Black Pain: It Just Looks Like We're Not Hurting by Terrie M. Williams, Susan L. Taylor (Foreword by), Mary J. Blige (Foreword by)

From the Publisher

Terrie Williams knows that Black people are hurting. She knows because she's one of them.

Terrie had made it: she had launched her own public relations company with such clients as Eddie Murphy and Johnnie Cochran. Yet she was in constant pain, waking up in terror, overeating in search of relief. For thirty years she kept on her game face of success, exhausting herself daily to satisfy her clients' needs while neglecting her own.

Terrie finally collapsed, staying in bed for days. She had no clue what was wrong or if there was a way out. She had hit rock bottom and she needed and got help.

She learned her problem had a name -- depression -- and that many suffered from it, limping through their days, hiding their hurt. As she healed, her mission became clear: break the silence of this crippling taboo and help those who suffer.

Black Pain identifies emotional pain -- which uniquely and profoundly affects the Black experience -- as the root of lashing out through desperate acts of crime, violence, drug and alcohol abuse, eating disorders, workaholism, and addiction to shopping, gambling, and sex. Few realize these destructive acts are symptoms of our inner sorrow.

Black people are dying. Everywhere we turn, in the faces we see and the headlines we read, we feel in our gut that something is wrong, but we don't know what it is. It's time to recognize it and work through our trauma.

In Black Pain, Terrie has inspired the famous and the ordinary to speak out and mental health professionals to offer solutions. The book is a mirror turned on you. Do you see yourself and your loved ones here? Do the descriptions of how the pain looks, feels, and sounds seemfar too familiar? Now you can do something about it.

Stop suffering. The help the community needs is here: a clear explanation of our troubles and a guide to finding relief through faith, therapy, diet, and exercise, as well as through building a supportive network (and eliminating toxic people).

Black Pain encourages us to face the truth about the issue that plunges our spirits into darkness, so that we can step into the healing light.

You are not on the ledge alone.

Ann Burns - Library Journal

Speaking from experience, Williams, a trained social worker now heading her own public relations firm, offers a compelling look at depression in the African American community. By chronicling her own battles with the debilitating disease, as well as the stories of other sufferers, from entertainers to athletes, she sheds light on the healing process.

Product Details

• ISBN: 0743298829
  
• ISBN-13: 9780743298827
• Format: Hardcover, 368pp
• Publisher: Scribner
• Pub. Date: January 2008
• Sales Rank: 36,776

• Read an Excerpt

Read an Excerpt

Chapter One

Depression

Not Killing Us Softly

I'm Coming Out, I Want the World to Know It's not just what we say, but what we don't say...

In June 2005 I wrote an article about my depression for Essence magazine. I was not prepared for the reaction it generated. I received over 10,000 letters, over half of them from people "coming out" for the first time about their pain and depression. Complete strangers wrote to me because I was the safest person they could share with. Not friends, not family members, but me -- someone they didn't know! I also wasn't prepared for the intensity of my frustration as I came to understand how many Black women and men are suffering silently.

The folks who wrote to me were scared -- some of them terrified -- to breathe a word to anyone; they were paralyzed by the fear that no one would understand or accept them. Their fear was echoed in conversation upon conversation I had while traveling across the country giving talks about how we are doing -- about waking up in pain each day -- to audiences that ranged from CEOs to regular churchgoers. After my talks, person after person would come to me to confide that they, too, were "going through it."

Sometimes I would come home from these trips totally drained in my heart and soul, having heard stories like the one I heard from a man whose two sisters are home suffering from major depression. He can't talk about it, nor can his family, even though he's a respected physician and his brother is a well-regarded man of the cloth!

If I'm honest with myself, and with you, the fact is that I'm more like these folks than I care to admit. If thenEssence editor in chief Diane Weathers hadn't sensed what I was going through and asked me to write the piece, I don't know how much longer it would have taken before I really told someone I was depressed -- or if I would ever have told anyone before the point where there was no hiding it anymore.

In fact, my mom, dad, and sister didn't know what I was going through until I mailed them a draft of the article and wrote a kind of offhand note saying, "I wanted you to see this before it came out." I didn't even ask for their responses!

My mom called immediately. "I'm so sad you didn't feel like you could come to me. Maybe there was something I could have done!" And my sister told me that she, too, had been through the fire. But I was so used to handling things on my own that I believed telling them would only make them worry. I knew I wasn't suicidal, even though I was dying on the inside. The pain I feel is so hard to talk about that my closest family still hears more about it when I'm in front of large groups than one-on-one.

These days I use my visibility to talk about pain and how we mask it. Every time I step up to the microphone I "out" myself as someone in pain. I do it because I know that by sharing my story, my fragility, insecurity, frailty, and woundedness, I liberate someone else to do the same.

Sometimes the liberation comes through humor. In the months after the Essence piece came out, people would see me at events and shyly come over to me. I knew they wanted to mention the article and talk about depression, but didn't know how, so I would break the ice. "I can tell you read the Essence article," I would say. "Don't worry. I took my medication today. Everything's okay -- and you don't have to whisper the word 'depression'!" That little bit of humor, that easy laugh, was usually all it took to open the gates to honest talk about something we think is shameful. And I'm telling you, there is not one among us who has not been touched by this!

This book is as much about identifying depression as it is about the power of testimony. Some of the people whose stories are in this book were willing to bare their souls for the record, in the name of a cause bigger than themselves -- and that includes some of the most well-known names here. Others were willing and even eager to share their stories, but feared that giving their names could jeopardize their livelihoods or hurt their families, especially their young children; these are not famous people and I have respected their requests for anonymity because I believe their stories are the most valuable thing they have to offer. Finally, I have drawn on magazine and television interviews from a handful of famous people who have spoken publicly about their struggles with depression.

More important than anything else is that the thousands of people who have communicated with me about this in person, in writing, or on the phone have broken the silence that makes depression so lethal. In the passages below Set Shakur, Mama DeBarge, Joyce Walker Joseph, and Diane Weathers come out to me about their depression.

Testimony

If you ever danced or sang along to the infectious music of the DeBarge family, you can thank Etterlene "Mama" DeBarge for bringing all those gifted artists into our world. Sadly, her marriage to their father was nothing like the sweet music her children made. A jealous, controlling man, he kept "Mama" pregnant for most of fifteen years -- pregnant, lonely, and depressed. She shared with me a chilling excerpt from her forthcoming memoir:

I lived every day in my own personal hell. I had noticed myself becoming more reclusive and despondent, and I spent every waking moment paranoid and afraid. I very rarely had visitors, and at one point I had even stopped answering the phone. The telephone was a luxury that I had learned to do without after my husband accused me of "talking to another man on the phone." It was actually a wrong number, and I had made the mistake of answering. It's a funny thing, depression; it's the only intangible thing I know of that can actually cause very real, very tangible changes in a person. The burden and the pain of my life weighed me down like a wet woolen blanket. I willed myself through every day by repeating to myself over and over again, I can do all things through Christ who strengthens me, and I would make it at least one more day.

"Mama" made it through many days, and helped bring her children to realize their gifts and share them, but how much richer would all their lives have been if only she had been able to get the help she needed when she needed it most?

Charles J. Ogletree, Jr., is the Jesse Climenko Professor of Law at Harvard Law School, as well as the founder and executive director of the Charles Hamilton Houston Institute for Race and Justice. This is what he told me about powerful Black men and depression:

African-American leaders in particular face tremendous obstacles rising to the top, and even greater challenges staying there. We are the face of the struggle and are expected to always show strength, grit, determination, and confidence, when the burden of depression is doing everything it can to pull us back down. It is time that we all talk about our depression, and fight with the same vigor we bring to the fight for racial justice. We must reveal the darker moments and show, despite the pain that tries to bring us down, we realize that seeking treatment, talking through our pain, and taking the mask off our helplessness will not only make us stronger, but will allow others to appreciate the fact that depression touches us all. But we can fight back, and we can win.

His words were much on my mind as I talked with two other powerful Black men, Carl Anthony Foreman and Bill Lynch, about their own pain.

Carl Anthony Foreman, the sixty-two-year-old powerhouse real estate mogul and owner of radio properties, was diagnosed only four years ago as suffering from bipolar disorder. For most of his life he experienced mood swings, at times feeling like he could conquer the world and buying up tons of property. At other times he felt bone weary, unable to talk, staying in bed in a darkened room for two to three days at a time.

Despite the range of his achievements his depression led him to move away from his wife and three sons when his youngest was fifteen years old. Although he supported them and lived nearby, when he sent the family on vacation, he couldn't go with them.

In some ways Carl's resources buffered him because he didn't have to go to a regular "job" every day. He would call his office at 3:00 a.m. "so I wouldn't have to talk to anyone." Then he'd leave a message that he wouldn't be in the office for a day or two so nobody would call and he could stay home alone, in silence. He wouldn't answer his phone. He would respond to voice mails in the middle of the night so he didn't have to talk to people. This strategy also gave him the advantages of surprise and respect, since people assumed he was working 24/7.

For a while he tried Zoloft and Lexapro, but they had side effects that, for him, were worse than the symptoms. "Chemical imbalance in our brains is no different than any other affliction we might have in our bodies. It's just that when it happens to the brain, it affects how you act and how you communicate."

Diagnosis late in life was a blessing and now Carl manages his depression by putting less stress on himself and not overworking. He attends fewer events, not stretching himself so thin, and does much of his business by phone. He also calls his therapist when he starts to feel overwhelmed. He's been coming out about his depression person by person, and each time he does, it's a little more liberating.

Sekyiwa (Set) Shakur is a thirty-one-year-old high-powered fashion designer and sister of the late Tupac Shakur. She's a warm and open spirit, someone who is clear about who she is and who she's becoming. She's also a woman who uses her own pain and challenges to help others. At twenty-three she began mentoring girls at the YWCA, because she feels it's important for young people to "hear us speak our truth, so that they know healing is possible."

She remembers always being uncomfortable in her own skin. Often she felt angry and would argue endlessly with anyone around her. She describes the feeling in her body "like a tornado." "When I opened my eyes in the morning I'd wish the sun wasn't up. And I often felt like I was outside of myself. At times it got to the point where I felt suicidal." Her family always referred to her as "Crazy Set" because she always spoke her truth. As we talk she tells me something I've heard many times: "All I really wanted was somebody to hold me." So many women have told me that they wish someone in their circle could have recognized their pain and comforted them. Instead her pain took the form of sex addiction and addiction to diet pills. She knew she needed real help when she found herself in a dark, suicidal place. "I was at a point where I didn't even think God would be upset with me. But then one day I saw God and my two brothers turn their back on me. The vision was so powerful I knew they didn't want me with them. I knew I had to keep living."

When we speak about Tupac she tells me that "in his music he often spoke of feeling crazy and alone. I wish he could have lived to hear others speak about their pain so he could have realized that he wasn't alone. As for me, it was such a relief when I was finally diagnosed. I wasn't just a 'bitch' or 'crazy,' there was a reason for all these painful feelings. I'm not crazy, I have a chemical imbalance!"

These days Set takes better care of herself. "I monitor my triggers -- lust and vanity drop me to my core, and so does the stress of overwork." She knows what she needs to do to stay sane, and once or twice a week takes some time for herself. She also nourishes her spirit by traveling as much as she can. "And I take antidepressants to control my depression and stabilize my mood."

***

I've known political strategist Bill Lynch for years. A longtime mentor, he has been the vice chair of the Democratic National Committee, helped get David Dinkins elected, and then served as his deputy mayor. An interesting fact that few people know is the role Bill played with New York Times bestseller The Covenant with Black America, edited by the amazing Tavis Smiley. Published by the small but mighty Third World Press, the book's demand grew way beyond initial expectations. In order to get the book on shelves Bill reached out to his close friend Len Riggio, chairman of Barnes and Noble, to help it find greater distribution streams. The result was the first time a small Black press made it to the New York Times bestseller list, and it was due in large part to Bill's caring intervention. What he does behind the scenes literally transforms lives! But Bill is, above all, a man who is unafraid of his feelings, a man I have seen weep openly in the face of human pain. He comes from humble beginnings and has stayed humble even as he wields tremendous political power. That quality is the thing that everyone who knows him treasures most in him. He is a man who lives his calling, to use his influence to help individuals and organizations achieve their highest goals, and that's what gives him his depth and capacity to feel. In recent years Bill had renal failure and needed a kidney donor to live. His son was a match and volunteered. As a parent it was very hard for Bill to see his son jeopardize his own life to save him. Surgery of any kind always bears a risk for the person who needs to have it, but needing to endanger his son's life in any way left him feeling helpless and depressed. These are feelings he's still working with and through, but that have made him even more compassionate.

Joyce Walker Joseph's pictures used to cover my walls when I was growing up. At nineteen, she had her first photo spread in a major magazine for a "Black Is Beautiful" article. In 1969, a year later, she was considered the top Black model in the industry. But her success had a dark side. At the height of her career she was also deeply depressed. For starters, her father didn't consider girls worth much of anything; her mother didn't have a much higher opinion. "My parents didn't think I was living up to my potential, so I didn't have their support. They told me I couldn't sing, they never came to see me on the Broadway stage, they kept saying I was wasting my education, and that I was just having fun. They had no idea how hard I worked or what I was going through. They weren't big fans of mine and at one point we were estranged, and during that time I was alone and got into destructive relationships."

Joyce entered the modeling industry so young, she had little choice but to grow up in the public eye. "It was a strain because it conflicted with my private life. I became addicted to drugs, but no one knew. I smiled for the cameras, but inside I was dying." Low self-esteem from her family's rejection, compounded by the isolation of a racist industry, led her to spiral downward.

"I found myself more alone and lonely on modeling shoots, always the odd Black girl with the Afro from Queens, who didn't fit in with the jet-setting cliques. The man I married was not there for me, physically or emotionally. We soon divorced, but I got into other relationships with men who kept me working in an industry that talked down to me. They also introduced me to drugs that they said would make me feel better, 'make everything all right.' I was too naïve to recognize their actions as manipulative and controlling. No one understood my pain and depression. My parents thought I was just being moody; I was a success, what did I have to be depressed about? My childhood friends put up a catty, jealous wall when I reached out to them. To the outsider, I had everything; to me on the inside, I had nothing -- no love, no companionship, no meaning. I continued to numb my body with drugs and alcohol until I was trapped in a dark place where suicide and death seemed like the only light. If this was the best of life, I wanted no part of it."

Joyce's journey of self-healing wasn't short, and it wasn't easy. "There were no sister-circles of support in those days. And you know how talking to a counselor or a shrink was seen as a stigma to Black folks, as a sign of personal weakness. I was held out to be strong, a role model." So what did she do that brought her to the truly strong place she's at today?

"I got healthy by being still and reaching deep inside for my connection with God. I wrote in my diaries, I meditated and prayed daily. I changed my career direction and entered Rutgers law school. I found a life partner and created a beautiful family. I sought out a female therapist, who was a good listener and sounding board. I cofounded a creative arts and leadership training program for Harlem teens. Giving to children, my own and forty others, has turned out to be the greatest gift I could give myself."

Diane Weathers is a veteran writer and editor. She is also, as I've said, the woman responsible for my coming out about my depression in the pages of Essence after hearing me speak about it on C-Span. She shared with me this story of her own depression:

Nights I could handle. I fell asleep easily, and sleep allowed me to forget. But my mornings were unmanageable. To wake up each morning was to remember once again that the world by which I defined myself was no more. Soon after opening my eyes, the crying bouts would start and I'd sit alone for hours, weeping and mourning my losses.

During one six-month period in 2005, my marriage ended, I was asked to resign as editor in chief of Essence, and my daughter was threatening to run away.

My spirit was shattered. I began to believe I must have been getting everything wrong. I feared I was cursed with some flaw that made me unfit as a wife, a mother, a magazine professional.

My recovery has come in baby steps, and it is ongoing. The first smart thing I did was e-mail a couple of dozen friends and people in my network, letting them know what a hard time I was having handling the sudden upheavals in my life. In the subject line I typed in the word "help," and I asked for their friendship, love, and suggestions for coping. I had written too many stories on the tragic lives of men and women who kept their personal suffering private. I long ago decided that if ever I found myself adrift at sea and drowning, I'd never be too proud to ask for a lifeboat. At this point in my life, I felt I needed an entire flotilla.

My next step was counseling. Initially, all I could do was sit on my therapist's couch and cry. Finally, I asked for antidepressants. Medication quickly helped quell the crying jags so that I could better tend to the business of my life. After a few months, I felt strong enough to sort out the mess still crowding my plate, without meds and without falling to pieces.

I am grateful that my therapist encouraged me to make meditation a daily practice. She helped me discover that my chaotic thinking and inability to focus on the present had become part of my problem. I still marvel at how simply sitting still each morning for thirty minutes, concentrating on my breathing, helps clear my mind of the debris left over from all my yesterdays. Letting go of the mental clutter lets me think and see more clearly and this helps me live more skillfully.

This probably won't be the last time that I come down with a blues that brings me to my knees. I can be hypersensitive to the disappointments, dashed expectations, and losses that come with life. I hope that next time around I'll be able to handle it better and if not, just handle it as best I can. And if I can't handle it on my own, may I never be too full of false pride that I can't reach out and ask the universe for help.

Even mental health professionals aren't immune. Take Derek S. Hopson, a well-known psychologist who previously shared his therapeutic practice and work as an author with his ex-wife. After eighteen years together, despite sharing so much, they divorced. At one point, Derek couldn't seem to get his life or practice back on track. He began to avoid friends, to suffer from a sense of failure, and to feel a loss of pleasure in the research that had always been a primary joy in his work. Like for me, being a therapist didn't help him diagnose or treat his own depression. It wasn't until about his fifth visit to his own therapist, reconnecting with family, close friends, and receiving loving support from his new wife, Flora Allen-Hopson, that it became apparent he might be suffering from symptoms of depression.

And then there's the long legacy of secrets and lies in the Black family. Since slavery, Black families have felt the need to cover up a million things they thought shameful, starting with the fact that so many of us were born out of wedlock or as the result of rape. The true tragedy lies not in hard truths but in the shame that keeps generations of family members unable to talk about their pain and find comfort with one another.

Rande Thompson was a classical pianist and Columbia University graduate. His talents were amazing, but he spent a great deal of time alone and had only a handful of friends. After years of erratic behavior, of disappearing and resurfacing, he called two of his closest friends to tell them he was in the hospital. He had full-blown AIDS. His friends were stunned. They hadn't known he was gay, either. It turns out that he had led a shame-based double life for years, and that the denial of his sexuality mirrored his denial of being HIV positive. Ashamed of being gay, he could never come out and find a stable long-term partnership that would nourish his soul; instead, he had hundreds of anonymous partners and rarely engaged in safe sex. The depression brought on by his sexual shame drove him to a compulsion that cost him his life.

Joan Cartons is one of the warmest people I know. Petite and stylishly dressed, she always has a smile on her face. But she was only willing to share this story with me on the condition that I change her name. "Last year I attempted suicide. My daughters don't know, and I don't think they're ready to hear the story."

It happened to Joan very recently, but her pain started a long time ago. "My mother used to send poison pen letters. They were so cruel I think she may have had borderline personality disorder. I would call my sister and say, 'I got a poison pen letter today.' She succeeded in pitting us siblings against each other. One on one we're okay, but as a group we're a nightmare."

Joan felt that the distance she kept between her mother and herself in adulthood would be enough to insulate her against her mother's toxic ways, but you know what happens to the best-laid plans of mice and men..."When my mother became ill, I swore I wouldn't be the one to take her in because I knew it wouldn't be healthy for me. But I ended up taking her in for two months. I was in debt and under stress about my daughter's education, so as a mother, daughter, friend, and sister, I was being pulled in too many directions."

One day it all became too much. "I came home, sat down at the computer, and suddenly started crying. I ran outside because I couldn't breathe. My husband ran out after me, and my daughter brought a paper bag for me to breathe into. At 2:00 a.m. when everyone was asleep I went back to the desk and started writing about my feelings. I printed it, packed my bag, and decided I would kill myself."

This wasn't the first time Joan had had suicidal thoughts, but every other time she was aware of them, and felt a little crazy for having them. She had understood those thoughts, correctly, as a warning sign, as a cry for help, but this time was different -- this was not a cry for help.

"The next morning I cleaned the house and took my mother to the doctor. My husband came home and read the letter on my desk, and he called, crying, saying 'Please don't do it!' In the middle of my talking with him the hospital fire alarm went off, so I had to take my mother out. My husband called my sister, she sent her son to the hospital, and he just missed me -- I even saw him driving in. I dropped my mother off at home and drove to hotels until I found a room, ordered prime rib and baked potato, took out wine and pills, and spread out pictures of my husband and kids. It was the first time I had felt painless in a long time. I watched Oprah, and in between bites I would pop handfuls of pills."

Her husband and nephew drove all over town looking for her, stopping at every hotel they saw because her husband knew from things she had said that she would check into a hotel. He finally saw her car at one hotel and had to call the police to find out where Joan was and get into the room.

"I was awakened by police shaking me and slapping me, and I passed back out. I saw my husband in the corner crying. He saved my life, because I had taken enough pills to kill myself. I was hospitalized for seventy-two hours, and then moved to a 'crisis home' for a week."

But recovery was not smooth or easy. "At the beginning I told my husband I was sorry he found me. He took six months off, because he was always worried about me. My therapist said it was a scary suicide because of how calm I felt.

"From a year ago March, up until January '07, I really had a lot of good days and bad days. In January I woke up and decided that I needed to try to help me as much as I could. It's like an alcoholic; you have to take it one day at a time. When I try to take on more than one day I can fall into a depression, because it's overwhelming to think too far ahead. I'm learning to say no. I need adequate sleep or I get depressed. And I've started exercising for my mental health. Now I have more energy and take my meds.

"I've learned that part of why I get depressed is that I have a lot of negative self-talk in my head and I diminish myself all the time. I think things like, 'I'm a bad mother, wife, friend,' even though people compliment me on being a good mother, et cetera, but when I'm depressed I can't feel any of that."

"Passing for Normal" at Work

The other day I was reading a study by the National Institute of Mental Health and I stopped short on this sentence: "Poor functioning while at work accounted for more lost days than absenteeism." That means those days when we're not effective at our jobs happen more often, and add up to more lost productivity, than days when we're not there at all! The study went on to say that some workers lose upwards of twenty-seven workdays a year this way. On top of this, they estimated that over 6 percent of workers in this country have major depression -- in dollars and cents, that translates into $36.6 billion lost to depression every year!

So many of us are "walking wounded" in the workforce, yet most of us deal with it by putting the game face on tighter, afraid to let anyone see what deep pain we're in. I can't even count how many times I've done my job perfectly on the outside while on the inside I felt like I was falling apart. And so many men and women tell me they feel the exact same way day after day, week after week. That means thousands and thousands of people are sitting at their desks not working. Not working for themselves and not working for their employer. Now, if you ask me, that's a lot of waste -- waste of human potential, and waste of corporate resources.

Listen to what Judge Nina Hickson, former chief juvenile judge of Fulton County Juvenile Court in Atlanta, who has struggled with clinical depression, has to say on the subject.

Although I had been in and out of counseling during my early adult life, when my counselor told me that she thought I needed to go to a psychiatrist because I seemed to be stuck, I resisted. She thought I might benefit from medication, but I was really afraid that it might cause me to be "a zombie," so I tried a variety of alternatives, including hypnosis. These alternatives would work for a little while, but eventually I would get in a rut. It took the intervention of my mother and my best friend from college to get me to a psychiatrist for an assessment and, eventually, a prescription for an antidepressant. At the time I was angry about the intervention, but I am eternally grateful to both of them for loving me enough to make me stop running from the help I needed.

My treatment initially consisted of 20 mg of Prozac a day and therapy once a week. After a few months the therapy was reduced to twice a month; after a few years, the antidepressant dosage was increased to 40 mg, which is normal because the body gets used to a certain dosage. Sometimes I increased my therapy sessions to weekly if there was a major life event I was dealing with, like the death of a family member, stress at work, or the end of a relationship.

I do my therapy with a psychologist and see a psychiatrist every few months for my medication management. This two-pronged approach is key to managing my depression. It is also important to me to read stories of other people who have managed depression and been successful in their careers.

As a judge I saw a great deal of depression in children and parents, often in the form of irritability and anger. Yet people are quick to label irritable or angry people as "bad children" or "bad people." But it's depression and it needs to be managed.

On the one hand, depression made me a good judge, but it also took its toll. The fact that I dealt with pain made me more empathic: When I saw kids acting out, my own depression made me look beyond the behavior that brought them before me. I would take the time to talk to each child, and I would try to find ways to have the child evaluated psychologically. Was there depression? Did we need to treat it?

My own experience with depression inspired me to go further to come up with meaningful interventions. I'd see children whose parents were addicts, so they weren't available to their children. They'd get clean and then come back and want to parent, but the kids were angry and acting out. The kids were dealing with the pain that addiction in a parent causes. So I tried to make sure they got the services they needed to deal with the emotional problems.

But at times seeing so much pain every day had a negative impact on me: It made my own depression worse. I tend to absorb other people's feelings, and some days I felt like I literally could not get out of bed. I would push myself to get up and go, but on weekends I would collapse and I couldn't move. I'd always had a low level of sadness, and at times even a hopeless outlook, but I'd cope by working so that I didn't have time to feel. I didn't tell people I was depressed, but it would have helped if I had. The people who worked for me would tell me I was getting irritable and short-tempered, which is not my nature, but it was part of how the pain manifested.

There was a white male judge I knew in another jurisdiction. When I heard folks talk about him, I knew he was suffering from depression. I reached out to him. And because I did, he went for treatment -- and he was grateful that I helped him seek help for himself. There is healing and help out there. We just have to not be afraid to ask for it in the workplace.

Then there's Jessica Martin, a beautiful and charismatic music industry vice president.

For most people the arrival of spring is a good thing. For me it brings on a series of questions: How am I feeling? Am I able to sleep through the night? But most of all, I wonder if spring will mean the return of "It." The Vise. The Grip. Depression.

For years I had made it through spring with my best "I'm a Black girl and I can get through this" face. Although I am a child of an attorney and I never wanted for anything, I do not remember having a carefree childhood, I was a shy and introverted child, racked with insecurity and worries too big for my young soul. But I made it through my childhood by escaping into a world of books where I found particular solace at night, reading by flashlight under my covers. Reading seemed to soothe the fear and anxiety that frequently gripped me in the middle of the night. For the most part I was a healthy child but I was prone to stomachaches and rashes and in the spring of my senior year in high school I was diagnosed with a peptic ulcer. High expectations were the norm in my household and I was accepted to six of the seven colleges to which I applied. In the fall I left for college and thought that a new environment would be good for me. And for the most part that was true, but year after year spring was still a problem. I often thought that the rest of the year merely supplied me with the enormous strength I needed to get through the spring.

I made it through college successfully and got a music industry job in New York and years passed. I worked long hours because sometimes it took a very long time for me to accomplish even a simple task. My low periods began to increase and eventually it was not just the springtime that got me down. But I was determined to fight the depression on my own. I would go to work earlier or stay later. I would just apply myself harder. I finally found the courage to ask a friend at work for the name of a therapist and then carried the address in my pocketbook for a year. By the time I called to make an appointment I was desperate. When I arrived at the office several days later I cried what seemed like an ocean of tears and then did the same thing for my next two appointments. My therapist suggested an antidepressant to take the edge off and eventually I agreed. When the medication started to take effect I woke up one morning amazed. Never in my life had I felt so clear and calm, and I thought to myself, "Wow! This is what everyone else in the world must feel like." I started to feel better and about a year later I decided that I didn't need medication any longer. For several years I was fine but then one spring the depression reared its torturous head again.

The winter of 1998 had been an emotionally difficult one and things got worse as spring approached. My birthday is in April and because of the depression, celebrating sometimes was of little interest to me. That particular year I sidestepped conversations with friends about birthday plans, and the Saturday before my birthday I could not get out of bed. I simply didn't have any energy. My friend Lori called me and insisted that I get up and go out, and I did manage to do that, and I also went to work the following week and things got worse. I don't remember much from this period of my life except that when I went to my therapist the following Friday, I was the lowest I'd ever been, I was in more pain than I could imagine, and at the end of my session my therapist quietly said, "We've been talking about your getting a rest and I think you should be hospitalized for a few days. I don't think you should be alone." Even though we'd recently discussed this I still couldn't believe what I was hearing. I was tired, but with sleep I thought I could make it through. My therapist then asked if there was someone I could stay with. Since my family was 600 miles away, we called my best friend and my therapist explained my situation.When I got to my friend's house I slept for sixteen straight hours. I went down to the kitchen to get something to eat and I was in such a bad place that even her cat knew that I wasn't well. I'm not a cat person and the cat always knew that, but today instead of being its usually pesky self, the cat simply curled up and lay at my feet. When I moved to a different seat the cat moved and curled up again.

I slept more that afternoon and into the next day. My therapist called to see how I was doing and quietly suggested that I needed a longer rest and medication. I decided that I needed to do what was necessary. Early Sunday evening my friend and her husband and two other friends took me to the hospital, where I stayed for several days, and then started to live the rest of my life.

That was almost ten years ago. I haven't had another major episode. I'm no longer in therapy or on medication, but if at such time that becomes necessary I will do what I have to do to not live in pain. It is important to know what triggers our depression, because if you look deeply into yourself you'll begin to recognize the patterns.

I had an extended bout of insomnia following 9/11 and immediately called a therapist for a tune-up, and there were also other issues that I wanted to address and during the next year and a half we worked on them.

Today my relationship with God is first and foremost in my life and my prayers and daily devotional with Him, the love of my family, friends, and wonderful Bible study family keep me lifted.

We don't have to live in pain.

The Silent Killer

Depression kills.

That's the bottom line. If I could communicate only one thing about what depression does, my message would be simple: It can kill you.

When I give talks, people often ask me, "What does depression look like?" I always give the same answer. Depression looks like your cousin who just got sentenced for dealing four grams of cocaine. It looks like your sister who works eighteen-hour days and hasn't made it to Sunday dinner in weeks. Depression looks like your sixteen-year-old neighbor who's having her second baby. Depression looks like the boy whose drive-by shot hit your niece instead of the rival gang member he was gunning for. Depression looks like the black-and-blue bruise on your troubled nephew's wife. Depression is the overweight mother of two who keeps forgetting to take her blood pressure medicine and has a heart attack in the supermarket where you shop every week. Depression looks like the corporate executive who wears an airtight game face all day and collapses at home every night, so tired of acting the part that he can't enjoy his own life. Depression looks like the twenty-eight-year-old Black woman who's starving herself to death to look like white models in her industry. Depression looks like the pastor who preaches like a man lit up with the holy spirit on Sunday mornings and drinks himself to sleep every night. Depression looks like your best friend who's stopped cleaning her house or doing her hair or taking any interest in your friendship. Depression is your coworker who's chronically late and blames everyone else for her missed promotions. Depression is your uncle's suicide that no one wants to talk about. And, yes, depression is being evil and irritable every day for months on end.

Suicide is the most obvious way that depression kills, and according to current statistics five African Americans a day take their own lives. But as frightening as those numbers are, they represent only a fraction of the deaths that can be laid at depression's doorstep. We face so many tough challenges in a year, a month, a week, or even a day. Do we respond to those hard knocks by going to a therapist and, as the Reverend Calvin Butts says, "getting a checkup from the neck up?" Or do we try to soothe our pain by shopping on already stretched credit cards, secretly binge eating in front of the TV, drinking every day after work and all day on weekends, doing a little recreational cocaine, using sex to numb ourselves out, ignoring our kids because we just can't take one more demand, not taking our medication because "it doesn't really matter..."?

I want to go beyond what depression looks like to what it feels like, what it is. To look at the life-threatening effects and side effects of depression when it's not acknowledged: suicide, crime, addiction, overeating, high blood pressure, overwork, juvenile detention, prison relapse, sexually transmitted diseases, shattered relationships, job loss, hopelessness. Or the connection between depression and HIV/AIDS, rooted in the bigger problem of Black self-esteem. As HIV/AIDS activist Tony Wafford says, "Too many Black people don't value themselves or the lives of others. Having unprotected sex, not informing your partner of your condition, is reckless disregard of Black life." And depression is one of the main reasons for that disregard of Black life.

I also talk in these pages about overeating, my own biggest symptom. Just as drug use can be a response to low self-esteem that leads to depression, which in turn fuels lower self-esteem, compulsive overeating almost always starts as a "solution" that quickly becomes its own problem and makes other problems -- like depression -- even worse. And I look closely at how violence operates in many of our lives not only as crime, but also as domestic and child abuse. I explore violence as the way we express frustration and hopelessness -- and homicide as the way we flip suicidal impulses. Take hip-hop mogul 50 Cent, whose gangsta game face almost cost him his life. In an interview in America Magazine he says, "I spent the majority of my life being angry. Anger is my most comfortable feeling. If I'm upset or my feelings are hurt, I become angry; if I'm confused, I become angry. Like if one of my homies got shot or stabbed at the club. You're upset because you feel for him, but instead of going somewhere and crying about it, you get angry. Then, after you respond, you change to having jitters about law enforcement finding out about what you just did."

Depression at Its Deadliest

Silky-voiced soul singer Phyllis Hyman was the kind of artist people call "a singer's singer" -- among her legions of devoted fans were musicians much more famous than she, who would do anything to hear her sing -- but even with all her gifts and all her devotees, she was unable to escape the demons of her manic depression. As she got older, her condition became more and more debilitating and she self-medicated with alcohol and food. Alcoholism aggravated her condition and contributed to her increasing despair about her weight gain in her late thirties. Blessed with the tall, stunning looks of a fashion model, she was racked with anxiety over what she thought was the loss of those looks. She was wrong -- she was beautiful right up to the end.

In the 1980s and early 1990s she threw herself into fighting AIDS, not only by raising money through one benefit concert after another, but by visiting people dying of the disease in hospitals and hospices all over New York. Many patients asked specifically for her, and while she was gratified that her visits could bring pleasure, she despaired about not being able to "really" help, and the visits left her drained emotionally as well as physically. Her sense of helplessness was magnified in 1993 when both her mother and her grandmother died less than a month apart. She honored them in the beautiful song "This Too Shall Pass."

She kept recording, kept performing, kept doing benefits, kept paying visits, but her depression was closing in on her like a storm cloud, and she was acting out her anguish in ways that went way beyond "diva" behavior into downright self-destruction. Even as her work became more and more emotionally honest and open with every new album, she was unable to bring that open honesty to help herself, and her life became more and more unbearable. One bright June day in 1995 she ran into fellow diva Jennifer Holliday, who had lost 200 pounds in the previous year and a half (see chapter two for more on Jennifer's battle with depression). She was full of praise for what Jennifer had accomplished, but there was so much agony in her face that she seemed to be saying wordlessly, You have done what I can never do. I'm beyond help. Three weeks later, on June 30, hours before she was supposed to open for The Whispers at Harlem's famed Apollo Theater, she took a lethal mix of pills and liquor, and died in her apartment, alone.

What's Going On'Too Many of Us Crying, Too Many of Us Dying

Over the last thirty years I've suffered from three serious bouts of depression and lived with dysthymia (a low-level and long-term form of depression), but it's only in the last two years that I've been able to face on a daily basis that I suffer from major depression -- that I am a victim of a disease. Like most Black folks, my resistance to naming the life-threatening cluster of symptoms I suffer from ended up ruining years of my life and jeopardizing my health. Facing the fact that I am depressed was the greatest challenge of my life.

As a child of sharecroppers who moved north and fought hard for a better life for their children, I am part of a generation that lived the first reality of integration. My parents had come up the old-school way, with old-school beliefs: Black life is hard, you don't talk about your feelings, you have to work harder than those around you to achieve, and you should never forget to give back. All this made a lot of sense for the ugly centuries when our people's lives were not their own. After all, we could be raped and tortured without receiving any help, our children could be sold away from us, our loved ones murdered without repercussion -- we had no choice but to play it close to the vest.

No one "owns" us anymore, but avoiding painful emotions has become a cultural habit, a habit that prevents so many Black people from openly acknowledging sadness and pain. We pay a high price for these habits of survival: The price is our well-being. To make matters worse, we're scared to death of being labeled mentally ill -- in a society still struggling with racism, our fear is powerful and very understandable. Yet evidence of our pain is everywhere, even if we haven't named its source or acknowledged its effects and presence in our daily lives. The reality of depression can be seen in our long artistic legacy, from early slave narratives to novels such as 72 Hour Hold by Bebe Moore Campbell and Beloved by Toni Morrison to popular films like Menace II Society, Boyz N the Hood, South Central, Colors, Training Day, American Me, and Hustle & Flow to the blues itself. I believe that depression has become an epidemic in the Black community, an epidemic that has been growing stronger with every generation. This is an obstacle we must overcome. We can no longer afford to be afraid to admit how depression is affecting us.

I can only imagine how many cases of unacknowledged depression have come out of Hurricane Katrina's destruction. I fear for the mental health of hundreds of thousands of African Americans as they try to put their lives back together. What will be the toll of Black denial of pain coupled with distrust of the mental health agencies set up to provide help? How much suffering will continue over the next few years as whole families remain psychologically untreated and their grief turns into full-blown depression?

But What Is Depression?

Let's start by talking a little about labels, especially those nasty ones that get stuck on people. The mother of all psychological/psychiatric reference books is the Diagnostic and Statistical Manual of Mental Disorders, 4th ed., more commonly known as the DSM-IV, a big fat volume of almost a thousand pages that's used by just about every mental health care professional: social workers, psychologists, psychiatrists, among others. (Stay with me -- I'm going to say this in English in a minute.) First published over fifty years ago, it's now updated regularly to reflect new research and deeper understanding. But even this book does not encourage the use of labels. According to the very useful Web site allaboutdepression.com, "the DSM-IV is not used to categorize people, but to categorize conditions or disorders that people have. This may be a subtle distinction, but it is a very important one. We do not say that a person is cancer, or is heart disease, or is an illness. A person has an illness. Likewise, we should not say that a person is a depressive, but that a person has clinical depression."

Am I Depressed?

But how do you know if you're depressed?

According to the DSM-IV a person has major depression if:

A. The person experiences a single major depressive episode.

¥ For a major depressive episode a person must have experienced at least five of the nine symptoms below for the same two weeks or more, for most of the time almost every day, and this is a change from his/her prior level of functioning. One of the symptoms must be either (a) depressed mood, or (b) loss of interest.

F Depressed mood. For children and adolescents, this may be irritable mood.

F A significantly reduced level of interest or pleasure in most or all activities.

F A considerable loss or gain of weight (e.g., 5 percent or more change of weight in a month when not dieting). This may also be an increase or decrease in appetite. For children, they may not gain an expected amount of weight.

F Difficulty falling or staying asleep (insomnia), or sleeping more than usual (hypersomnia).

F Behavior that is agitated or slowed down. Others should be able to observe this.

F Feeling fatigued, or diminished energy.

F Thoughts of worthlessness or extreme guilt (not about being ill).

F Ability to think, concentrate, or make decisions is reduced.

F Frequent thoughts of death or suicide (with or without a specific plan), or attempt of suicide.

¥ The person's symptoms do not indicate a mixed episode.

¥ The person's symptoms are a cause of great distress or difficulty in functioning at home, work, or other important areas.

¥ The person's symptoms are not caused by substance use (e.g., alcohol, drugs, medication) or a medical disorder.

¥ The person's symptoms are not due to normal grief or bereavement over the death of a loved one, they continue for more than two months, or they include great difficulty in functioning, frequent thoughts of worthlessness, thoughts of suicide, symptoms that are psychotic, or behavior that is slowed down (psychomotor retardation).

B. Another disorder does not better explain the major depressive episode.

C. The person has never had a manic, mixed, or a hypomanic episode (unless an episode was due to a medical disorder or use of a substance).

I don't know about you, but I find the DSM-IV a little cold and hard to follow. I must have read that definition a hundred times without ever really seeing myself in it -- and I should have! So let me break it down in a more human way. Here are a few things that should have tipped me off years ago if I hadn't been so busy denying my own feelings. I call it:

Twenty Signs That You Might Be Depressed

1. You are always too busy -- never have or take the time to give yourself the care you need.

2. You are running from something; something is eating at you.

3. You keep things that bother you locked up inside, festering. You are afraid to speak about disappointment, hurts, fears; you are afraid to express anger. You hold on to grudges for way too long.

4. You can't ask people for what you need.

5. You lie about everything, even simple things.

6. You can't wait to get home to eat -- something, anything -- and lots of it. It's the only thing that soothes you.

7. You just don't have energy to do anything -- you have to force yourself to do everything.

8. Everything is so hard that you're sleeping a lot. It's damn near impossible to get up. You are afraid to get up.

9. You can't seem to concentrate -- on any one thing. You look at the same piece of paper five times.

10. You are steadily gaining weight. You know because everyone tells you in their demeanor, words, glances, and in advertising campaigns that you are not desirable, and definitely not some man's idea of eye candy. Oh, you might be very cool to hang out with; they love your energy, your spirit and contacts, but you feel "less than" and your self-esteem plummets.

11. You are not doing work that brings you joy; you are just working a gig and holding out for the check.

12. You haven't been touched in months or years; you haven't gotten any (yeah, I said it!) in who knows how long; hell, you haven't even had a massage!

13. You have a persistent, gnawing feeling that something is wrong. And you're right!

14. People are talking -- you know this because their lips are moving -- but you have no idea what they are saying. You aren't even there.

15. You used to care a lot about what you wore; now you just wear anything that fits.

16. You stay home a little too often. You call in sick at least once a month.

17. You think this is the end of your rope -- there's no way you can face another day.

18. You wonder if you're having a nervous breakdown.

19. You cry a lot and without warning.

20. Every morning you wake up with crippling anxiety, terrified to get out of bed and face the world.

And these are some common things you might hear a depressed person say. I'm guilty of saying at least five of these things in the last two weeks alone!

What Depression Sounds Like I just don't feel like it.

Go without me.

I don't care.

I just want to die.

You want a piece of this, motherfucker?!

I'm 'a bust a cap in his ass.

Shut up, bitch.

Somebody's gonna pay.

I'll give you something to cry about.

Go away.There's a big hole inside me.

I can't feel anything.

What's the point?

I don't drink too much!

I'll stop drinking next week.

Something inside me has died.

I don't feel right. I know something is wrong with me, but the doctor can't find it.

It's just nerves.

I can't stop crying.

I can't handle it.

I don't need anybody.

People just let you down.

I don't trust anyone.

Can you supersize that?

I'm fat and ugly; nobody would want me.

I can't breathe.

I think I'm having a heart attack.

Nothing good ever happens to me.

Life sucks.

I ain't shit.

That nigga ain't shit.

I feel like blowing my f***ing brains out.

Every day we bear witness to pain, yet most of us are so numbed out by the pain inside us and around us, and the constant media images of violence and despair, that we no longer register it. We may not be able to take in that pain, but we keep being it. I think the pain of depression is all over daily headlines like these:

5 Are Shot, 2 Fatally on Detroit Streets

Depressed Brooklyn Ma's Horrifying Confession: Demons Told Her to Kill Her Boy

Rally of Rage: Bachelor Partygoer Killed in Hail of 50 Police Bullets

Officials Say Slain Detective and Murder Suspect Crossed Paths Before

Dad Slay Is Third Murder in Turf War

Cold-blooded Killer Blew Away "Begging Cop"

Subway Murder: Fast-food Death Feud Grandma Dies After Gun Horror

14-year-old Throws Own Infant from Window Harlem Boy Kills Fellow Teen Mother Charged with Killing Newborn in Microwave I Need to Tell You Something

Finally, I would like to provide you with an option. You may be in pain, reading this book and wishing you could somehow tell another person what it feels like for you. But, like me, although you want to "let it out" -- to share your feelings, you find it hard to put them into words, and somehow the right moment never comes up. Because coming out about being in pain is so important, and because isolation can be so hard to break, I'm including the line below for you if you need a little extra help sharing your story. I wish someone had given me this option years ago. I wish I could have had someone explain to my therapist, my mother, my sister, and my best friends that I was suffering so deeply inside, but just didn't know how to reach out and tell them. This book could be your lifeline. Sign your name and give it to someone you love, and/or your therapist/doctor. Let them know you're suffering and begin the road to healing through truth. And if this book is for you, see my "Guide to Breaking Our Silence and Getting the Healing Started" at the end of the book.

Maybe you're reading this book because a loved one is in pain, or maybe you're reading it because you're in pain. Maybe you'd like to help a loved one share their pain with you, or you would like to let a loved one know that you're hurting. If that's the case, I urge you to give this book to someone you love as a gesture of setting yourself free. "Hey, Loved One, this is me. Maybe it's you, too." Even if for now you still can't talk about the pain, you don't have to be alone. Write your name in the sentence below and begin the process of setting yourself free.

I, _______________________________________, would like to tell you that I'm in pain.Copyright © 2008 by Terrie Williams