Screening methods for depression that take context and culture into consideration could be more effective in uncovering clinical depression in African American mothers, according to a study led by a Rutgers University‒Camden nursing professor.
Referencing well-known theories about the “strong woman complex” in Black women and its relation to depression, “they may not admit when they have certain feelings,” says Rahshida Atkins, an assistant professor at the Rutgers School of Nursing‒Camden. “Face to face, they may not answer ‘yes’ to depression screening questions that ask, ‘Are you depressed?’ or ‘Do you feel sad?’”
In these situations, the medical professional may not detect that the patient is depressed and the patient may not receive the treatment that they need. Healthcare providers are required to ask all adults these questions during health visits.
The Rutgers University–Camden researcher has found that Black single mothers experience depressed mood because of stressors created by issues including poverty, unstable relationships and housing, parenting and family stressors, and lack of access to high-quality health care for themselves and their families.
“Growing up with a depressed mom is also an adverse childhood experience,” explains Atkins. “The emotional, cognitive, and social development of children can be hindered when their mothers are depressed and do not receive treatment.”
In the study, “Exploring Expressions of Depression in Black Single Mothers,” Atkins and her team of researchers distributed questionnaires in Camden, Trenton, and Philadelphia at social service agencies, day care centers, pediatric primary care offices, and dance schools.
The questionnaire asked open-ended questions about their feelings of depressed mood, such as, “How do you feel when you are ‘down in the dumps?’”
The women revealed on the questionnaires that they predominantly felt sadness and hopelessness, and, at times, they would cry, which are all symptoms associated with depressive illness.
Atkins was surprised at how the women candidly shared their experiences of sadness and depression. “It appears to go against the theoretical literature about depression in Black women, which often proposes that they don’t readily admit when they are sad—that they have to put up the strong woman complex.”