Mental illness in the African-American community – My journey to getting help
by Jaha Zainabu
“Roller coaster! Roller coaster! Up, up, up, up! Down, down, down, down!” This is the song my three year old cousin, Aubrey made up and voraciously danced to one night as her mother and I sat up talking and watching television. As she repeated it, the song stuck with me. I thought about how it reminded me of how I feel on many days. Up. Up. Up. Up. Then down. Down. Down. Down.
I had been experiencing emotional lows since late in my elementary school years. I remember times as a little girl when I asked my sister Roshann, who is four years younger than I if she ever felt really sad but didn't know why. I don't remember her answer. I don't know if the question even made any sense. I knew I felt that way sometimes and didn't understand why. In my middle school years the sadness and sudden feeling like being alone was interpreted as moodiness by my friends. It was also in middle school when I remember first experiencing the highs. The extreme happiness for no reason. I was puzzled by it. And then high school was just, well... high school.
In 2012 it was serious. Before then I don't ever remember having suicidal thoughts. Even though depression, which showed itself as “moodiness” had shown up in many ways in my romantic relationships. The hardest part was not being able to communicate what was wrong. Nothing was really...wrong. There were just these tears sometimes. I spent a lot of time hiding sadness; and when I did feel safe enough to express it, it seemed like every man in my life wanted to fix it and then became frustrated that they couldn't. And then the tears would stop and later I would be so happy and excited about everything. The color of the sky, the sounds of the birds, everything. I could fit football fields between the two feelings. The actual thoughts of ending my life were brand new though. I knew I needed help. I knew I didn't really want to die. I knew I had too much to live for and more than that, I had someone I wanted to live for, my son Uraeus. But none of the reasons I had to live were enough to keep the thoughts at bay. And then there were the highs that kept coming. And highs by the way, do not always show up as happy. Sometimes they show up as extreme irritation, especially when I feel trapped. Like in traffic. There were times I felt I would combust if I didn't get off the road. And then sometimes, and more often, the highs showed up as me laughing uncontrollably in situations that were either not that funny or not funny at all. My clue that the highs were onset was that I would be talking way too loud and fast. I could feel myself doing it but couldn't seem to control it. That would last for a while then I would crash and the lows would come.
One day I asked a friend of mine, Donny, who is a poet and psychologist, to meet me at a coffeehouse to talk about what was going on with me. He gave me his listening ears and some recommendations for psychologists to see. One night after a poetry event I went to Denny's with a group of poets. I was talking to Donny at one end of the table and there was another conversation at the opposite end. There were about twelve of us all together. At the opposite end were mostly young men who were engaged in a conversation with two young women. One of the women was a young poet I know named Venessa and the other woman was her visiting cousin. The way I remember it is that Venessa's cousin said something and the men were laughing at her. That's how it felt, like they were laughing at her and not with her. I saw the look on her face and knew something was wrong. I didn't know what they were talking about but I sensed her great discomfort. As a woman at least a decade older than Venessa and her cousin, normally I would have at least inquired about the situation added my voice to help. But for some reason, I started laughing. I don't know why. To this day, I wish I could take those moments back. I laughed so hard and couldn't stop. I remember Donny sternly whispering my name to get me to stop. But I couldn't. Venessa's cousin got up and went to the restroom wiping her face. I felt awful. I knew that nothing I could say at that moment could change the situation. Shortly after, I left and went home. Still feeling bad. I cried the whole night. About nothing. About everything. I hid my tears because I was in a live-in relationship and didn't want to explain that I was crying and didn't know why. Not that he wouldn't have held me and empathized but even that would have made me feel sad.
The next morning was my first appointment with my therapist. By the time I got to her office I was twenty minutes late and felt dreadful about that. I cried and felt hopeless and miserable like I couldn't do anything right. I was a wreck. Thankfully she was a wonderful, understanding and patient woman. But I was still nervous. Dr. M was my second therapist. My first abruptly ended our sessions in a way and for reasons that still baffle me. I was seeing the first one, a woman I will call B for about six months. I was reluctant at first because I didn't know how comfortable I would be telling my deepest pains to a white woman whom I didn't know whether or not could relate to me. But shortly into our first few sessions I relaxed. I started seeing her to sort through a relationship that ended badly. I was depressed then for many reasons and no reason. But I was experiencing the cycles back then way more frequently than was comfortable for me. One week she asked me on a scale of one to ten where was I in my place of sadness and I told her I was at an eight. Our session for the week ended with her having me write down names and numbers of friends I knew I could call if I felt suicidal. She even asked me to include her on my contact list. I did. The next week with B I felt a little better but still jittery and uneasy. Then the next week before I even had a chance to say anything, she began the session by telling me that she was going to end our sessions because she felt like she had similar issues and couldn't advise me as she should and blah blah blah and that I could see someone else in her office or another office. She watched me slowly gather my things and walk out. It was like a bad break up movie. I even remember her faintly calling my name as I walked out the door. I was too confused to turn around. I was so pissed at her because just two weeks before I told her I was having suicidal thoughts. Then, with no reason that made any sense to me, I had to see someone else. So, needless to say, I was reluctant to seeing another therapist. But I knew I needed help. I knew it.
So I went to see Dr. M and knew immediately that she would be a good match for me. She looked and felt like family. Her soft brown face, style, grace and familiar and wonderful sense of humor. She was easy to relate to. But the first day, I was a mess. I was breathless from being late. I have a huge thing about time. I sat in her immaculate office and wiped my face with the tissue she gave me. I also have a huge thing about things being immaculate and was glad she shared that need. I still couldn't stop crying. I told her I had been so sad lately for reasons and for no reasons and had been on an up and down cycle for too long and needed answers and help. I also told her about the incident the night before when I couldn't stop laughing at Venessa's cousin. Told her I was tired of being so sad and that I kept having awful thoughts and I was tired of having them. I told her I thought I would give in one day. A day I felt would come sooner than later. And yep, I had a plan.
I had and have a very healthy spiritual relationship with a power I call God and all of the proselytizing about religion and mental health on social media was infuriating. I am an African-American woman and perhaps people of many ethnicities look down on people dealing with depression but it for sure happens way more than I am comfortable with in our community. People saying that if people had a better relationship with God and Jesus then they wouldn't have those thoughts or be depressed is not true and to me, only adds to the stigma of mental illness. No wonder we are so reluctant to get the help we need. It doesn't make sense to me that if a leg is broken then it's okay to see a doctor but if there is an internal problem then seeing a doctor is somehow considered treason to God.
Here are a few notable facts on the African-American Community Mental Health Fact Sheet by NAMI Multicultural Action Center:
- African-Americans tend to rely on family, religious and social communities for emotional support, rather than turning to health care professionals, even though this may at times be necessary.
- Mental illness is frequently stigmatized and misunderstood in the African American community.
- African Americans are often at a socioeconomic disadvantage in terms of accessing both medical and mental health care in 2001, 20.2% of African Americans were uninsured.
So it seems we know we need help and are afraid to reach out because we may be looked down upon by friends and family. We know we need help and are reaching out to people who could be giving us unhealthy advice. Or we know we need professional help and don't get it because we are unable.
I was so glad that Dr. M heard me. That's what I wanted all along, to be heard and gotten even if I couldn't explain completely how I felt. Even if she had not felt the way I felt I knew she was listening. She didn't let me leave that day when the hour was up. She told me to give her my beau's name and number so she could call him to take me to the hospital. I refused. I knew that if I couldn't even cry about this in front of him, I wouldn't be able to explain why I needed to be in the hospital. Also, I didn't want him to feel responsible or have to take off work. I tried to get her to just let me go. I tried to convince her, through my tears that I couldn't explain, that I would go on my own. Thankfully she didn't believe me. She said that she would either call the police to take me to the hospital or I could give her a name of a friend to come to her office and get me. For the record, it is not standard that when one goes in to see a therapist on the fist visit, then the therapist threatens to call the police. In my situation, she made the best professional move she could make. I was in a really bad state and had confessed that I thought about suicide and I wanted and needed help. I gave her my friend Laura's number as she worked fairly close to where I was. In the state I was in, I was so afraid that Laura would be upset because I interrupted her work. I was obsessed with the thought that people don't want to be interrupted from their busy lives to take people to hospitals for something that they can't see. I didn't want her to call my mother because I didn't want her to worry and I knew I wouldn't be able to explain it in a way that I felt made sense. Thankfully though, Laura answered the phone and agreed to meet me. I was so happy that she was available and happy that Laura was always someone to whom I could explain my unexplainables. And I was still crying and unsure at the same time. Dr. M talked to her and told her what she felt I needed and where I should go. Laura met me at Dr. M's office. We all talked then Laura took me to a treatment center near USC Hospital called Exodus.
By the time I got there with Laura I wasn't crying anymore. I was much more relaxed being with her. She told me when I went back there not to act like I was okay so they wouldn't keep me. She told me to tell the truth. She knew me well because putting on my it's all good face was exactly my plan. I had become pretty skilled at it once the tears stopped. They finally called my name after almost an hour wait. I went back and talked to the doctor and told him about what led me to being there and he asked me about my history, symptoms and family history. After our meeting he told me that he suspected I had a mood disorder called Bipolar two which is a form of mental illness with moods cycling between high and low. He prescribed medication to even out my moods. Their pharmacy was closed that day where I could get medication for free so I left with a plan to come back the next day to pick them up.
The next day was Wednesday, March 28, 2012 (I'm glad I keep journals) and I stayed at Laura's house that night so I could get up early and pick up my medication the next morning and not have to travel far. I woke up and prayed, wrote in my journal, dressed and was out the door. My head felt clearer. I think mostly because there was some reason to why I would go from being so happy to the river of tears in which I would get lost. I needed a reason. The traffic that day was easy. I picked up medication and took a short walk in effort to keep the commitment to myself to exercise more. I was making done check marks in my iPad calendar which made me happy. I still hadn't had the conversations I needed to have with my partner and family. But I ran a couple of errands and then I went to work and for the most part it went well. Then I felt myself getting anxious again. Very anxious. And I was afraid.
At that time I was working as a home health aide and thankfully I only had one client. There was a time less than a year before I had seven. I was taking care of an elderly woman whose company I enjoyed. The family I worked for was really cool. And supported me taking care of my health. The woman's son is a nurse, musician and majorly into yoga and meditation. It was easy to talk to both him and his wife about how I was feeling. I knew I had to be honest with them because I wouldn't want anyone to take care of my mother or family member if they were feeling unwell.
I hadn't taken my medication yet because I wanted to be at home first. I didn't know how I would react to the pills. I didn't know if they made me sleepy or not and I didn't want to be asleep with my client. I didn't want to be sleepy driving home. So I waited. My therapist called me the same day while I was at work and I told her how uneasy I felt. She reminded me to do what I had to do to take care of myself.
My anxiety kept growing greater and greater. Every little thing scared and irritated me. I began to feel that spiral. That sinking feeling again. That's what it feels like. Like I'm trying to climb but I can't because I'm being pulled then eventually I just give in and am stuck. The man I was in a relationship with at the time was working nights then and I was still not in full communication with him about what I was feeling. I didn't even want to communicate how afraid I was of myself being left alone at night. There is a lot of hiding in depression. A lot of pretending to be okay. Prior to going to the hospital I was self medicating with pills to help me sleep. Sleeping was always an issue. Even with the pills I still couldn't seem to sleep. That night the anxiety was too much. I was afraid of being alone and afraid of being with anyone. The dark scary cloud was there and that was never a match with the anxiety. When I got on the freeway I was so afraid. I was having panic attacks and I felt like people were after me. I pulled off the freeway and called my brother, George. George and I have known each other for many years and we aren't blood but...we are. He was at work at the time and I told him I needed to stop driving and he told me to come to his job. We sat in the parking lot and talked. I think he talked and I cried and rambled. I told him I needed to go to the hospital but I was afraid they would keep me. I didn't want to stay in the hospital but the thoughts were back. The dark, scary thoughts I didn't know I could defeat anymore. So, I drove myself back to Exodus.
They kept me there, as I assumed they would. As much as I didn't want to be there, I knew it was where I belonged. I am so happy that I got the help I needed. And I will say here that if you need help then get it. There are all the voices that may tell you to be embarrassed and feel weird but I advise anyone to thank those negative thoughts and voices for sharing and keep driving.
When I'm panicked I notice that I can stay awake for days at a time. Then when I'm in a place where I can sleep, without any attachments to the place, without concern for dirty dishes or the ringing phone or who knocks on the door, I crash. I think that's why I love hotels so much. Thursday night at the hospital they gave me medication that had me rest so well. I didn't wake up wake up until almost two p. m. the next day. I needed that kind of sleep. I felt so much better. No clouds. No anxiety. No cops chasing me. That's my paranoia. The cops, when I'm extra anxious, are chasing me. All cars around me are undercover cops. And "cops" ya dig? Not police. For some reason in my paranoid state they are cops. Everyone crossing the street, in line at the doughnut shop, at the gas station, they're all cops. And they all want me. It doesn't get this bad too often but when it does, it's bad.
When I woke up from my perfect rest, I was cool. I thought I could just thank the nice people for a bed and turkey sandwich, declare myself well and deuce out. Nope! Seventy-two hour hold, Son! The nurse came to get me and told me that the ambulance was waiting to take me to some hospital in the valley. I looked at him and was like “Ummm, no thank you. I'm feeling much better now.” Then had the nerve to ask for my belongings. He laughed at me and said “Oh no, you need to go with them.”
Okay, so here is where I say this, again, get the help you need! Who is to say that the cloud, or whatever you call your dark moments, won't be back? The cloud, the thoughts, the anxiety, the poorly dressed undercover cops pretending to be just crossing the street or whatever your thing is could be back without you staying in the process of getting the help you need. I didn't fight it, not that fighting at that moment would have helped the situation. They gave me my things from the safe and put me in the ambulance. I made phone calls to my mother, sister, a couple of friends and my employer. I think I left a strange message on my lover's phone then I hung up and just tried to focus on taking care of myself and being well.
When we arrived, the check in nurse spoke with me. I liked her right away. She was thankfully easy to talk to which had me more comfortable in the busy place. She showed me to my room and I sat on my bed for a minute then it really sunk in. I was in the the psych ward. The. Psych. Ward. Say that three times fast. There were people there whom I was sure were more ummm... psych than I but there were plenty of staff to handle that. I openly say things like psych ward, anxiety and paranoia because they are truthfully uncomfortable for me to admit. But we find ourselves in uncomfortable situations sometimes and better to get the help we need than to hide behind our shame. Our shame, our silence, our fear has not protected us.
As much as I didn't really want to be there, it was the best place for me. Yes it was a bad time. Yes I had work to do. Yes I felt like I needed to have better explanations to my friends and family. But it wasn't about any of that. I was the one who mattered. Me. One of the hardest things for me to do was tell my mother from inside an ambulance that she couldn't come up and see me while I was there. I knew it would be hard for me to see her seeing me there and I just couldn't take care of her while I needed to take care of myself. My mother, by the way, is as strong a mother and woman as any. I just know that it would be hard on any mother to see her daughter in the psych ward. It would be hard for me. I think it showed more courage and strength on her part to not fight me and accept want I wanted and needed.
I didn't eat much while I was there. I skipped breakfast often mostly because I didn't feel like eating with everyone. I skipped "group" because I didn't feel like talking to everyone. I skipped exercise because I didn't feel like doing braless jumping jacks with everyone and the guy two doors over kept calling me fine. I didn't have a change of clothes and the times I could use the laundry room kept shifting. Basically I walked around in my gown looking like Casper the non-compliant ghost. I talked to my doctor, the nurse and my roommate and that was pretty much it. I don't know if that's how it was supposed to go but that was how I worked my program. Oh, and I wrote a lot. Writing is necessary for me. I would have gone flip without the pencil the nurse gave me that was only almost as large as my pinky finger and the few sheets of paper I was rationed to to scribble my thoughts onto. I think I just needed the time and space and constant supervision of professionals.
I had some favorite and funny moments though. One was when a guy creeped up on me as asked me what I looked like before they cut my hair. For twenty years I have rocked my hair cut near bald and I guess he thought the staff had to strap me down and shave me for some reason. Bless his heart. Then there was the German doctor who stared at my head the whole time we talked and didn't seem to believe I was a writer. I guess he thought in some fit of frenzy I snatched my hair out by the follicles and was tied down by two big men in white jackets. And of course as the nurse went down the hall each evening and called for quiet time was when someone had to use the phone. And television was always interesting. In the TV room we watched dolphin documentaries because Cold Case made That Girl sad and He got angry if This was on and Neither of Them were comfortable with That. And you probably didn't know that many documentaries existed about dolphins but there are plenty.
The funniest thing that happened was the one time I went to a group session. Partly because I wanted credit for going to group and partly because I was bored. Thankfully it was game day. I never went to group so the others didn't jump at the chance to pair with me. For a little while I pretty much played Connect Four and Chinese Checkers by myself. One of the staff members said to another young lady, "Why don't you play with her?" Talking about me. Except he said it in Spanish, but I understood. She almost broke out into real tears. She may even have, I just didn't turn around to see. "Noooooooo!!!!! Noooooooo!!!!! No! No! I don't want to play with herrrrr!!!" She said that in English, probably so I would understand. Baby, no worries. No worries. But see if I rush off the phone for you next time. I thought.
Yes, I shared things that were funny and I should have taken group more seriously but I did really get the help I needed there. I really did. A particularly special moment for me was when the guy I was in a relationship with came up to see me. I needed that. I was finally able to talk and share with him ways that I was feeling that I couldn't or wouldn't articulate before. I needed the conversations I had with my therapist, my doctor and the nurses. Even the conversations I got to have with my roommate really helped me. It helped me feel not alone. I watched her go back and forth to the bathroom to cry. I understood that kind of hiding. I asked her if she knew why she was crying and I understood when she said no. It was a blessing to me to see us give each other the space we needed. We were mirrors for each other. There was a big part of me that wanted to feel like I wasn't them. I was better. I was okay and they were ill but that wasn't so. We were all there. All of us for different reasons.
I was there for about a week. My doctor wouldn't release me until he felt comfortable that the medication was settled in my system and that I was not a threat to myself. When I got out I continued taking my medication. I still have ups and downs and I am still in therapy. Perhaps I will be for my life, I don't know. A year later I experienced another really challenging cycle and immediately went to the doctor. I didn't have to stay that time. My diagnosis was changed from Bipolar two to Bipolar one. Which is also a form of mental illness. A person with Bipolar one cycles from manic episodes to episodes of depression. Which in other words means, I was going from super highs to super lows. Because I was diagnosed as that then doesn't mean I will stay that way but it does make me aware of how I need to take care of myself. I am careful about taking my medication and being aware of my triggers. I am also more communicative about how I'm feeling to the people in my life. I don't hide out as much as I used to and I keep my appointments with my doctors. I'm working my program now and my life is better than it's been in many years. I don't have the high highs or low lows anymore. Probably because of the medication in my system as well as my continued practice of meditation, prayer and art. Art is important. I am always writing. I am constantly painting and taking pictures. Art feeds my soul. Find what feeds yours and nurture it. I no longer have thoughts of suicide. As a matter of fact, I value life much more. I know how blessed I am to be here. I am thankful I got the help I needed at the right time. It doesn't mean that I don't have my days, we all do. All of us. I am treading carefully these days. And bravely at the same time.