National Alliance on Mental Illness
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NAMI NYC Leader on NBC's Today Show

Running concurrently with our 25th Anniversary Convention in Washington, D.C. this week, NBC's Today Show is airing a series on "Women and Depression" which includes an interview with Karen Gormandy, a literary agent and NAMI New York City leader.

Gormandy will also participate in a special symposium on "African Americans: Facing Mental Illness and Experiencing Recovery" this week, as part of our national convention.

The Symposium will address key mental health issues that affect the African American community, highlight major research findings, and discuss mental illness and recovery from a family approach. This event will bring together consumers, family members, researchers, and providers to share information, tools, ideas, and approaches to reach African American families.

Women & Depression

*In any given year, 10 to 14 million people experience a clinical depression. Women 18 to 45 years of age account for the largest proportion of this group. Clinical depression is a serious medical illness that is much more than temporarily feeling sad or blue. It involves disturbances in mood, concentration, sleep, activity level, interests, appetite, and social behavior. Clinical depression can develop in anyone, regardless of race, culture, social class, age, or gender. However, across virtually all cultures and socioeconomic classes, women are more likely than men are to experience depression.

*Clinical depression affects two to three times as many women as men, both in the U.S. and in many societies around the world. It is estimated that one out of every eight women will suffer from clinical depression in her lifetime. Women also experience higher rates of seasonal affective disorder and dysthymia (chronic depression) than men. While the rate of bipolar disorder (manic depression) is similar in men and women, women have higher rates of the depressed phase of manic depression and women are three times more likely to experience rapid-cycling bipolar disorder.

*There appear to be important links between mood changes and reproductive health events. Gender differences in rates of depression emerge when females enter puberty and remain high throughout the childbearing years and into late middle age. Hormonal factors seem to play a role in some of the mood disturbance experienced by women.

*Psychosocial factors that may contribute to women’s increased vulnerability to depression include the stress of multiple work and family responsibilities, sexual and physical abuse, sexual discrimination, lack of social supports, traumatic life experiences, and poverty.

*Studies also indicate that sexual and physical abuse are major risk factors for depression. Women are twice as likely as men to have experienced sexual abuse. A recent study found that three out of five of the women diagnosed with depressive illnesses had been victims of abuse. In one major study, 100 percent of women who had experienced severe childhood sexual abuse developed depression later in life.

*Although it once was thought that women experienced low rates of mental illness during pregnancy, recent research reveals that over 10% of pregnant women and approximately 15% of postpartum women experience depression. As many as 80 percent of women experience the "postpartum blues," a brief period of mood symptoms that is considered normal following childbirth. However, the related hormonal and biological changes associated with pregnancy or giving birth may initiate a clinical depression. Or, the changes in lifestyle associated with caring for a young infant may constitute a set of stressors that have mental health consequences for the mother. There is a three-fold increase in risk for depression during or following a pregnancy among women with a history of mood disorders. Once a woman has experienced a postpartum depression, the risk of having another reaches 70 percent. One woman in a thousand experiences a postpartum psychosis -- a medical emergency in which the woman may inflict harm upon herself and/or her baby. The first episode of bipolar disorder in women frequently occurs following the birth of a child.

African Americans

*Approximately 12% of the U.S. population, 33.9 million people, identify themselves as African Americans. The African American population is increasing in diversity as immigrants arrive from many African and Caribbean countries.

*Over half of the nation's African American population (53%) live in the South; 37% reside in the Northeast and Midwest combined; 10% live in the West. In 1997, nearly one-fourth of all African Americans earned more than $50,000 a year. And yet about 22% of African American families lived in poverty, compared to 13% of the United States as a whole and 8% for non Hispanic white Americans.

*African Americans may be less likely to suffer from major depression and more likely to suffer from phobias than non-Hispanic whites. Somatization is more common among African Americans (15%) than among whites (9%). Moreover, African Americans experience culture bounds syndromes such as isolated sleep paralysis, an inability to move while falling asleep or waking up, and falling out, a sudden collapse sometimes preceded by dizziness.

*While non-Hispanic whites are nearly twice as likely as African Americans to commit suicide, suicide rates among young black men are as high as those of young white men. Moreover from 1980-1995, suicide rate among African American ages 10 to 14 increased 233%, compared to 120% of comparable non-Hispanic whites. African Americans are over-represented in high-need populations that are particularly at risk for mental illnesses, yet African Americans account for only 2% of psychiatrists, 2% of psychologists, and 4% of social workers in the United States.

*Nearly 1 in 4 African Americans are uninsured, compared to 16% of the U.S. population. Rates of employer-based health coverage are just over 50% for employed African Americans, compared to 70% for employed non-Hispanic whites. Medicaid covers nearly 21% of African Americans. Overall, only one-third of Americans with mental illnesses or mental health problems get care. Yet, the percentage of African Americans receiving needed care is only half that of non-Hispanic whites.

*African American are more likely to use emergency services or to seek treatment from a primary care provider than from a mental health specialist. Moreover, they may use alternative therapies more than whites. African Americans of all ages are under represented in outpatient treatment but over represented in impatient treatment. Few African American children receive treatment in privately funded psychiatric hospitals, but many receive treatment in publicly funded residential centers for emotionally disturbed youth.

While few clinical trials have evaluated the response of African American to evidence-based treatment, the limited data available suggest that, for the most part, African Americans respond favorably to treatment. However, there is cause for concern about the appropriateness of some diagnostic and treatment procedures. For example, when compared to whites who exhibit the same symptoms, African Americans tend to be diagnosed more frequently with schizophrenia and less frequently with affective disorders. In addition, one study found that 27% of blacks compared to 44% of whites received antidepressant medication. Moreover, the newer SSRI medications that have fewer side effects are prescribed less often to African Americans than to whites. Finally, even though data suggest that blacks may metabolize psychiatric medications more slowly that whites, blacks often receive higher dosages than whites, leading to more severe side effects. As a result, they may stop taking medications at a greater rate than whites with similar diagnoses.