Drunkard, drug addict and schizophrenic are the most frequent labels given to African-Americans who have undiagnosed bipolar disorder, according to mental health professionals.
Blacks face bipolar disorder at the same rate as other groups in the United States. But frequent misdiagnose leave many African-Americans facing bipolar disorder without treatment, health experts say-a fact that's also compounded with having a negative history with doctors, less access to mental health resources and, consequently, a negative outlook on seeking help.
A study conducted by social psychologist Crystal Glover found that many black men are apathetic about the discrimination they face in the U.S. education system. The study's findings, argues Glover, would also apply to medical care. There, such discrimination is so common that it becomes normalized and could lead to a reluctance to seek medical treatment.
Additionally, research conducted by doctors F.M. Baker and Carl C. Bell show that misdiagnosis of bipolar disorder in black patients has been prevalent since around the 1990s. Diagnosis of bipolar disorder, which affects roughly 6 million Americans, is difficult generally, say health experts.
"The average person with bipolar disorder takes three different doctors over the course of 10 years to diagnose," said Lisa Goodale, vice president of training at Thresholds, a mental health advocacy group.
Even if a person is correctly diagnosed, the condition itself can serve as an obstacle to treatment, because individuals suffering from the disorder can often seem fully engaged with life.
"People will think: wow, this person has so much energy or has done such great work-until they crash," Goodale said. "Some of the most creative people in the world are bipolar and resist treatment because they are afraid they will lose their artistic edge."
These issues serve to complicate the experience of an African-American who already might feel stigmatized by the diagnosis. Glover adds that they are often forced to cope in other ways.
"We have research that indicates they wind up being homeless or in the criminal justice system," she said. "If a problem is not diagnosed or treated, the person is often unable to carry a household, may not have friends or family to support them. This may lead them to substance abuse."
Theater as therapy
In an attempt to combat stigmas related to mental illness, one group in Chicago uses theater to tell the stories of mental illness sufferers.
Erasing the Distance is a nonprofit performance group that brings its monologues to middle schools, high schools, universities and other locations throughout Chicago.
"All of our stories are true stories," said Jessica Mondres, a staff member and actress on the Erasing the Distance ensemble.
The theater company's staff regularly interviews people who have mental disorders and wish to share their story. Mondres said her group edits those interviews down to a monologue of two to three pages, but insists, "We don't change their words."
It was through this theater company that Dawnn Marie Brumfield, an African-American youth minister suffering from bipolar disorder, felt comfortable sharing her story.
"It's okay to be depressed," she said about seeking treatment. "But [the attitude is] suck it up and get over it, because you're not going to tell somebody else you're depressed."
Blacks, she noted, are often silent so that they don't have to expose their problems to others. This includes the medical doctors who may misdiagnose them as schizophrenic or substance abusers.
Erasing the Distance has one particular monologue related to an issue Brumfield speaks to young African-American girls about-about a girl whose parents find out she has a mental health issue and is injuring herself.
"Her mom's reaction is, 'This is not something black girls do,'" Mondres said. " 'This is something white girls do. If you want to do this, if you want to act crazy, then fine: you're grounded.'"
It is a typical reaction of parents, according to Mondres; and especially poignant for blacks, creating an additional block on the road to treatment.