In 1995, Rene Ruballo noticed a troubling change within him. This now retired New York City police officer and father of four started losing interest in everything he once felt passionate about, including his police work and spending time with his family. At times he would ditch work and sleep all day. Other times, he’d function on only an hour’s sleep. He no longer felt he had anything to look forward to in his life.
As he grew more and more withdrawn, Ruballo’s family realized something was very wrong. “My wife and children saw that I wasn’t interested in the things we used to do,” says 43-year-old Ruballo. “If there were family outings, I used to just tell my wife, ‘You can take [the kids].’ And I would just stay home.” Ruballo’s wife urged him to seek counseling. Eventually he did get professional help, and his suspicions about the cause of his feelings were finally confirmed: He had depression.
Most people use the word depression to describe feeling sad or blue, but it is much more than that. This serious medical illness affects some 18 million Americans and can have debilitating effects on those who suffer from it. Twice as many women suffer from depression as men, but men are less likely to admit they are depressed or seek help. Across racial and ethnic lines, poor and less educated individuals suffer from higher rates of depression. And although depression goes largely undiagnosed among all ethnic groups, the disparities in treatment are stark in the African American community.
“Non-Hispanic blacks and Hispanics both have lower rates of treatment than non-Hispanic whites,” says Ronald Kessler, professor of healthcare policy at Harvard Medical School. “When they get treatment, furthermore, it is less likely to be in the specialty mental health sector and more likely to be treatment from a primary care physician or social worker or minister. This is a double disadvantage — lower overall treatment and presumably lower quality of treatment once in treatment.” Social stigmas surrounding mental health in the African American community, as well as limited access to health plans that provide direct mental healthcare, contribute to undertreatment. Public health institutions are more likely to offer poor clients medication than psychotherapy.
“There still is a stigma in the African American community that psychotropic medications are being used as a social control mechanism,” says Kessler. But depression, left untreated, can completely halt one’s ability to function day to day and, at its worst, may even lead to suicide. There were 30,622 suicides in the U.S. in 2001, 1,957 of which were committed by African Americans, according to the American Association of Suicidology. This breaks down to 5.4 African American suicides per day.
Depression is not uncommon among African American professionals and executives. “It’s very difficult for African Americans in corporate settings, where they know they are being looked at closely,” says Dr. Annelle B. Primm, associate professor of psychiatry at Johns Hopkins University School of Medicine. “They never know if they’re being responded to for who