An estimated 4.4% of U.S. adults have bipolar disorder. A person with bipolar disorder can go from feeling very high (called mania) to feeling very low (depression). While the rate of bipolar disorder is the same among Black Americans as it is among other Americans, Black Americans are less likely to be diagnosed and treated for this mental health condition.
In this article
Key points
Many Black Americans with bipolar disorder do not get the help they need. This is partly because doctors may see symptoms of Black Americans as misbehavior rather than mental health-related. This can lead to a mistrust of doctors. Black Americans may also struggle to get the help they need due to a lack of access to health insurance and stigma about mental health. Black children and adults with bipolar disorder are also more likely to be punished instead of helped.
Bipolar disorder has clear signs and can be treated. People with bipolar disorder experience extreme mood swings, ranging from feeling very happy and full of energy (mania) to feeling very sad and tired (depression). Treatment can include medicine, counseling, peer support, and community support through barber shops, faith groups, support groups, etc.
Access gaps for Black Americans
Many Black Americans with bipolar disorder are going undiagnosed and untreated. Several factors contribute to Black Americans not receiving help for bipolar disorder and other mental health conditions, including:
- A mistrust of health professionals, based in part on a history of abuse from the medical system (such as the Tuskegee syphilis study) and historically higher-than-average institutionalization of Black Americans with mental health conditions.
- Cultural barriers between many doctors and their patients.
- Reliance on family and religious community, rather than mental health professionals, during times of emotional distress.
- A tendency to talk about physical problems rather than discuss mental symptoms or to mask symptoms with substance use or other medical conditions.
- A lack of access to health insurance since many people in the U.S. get their insurance from their jobs. But Black Americans are more likely to work lower-wage jobs that do not offer health benefits.
- Stigma about mental health conditions.
- Embedded assumptions about race lead law enforcement to treat Black people with mental health conditions unfairly. This also leads a high number of Black males with a mental health condition to be incarcerated.
- Embedded assumptions about race lead teachers in schools to punish the behavior of Black children with bipolar disorder rather than helping them find support.
Signs of bipolar disorder
Bipolar disorder often starts in the teen years but can also show up later in life. Early recognition and treatment of bipolar disorder can help people recover more quickly and with less disruption to their lives. Tragically, people with bipolar disorder are 8.66 times more likely to die by suicide than the general population. The signs of bipolar disorder include:
Mania
- Excessive energy, restlessness, racing thoughts, and rapid talking
- Denial that anything is out of the ordinary
- Extremely happy feelings
- Easily irritated
- Needing little sleep
- Unrealistic belief in one’s abilities
- Poor judgment
- Increased sex drive
- Substance misuse
- Aggressive behavior
- Paranoia
Depression
- Poor appetite or eating too much
- Trouble sleeping or sleeping too much
- Nervousness and worry
- Loss of interest in and withdrawal from usual activities
- Feelings of sadness that don’t go away
- Irritability or restlessness
- Lack of energy
- Feelings of sadness, worthlessness, or guilt
- Inability to think or concentrate
- Repeated thoughts of death or suicide
- Chronic pain or other physical problems that don’t respond to treatment
- Increased risk-taking behavior, including reckless driving or substance misuse
Causes
Causes of bipolar disorder may include:
- Brain chemistry – There are chemical changes in the brain during both extremes of behavior (mania and depression).
- Genetics – Close relatives of people with bipolar disorder are more likely to have depression or bipolar disorder than other people.
- Drug and alcohol use – Many people with bipolar disorder have histories of substance use. In some cases, substance use comes before the development of bipolar disorder; in others, alcohol or other drugs may be used as a form of self-medication.
- Stressful or disturbing events – Both can trigger a genetic predisposition for bipolar disorder in addition to causing mood changes.
Tools for recovery
There are many different treatment options and supports that can help people recover from bipolar disorder:
- Medication – A mental health provider may prescribe one or more medicines to find what works best.
- Counseling – Often, psychotherapy or other forms of counseling are used along with medication. To be effective, counselors must take into account the unique experiences of Black Americans with mental health conditions and the stigma they may face in their community.
- Peer support – The advice and support of others who have bipolar disorder can aid recovery. This can be especially helpful when peers share a common racial identity to make support relevant to their experiences.
- Support groups –Some organizations, like the Depression and Bipolar Support Alliance (DBSA) offer groups for Black Americans experiencing bipolar disorder.
- Electroconvulsive therapy (ECT) – This is used as a last resort to treat severe bouts of depression and suicidal thoughts. It’s only considered when medication and therapy haven’t worked.
- Barber shops and salons – In the Black community, barber shops/salons often serve as a place to find community and gain support. Many Black barbers/hair stylists are being trained to support people through mental health challenges because of their established role in the community.
- Complementary care – Some people benefit from exercise, stress reduction classes, and other activities to go with their treatment and help them manage their illness.
- Culturally-based practices – These practices are rooted in cultural traditions that have been passed down for generations to help people heal. Some examples include prayer circles, energy cleansing, and more.
- Spirituality and faith – Black Americans with bipolar disorder who are part of a spiritual or religious community may find comfort and support there. Spiritual practice can help you feel more connected to others as well as something greater than yourself.
Survey
Other resources
National Medical Association (for a list of Black doctors)
Black Psychiatrists of America
Take a mental health test
If you or a friend are struggling with your mental health, take an anonymous, free, and private mental health test. It only takes a few minutes, and after you are finished, you will be given information about the next steps you can take based on the results.
