Lifting the veil on depression in Black Gay Men

by Antoine Craigwell, AlterNet

On Friday, Apr 30, according to a New York daily, “New York Daily News,” a 20-year-old man posing as a subway track worker caused a terror scare. At about 5:30am, track maintenance workers picking up garbage, noticed someone they did not recognize as being a worker like them in the subway tunnel connecting the Borough Hall in Brooklyn and Bowling Green in Manhattan stations, under the East River, along the Number 4 and 5 lines. The police was summoned and the young man, a Pace University student, was taken into custody on suspicion of attempting to commit a terrorist act, but when his backpack was searched, it was discovered to contain a bottle of sodium cyanide pills – when heated is used for cleaning jewelery, a large bottle of water and some flares. On questioning, Aaron Fetto, declared to the authorities that he was not a terrorist and that all he wanted to do was to find a corner where he could mix the pills with the water and drink it, to commit suicide.

“He did not want to be found,” said Deputy Commissioner Paul Browne, the New York Police Department spokesman. “He had no ID on him. He was looking for some isolated place in the system.”

Fetto, who is from New Hampshire and ran track and field in high school, and who was in the fall of 2008 on the Dean’s list at the University, admitted to investigators that he was depressed and wanted to end his own life – not that of anyone else. According to the police, even though a source said that he was on medication, it was not immediately clear what was troubling him.

Eon Scott, a 22-year-old man from the rural town of New Amsterdam, Berbice, in the Caribbean country of Guyana, committed suicide on May 7. The cause and nature of the agent Scott used, as discovered through an autopsy report, was that he drank a quantity of Gramatzone, a powerful pesticide. In a published report in a local daily, Kaiteur News, although Scott’s family claimed someone else had given him food and poisoned him, the pathologist determined that there was no food in his stomach, and it was quite likely that the pesticide was self-administered. According to the report, investigators were told that Scott drank the poison because of a broken relationship. Scott was a customer service representative for a local telecommunications company and was described as a cross-dresser.

The U.S. National Institutes of Mental Health designated May as Mental Health Month. As a mental illness, the universality of depression has several different characteristics and manifestations, and when acknowledged, is either treated through medication, talk therapy, or a combination of medication and talk therapy. A new U.S. Centers for Disease and Control and Prevention report — Surveillance for Violent Deaths — National Violent Death Reporting System, 16 States, 2007 — summarizes data on 15,882 fatal incidents involving 16,319 deaths in 16 states. The majority of deaths were suicides, 56 percent, followed by homicides and deaths involving legal intervention at 28 percent, deaths of undetermined intent at 14.7 percent, and unintentional firearm deaths at 0.7 percent.

For many Black men, especially those struggling with their identity and more importantly, their sexual identity, the stress of adjusting to demands of family, friends, co-workers, culture and the society as a whole has created a pressure-cooker type of situation, where many men suppress their feelings, and as they do, the bottling up of their emotions finds unlikely but often socially accepted, and sometimes misunderstood outlets. These outlets include alcohol and drug use and abuse, persistent feelings of sadness, prolific sexual promiscuity with unsafe sexual practices, violence – against a spouse or partner, inabilities to maintain stable relationships and jobs, and a desire to withdraw or be alone and away from everyone. From a biological perspective, even though men and women experience depression differently, for someone who is Black and gay, there is a particular difference.

But, for men who are Black and gay or same-gender loving, there are additional stressors on top of those experienced by their counterparts in the heterosexual community, including the influence of stigma and discrimination from within culture, the role religion plays – which tells them that being gay is an abomination, their ethnicity, and gender identity reconciliation from society – that being gay is a weakness to be eradicated; all of which contribute significantly to the level and intensity of depression, and which combines to inhibit their ability to lead productive and wholesome lives.

In the Black community, it is taboo to speak about depression. Because of expectations from family and society, most of which are based in history, the unspoken rule is that if someone is suffering from any of the symptoms of depression and can identify it as such, he is not encouraged to speak about it; rather, he is strongly persuaded to “man up” and “be strong”.

A commentator to a Facebook page said, “It isn’t just the Black gay community. Mental illness still carries a stigma in this country that prevents most people from openly discussing their personal struggles.”

But, Ocean Morrisset, another commentator on Facebook, on the issue of depression in the Black gay community said, “because it’s not a party or about sex, although those may be the very root causes of depression, the topic in and of itself in the Black community is one of those taboo topics that most would rather avoid.”

Generally individuals are reluctant to acknowledge that depression is present, let alone when it involves a specific group,  Rose  October-Edun said in a comment on FaceBook, “You’d be surprised how many people are experiencing depression and sometimes do not even know it. I am not saying this is so across the board, but the bottom line is, if I don’t know I have it, I cannot and will not talk about it. Sometimes individuals categorize depression as something else like, “I feel (or have been feeling) a little down, but I always bounce back”. Remember if one recognizes something as a problem, in this case depression, and look for professional intervention, they often wonder what others would say if they were to find out, thus some stigma might be attached. Now when we throw in someone’s sexual orientation (homo, bi, or transsexual), this creates different scenarios for that particular person involved. Depression is very alive in the real world and the sooner we acknowledge and address it, the better we will be as a person, group, nation, or country.”

Depression and sexual risk

In March 2010, a group of academics and researchers published a paper, “Depression is Associated with Sexual Risk Among Men Who Have Sex with Men, but is Mediated by Cognitive Escape and Self-Efficacy,” and in it the authors focused directly on the specific issue of the underlying cause or factor responsible for risky sexual behavior among men who have sex with men. In the paper, the authors, Lisa Alvy and David McKirnan of the Department of Psychology at the University of Illinois at Chicago and the Howard Brown Health Center of Chicago; and Gordon Mansergh and Stephen Flores of the Division of HIV/AIDS Prevention, U.S. Centers for Diseases Control and Prevention, in Atlanta, GA; and others, stated that they examined and conducted an investigation of a national sample of 1,540 HIV-positive and HIV-negative men who have sex with men, and who reported unprotected sex and drug use with sex partners, “we found evidence that depression is related to HIV transmission risk. Qualitative research with MSM in community settings suggests that depression and negative affect are strongly associated with risky sex”.

Addressing coping and escape, the authors said that, “there is consistent finding that those who experience negative affect are more likely to engage in avoidant coping or affect-based regulation, as opposed to instrumental problem-solving. Avoidant coping has also been found to be associated with unprotected sex. In one sample of HIV-positive men, avoidant coping was the best psychosocial predictor of unprotected anal intercourse with an HIV-negative or unknown status partner. From a cognitive escape perspective, individuals may cope with negative mood states by attempting to escape cognitive awareness of behavioral norms, narrowing their attention to more immediate, pleasurable outcomes. The concept of cognitive escape is similar to theories involving alcohol or drug expectancies, but frames substance use as a specific form of avoidant coping. Studying a high-risk MSM sample, McKirnan, and others found that men who combine drugs with sex to cognitively escape awareness of HIV risk were more likely to engage in sexually risky activities. Although researchers have not explored a relationship between depression and cognitive escape, conceptual similarities between escape and avoidant coping suggest that escape tendencies may be higher in depressed MSM.”

In the paper, the Alvy, McKirnan, and others said that while conducting group interventions sessions of MSM sexual behavior interventions, there emerged from the participants reports of feelings of sadness and loneliness as consistent themes related to sexual risk. Similarly, interview data collected by other researchers, Bancroft and others, revealed that some gay men described engaging in unsafe sex when depressed because they were less concerned about the consequences.

The authors, Alvy, McKirnan stated that their sampling of 1,540 MSM contained a near equal representation of HIV-positive and HIV-negative MSM, with strong representations of African-American, Caucasian, and Latino men, and that the depression severity yielded 611 participants or 40 percent with low depression; 594 participants or 39 percent with moderate depression; and 335 participants or 22 percent with high depression. According to the sample, 493 or 32 percent were African-American men, 583 or 38 percent Caucasian, and 294 or 19 percent Latino. While the report details the age groups and other demographic information such as income ranges, location by major cities, and education, it did not specifically identify or focus in to provide clearer details of the 493 African-American men who participated in the study. Needed are specific studies of the issue of depression in Black gay men and the correlation between depression and sexual risk and HIV infection rates, and with a larger and more representative sample size.

Henri’s Story

To protect his identity the name Henri is used: With one younger sibling, Henri had experienced lots of self-hate and low self esteem. Henri who’s originally from Haiti, still lives at home with his parents in a family house that sits on the border between Queens, NY and Long Island. Born in Haiti, he came to the U.S. with his parents when he was 2-years old.

As a 19-year old Black young man, Henri said he knew that even though he was attracted to other boys, he never knew how to express his feelings or what they meant. Now, on the verge of leaving his teens and entering his 20s, he is still in the process of accepting himself as gay. This acceptance, he says, was fraught with internal and external struggles, “I haven’t arrived completely at acceptance.”

He recalled that when he was about 8-years old, he was sexually abused by a relative, one of his older cousins, but it wasn’t until he was abused again when he was 14-years old, by someone he said was a stranger, that together with the realization that he was attracted to someone of the same sex, that he began to feel guilt, shame and sadness.

While he wanted to and struggled to accept himself, he was torn between obligations to his family – the love he knew they had for him, but reasoned that if they knew he liked guys, he was unsure of their reaction –and confusion, and saw himself falling into a category of stigma with bias attached, to experiencing rejection by family and friends, and with thoughts of suicide and contracting diseases, including HIV all swirling in his head.

“I was taught that I if could have sex with 20 girls and if I get a disease, that’s okay, but if it’s with a guy, then that’s not okay,” Henri said.

He said he spoke with a psychologist who asked him why he was depressed and he responded that he was fighting to put his feet in a “straight man’s” shoes, “I don’t know how I lived this long. I stopped going to church,” he said.

Henri and his mother had a close relationship but when he told her that he is gay, she cried and said some hurtful things. She had said, “How did I give birth to this? What did I do wrong? People at my job ask how my son is doing and I don’t talk about him; he stays by himself. They have somehow figured out that my son is gay. I never thought it’d be in my house, but in other people’s houses. What did I do wrong?”

He declared that he would not let his sexuality stop him from achieving happiness in his life, “I want to become an artist and entertainer,” he said.

But, Henri is concerned about rejection from his culture, “It would affect me a lot; in life no one wants to be alone, everyone wants to be accepted, but I know I’m not mentally strong.”

This is a special “place” where articles and stories of Black gay men who are suffering from depression is published. As a “place” it is an opportunity to begin or advance discussion, which is possibly a cultural paradigm shift in the Black community and the Black gay community, about depression, a silent killer and destabilizer of lives. This is a “place” through the publication of stories and articles, that shines light into the shadows of a taboo subject and through the sharing, brings healing for better, more productive and quality lives in Black gay men.

via AlterNet
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