By Dr. Ardis C. Martin, M.D.

Editor’s Note: The original version of this article included footnotes. See the PDF version of the article for the citations.

Maintaining good mental health is essential for our overall well-being. However, various factors can have a negative impact on our mental health. These factors include genetics and family history, environmental factors, socioeconomic disparities, and adverse life experiences.

For people of color, experiencing and confronting racism and discrimination is an additional factor that can adversely impact their mental health. The pervasive nature of these challenges continues to permeate through our society and profoundly affect people on social, political, medical, and individual levels.

In this article, we will (1) define racism and describe the various forms experienced by people of color, (2) examine two types of trauma resulting from racism and discrimination, (3) underscore the detrimental consequences of denying racism’s continued pervasiveness, and finally, (4) explore the mental and physical impact of racism on people of color.

While various definitions of racism exist, one that I find particularly relevant in setting the stage for a better understanding of its consequences is as follows:

RACISM = Racial Prejudice + Power.

This equation highlights racial prejudice as a set of discriminatory attitudes based on assumptions related to one’s race or skin color. Power, in this context, signifies the authority granted through social structures to reinforce racial prejudice, regardless of the validity of the underlying assumptions. Racism is a system of advantage based on race.

Having a clear understanding of racism and its different types is meant to be empowering so that people of color can recognize and describe their experiences and acknowledge the negative impact it can have on them.

There are four types of racism that are crucial for people of color to be aware of:

• Interpersonal or Individual Racism: Involves the beliefs, attitudes, and actions of individuals that consciously or unconsciously support or perpetuate racism.

• Cultural Racism: Encompasses messages and stories that convey the idea of assumed racial superiority among the majority and assumed racial inferiority among the minority.

• Systemic Racism: Evident in the practices of social and political institutions, leading to discrimination in areas such as criminal justice, employment, housing, health care, political power, and education.

• Internalized Racism: Involves the conscious or unconscious acceptance of the dominant society’s racist views and stereotypes, as well as biases within one’s own racial/ethnic group.

These forms of racism, coupled with discrimination, can lead to significant and far-reaching trauma—historical and racial.

Historical Trauma:

• Historical trauma is experienced across generations by a specific cultural group with a history of systematic oppression.

• Historical trauma is cumulative; current experiences of trauma along with past exposure can lead to additional adversity.

• Historical trauma impacts both psychological and physical health.

An important point to understand about historical trauma is that even descendants who haven’t directly been exposed to these traumatic events can display signs and symptoms which may include depression, fixation on trauma, low self-esteem, anger, and self-destructive behavior.

• Racial trauma refers to the emotional and physical reactions that people of color experience following multiple exposures and incidents of racism. It can manifest as hypervigilance, self-blame, fear, shame, and guilt.

To further explore the multifaceted nature of racism and its impact on mental health it is important to note that it can present as both overt (explicit) and covert (implicit) forms of bias, as macroaggressions and microaggressions, respectively. Macroaggressions are systemic and institutional forms of racism that negatively impact a group or class of people. Microaggressions are brief, intentional (conscious) or unintentional (unconscious), hostile verbal, behavioral, or environmental communications directed towards people of color.

Microaggressions can give way to racial gaslighting which is a form of psychological manipulation that involves causing people of color to doubt their experiences of racism and discrimination by denying or trivializing its existence. This invalidation of their lived experiences serves to perpetuate racism and leads to exacerbating mental health challenges with the potential of causing lasting adverse consequences. This may manifest as anxiety, confusion, paranoia, fear, anger, frustration, helplessness, and hopelessness. Research has even suggested a direct correlation between racial gaslighting and conditions such as unhappiness, depression, and suicide.

Recognizing these forms of racism and trauma and their consequences is essential for people of color, enabling them to stand up for themselves, especially in a medical system inherently fraught with biases that contribute to significant health disparities. Racism has direct and detrimental impacts on people of color’s access to mental health care; they have less access, reduced likelihood of receiving necessary care, and when care is received, it is often poorer in quality. Multiple studies have linked racism and discrimination to adverse physical and mental health outcomes, including hypertension, obesity, heart disease, increased infant mortality and maternal morbidity rates, depression, and generalized anxiety.

Knowledge is power, and for people of color, being aware of the way that racism and discrimination can impact their mental and physical health can be transformative and potentially life-saving. This awareness not only validates their lived experiences but also facilitates a deeper understanding of the underlying mental health challenges they may be facing because of it. By recognizing these issues, they can be empowered to feel confident, acknowledging when they need help. It sets the stage for them to comfortably advocate for themselves, seeking and receiving the treatment and support they deserve within a system that has been slow to change, enabling them to improve their overall mental and physical well-being.

By Dr. Ardis C. Martin, M.D.
True InSight Psychiatric
1407 Oakland Blvd., Suite 300
Walnut Creek, CA 94596
http://www.trueinsightpsychiatric.com