultation call to give you a better understanding of how therapy with this particular practitioner works. The top two questions I recommend that you include in that list are:
- Can you tell me about your treatment approach for people who struggle with depression or anxiety?
- Can you give me insight into your therapeutic process and what I should expect as we work together?
Remember that getting help is not a weakness, it is a sign of strength because a wise person understands that we all have limits and that we cannot do it all.
Community care means learning to be vulnerable and giving ourselves permission to lean on those who offered to be supportive structures for us to hold ourselves up on.
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