July is National Minority Mental Health Month. It is a time to recognize the need to provide a bridge to those who lack access to mental health treatments. Specifically, we need solutions for broken and underserved communities of color. As I think about the importance of Minority Mental Health Month, I would like to share my personal journey about battling mental health issues while living with a chronic disease.
Since being diagnosed with chronic kidney disease in 2013, I learned that mental health is rarely talked about. As a person of color, I have overcome many challenges during my time on this earth. Sadly, just waking up as a Black man is a miracle these days, much less a Black man of middle age living with kidney disease and diabetes, recovering from Covid-19. When you compound your chronic illness with two different pandemics simultaneously, it can be traumatic and depressing. I have been in many discussions about this subject, and I still rarely see any in-depth solutions to providing adequate access to mental health services.
COVID-19 highlighted the racial and social injustices in our health care system. It took me on an unexpected journey, along with many other Black Indigenous People of Color (BIPOC). After contracting Covid-19, I then became a COVID-19 survivor and long hauler for 291 days. Along with protecting my kidney transplant of four years, life sometimes became unbearable.
For 291 days, my physical and mental capacities were constantly challenged. I did not know who to turn to. Trying to take/make time for myself was not working. I continued to receive calls and messages from others suffering from medical and spiritual tragedies that left me drained and feeling slighted. As I was listening, counseling, and praying for others, I wondered who was praying for my recovery. I felt the walls come down on me as I dealt with a multitude of feelings. Several friends and colleagues were also negatively impacted by the racial and social injustices presented by COVID-19, including death. I got to the point that I had to stop watching television and refrain from social media because of all the negative feedback. It was at that moment that I realized I was in desperate need of mental health wellness assistance and accessibility.
I found my answer On June 12, 2021. It came to me through a church event. My church, Mountain Movers Ministries, gave a presentation entitled Grieving Well: Helping each other to acknowledge our grief and move toward healing. The purpose of this workshop was to talk about grief and how to manage it. When dealing with the loss of a loved one, a chronic or terminal illness, or learning to maneuver through a pandemic that you cannot control, it can all become overwhelming. This presentation was my salvation and started my healing journey.
July is not only National Minority Mental Health Month, but it is also National Chronic Disease Awareness Month. As a person living, and once again thriving, with Chronic Kidney Disease, I would like to share the following educational tools and resources. These resources assisted me in achieving a better mental health outcome and should be available throughout the kidney and other chronic disease communities:
Types of Grief and Loss
Grief is a reaction you have to a loss in your life. This loss can refer to death, but it can also refer to the loss of physical or cognitive abilities or the loss of something routine in your life, such as a job. You can also grieve the way you are treated by family, friends, and co-workers.
Below are descriptions of the various types of grief:
For family caregivers, grieving can start long before the person you are caring for passes away. Anticipatory grief often begins when the person you care for gets a significant diagnosis, and their health begins to deteriorate. Feelings are related to the loss of what you thought life was going to be like. It can be challenging to speak with others about anticipatory grief because the person you care for is still alive. You may have feelings of guilt or confusion as to why you are feeling this kind of grief.
Contrary to what the name might suggest, there really are no set guidelines to define normal grief in terms of timelines or severity of grief. Instead, think of normal grief as any response that resembles what you might predict grief to look like (if that makes any sense!). Many people define normal grief as the ability to move towards acceptance of the loss. With this comes a gradual decrease in the intensity of emotions. Those who experience normal grief can continue to function in their basic daily activities.
Delayed grief is when reactions and emotions in response to death are postponed until a later time. This type of grief may be initiated by another significant life event or even something that seems unrelated. Reactions can be excessive to the current situation. The person may not initially realize that delayed grief is the real reason for becoming so emotional.
Complicated grief (traumatic or prolonged)
Complicated grief refers to normal distress that becomes severe in longevity and significantly impairs the ability to function. It can be difficult to judge when suffering has lasted too long. The following are contributing factors in diagnosing prolonged or traumatic grief: the loss or death, relationships, life experiences, and other social issues. Some warning signs include self-destructive behavior, deep and persistent feelings of guilt, low self-esteem, suicidal thoughts, violent outbursts, or radical lifestyle changes.
Disenfranchised grief (ambiguous)
Disenfranchised grief can be felt when someone experiences a loss. Still, others do not acknowledge the importance of failure in a person's life. Others may not understand the importance of the loss or minimize the loss's significance. Dis disenfranchised grief can occur when someone experiences losing an ex-spouse, a pet, or a co-worker. The other side of disenfranchised grief is when you experience a loss, such as when the person you care for has dementia or a decline in their physical abilities. The person is physically present, but they are also absent in other significant ways.
This type of grief can be experienced in many ways: feelings of hopelessness, a sense of disbelief that the loss is actual, avoidance of any situation that may remind someone of the failure, or loss of meaning and value in a belief system. At times, people with chronic grief can experience intrusive thoughts. If left untreated, chronic distress can develop into severe clinical depression, suicidal or self-harming thoughts, and even substance abuse.
This type of grief can occur when multiple losses are experienced, often within a short period. Cumulative grief can be stressful because you do not have time to properly grieve one loss before encountering the next.
Masked grief can be in the form of physical symptoms or other negative behaviors that are out of character. Someone experiencing masked grief is unable to recognize that these symptoms or behaviors are connected to a loss.
Unfortunately, distorted grief can present with extreme feelings of guilt or anger, noticeable changes in behavior, hostility towards a particular person, plus other self-destructive behaviors.
Exaggerated grief is felt through the intensification of normal grief responses. This intensification tends to worsen as time moves on. This may result in self-destructive behavior, suicidal thoughts, drug abuse, abnormal fears, nightmares, and even the emergence of underlying psychiatric disorders.
This type of grief is when someone does not outwardly show any typical signs of distress. Often this is done consciously to keep suffering privately. Problems can arise with inhibited grief through physical manifestations when an individual does not allow themselves to grieve.
Secondary losses in grief
Secondary loss is felt after the primary loss and can affect multiple areas of an individual's life. The grief from secondary loss is the emotional response to the subsequent losses resulting from death (the primary loss).
Collective grief is felt by a group. For example, this could be experienced by communities due to natural disasters, the death of a public figure, or a terrorist attack.
Abbreviated grief is a short-lived response to a loss. This could occur due to someone or something immediately filling the void, the distance that was felt, or the experience of anticipatory grief.
Absent grief is when someone does not acknowledge the loss and shows no signs of distress. This can be the result of complete shock or denial of the death. It can be concerning if someone experiences absent grief for an extended period.
It is important to note that just because you cannot see the signs of grief in some instances does not necessarily mean that someone is not grieving. Speak with a health care professional if you need help coping with any sadness, loss, or uneasiness. If you feel the symptoms of depression while dealing with CKD or ESRD, do not keep it to yourself. You must speak up to your doctor, another professional, or even a loved one so they can help you get the support you need.
Every human being living in this world is entitled to access to mental wellness. It is a necessary means of achieving optimal care for our physical, emotional, and spiritual fitness. Learning to overcome barriers due to racism and stereotyping, healthcare access, cultural beliefs, and language gaps can be difficult for marginalized communities of color. One way to overcome these challenges is to understand what it means to be human. Most Americans in this country believe in a Supreme Being. Let us do the things necessary to help the brokenness in others by respecting everyone’s suffering and aiding in their recovery.
Holy Scripture says in Romans 8:28 HCSB, 'We know that all things work together for the good of those who love God: those who are called according to his purpose." His Word promises that those who are in the midst of suffering, whether experiencing death or depression, have the hope that everything is working together for the good of those who love Him are called according to His purpose. Let us be purposeful in assisting in the healing process through our humanity.
Listed below are additional mental health resources.
Mental Health Hotline Resources:
· National Suicide Prevention Lifeline: call 1-800-273-8255
· Veterans Crisis Line: call 1-800-273-TALK (8255) and press 1 or text 838255.
· Crisis Text Line: text the word "Home" to 741-741
· The Trevor Lifeline for LGBTQ Youth: call 1-866-488-7386
· The Trans Lifeline: call 1-877-565-8860