1. Virletta Bryant Assistant Professor Coppin State University

3. Women & Depression Annually, approximately 12 million women in the US experience clinical depression. About 1 in 8 women can expect to develop clinical depression during their lifetime. Depression occurs most frequently in women aged 25- 44. (National Mental Health Association, 2001)

4. African American Women & Depression When African American women are compared to White women: Less likely to use mental health services. More likely to be misdiagnosed. More likely to rely on spirituality and religion to treat depression. (Carrington, 2006; Nadeem et.al, 2008; National Mental Health Association, 2001)

5. African Americans & Religion The U.S. tends to be a highly religious nation and African Americans are markedly more religious on a variety of measures than the US population. 85% of African Americans report being “fairly religious or “vary religious”. African American women have the greatest religious affiliation than any other demographic group in the U.S. population.(Lesniak et. al, 2006; Pew Research Center's Forum on Religion & Public Life, 2007; Taylor, Chatters, Taylor, Levin, & Lincoln, 2000)

6. African Americans, Depression & Religion Almost 2/3 of respondents said they believed prayer & faith alone will successfully treat depression “almost all of the time” or “some of the time.” 1/3 of African Americans said they would take meds compared to 69% of the general population. (National Mental Health Association, 2001)

7. Purpose of Study To understand from an emic perspective why African American women are more likely to use religion and spirituality to treat depression. What beliefs and attitudes about depression do religious African American women have? What are factors that influence their help-seeking patterns?

9. Methodology Theoretical Framework Symbolic Interactionism Sampling Strategy, N=10 Purposeful sampling 3 Gatekeepers Snowball sampling AA women (25-40) Self reported regular attendees of Mid-Atlantic Christian Church Data Collection 2 Face-to-face semi- structured interviews 1 Phone interview Interviews audio-taped Interviews & Field notes-transcribed

10. Methodology Data Analysis Constant Comparative Method Trustworthiness of Findings Peer debriefing group Triangulation of findings with male/female minister Prolonged engagement Reflexive journaling Audit trail Member checking

12. IDMem.MarriedChildProf.Abuse Hx. Treat. 13651Day-careXPastoral 23981TeacherOn-line 31272House- wife None 41061House- wife None 540111Contract Officer None 63171TeacherNone 740163Social Worker XPsych. 840152TeacherXSocial Worker 93482SecretaryPsych. 103442Business Owner Psych.

14. Beliefs About Depression Depression, Satan and God were interconnected Depression was transitory, situational, described as “spiritual warfare” a “battle” that was “won or lost” through relying on a higher source (God). Satan used circumstances and depression to keep the person disconnected from God. Depression was greater than their individual experiences, a battle between good and evil.

15. Beliefs About Depression Participant: …I think we become depressed because of the situation, but if we have that relationship with Christ then you fight the depression with Christ and you ask Christ to help you.…It’s a struggle between Satan and God, it’s a struggle between evil and God….So it’s a struggle between Satan trying to take you and God trying to save you.

16. Beliefs About Depression Participant: I go into depression…because I felt like He (God) needed me to be there in order for me to understand my helplessness, my lack of hope without having asked Him to come into the picture. I always feel like I go to that place because I realize that I’m the furthest away from God at that point, and it helps me to realize that I have some place to go. I can always go back to Him and know that the way I see myself right now is someplace I don’t have to be because my experiences have taught me that when I am prayerful, when I’m reading, He just fills me and things become clearer.

17. Beliefs About Depression Depression was self-induced through indulging in self- pity and remaining despondent. Participant: If you are depressed, you really have allowed yourself to sink into a state of hopelessness where you can’t see you’re way out…

18. Beliefs About Depression Women depended on spirituality to cope with depression because they viewed depression as being more of a spiritual concern and less of a clinical illness. Participant: Depression is merely a time when there is stillness in my soul and it is waiting to hear a word from God. Therefore, I don’t see depression as you (pointing to the clinician/researcher) would see it, something that needs to be fixed or even talked about it is my time to be still and listen.

20. Conclusions & Implications Religious African American women are more likely to conceptualize depression as a spiritual concern and seek help in a faith community, through prayer or with spiritual leaders (Musgrave, Allen, & Allen, 2000; Schnittker, Freese, & Powell, 2000). The participants in this study felt that their faith community provided security and a non-stigmatizing space where emotional and spiritual needs could be met. They also relied on spiritual tools such as prayer, affirmations, reading and inspirational materials.

21. Conclusions & Implications This work suggests that spiritual beliefs systems of religious women can either contribute to depression, or act as a protective factor against depression. Consequently, the practitioner’s ability to integrate, reframe and redefine religious African American women’s spiritual belief systems becomes an integral part of treatment.

22. Questions?