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Haitians and mental health: a taboo subject


This may sound incredibly cliché, but it was indeed on a very rainy day back in 2016, when a very close friend of mine had the courage to confide in me about a very personal matter. It was Saturday, and most young people were out partying— but my friend was sitting at home, curled up in tears.

I find it necessary to point out the fact that my friend came from a very traditional and conservative Haitian family. Where the prescriptions for emotional pain were typically the following:

"Pray. It's just Satan trying to trick you."

"Ah, get over it"

"You're just bored, find yourself something to do."

He was always the life of the party, he was a clown. It was all smiles when he was around. You would've never guessed there was anything wrong. You would've never guessed he was molested as a child and spent his entire childhood running from it. He always seemed to have it all together.

Until, the night him and his partner tried to get to first base and his demons resurfaced and he could no longer escape them. He suddenly had no one to talk to. Not one soul in his "circle" with the capability of understanding him.

"What about his friends?" You must be wondering.

Well, effectively, he had many friends. However, none of them listened to him when he needed it. Nor did they try to be there for him. Some claimed that he was a man, that he needed to be strong— the other half told him that he was just trying to get attention. No one picked up on the signs.

Yet, after his attempt to take his own life, everyone became alerted. Everyone suddenly cared about his mental health, but to a certain extent.

His parents told him that he needed to pray more, his friends called him selfish... his girlfriend blamed him instead of being there for him. Making it in hard for him to go on in a community where his love ones focused on being ignorant and passive about his trauma. To Haitian people, especially to Haitian parents, mental illnesses are a myth.

Now, there he laid, unable to put a finger on why he was feeling this way, misunderstood and depressed as hell.

Oh, you read right, depressed as hell.

Haitians and Mental illnesses 

Sally Riche, Haitian blogger, poet, linguist and psychologist— in her last article about depression, mentioned that it was safe to say that most Haitians don’t really understand what it’s about. She was a hundred percent right. Mental illness is a myth to Haitian people.

Granted, there are many different conditions that are recognized as mental illnesses, especially depression.


de·pres·sion/dəˈpreSH(ə)n/
Noun
1. feelings of severe despondency and dejection.

What is depression?

Based on the definition given by the National Institute of Mental Health (NIMH), Depression, also known as major depressive disorder or clinical depression— is a common but serious mood disorder.

Being sad is a normal reaction to difficult times in life. But usually, the sadness goes away with a little time. Depression is different—it is a medical condition that may cause severe symptoms that can affect how you feel, think, and handle daily activities like sleeping, eating, or working.

Nonetheless, some forms of depression are slightly different, or they may develop under unique circumstances, such as:

Persistent depressive disorder (also called dysthymia) is a depressed mood that lasts for at least two years. A person diagnosed with persistent depressive disorder may have episodes of major depression along with periods of less severe symptoms, but symptoms must last for two years to be considered persistent depressive disorder.

Postpartum depression is much more serious than the “baby blues” (relatively mild depressive and anxiety symptoms that typically clear within two weeks after delivery) that many women experience after giving birth. Women with postpartum depression experience full-blown major depression during pregnancy or after delivery (postpartum depression). The feelings of extreme sadness, anxiety, and exhaustion that accompany postpartum depression may make it difficult for these new mothers to complete daily care activities for themselves and/or for their babies.

Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations). The psychotic symptoms typically have a depressive “theme,” such as delusions of guilt, poverty, or illness.

Seasonal affective disorder is characterized by the onset of depression during the winter months, when there is less natural sunlight. This depression generally lifts during spring and summer. Winter depression, typically accompanied by social withdrawal, increased sleep, and weight gain, predictably returns every year in seasonal affective disorder.

Bipolar disorder is different from depression, but it is included in this list is because someone with bipolar disorder experiences episodes of extremely low moods that meet the criteria for major depression (called “bipolar depression”). But a person with bipolar disorder also experiences extreme high – euphoric or irritable – moods called “mania” or a less severe form called “hypomania.” experiences extreme high – euphoric or irritable – moods called “mania” or a less severe form called “hypomania.”

Break the cycle 

Don't get me wrong. It's not that my friend's parents/friends did not care. However, here's this; Haitians were taught and are known to be strong and resilient.

Political issues, poverty, diseases, illnesses, earthquakes, you name it— they've seen and have managed to survive it all and were all taught to "acknowledge and move on".

Well, I'm here to tell you that your mental health, your friend's, your children and your partners mental health is important.

Little boys turned into men with the reminder of their parents telling them that they are men and cannot allow themselves to be weak.

Little girls turned into women with the reminder of their parents reminding them to put their "big girl" panties on and deal with life.

Truthfully, all of it screams, "Screw your trauma, suck it up. God knows I had to." 

Like, yes, it happened. But, it's not the end of the world. Therefore, I will toss my trauma aside and move on.

Which means that, those men and women turned into our great grandparents, grandparents, parents. Therefore, how would they ever fathom the thought of their close friend, family member, loved one battling with depression? Matter of factly, how would they even fathom the thought of them possibly dealing with any mental illness in general?

I'm here to give you the signs, I'm here to help you break the cycle.

Men and depression

"Men and women both experience depression but their symptoms can be very different. Because men who are depressed may appear to be angry or aggressive instead of sad, their families, friends. In addition, men are less likely than women to recognize, talk about, and seek treatment for depression. Yet depression affects a large number of men. Both men and women get depression but their willingness to talk about their feelings may be very different.

For example, some men with depression hide their emotions and may seem to be angry, irritable, or aggressive while many women seem sad or express sadness. Men with depression may feel very tired and lose interest in work, family, or hobbies. They may be more likely to have difficulty sleeping than women who have depression. Sometimes mental health symptoms appear to be physical issues. Many men are more likely to see their doctor about physical symptoms than emotional symptoms.

Some men may turn to drugs or alcohol to try to cope with their emotional symptoms. Also, while women with depression are more likely to attempt suicide, men are more likely to die by suicide because they tend to use more lethal methods."


What are the signs and symptoms of depression in men?

Different men have different symptoms, but some common depression symptoms include:

- Anger, irritability, or aggressiveness

- Feeling anxious, restless, or “on the edge”

- Loss of interest in work, family, or once-pleasurable activities

- Problems with sexual desire and performance

- Feeling sad, "empty," flat, or hopeless

- Not being able to concentrate or remember details

- Feeling very tired, not being able to sleep, or sleeping too much

- Overeating or not wanting to eat at all

- Thoughts of suicide or suicide attempts

- Physical aches or pains, headaches, cramps, or digestive problems

- Inability to meet the responsibilities of work, caring for family, or other important activities

- Engaging in high-risk activities

- A need for alcohol or drugs

- Withdrawing from family and friends or becoming isolated


Women and depression

"Depression is more common among women than men, likely due to certain biological, hormonal, and social factors that are unique to women.

"As women, we have many life roles. Mother, wife, employee, friend, healer, caregiver, and the list goes on. The complexity of all of these roles can cause ups and downs throughout life. Some of these mood changes may be due to life events (e.g., getting in an argument with a friend) or may be due to hormones (e.g., pregnancy, menstrual cycle). In general, after a few days, your emotions tend to level out and you don’t feel down in the dumps anymore. But, if you are suffering from depression, your “downs” don’t go away after a few days and may interfere with your daily life activities and relationships. This can be a debilitating cycle and can occur due to a number of causes. Symptoms can last weeks, months, or years and can be intermittent or a one-time occurrence."

There are a multitude of genetic, hormonal, psychological, and social factors that come into play when citing the cause of depression in women:

Hormones, psychological causes and social causes."


What are the signs and symptoms of depression in women?

Just like men, signs and symptoms of depression vary from woman to woman. Some of the most common signs and symptoms are listed below:

• Feelings of emptiness, hopelessness, despair, and sadness

• Irritability, anxiousness, and guilt

• Feelings of exhaustion, severe tiredness

• Loss of interest in previously pleasurable activities

• Inability to concentrate or remember details

• Suicidal thoughts or attempts of suicide

• Sleep disturbances; sleeping too much or too little, insomnia

• Changes in appetite – eating too much or too little

• Physical symptoms – aches and pains, cramps, headaches, digestive issues, breast tenderness, bloating

• Lack of energy

• Feeling out of control

• Mood swings and feelings of tearfulness

• Panic attacks

• Feelings of tension

• Disinterest in daily activities and relationships


Dr. Aris Peguero discusses Depression 

I decided to interview a licensed psychologist and asked him a few questions that I know some of y'all were wondering about.

Muhreah: Could you please introduce yourself to the readers?  

Dr. Peguero: My name is Aris Peguero and I am a licensed psychologist with a specialty in child and adolescent psychology. I also have training in family systems. I am a black psychologist born in The Dominican Republic with family ties in both Haiti and the Dominican Republic. 

Muhreah: Dr. Peguero, how do you perceive depression?  

Dr. Peguero: According to the Diagnostic and Statistical Manual of Mental Disorders, depression is a mood disorder characterized by symptoms such as: loss of interest or loss of pleasure in almost all areas of life every day, nearly every day; changes in appetite; sleep disturbance; diminished ability to concentrate or indecisiveness; recurrent  thoughts or death or suicide; fatigue or loss of energy nearly every day.

Muhreah: Why do you think it’s such a mysterious mental disorder/illness? 

Dr. Peguero: Disorders that are perceived as disorders of the mind are typically seen as different as disorders that are considered disorders of the body. No one would question why a diabetic cannot produce insulin, but many people feel perfectly fine asking a depressed person to just "snap out of it". There is a false dichotomy between the mind and the body, almost as if the mind, which is logically linked to the brain, is also part of the body.  

Muhreah: How do you conceive “good mental health”? 

Dr. Peguero: Among other things, good mental health is the capacity to feel joy, and, to feel capable of managing negative emotions. It is the ability to form positive interpersonal relationships and sustain them over time. It is also the feeling of having self-agency or the ability to direct one's own life based on one's values. ability to feel that both negative and positive emotions can be handled. In other words, good mental health is knowing that no matter what happens, you have the emotional tools to survive.

Muhreah: Can someone ever be treated from depression?

Dr. Peguero: Absolutely! Someone with depression triggered by a separation or a loss may benefit from counseling to help them integrate that episode into the fabric of their life moving forward. Sometimes, just having a close friend who is supportive can help a person to regain balance. 

A person can have one depressive episode in their lives and never have another. It all depends what type of coping mechanisms or social resources are available to the person as she recovers. 

Muhreah: Is there such a thing as environmental impact on your mental health?

Dr. Peguero: Humans are social creatures, so we are always looking at our referent group to decide how to respond to situations.

If you had a parent who became helpless in the face of difficulty, you may also develop the same maladaptive coping style. The environment may also influence what type of locus of control you develop. Are you the type of person who sees things as permanent and rigid, or do you believe that through reflection and observation of your thoughts and behaviors you can alter feelings and behaviors? The difference in worldview can impact on how you engage with life itself.  

Muhreah: How can you really tell that someone is depressive? 

Dr. Peguero: By definition, a depressive person does not experience much joy and tends to isolate herself sometimes because of feelings of guilt or worthlessness; sometimes, having to relate to others may feel more like a burden than an enjoyable act. Anyone can have a day or two when they feel down due to a change in circumstances or due to a loss. A person suffering from depression, has the depressed moods almost all the times and continuously for at least two weeks. 

Muhreah: How does one get rid of depression without an access to a psychologist? 

Dr. Peguero: Sometimes feelings of depression will go away, but there are people who suffer from major depression who need treatment such as medication and psychotherapy. The real question is 'why do people feel that they should get rid of their depressive symptoms on their own'

Muhreah: How do you ask someone if they’re having depressive episode without sounding offensive?

Dr. Peguero: Ask the person if they are eating and sleeping well. You can also inquire about their mood; I see you weepy most of the time, are you feeling constantly down" 

Muhreah: Is Depression madness? Reality or social construction?

Dr. Peguero: Depression is real and should be taken seriously. Some cultures do not encourage people to openly talk about sadness but that does not mean that the experience of the individual is any less real. 

Muhreah: Is Depression hereditary? 

Dr. Peguero: There seems to be a genetic component to depression, but I always tell people that genes are not destiny. Just because one of your parents suffered from depression does not mean that you will too. It is also important to consider that thought patters can also be passed down and these patters can also lead to depressive moods. (e.g. catastrophizing, black and white thinking, etc.)

Muhreah: Why do you think Black parents, especially Haitian parents, categorize depression as a “Satanic curse” or something their kids bring up when they want “attention”? 

Dr. Peguero: I think it goes back to lack of knowledge about what depression is. On the other hand, having an answer such as "this is being caused by a demon", may be in some sense more reassuring than not knowing the cause or possible cure. 

Muhreah: How can black parents, Haitian parents specifically— do better as parents? And, truthfully... how can we, human beings be better friends, partners, to people who suffer with depression?

Dr. Peguero: More than anything, humans need to feel safe. We need to feel that our experiences are validated and that we are not alone. 

So whatever we can do to help someone going through depression will help in the healing process. something as simple as encouraging them to take a walk and get some sun; Urging the person going through depression to eat healthful foods and to resist isolation can also be helpful. 

Protect your mental health 

While it's great that you recognize the signs of depression in others, men and women, your mental health matters— and I cannot stretch this enough. Here are a couple ways that you can protect your mental health:

1. Meditate

“Meditation is a great way to protect your mental health as you age,” — Jodi Baretz, a licensed clinical social worker and author of Mindful Is the New Skinny. “Not only does it train your brain to focus and improve your attention, it also decreases anxiety and increases your ability to enjoy the everyday moments of your life.”

2. Stay connected

“The most important thing you can do is stay in communication with others,” — Colleen Mullen, a licensed marriage and family therapist at San Diego’s Coaching Through Chaos.

3. Adopt an attitude of gratitude

Studies suggest that taking a moment to count your blessings can boost your happiness. “Practicing gratitude has been demonstrated to help people manage stress, decrease depression, increase empathy and decrease aggression,” — Colleen Mullen.

4. Get moving

Exercise increases blood flow to the brain, which brings oxygen, which helps prevent the dreaded ‘brain fog’ that so many women complain about once they reach a certain estrogen-deprived age,” — Maria Shriver, founder of The Women’s Alzheimer’s Movement and Move for Minds — the organization’s annual fundraising initiative.

5. Try something new

“Keep an open mind,” — Susan London, director of social work at Shore View Nursing and Rehabilitation Center. She suggested taking any opportunity possible to step out of your comfort zone.

“You never know the kinds of experiences you might have as a result of this, and it could change the course of your life without you even realizing it,” London added.

Shriver also advocated for challenging your mind. “Mental activity offers benefits to brain health. Learn something new to create new neural connections,” Shriver said. Try studying an unfamiliar language or taking up an instrument.

6. Form a new routine

Sitting at home all day with nothing to do can take a toll on you emotionally. According to Ramani Durvasula, a professor of psychology at California State University, “having a routine can provide meaning and purpose, which many view as two of the most essential ingredients for health.” Sign up to volunteer, take on a part-time job in an industry that has always fascinated you, try a new hobby, become a mentor or get involved in local civic activities.

7. Get your Zs

“As you age, unfortunately, insomnia becomes an issue for many Americans, afflicting almost half of adults over the age of 60,” — Bill Fish, a certified sleep science coach and co-founder of Tuck.

A lack of sleep can lead to mental health ailments such as anxiety and depression. And a 2012 study linked sleeplessness with an increased risk of Alzheimer’s.

“Your brain goes through a rebooting process each night, essentially recharging itself, so we feel brighter and refreshed in the morning,” Fish said. “If you aren’t achieving the recommended sleep of seven to nine hours per night, you aren’t giving the brain a chance to recover to take on the day ahead.”

8. Practice self-love

Developing a compassionate relationship with your body will go a long way in helping you to combat any dissatisfaction that may coincide with the process of aging. Richard Matzkin, psychotherapist and co-author of Art Of Aging, suggested practicing positive affirmations and visualization to achieve this.

“The thing that kills self-love most is negative self-judgment,” he said. “You can counter this with positive self-talk. When negativity arises, rather than allowing yourself to be drawn into self-defeating, negative thoughts, replace it with thoughts about what you like about yourself.”

9. See a therapist

If you begin to feel sad, frustrated or anxious, you might want to consider giving therapy a try.

“Therapists can help identify counterproductive patterns in thinking and emotion that will help you get back to loving life quickly, should you hit a rough spot,” said Whitney Owens, a licensed clinical psychologist in Las Vegas.

Grief can also be a reason to call in a professional. There is no shame in getting support from an experienced practitioner who understands what you are going through.

“Don’t ignore the signs. If you are experiencing grief for an inordinate amount of time, usually longer than a year after the loss of a loved one, don’t be afraid to seek help,” London said.

10. Keep a positive support system

Having a good support system can help to tackle conditions like stress and depression. Surround yourself with people who love and care about you. That also means cutting out toxic people.

“Stop catering to people who suck your drive. Let them go,” Durvasula, the professor of psychology, said.



Dear Haitian people, 

No, your daughter/son isn't looking for attention. No, the food that you put on the table isn't a sufficient factor that will keep them from being depressed. No, reminding him/her of the sacrifices you’ve made or what you've done for him/her will not help, it's just ugly, nor will it prevent her/his from being depressed. No, prayer doesn't always fix it. No, the Bible doesn't always help. He/She has enough on his/her plate, they don't need a toxic parent too. Be there for them, listen to them and learn how to validate their feelings.

No, your friend isn't "acting up", no she doesn't need to put her big girl panties on. No, she shouldn't just move on and get over it. Don't make her feel that she's weak. Don't make her feel that she cannot and shouldn't open up to you. Don't be ignorant, be there for her.

No, your partner isn't cheating on you. No, he/she hasn't lost interest in you. No, He/She isn't being selfish. He/She loves you. Educate yourself.

No, you're not bugging. It's okay.. to not be okay. Talk to somebody, write. Don't keep it all bottled up.

Yes, your trauma matters.

Yes, it's okay to talk about it. 

Yes, it is absolutely okay to see a therapist. 

Depression doesn't have a face. Check on your loved ones, be there for them. Too many people lose their loved ones due to their ignorance.

We're in 2019, a year and a generation in which the internet has opened up a flood of resources. Make no more excuses. Please, DO BETTER!




Writer's Note 

If you're reading this, I hope this article has helped you and will also help you in the future. I hope you will reflect, question yourself to see if you've been a good friend, a good partner, a good relative, a good parent— and most importantly, how well you've been protecting your mental health.

I hope you will use the results of your reflection to start or/and continue being a better friend, better partner, better relative, a better parent — and to protect your own mental health.

Thank you to Dr. Aris Peguero for taking the time to answer the questions, and thank you to everyone who has sent in questions. 



Written by MuhreahWrites