Authors’ Note: There is widespread recognition and open discussion within the black community about the pervasive presence of racism and its detrimental effects on equal access to essential resources such as education, housing and healthcare. However, less attention is often paid to the impact of racism on mental health. In this article, we aim to shed light on the relationship between experiences of racism and mental health, with a particular focus on anxiety disorders and symptoms, which are highly prevalent in the United States. We also offer coping strategies that may prove useful in dealing with the challenges posed by racism. It is critical to emphasize that as Black Americans, we bear no responsibility for the existence or persistence of racism, yet we are unfairly burdened with the task of coping with the distressing consequences of these oppressive experiences.
- Experiences of racism have a profound impact on the physical and mental well-being of black Americans, leading to negative health outcomes.
- Emotional responses such as anxiety, anger and sadness are natural and justified responses to the distressing experiences of racism.
- Three specific mechanisms by which experiences of racism contribute to increased stress and anxiety for Black Americans are a sense of diminished control, internalisation of negative beliefs, and avoidance of activities consistent with personal values.
- One potentially effective strategy for managing experiences of racism and mitigating its impact on anxiety symptoms is to prioritise and act in accordance with one’s personal values and what is meaningful to them.
- Acceptance involves fostering a compassionate relationship with our emotional responses to racism, recognising that feelings of fear, anger and sadness are valid responses to these painful experiences. Acceptance does not mean condoning the existence of racism or tolerating racist experiences.
Racism is a pervasive and significant problem in the United States, and its impact on mental and physical health, particularly anxiety and stress, is well documented. National surveys and polls of Black Americans have consistently found that
- The majority of Black Americans believe that racism is prevalent in the country, with 88% acknowledging the existence of racism and 87% describing it as a “very serious” or “serious” problem.
- A significant proportion (78%) believe that racism is widespread in the United States.
Racism manifests itself in a variety of ways, including racial macroaggressions, which include overt racist experiences such as racial slurs, physical assaults based on race, or unfair wage treatment based on race.
On the other hand, racial microaggressions are more subtle and may be intentional or unintentional, but still denigrate people of colour because of their race. Examples include assumptions of inferiority or criminality, lack of representation in work, education or government, being told that discussions of race are excessive, and presumptions of equality based on race. Racism can also be experienced at both structural/institutional levels, such as voter disenfranchisement, and individual levels, such as being met with surprise or disbelief when demonstrating intelligence or articulacy in a professional setting.
Approximately one in four black Americans will experience an anxiety disorder at some point in their lives. Among Blacks, social anxiety disorder is the most common anxiety disorder, with a lifetime prevalence of 10.8%, followed by generalised anxiety disorder (5.1%), panic disorder (3.1%) and obsessive-compulsive disorder (3%). In addition, anxiety symptoms tend to be more persistent in black Americans than in the general population. Despite these rates, Black Americans are less likely to seek mental health treatment and more likely to drop out of treatment than the general population.
Racism and anxiety: understanding the link
The impact of racism on the mental health of Black Americans is significant, with chronic experiences of racism and microaggressions leading to negative physical and psychological outcomes. Some researchers have coined the term “racial battle fatigue” to describe the anxiety, hyper-vigilance, headaches, increased heart rate and blood pressure, and other symptoms that can result from persistent experiences of racism.
In this context, there is evidence of a link between racism and symptoms associated with anxiety. Here are three specific ways in which experiences of racism negatively affect stress and anxiety for black Americans:
- Perceptions of lack of control: Racism can create a sense of powerlessness and lack of control over one’s circumstances. Constant exposure to discrimination and the perception that it is largely beyond one’s control can contribute to increased stress and anxiety.
- Internalisation: Black people may internalise negative stereotypes and prejudices about their racial group. This internalisation can lead to self-doubt, self-consciousness and anxiety about how they are perceived by others, perpetuating a cycle of distress.
- Avoidance of valued actions: Experiences of racism can lead to fear of judgement, rejection or mistreatment, causing individuals to avoid situations or activities that they value because of anticipated discrimination or prejudice. This avoidance can limit opportunities for growth, contribute to social isolation and exacerbate anxiety symptoms.
Perceptions of control
An individual’s sense of control over their circumstances, safety and environment is closely related to levels of stress and anxiety. In the context of racism, where experiences of discrimination are beyond our control, it is understandable that racist encounters can lead to a perception of lack of control over one’s environment. This perception contributes to the development and maintenance of stress and anxiety.
As Black Americans, we often strive to work hard, provide for ourselves and our families, and live up to societal expectations and our own values. We expect fair treatment, dignity and respect in return for our efforts. This drive to control our environment through hard work and conformity to societal norms is commonly referred to as ‘John Henryism’. The concept of John Henryism reflects a belief in the value of determination and perseverance in the face of formidable challenges such as racism and oppression.
Despite our best efforts, the frequency of racist experiences continues to undermine our sense of control over our safety and environmental contexts. The expectation that hard work, determination and compliance with societal rules will lead to fair treatment is repeatedly shattered by encounters with racism.
Frequent experiences of racial discrimination can also create a sense of devaluation and invisibility among black men and women. This sense of being unseen or undervalued contributes to the belief that we have little control over whether our talents, abilities, character and right to security are recognised and acknowledged by others in society. This experience is known as the “invisibility syndrome”.
Recognising the impact of racism on our sense of control is crucial to understanding the link between racism and fear. By acknowledging this dynamic, we can work towards strategies and support systems that help restore a sense of agency and mitigate the detrimental effects of racism on our mental well-being.
Experiences of racism can lead to internalised racism and negative self-evaluations that contribute to the development and persistence of stress and anxiety among Black Americans. While not all Black people experience internalised racism, it is a phenomenon in which beliefs of racial inferiority held by the majority about Black people are accepted and internalised. This internalised racism refers to the conscious or unconscious acceptance of negative and critical beliefs about one’s worth within the marginalised group.
An example of internalised racism is the belief that lighter skin or softer hair is more beautiful and worth more than darker skin and coarser hair. Numerous studies have linked internalised racism to low self-esteem and higher levels of psychological distress. Notably, critical self-beliefs and negative self-focused thoughts are associated with the development and maintenance of anxiety symptoms.
These findings underscore the significant impact of the pervasive negative messages about the worth of black Americans that permeate our society, as we see in media portrayals, political rhetoric, and disparities in charging and conviction rates for police violence against black people. Internalising these negative beliefs can lead to feelings of helplessness, worthlessness, sadness, fear and shame.
The internalisation of racism highlights the importance of addressing not only external sources of discrimination, but also the internalised negative beliefs and attitudes that can adversely affect the mental well-being of Black people. Promoting self-compassion, challenging and reframing negative self-perceptions, and fostering a positive racial identity can be important strategies for combating the harmful effects of internalised racism and reducing stress and anxiety.
Avoidance and impact of racism on black Americans
Experiences of racism can cause stress and anxiety for Black Americans, who often resort to avoiding activities that have personal meaning. Wilson and Murrell (2004) explain how the avoidance of both emotions and meaningful contexts contributes to the persistence of stress and anxiety. Society instils the belief that positive emotions are desirable and negative emotions are not. As a result, a child who cries after being knocked down at football practice is labelled as weak, while adults are told to shrug off job rejections.
This underlying assumption encourages the suppression or replacement of negative emotions with confidence, self-esteem or optimism in order to navigate life and pursue meaningful goals. However, an extensive literature reveals the paradoxical consequences of controlling emotional experiences. Avoidant coping, such as ignoring or denying the impact of racism, correlates with poorer long-term mental health outcomes.
The pursuit of valued actions is constrained when the sole focus is on avoiding distressing emotions. In addition, negative life events such as racism can lead to inflexible responses that hinder engagement in personally meaningful endeavours. For example, someone with social anxiety may avoid social interactions in order to avoid anxiety. However, this contradicts their value of forming social connections and finding a life partner.
In the context of racism, frequent encounters with discrimination can lead to anxiety symptoms such as increased heart rate, elevated blood pressure, negative self-reflection and excessive worry. These overwhelming symptoms can cause individuals to become overly preoccupied with these distressing emotions, thoughts and feelings. In an attempt to cope with these overwhelming reactions, individuals may suppress negative emotions and avoid places and people associated with racism (e.g. certain shops or neighbourhoods).
On the surface, avoiding situations where racism may occur seems adaptive and safe. However, racism can occur at any time and in any place, and this avoidance makes it harder to engage in personally meaningful actions or to uphold values such as being treated with equal respect in all settings or having equal access to education, health care and employment. Experiencing racism in school, work or social settings can hinder meaningful pursuits such as education, career advancement and social relationships. In addition, research suggests that a lack of engagement in valued activities contributes to stress and perpetuates anxiety symptoms.
As Black Americans, we face numerous barriers to engaging in personally meaningful activities, with racism being a pervasive factor in our daily lives. It is natural to want to avoid this pain, but it is crucial to recognise that such avoidance can inadvertently lead us to neglect important and meaningful endeavours, ultimately exacerbating distress.
How to Cope
An effective strategy for coping with the effects of racism and alleviating associated anxiety symptoms is the practice of valuing and acting on what is meaningful to us as individuals. By identifying and understanding our values, we can become more aware of what really matters in challenging moments and make choices and take actions that are aligned with those values.
For example, in the midst of a stressful encounter, it is often difficult to recognise that we still have agency and the power to respond, despite restrictive and judgmental thoughts. Examples include feeling compelled to tolerate racist remarks from a boss for fear of losing one’s job, or believing that one should remain unaffected by a consultant’s doubts about one’s abilities. For black Americans, however, regaining a sense of empowerment by reconnecting with their values can be transformative, even in the face of racism.
Consider the person who experiences distress because of racist jokes made by their boss. By reconnecting with the value of respect, they may choose to confront their boss about the offensive remarks. Accepting such remarks would be contrary to their identity and principles. Similarly, a black woman who feels that her counsellor is treating her unfairly because of her race may reconnect with the importance of her educational pursuits.
She may decide to assert herself by reporting the discrimination to the dean or by seeking a more supportive advisor, in line with her value of pursuing education. Recognising the importance of social connectedness, she may also create safe spaces with colleagues or fellow students to gain social support and process these experiences. By acting in accordance with her values despite the pain and injustice, she can alleviate some of the stress associated with racism.
Caring for our emotions
Rather than avoiding or suppressing our emotions, it is important to embrace them and develop an accepting relationship with our emotional responses to racism. This acceptance does not mean accepting the existence of racism or tolerating racist experiences. Rather, it involves cultivating a mindful awareness of our overwhelming and distressing emotional responses to racism, which can help to alleviate anxiety.
Interestingly, attempts to control or suppress emotions often intensify their impact. Therefore, it may be beneficial to explore more flexible coping strategies and to be open to acknowledging and discussing the deep emotional intensity that arises in response to racism. As Black Americans, we might ask ourselves how we can balance strength and resilience while acknowledging and addressing our emotions. It is important to acknowledge that controlling emotional responses to racism can be effective and has contributed to our strength in various contexts.
However, it is equally important to recognise that emotions provide valuable information and play a crucial role in navigating a world where racism is often experienced. Our emotions communicate when we perceive threats or danger (e.g. fear or anxiety), when our needs are not being met (e.g. anger), or when we experience the loss of something valuable (e.g. sadness).
Experiences of racism can trigger any or all of these emotions at the same time. Racism can threaten our safety, create barriers to accessing resources such as employment, healthcare and education, and undermine our sense of self-worth. While it is natural to want to avoid these emotional experiences, they provide essential information that, when clearly understood, enables us to respond meaningfully to racism.
A notable example is the Black Lives Matter movement, which emerged as a powerful response to the fear, anxiety, sadness and anger that many black Americans experienced following the numerous incidents of unarmed black men being killed by law enforcement officers.
As discussed earlier, emotions serve as valuable indicators and tools for adapting to the challenges posed by racism. However, social norms often discourage the acknowledgement of emotions such as fear, sadness or anger, portraying them as signs of weakness or lack of self-control. As Black people experiencing racism and emotional responses to it, we often encounter dismissive labels such as ‘overreacting’ or ‘oversensitive’, which reinforce the notion that emotions equate to weakness or being out of control.
To counter this narrative, we can actively practice self-compassion when faced with emotional responses to racism. This involves recognising that our fear, anger, sadness and other emotions are natural and understandable responses to the pain we are experiencing. Self-compassion involves acknowledging that our emotional reactions are valid and inherent aspects of our human experience. It requires cultivating an awareness of our tendency to judge our emotional responses to racism, and offering self-compassion both to the emotions we experience and to any self-critical judgments that may arise.
For example, in the face of a racist encounter, a Black woman can acknowledge her anger and recognise that this anger is a reasonable and justifiable response to an unjust situation. Rather than dismissing or suppressing her emotional response, she embraces self-compassion, understanding that her feelings are valid and deserve to be acknowledged rather than labelled as unreasonable or something to ‘get over’.
- Pew Research Study, 2013
- CNN/Essence Magazine/Opinion Research Corporation poll, 2008
- Gallup, 2008
- Breslau, 2004; Breslau, 2006; Wang, 2005).
- Jackson, Neighbors, Torres, Martin, Williams, & Baser, 2007; Snowden, 2001; Wang et al., 2005
- Barnes & Lightsey, 2005; Donovan et al., 2012; Hill, Kobayashi, & Hughes, 2007; Pieterse et al., 2012
- Smith, Allen, & Danley, 2007; Soto, Dawson-Andoh, & BeLue, 2011
- Sherman et al., 1984
- Franklin & Boyd-Franklin, 2000; Carr & West, 2013
- Carr et al., 2013; Graham et al., 2015; Syzmanski & Gupta, 2009
- Mckorkle, 1991; Tomes et al., 1990; Wei et al., 2010; Williams & Chung, 1999
- Ma et al., 2008; Rucker, West, & Roemer, 2009; Soto et al., 2011; Townsend et al., 2007
- Crocker et al., 2008; Michelson et al., 2011
- Wilson & Murrell, 2004
- Hayes, Strosahl, & Wilson, 2012; Roemer & Orsillo, 2009
- Sue, Nadal, Capodilupo, Lin, Torino, & Rivera, 2008