Struggling in Silence? How to Recognize When It’s Time to Seek Help

Mental health awareness has gained significant traction in recent years, yet many barriers still exist—particularly within the Black community. 

Dr. Sidney Hankerson, a psychiatrist and advocate for mental health equity, shares some of the most pressing issues related to mental health, including stigma, access to care, and the importance of seeking support early. This article explores key insights from the conversation.

Understanding Psychiatry and Its Role

Psychiatry is a branch of medicine that focuses on mental health conditions affecting thoughts, emotions, and behaviors. These conditions range from anxiety and depression to more severe disorders such as schizophrenia and bipolar disorder.  

According to the World Health Organization, depression is the leading cause of disability worldwide. In the Black community, depression can be particularly debilitating due to systemic factors and a lack of culturally competent care.

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Signs That Indicate a Need for Professional Help

Mental health struggles can manifest in various ways. Dr. Hankerson emphasizes that people should seek help when they experience:

• Difficulty completing daily tasks, such as work or family responsibilities
• Changes in sleep patterns—either excessive sleeping or insomnia
• Persistent feelings of hopelessness or thoughts of self-harm
• A withdrawal from social activities and relationships

One of the most alarming trends is the rising suicide rate among Black youth. Dr. Hankerson stresses that if someone expresses a desire to end their life or exhibits extreme withdrawal, they should seek professional support immediately.

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Prevalent Mental Health Conditions in the Black Community

Mental health issues are common, yet often overlooked. The most prevalent conditions in the Black community include:

• Anxiety Disorders – Chronic worry about finances, relationships, or safety
• Depression – Often triggered by life transitions, family history, or job loss
• Substance Use Disorders – While some substances are used less frequently in the Black community compared to other groups, opioid overdose deaths among Black and Latino men have surged in recent years

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Stigma and Historical Distrust of Psychiatry

Many Black individuals are hesitant to seek psychiatric help due to historical mistreatment in medical settings. Dr. Hankerson highlights that in the 1970s, Black men were frequently misdiagnosed with schizophrenia instead of conditions like depression or bipolar disorder, leading to improper treatment. This history, combined with cultural beliefs such as “what happens in this house stays in this house,” contributes to a reluctance to seek therapy.

“One way we’re working to address this stigma is by engaging trusted messengers—such as pastors, barbers, beauticians, and athletes—to talk about their own mental health journeys. When people hear others share their experiences with treatment, it helps chip away at the stigma,” Dr. Hankerson shares.

The Importance of Early Mental Health Care

There is a great need to integrate mental health checkups into regular healthcare routines. On average, individuals wait seven years between experiencing symptoms and seeking treatment. This prolonged suffering could be prevented by:

1. Increasing awareness of mental health symptoms
2. Recognizing that all mental health conditions impact thoughts, feelings, and behaviors
3. Seeking help from a primary care doctor, therapist, or community-based mental health professional

“Mental health conditions—whether anxiety, depression, or substance use disorders—affect the way we think, feel, and behave. If you notice struggles in any of these areas, it’s important to seek help,” Dr. Hankerson adds. “It’s also beneficial to speak with trusted individuals in your community. Many churches, community centers, and primary care doctors have connections to mental health professionals. You don’t have to go straight to a psychiatrist—you can start with a social worker, licensed therapist, or even your primary care doctor for a referral.”

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How Loved Ones Can Support Someone Struggling

Family and friends play a crucial role in supporting loved ones with mental health issues. Dr. Hankerson recommends:

• Asking open-ended questions such as, “How are you feeling?” or “I’ve noticed you’ve been distant lately—what’s going on?”
• Avoiding pushing someone toward a psychiatrist immediately, as this may make them defensive
• Seeking therapy for oneself if struggling to cope with a loved one’s condition

By engaging in open conversations and offering non-judgmental support, loved ones can create a safe space for healing.

Differentiating General Mental Health Support from Psychiatric Care

It can be difficult to determine whether someone needs general counseling or specialized psychiatric care. Dr. Hankerson advises starting with a trusted healthcare provider, such as a primary care physician, OB-GYN, or licensed therapist. These professionals can assess symptoms and determine whether psychiatric intervention is necessary.

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Barriers to Mental Health Care and Potential Solutions

Access to mental health services remains a significant challenge. The biggest barriers include:

• High Costs – Many psychiatrists do not accept insurance, making treatment unaffordable for many individuals
• Lack of Black Psychiatrists – Only three percent of psychiatrists in the U.S. are Black, limiting access to culturally competent care
• Stigma and Misinformation – Many people do not recognize when professional help is needed

To overcome these barriers, Dr. Hankerson recommends starting with primary care doctors, who prescribe the majority of antidepressants in the U.S. Many doctors now collaborate with social workers and therapists, providing a more accessible entry point for mental health care.

If you or someone you know is struggling with mental health concerns, consider reaching out to a mental health professional or trusted healthcare provider today.