Today is World Bipolar Day. According to Mental Health America, an estimated 2.3 million Americans have bipolar disorder, also called manic-depressive illness. A person with bipolar disorder can go from feeling very, very high (called mania) to very low (depression). Unfortunately, most Black people with bipolar disorder are going undiagnosed and untreated. This is partly due to a general mistrust of health professionals historically, cultural barriers between many doctors and their patients, and dependence on family and religious communities rather than mental health professionals during times of emotional distress. However, with proper treatment, those with it can control these mood swings and lead fulfilling lives. Although the rate of bipolar disorder is the same among Black Americans as among other Americans, Black Americans are less likely to receive a diagnosis and, therefore, treatment for this illness.
Black Girl Smile Inc. is on a quest to lower those glaring statistics. The organization was founded in 2012 to empower the mental health and well-being of young Black women and girls through culturally and gender-responsive educational programming, support initiatives, and resource connections. Since its inception, BGS has grown to support over 10,000 Black women and girls nationally through mental health literacy programming, intersectionality workshops, and a therapy scholarship program. Their goal is to curate a safe space for Black women and girls to speak candidly about mental health and illnesses like bipolar disorder.
For Black women, however, bipolar disorder tends to show up differently, as it’s often misunderstood, overlooked, or misdiagnosed in Black women. “This is largely due to how symptoms can be racially characterized and dismissed as stereotypically ‘Black women behavior,'” states Nadia M. Richardson, Ph.D., founder and CEO of Black Women’s Mental Health Institute.
She continues, “This looks like labeling Black women as dramatic, irritable, aggressive, emotional, and irrational, even when just speaking up for herself and her well-being. This is one of the contributing factors as to why Black women are statistically diagnosed with bipolar disorder later in life although the average age of diagnosis is 12-25.”
Another issue Black women are encountering when it comes to bipolar disorder is definitions of the illness in the Diagnostic and Statistical Manual of Mental Disorders, commonly known as the DSM, a handbook used by healthcare professionals in the United States and much of the world as the authoritative guide to the diagnosis of mental disorders. Lauren Carson, Black Girls Smile Inc. founder and executive director, believes the definition in the DSM is based on white participant models. “Historically, Black female participants have not had a large voice or say in the behavioral health field, even down to diagnoses and treatment options. It’s common for mental health issues and symptoms to display differently among Black women and girls. Things such as anger or fight or flight response are often dismissed as mental health symptoms, and psycho-somatic symptoms, also known as manifesting mental health issues physically in our bodies, is prevalent among Black women but often overlooked by the medical community,” she shares.
She continues, “While we always advocate for more inclusive and expansive views of mental health issues, we must advocate for more equitable researchers, research methods and treatment options.”
So what are the concerns of Black women who do have bipolar disorder? “Many concerns include medical racism, social isolation, and still being expected to be ‘strong’ or ‘high functioning’ in personal and professional relationships. The lack of education and miseducation about bipolar disorder perpetuates the stigma associated with these extreme mood swings. As opposed to being viewed as emotionally vulnerable and in need of care and community, Black women with bipolar disorder can be ostracized,” shares Ayanna Abrams, Psy.D, licensed clinical psychologist and founder of Ascension Behavioral Health, LLC.
Additionally, isolation and stress are triggers for manic or depressive episodes, causing Black women to be more at risk of deteriorating mental health. Richardson also lives with bipolar disorder and can identify with the looming anxiety of being written off as unwell. “Black women with bipolar disorder are worried about being written off as incapable of living a full life. Even with a doctorate and several accolades, I have found myself in professional spaces where my capabilities were questioned solely because I chose to speak openly about my diagnosis. When a Black woman living with bipolar sets a boundary, fiercely advocates for herself, or lives in the fullness of her self-worth, it is often interpreted as aggressive and combative and ultimately associated with a bipolar mood episode,” she says.
With stigmas and assumptions attached to having bipolar disorder, it can be challenging for Black women to find community. Still, Carson believes there are ways to cultivate a strong sisterhood of support and understanding. “One of the best ways to build a community around mental health diagnosis is to be open and authentic about personal experience with mental health challenges and specific disorders. This naturally creates dialogue and shared experiences that hopefully turn into peer support,” she shares.
She continues, “Another way to find support is through referrals, support groups highlighted on social media, and websites like Psychology Today. Virtual therapy platforms like BetterHelp and other mental health forums are great places to build community and peer support. I encourage others to seek peer support and lean into the community to help empower their mental health and well-being and not feel alone along their mental wellness journey.”
Also, organizations like Black Girl Smile Inc. provide support and free resources that help reduce the stigma of seeking assistance for mental health challenges like bipolar disorder. They have programs like the Charlyne McFarland Therapy Assistance program that provides financial support for up to six months of therapy sessions with a licensed mental health provider. They also offer events and a community-driven support system to help our participants deal with stressors and recognize when their mental health is waning.
Although bipolar disorder may seem isolating and inescapable for Black women who suffer from it, there are some solutions and hope at the end of the tunnel. According to Abrams, there are several treatment options. “Currently, the most effective options for treatment include consistent psychotherapy with a therapist who is trusted and knowledgeable about bipolar disorder in communities of color. Additionally, while not necessary for all diagnoses, a prescribed mood stabilizer can help significantly mitigate depressive and manic symptoms. Many people with bipolar disorder lead full, healthy lives with family, friends, travel, occupational accomplishments, and joy,” she says.
There are non-medical care options that include consistent social and emotional support and attunement to your unique needs and symptom patterns, regular physical movement if possible, and a tailored, nutritious diet, adequate stress management, and priority of your sleep hygiene and circadian rhythms.
However, the essential solution is educating and empowering Black women to unapologetically prioritize their mental health. This can be done by curating a wellness team of clinicians to offer support, removing shame, and normalizing the conversation about it.