Occasional anxiety is a natural part of life. However, those with anxiety disorders often face intense, excessive, and persistent worry and fear about everyday situations. These disorders frequently involve sudden, intense episodes of anxiety and terror, known as panic attacks. Such feelings can disrupt daily activities, are hard to control, and are disproportionate to the actual threat, often lasting a long time. People might avoid certain places or situations to prevent these feelings. Symptoms can begin in childhood or adolescence and persist into adulthood.

Understanding Anxiety in the Black Community

Anxiety is a prevalent mental health condition. However, many Black individuals avoid treatment due to the stigma surrounding mental health. Those who do seek help may encounter clinicians who fail to recognise the impact of racial trauma.

Types of Anxiety Disorders

Anxiety disorders include:

• Generalised Anxiety Disorder (GAD)
• Social Anxiety Disorder
• Specific Phobias
• Post-Traumatic Stress Disorder (PTSD)
• Obsessive-Compulsive Disorder (OCD)
• Panic Disorder

Symptoms of Anxiety Disorders

These symptoms can occur during stressful times for anyone. However, individuals with anxiety disorders might experience them even without stress, with greater severity, and with multiple symptoms at once:

• Inability to relax
• Unrealistic or excessive worry
• Difficulty falling asleep
• Rapid pulse or heart palpitations
• Nausea, chest pain, or pressure
• Feeling a “lump in the throat”
• Dry mouth
• Irregular breathing
• Feelings of dread or losing control
• Trembling, sweating, or chills
• Fainting or dizziness
• Thoughts of death

Peculiarities of Anxiety Disorders in the Black Community

Prevalence and Diagnosis:

• Anxiety disorders are often underdiagnosed in minority populations.
• Black individuals are less likely to be diagnosed with anxiety disorders than White individuals.
• Cultural differences in expressing and understanding mental health symptoms contribute to diagnostic discrepancies.

Cultural Stigma:

• Cultural stigma significantly hinders seeking help.
• Many Black families expect resilience and view mental health conditions or seeking care as signs of weakness.
• Racism can heighten mental health stigma, with fears of being perceived as “crazy” or “dangerous.”

Socio-economic Barriers:

• Higher rates of unemployment, underemployment, and poverty increase chronic stress, worsening anxiety disorders.
• Limited access to quality healthcare means many do not receive timely or adequate treatment.

Obsessive-Compulsive Disorder (OCD) in the Black Community

OCD involves persistent, unwanted thoughts (obsessions) and repetitive behaviours (compulsions). In the Black community, OCD is often misunderstood and underdiagnosed.

Prevalence and Cultural Perceptions:

• OCD prevalence is similar in Black and White populations, but Black individuals are less likely to be diagnosed.
• Cultural perceptions may lead to compulsive behaviours being viewed as superstitions or extreme tidiness instead of symptoms of OCD.

Unique Symptom Presentation:

• Misdiagnosis: Black individuals may be misdiagnosed with psychotic disorders due to biases, resulting in inappropriate treatment.
• Symptom Dimensions: They may present different symptoms, like more contamination fears and concerns about animals, which clinicians might overlook.

Panic Attacks: A Silent Epidemic

Panic disorder is characterised by sudden, repeated attacks of intense fear. While everyone experiences anxiety and panic occasionally, those with panic disorder experience these feelings regularly and often without apparent reason. In the Black community, the experience of panic attacks can be exacerbated by a lack of understanding and support.

Symptoms and Misinterpretation:

• Panic attacks often include physical symptoms like chest pain, shortness of breath, and dizziness.
• These symptoms can be misinterpreted as medical emergencies, leading to repeated emergency department visits.
• Black individuals are more likely to present somatic symptoms of panic attacks, leading to misdiagnosis and inadequate treatment.

Treatment and Coping Strategies for Anxiety Disorders

Mental health professionals may use various strategies, including psychotherapy, lifestyle adjustments, and medications, to manage anxiety disorders.

Counselling and Psychotherapy:

• Cognitive Behavioural Therapy (CBT): Helps reframe worries and develop strategies for managing triggers.
• Cognitive Therapy: Neutralises unhelpful thoughts linked to anxiety.
• Exposure Therapy: Involves controlled exposure to anxiety triggers to help confront fears.
• Relaxation Techniques: Breathing exercises, guided imagery, progressive relaxation, biofeedback, and autogenic training can be helpful.

Medication:

• Antidepressants: SSRIs (e.g., citalopram, fluoxetine) and SNRIs (e.g., duloxetine).
• Beta-blockers: Manage physical symptoms like a rapid heart rate (e.g., propranolol, metoprolol).
• Anti-anxiety Drugs: Benzodiazepines can quickly suppress symptoms but are typically prescribed for short-term use due to the risk of dependence.

Often, a doctor recommends a combination of treatments and may need to adjust the treatment plan over time.

Self-care and Alternative Strategies:

• Good Self-care: Regular exercise, quality sleep, and a balanced diet can ease anxiety and promote overall health.
• Activism: Provides an effective outlet for those experiencing anxiety due to racial trauma.
• Supportive Community: A network that understands the intersection of race and anxiety can be invaluable.
• Alternative Remedies: Meditation, acupuncture, and yoga may help calm an anxious mind.

Conclusion

Anxiety disorders can be overwhelming, making daily life difficult to manage. Racial trauma significantly exacerbates these symptoms in the Black community. Stigmas and barriers to accessing care complicate the search for appropriate help. However, with effective, culturally competent treatment—including therapy, medication, and community support—managing these conditions is possible. Building a trusting relationship with a provider who understands the impact of racial trauma is essential for effective treatment.

References

• Bhui, K., et al. (2018). Ethnic variations in pathways to and use of specialist mental health services in the UK. British Journal of Psychiatry, 212(4), 231-237.
• Williams, D. R., et al. (2017). The mental health of Black populations in Europe: An overview. European Psychiatry, 41(2), 1-8.
• Purdon, C., & Clark, D. A. (2019). Cultural aspects of obsessive-compulsive disorder: A review of the literature. Journal of Affective Disorders, 257, 28-35.
• Rathod, S., et al. (2015). Culturally adapted cognitive behavioural therapy for minority ethnic groups: A systematic review. BMC Psychiatry, 15(1), 164.
• Anxiety disorders – Symptoms and causes. (2018, May 4). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961
• Vandergriendt, C. (2017, November 15). What’s the difference between a panic attack and an anxiety attack? Healthline Media. https://www.healthline.com/health/panic-attack-vs-anxiety-attack#home-remedie

Panic disorder. NHS. Retrieved July 3, 2024, from https://www.nhs.uk/mental-health/conditions/panic-disorder/