One group that I seemed to have not written about yet is mothers. So I would like to dedicate this post to the discussion of postpartum depression and race. In my opinion, in at least understanding the intersection between postpartum depression and race, a dialogue surrounding the socio-cultural and environmental factors of postpartum depression. This is in turn can lead to a dialogue how to support these mothers and potentially how to strategically minimize this type of depression.
After doing a quick search online, I came across this article.
The key idea to pull this from this article is: “Statistically, postpartum depression can be ranked from high to low as Native Americans, Whites, African Americans and Hispanics”.
So the question is why? Why is it that Native American women have the highest levels of postpartum depression? (Of course there are other factors and identities that inform this but it is still a valid question to pose).
The first idea come to my mind is the disproportionate violence that indigenous women face. Trauma and violence experienced throughout a lifetime can certainly inform ‘potential’ to depression.
On the flip side, why is that Hispanic women experience the lowest levels? What factors within the Latina community may provide for better support systems during pregnancy?
As a final thought, how accurate is this study at all? What other identities were considered throughout this study, if any?
As someone who engages in social justice/community organizing work (what some people might call activist work), I have had to over time re-assess and learn to understand my mental health on new levels. That is, the emotional and mental health toll that occurs with organizing can sometimes be overpowering. To have to balance work, school, a social life and organizing work often leads to being burnt-out. For me this type of burnt-out is usually beyond any other type I have experienced.
Recently, after feeling slightly on the verge of being burnt out and discussing the situation with my friend, I was sent this article.
In this article, what resonated with me was tip number 4: “Identify the specific causes of your burnout.”
Feeling burnt-out, overwhelmed, especially when you face other psychological/mental health challenges (whether in a form of a disorder or mental states such as grief) is extremely confusing. Thus, I think this tip is especially helpful because it helps orient us.
By finding the source of our pain and feelings of burnt-outness, we can re-orient and find solutions. Self-care should, in my opinion, ALWAYS come first. But finding the source can help us avoid it in the future. In social justice work this is especially important because usually the decision to commit to social justice is for life. In one way or another, those who are committed to social justice tend to continue with the movement.
This month, the topic of my organization (The Student Mental Health Initiative) is forgiveness and mental health. We are hosting a meeting to talk about the subject matter and discuss when it is best to forgive someone who negatively impacted your mental health and when that may not be an option nor should it be. For example, if someone uses the word ‘crazy’ to describe one of your actions and you have a psychological disorder, does it make sense for you to forgive them (even if they haven’t asked for forgiveness) for your own healing? Or if someone tries to minimize the trauma you went through, should you forgive them on the assumption that they misunderstood you?
Of course, I do not have the answer to this. Each situation will be different. But I think we can find common themes within our own experiences of what works best when. And being conscious of these themes can help us heal. It can help us create dialogue with certain individuals at certain times.
In thinking about myself, there are probably folks I need to forgive in order to give myself room to heal. There are folks who were simply ignorant but not malintentioned. Yet there are plenty of others who were; they made the decisions they did because they had no respect for me. So for me, those are the people I believe I shouldn’t forgive. Not now, not ever. Forgiving them is accepting their behavior and enabling them continue their actions. The question then is, is confronting them on these issues ever an option or should it even be an option?
I recently came across this article and thought it was so incredibly important that I should share widely.
Plett, the author describes ‘holding space’ as ‘”willing to walk alongside another person in whatever journey they’re on without judging them, making them feel inadequate, trying to fix them, or trying to impact the outcome. When we hold space for other people, we open our hearts, offer unconditional support, and let go of judgement and control.”
So what does this mean? It means that instead of giving advice, thinking about yourself in the situation (although of course within reason in relation to self-care), trying to direct them into any activity, etc. It means being there for the person in ways that provides them comfort, support but does not erase their agency or harm them (even unintentionally).
What does this look like? Plett provides eight key tips. They range from ‘giving them permission to trust their own intuition’ to ‘keep your ego out of it’. However, of course these are only guiding tips and each situation will be different. In my opinion, to ‘hold space’ is to practice giving and listening without involving your personal into it (but perhaps Plett is right to call it ego).
In the realm of mental health and psychological disorders this is especially important because we can unintentionally marginalize, misdirect, dis-empower, etc individuals. By practicing our skills of support, we can work towards healing as individuals, as community and as humanity in general.
The DSM (or the Diagnostic and Statistical Manual of Mental Disorders) in theory is a great idea. Since society (or is it human nature?) drives us to quantify and understand the world around us and ourselves, it makes sense that people created a manual on mental health. However, in certain instances the drive for concrete rules regarding mental health can become marginalizing. In fact, sometimes it can prevent an individual from gaining treatment.
Taking eating disorders as an example, below is a partial list of issue that the DSM has caused (or does cause).
1. Until the new DSM- V (2013), anorexia nervosa had requirements related to menstruation. To be diagnosed with anorexia nervosa, one had to have not had a menstruation cycle for at least to three months (or meet certain other criteria in a different category). But what about men? Or menopausal women? Or pregnant women?
2. Binge Eating Disorder has only been recognized in the new DSM as an eating disorder. That means that for years, these individuals have been discriminated against and not able to get treatment because their disorder was not recognized by the DSM specifically (it was recognized within other communities).
3. Diabulmia and orthorexia remain unrecognized by the DSM. Although they are largely recognized within the eating disorder community, their lack of recognition in the DSM can be used by insurance companies for insurance denial. Also treatment options are not as widely available.
4. The default categorizing of individuals who don’t quite fit into other categories as Eating Disorders Not Otherwise Specified (in DSM IV) or Other Unspecified Feeding and Eating Disorder (DSM V). This is often used as a default diagnosis for individuals without understanding the complexities of the situation. This also often means that insurance companies have a basis of denial of treatment.
Although I have less specific knowledge on other parts of the DSM, I am sure the same types of problems exist in other parts of the manual.
For more info on DSM V changes regarding eating disorders.
TW: forceful treatments of eating disorders
Cultural profoundly influences the way we think and speak about everything, including mental health. Cultural perceptions of mental health influence everything from stigma to the types of treatments available. In combating mentalism and in working to provide services to those with psychological disorders, we have to acknowledge the importance of culture. After all, giving someone advice that is not culturally competent, can in fact put them in a dangerous situation.
Lately, I have been thinking about mental health in the context of Russian culture, specifically eating disorders. Eating disorders in Russian culture are largely misunderstood (like in most countries and cultures) but are also voyeuristically portrayed. For example, there are documentaries with interviews with recovered anoretics that focus on their behavior, rather than the underlying causes. That is, the documentaries or news pieces related to eating disorders like to describe what the person ate and did not, as well as their families reactions. They do not focus heavily on the mental health aspect of the situation.
In terms of how eating disorder treatment is carried out in Russia, it is often reduced to force. Individuals with eating disorders are often forcefully fed and restricted, in order to make sure they survive. Although this tends to ensure their basic survival (for at least a certain amount of time), it also traumatizing. Since eating disorders are often a coping technique in relation to control within one’s life, this sort of physical restriction can exacerbate the mental anguish of an individual with an eating disorder. However, plenty of immigrant Russians send their children, who have eating disorders, to Russia because they believe that this forceful treatment is the only treatment that will save the lives of their children.
Thus, in dealing with Russians, who have eating disorders, it is important to consider this aspect. If Russians families tend to perceive physical survival of their children or family members as most important, language regarding treatment needs to prioritize this, so as to assure the family the quality of the treatment. In other words, at times it is important to show progress to concerned family members through facts regarding physical health, in order to assure their furthered support of recovery. If mental health issues are discussed foremost, the family may feel that progress is not necessarily being met and look for alternate (and potentially harming) ways to deal with the situation.
In this post, I just wanted to present this cute video on mental health awareness. I truly believe that mental health and psychological disorders are something that affect and surround all of us. Yet we do not talk about them. Like the cute little elephant in the room, they take up space but in silence.
TW: Suicide, mentalism, depression (in the link provided).
I would like to dedicate this post to the ongoing conversation coming out of the suicide of Yale student. She committed suicide because her psychological disorders and adaption to her medication were putting her in the position where she would need to withdraw from Yale. However, this meant she may not have been able to go back to school due to bureaucratic, financial and discrimination issues. Please see this article for more on the story.
The article demonstrates and talks about the issue better than I can but I want to just point out a few key things in relation to how medical withdrawal/re-admittance policies in universities need to be re-evaluated.
- The language – is the language dehumanizing or marginalizing of the individual? Is there vitvim blaming? Is there erasure of agency?
- The financial procedure – are individuals able to be protected financially for withdrawing? Are scholarships lost upon temporary withdrawal? Are counseling services provided free? Does the student have to pay an application fee for re-entry?
- Whose needs are met – is the priority on the student’s health or the consequences for the university? Does the student get a choice of how and when to withdraw? Is the student given special resources and support to re-apply when able to?
Those are just some starting points to think about. But in the greater picture, these things help direct how much mental health is stigmatized, how comfortable students feel getting help when needed and how many students are able to finish college.
In this post, I would just like to take the time to recognize a wonderful victory for survivors of sexual violence on college campuses. Know Your Title IX, a national campaign fighting to end college sexual violence, recently released a letter from the Department of Education. In this letter, the department rights notes many key things as to the protection of survivors. For my purposes, the one thing I want to point out is their statement that “[i]f a school determines that it needs to offer counseling to the complainant as part of its Title IX obligation to take steps to protect the complainant while the investigation is ongoing, it must not require the complainant to pay for this service.” That means, if a survivor requires counseling, the university or college may NOT charge the survivor for these services.
This is truly a victory not only on the basis of gender and economics, but mental health justice as well. Given that survivors are 6 times more likely to suffer from post-traumatic stress disorder and 26 more times more likely to abuse drugs, mental health services are integral to the well-being of survivors. Such a determination both recognizes the intersection between mental health and survivors, and works to protect survivors.
I have recently come across an article about a new project started by Dior Vargas that attempts to de-construct and challenge the notion that only white people live with psychological disorders.
As a white person myself, there is a limited of commentary I can make on this project. However, I believe that this project is fantastic. People of color who live with psychological disorders are routinely erased from our society’s narratives. Or if the intersection is present, it is to demonize the person further.
More importantly perhaps, this project brings into our narrative the disproportionate amount of people of color who live with psychological disorders. As this infograph shows, the amount of suicides committed by Native women is disproportionately high. And this project can help us question why? What is it in our society, what is it that people of color experience that causes many of them psychological distress and triggers?
One aspect of this problem is of course cultural/societal- the racism and other forms of oppression these folks experience is often traumatic, triggering, etc. Another aspect however is lack of access to health care. According to a report produced by Massachusetts Health Policy forum, ” found that 29.2 percent of Latino adults with mental illness received treatment compared to 51.5 percent of whites. Blacks and Asians had slightly lower rates of treatment than whites. The disparities are greater in the United States as a whole.” What makes it worse is that often times people of color are also less likely to be insured, so if they do overcome ethnic/racial/cultural barriers and do have some access to mental health care, they often are uninsured. For example, in Tennessee, Latinas/os are 30% more likely to be uninsured than whites.
Of course the issue is even more complex than that, with family dynamics, access to education, economic class status, gender, etc having an effect on the situation. However, the project is an amazing step toward mental health justice because it opens up a conversation on the intersection between race and mental health.