18 April 2012

Anxiety and the StrongBlackWoman

I’m anxious. There, I said it. Ironically, saying it publicly is not as freeing as I’d hoped it would be. In fact, it’s somewhat anxiety-producing. Perhaps I should stop writing now, delete this line, and move on.


No, it must be said. It is part of my recovery as a StrongBlackWoman. You see, a SBW isn’t supposed to be anxious. At least, most people think she's not supposed to be. A SBW is supposed to be…well, strong. Impervious to fear, worry, and anxiety. She’s supposed to have everything - especially her emotions - under control. Her strong religious faith (a SBW is usually religious) is a prophylactic against worry. She stands on platitudes such as “God won’t give me more than I can bear” and “If God brought me to it, He’ll bring me through it.” And if she is an especially good Christian, she can quote or paraphrase off actual Biblical verses such as the one about lilies and sparrows (cf. Matthew 6:25-34). And if those don’t work, she is simply to immerse herself in more busyness and keep her feelings to herself.


That’s precisely what I’ve done for most of my life - kept my fears and anxiety to myself. About ten years ago, I realized that I probably have a strong biological predisposition to anxiety. A lot of people in my family have a lot of fears: dogs, scary movies, lightning, New York cabbies. Some of my relatives (who shall remain nameless) practically jump out of their skin at the least provocation. Some of us are pretty open about our fears, prompting the rest of us to label them “scary,” as in “Chile, you kno’ she ain’t goin’ to that movie. She so scary.” Others suffer silently. Since I’m a clinical psychologist, some of my relatives have come to me over the years to talk about these issues - the panic attacks, obsessions and compulsions, the prescriptions. And all the while, I’ve thought that it was strange that I didn’t have an anxiety disorder given my familial predisposition and my personal history of trauma.


Somehow, I overlooked a lot of symptoms - the nightmares and insomnia that started by my sixth birthday, my fear of the dark, my refusal to walk alone in my suburban neighborhood during the day because it seemed too deserted, my self-consciousness, and my chronic mental multi-tasking. The symptoms have appeared - and disappeared - at different stages in my life. And most of the time, they’ve been subclinical, meaning that they were not severe enough to require professional intervention. Mindfulness-based activities such as yoga and meditation, along with good nutrition and exercise, were sufficient to keep the symptoms in check.


Then came parenthood. The hypervigilance required of parents during the first few years of a child’s life is enough to trigger any subclinical anxiety problems into a full-scale clinical syndrome. Next came a one-year period of tremendous loss, trauma, and change, the cumulative effects of which created multiple cracks in the dam of strength that I’d built over the years. Finally, two months ago, I came home to discover that someone had broken into our house, just the right trauma to unleash a Katrina-like flood of anxiety over my already weakened defenses.


The typical SBW reaction would have been to act as if all were okay. If I were operating in full SBW mode, in response to queries about how I was feeling, I would have offered some heroically faithful retort like, “God is my fortress and my shield!” But I haven’t been in full SBW mode for a long time. In fact, I have been in recovery for almost ten years. Granted, there have been a few relapses, but at this point in my journey, I have no interested in being a myth. I am committed to discovering and embracing my authentic, fully human self, including my needs and vulnerabilities. So I told the truth: I’m not okay. I’ve had problems with anxiety for a long time and this just puts me over the edge. I am afraid, more afraid than I can tolerate on my own.


For the first time, rather than suppressing my fears, I owned them. Instead of trying to deny my anxiety (to myself and others), I decided to make sure that my anxious self received the care that I needed. I continued my weekly therapy sessions, made sure that I exercised and ate well, and went for a massage. But when, after a few weeks, my anxiety level remained sufficiently high enough to jeopardize my sleep and my blood pressure, I took another step: anti-anxiety medication.


As a psychologist, I tend to favor “talk” therapy over medication. And in this case, I knew that my symptoms would eventually decrease and return to their normal levels. Yet I also agreed with my therapist who, as both a licensed counselor and priest, reminded me that God does not require us to suffer needlessly. Suffering anxiety was not doing me, or anyone else, any good. In fact, with every day of elevated blood pressure increasing my risk of eventual stroke, a few months of untreated anxiety could have a much worse long-term impact.


I wish that more of my SBW sisters would recognize their problems with anxiety and seek treatment, whether it be counseling (with a properly trained and licensed therapist), medication, or both. Despite the myths about our mental and spiritual fortitude, SBW are actually quite anxious. Epidemiological research consistently demonstrates that Black women in the U.S. have a relatively high rate of anxiety disorders. Nearly 1 in 5 Black women has a diagnosable phobia, higher than any other racial-ethnic group. Black women also have significantly higher rates of post-traumatic stress disorder (PTSD) than Black men or women of other racial/ethnic groups. It turns out that hidden behind the myth of strength is a lot of unnecessary suffering.


The first step in releasing our fears is to admit them. Huh, this is starting to feel liberating, after all.