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Understanding Bipolar Disorder: A Focus on Women of Color

Written by: Michelle Tillman-Cureton, LCMHC, PsychoTherapist


World Bipolar Day (WBD) serves as a crucial opportunity to raise awareness, challenge stigma, and foster a deeper understanding of bipolar disorder. The vision of WBD is to promote global education about bipolar disorders while reducing the social stigma surrounding mental illness (International Society for Bipolar Disorders, n.d.). Through international collaboration, this day seeks to provide accurate information that enhances sensitivity and compassion for those living with the condition.


As mental health professionals, we recognize the profound impact bipolar disorder has on individuals and families. However, it is essential to acknowledge that no two experiences with this condition are identical. For Black women and women of color, the journey is often shaped by systemic inequities, cultural influences, and the complexities of intersecting identities.


Barriers to Diagnosis and Treatment

Research suggests that Black individuals are less likely to receive an accurate and timely diagnosis of bipolar disorder compared to their white counterparts (Ward et al., 2013). This disparity is influenced by multiple factors, including:


  • Stigma Within Communities of Color: Mental health struggles may be viewed as a sign of weakness or a betrayal of cultural expectations. The “strong Black woman” archetype, often framed as a symbol of resilience, can discourage vulnerability and prevent individuals from seeking support (Abrams et al., 2019).


  • Racial Bias in Mental Health Care: Studies indicate that Black individuals are more likely to be misdiagnosed with schizophrenia rather than bipolar disorder due to biases in symptom interpretation by healthcare providers (Schwartz & Blankenship, 2014).


  • Cultural Explanations for Symptoms: In some communities, mood instability may be attributed to spiritual or supernatural causes rather than recognized as a medical condition. This can lead individuals to seek alternative forms of healing that may not fully address the underlying biological and psychological factors (Alvidrez et al., 2008).


The Impact of Racial Trauma on Mental Health

The daily realities of racial trauma, microaggressions, and systemic discrimination contribute to emotional distress and can exacerbate mood fluctuations in women of color. Studies have shown that chronic exposure to racial stressors increases vulnerability to mood disorders, including bipolar disorder (Carter et al., 2017). The emotional toll of navigating these challenges can intensify symptoms and complicate treatment, making culturally competent care essential.


The Role of Hormonal and Physiological Factors

Women with bipolar disorder already experience mood fluctuations influenced by hormonal shifts. For Black women and women of color, the physiological effects of chronic stress, often referred to as “weathering,” may heighten risks for mood instability (Geronimus et al., 2006). Life stages such as pregnancy, postpartum, and menopause can trigger or worsen mood episodes, necessitating specialized and culturally informed care (Viguera et al., 2018).


Prioritizing Culturally Responsive Care

To improve mental health outcomes for Black women and women of color with bipolar disorder, we must integrate culturally competent and trauma-informed approaches into our practice:


  • Culturally Competent Care – Recognize how race, ethnicity, and culture shape mental health experiences and tailor treatment approaches accordingly.

  • Addressing Racial Trauma – Create a safe therapeutic space where clients can process racial trauma, microaggressions, and identity-related stress.

  • Challenging Stigma – Engage in community education to normalize conversations about mental health and encourage early intervention.

  • Building Community Support – Facilitate access to peer support groups and culturally relevant mental health resources.

  • Advocacy for Equitable Care – Work toward reducing healthcare disparities and increasing access to mental health services for marginalized populations.

  • Intersectional Approach – Recognize that women of color have multiple intersecting identities, and treatment must address the whole person.


Moving Forward with Awareness and Action

On this World Bipolar Day, let us center the voices of Black women and women of color, honoring their lived experiences and advocating for a more inclusive and equitable mental health system. By fostering a culturally sensitive and trauma-informed therapeutic environment, we can empower our clients to navigate their journeys with resilience and strength.


Let’s commit to ensuring that all individuals affected by bipolar disorder receive the understanding, care, and support they deserve.


In health and wellness, it is vital to prioritize mental health alongside physical health. By fostering an inclusive environment where open discussions about bipolar disorder take place, we can break down stigma and promote awareness. This includes providing access to quality healthcare, educational resources, and support groups that empower individuals living with this condition. Together, we can build a community that values empathy and encourages continuous personal growth and recovery for those affected.


References

  • Abrams, J. A., Maxwell, M., Pope, M., & Belgrave, F. Z. (2019). Carrying the world with the grace of a lady and the grit of a warrior: Deepening our understanding of the “Strong Black Woman” schema. Psychology of Women Quarterly, 43(1), 49-63. https://doi.org/10.1177/0361684319828590


  • Alvidrez, J., Snowden, L. R., & Kaiser, D. M. (2008). The experience of stigma among Black mental health consumers. Journal of Health Care for the Poor and Underserved, 19(3), 874-893. https://doi.org/10.1353/hpu.0.0058


  • Carter, R. T., Lau, M. Y., Johnson, V., & Kirkinis, K. (2017). Racial discrimination and health outcomes among racial/ethnic minorities: A meta-analytic review. Journal of Multicultural Counseling and Development, 45(4), 232-259. https://doi.org/10.1002/jmcd.120764


  • Geronimus, A. T., Hicken, M. T., Keene, D., & Bound, J. (2006). “Weathering” and age patterns of allostatic load scores among Blacks and whites in the United States. American Journal of Public Health, 96(5), 826-833. https://doi.org/10.2105/AJPH.2004.060749


  • International Society for Bipolar Disorders. (n.d.). World Bipolar Day. Retrieved from https://www.isbd.org/world-bipolar-day


  • Schwartz, R. C., & Blankenship, D. M. (2014). Racial disparities in psychotic disorder diagnosis: A review of empirical literature. World Journal of Psychiatry, 4(4), 133-140. https://doi.org/10.5498/wjp.v4.i4.133


  • Viguera, A. C., Whitfield, T., Baldessarini, R. J., Newport, D. J., Stowe, Z. N., & Reminick, A. M. (2018). Risk of recurrence in women with bipolar disorder during pregnancy: Prospective study of mood stabilizer discontinuation. American Journal of Psychiatry, 175(2), 175-183. https://doi.org/10.1176/appi.ajp.2017.17010014


  • Ward, E. C., Wiltshire, J. C., Detry, M. A., & Brown, R. L. (2013). African American men and women’s attitudes toward mental illness, perceptions of stigma, and preferred coping behaviors. Nursing Research, 62(3), 185-194. https://doi.org/10.1097/NNR.0b013e31827bf533

 
 
 

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