To be a woman, Black, and in need of some healing 00:00

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Dimensions of Health Mental health disparities in Black communities

To be a woman, Black, and in need of some healing

iPondr’s Stephanie Moore, an advocate for mental health, and Crystal Smith discuss their personal journeys to find answers and the proper care for their own mental health issues, and some of the challenges they faced along the way.

Did You Know? Tap to expand
Less than 50% of all Americans with a mental health disorder are able to get the treatment they need. Source: National Institute on Minority Health and Health Disparities

A note from the producer, Stephanie Moore: A variety of circumstances put Black women at high risk for mental and emotional stress — economic insecurity, responsibilities for caregiving, lack of social support, physical illness or disability, and even generational trauma. Additionally, mental health resources in the Black community are limited and overtaxed, resulting in a community health crisis that takes a toll on the souls of Black women. Crystal Smith has battled these issues for 30-plus years. In an open conversation with Crystal, we talk transparently about our mental health journeys as Black women.

Stephanie Moore 

This is Stephanie Moore and I am an iPondr Growth Strategist and lifelong advocate for mental health. I recently had an open conversation with Crystal Smith. We talked transparently about her mental health journey as a Black woman. 

My first question to you, Crystal, is — can you walk me through the journey of your mental health and the impact it has had on you as a Black woman? 

Crystal Smith 

Okay, my mental health journey started around 13 when I was going through puberty. I slept a lot and didn’t realize it was depression. I did not want to face the day. I wanted it to be over and start again. 

I had a good childhood. I don’t know what would have made me depressed. I wasn’t deprived or anything but my first initial bout with going into a facility, I was in my early 20s after the birth of my first son. I had postpartum depression and they put me in a facility for three days. And after that I do believe my children helped somewhat was my depression because I was more focused on raising them. But I still struggled with concentration, feeling inadequate, feeling unaccomplished. I was put on several different medications I’ve been going to counseling off and on for the past 30 years. That’s a long time. 

I’ve always been the one to help everybody and here I am 53 years old and I feel like I have nothing to show for it. I’ve been hospitalized at least four times and still did not figure out what was wrong with me. Never got a diagnosis or anything. It wasn’t ‘till 10 years ago, I got the diagnosis of Bipolar Two and then it changed to Bipolar One and then depression and anxiety. 

Stephanie Moore 

Wow. So now that you see that you’ve been diagnosed with first Bipolar Two and then Bipolar one, anxiety, and depression…what were some of your initial thoughts and reactions to receiving those diagnoses? 

Crystal Smith says she been going to counseling off and on for the past 30 years. (Photo courtesy of Smith)

Crystal Smith 

I finally know what’s wrong with me. With the manic episodes, I’d find myself…A lot of energy. A lot of ideas going on at one time. 

Wanting to do a lot of different things and I was getting a lot of things done.

I dream about the things that I want to get done and I was just happy and just just just full and I’d crash.

My manic would only last two, two days maybe. But my depression part would last weeks. So now I can recognize now wait a minute now am I being manic, or am I really happy?

Stephanie Moore 

Yeah, I can resonate with that heavily because for me during undergrad, that was when I was first hospitalized for about a couple of days myself. And my depression started, I want to say 2016. And that’s when I started counseling. And for me, it was a roller coaster of trying to figure out like, “What is it? Is it anxiety? Is it depression? Is it ADHD? Is bipolar disorder?” 

And they had diagnosed me with bipolar, and I started taking Seroquel. And for some reason, it was like, once they put me on that medication, things got severely worse and that’s what led to me being hospitalized. All for them to say it was a misdiagnosis. 

But I was feeling some of the same symptoms of manic episodes. I felt a euphoric feeling. I felt like it was like I was on a high. I was able to knock out assignments for class, I was up at like two, three o’clock in the morning, I had so much motivation. So much life. And of course following that, that’s when my depression hit. And when it hit, it hit hard. It felt like a huge weight on my back, my shoulders, my mind. My entire being. 

There were so many different days where I couldn’t go to class, just because I couldn’t even scrape myself out the bed. There were days where, you know, I was in class physically, but mentally, I…everything just sounds monotone. I’m not really hearing or resonating with anything I’m retaining in class. 

So you know, there were a lot of different questions I had for my psychiatrist and for my counselor. And honestly, that part in itself is mentally tasking. On top of trying to figure out my own mental health. So I definitely resonate with that. 

So, I do want to follow up on just asking. As you said, this has been something that’s been ongoing for 30 years or so. So what have been some of the agitations when it comes to counseling over the years?

Crystal Smith 

Well I started in North Carolina and the model in North Carolina, at least it was one-on-one, but you had interns. So my frustration was getting to know someone, and then six weeks later you had to start over with somebody else. 

With counseling, I became their counselor. They look forward to talking to me because I made them laugh. Basically, I was their relief. I wasn’t getting anything out of it, they were actually getting something out of talking to me. Because I’ve been everybody’s counselor. 

Stephanie Moore 

Yes, they’re receiving more of the therapy than you were.

Crystal Smith 

Yes, exactly. 

The counseling that I am going through now, Virginia has changed its model. And it’s group counseling, which I really didn’t want to do. But it’s the only thing that’s available. And this group is not doing it for me. There’s really no structure. Everybody’s just nilly willy talking about their flowers in the garden, or goats, or whatever. 

Stephanie Moore 

It’s not helpful for you. It’s not getting to any, any root problems. 

And also for me, it’s been especially hard to find a Black therapist because all of my counselors have been white. And I can honestly say that they’re just talking to them about my life as a Black person, as a Black woman. It does not resonate, it does not come across as they understand the Black experience.

So for you and your counselors, have they been predominantly white? Or have you had any Black therapists?

Stephanie Moore says she got help for depression and started counseling in 2016. (Photo courtesy of Moore)

Crystal Smith 

I haven’t had any Black therapists. I live in an area where I’m the only Black female.

I grew up in the Catholic faith. So there’s not that many Black Catholics in the South. I’m from Rock Hill, South Carolina.

I went to Catholic school. And of course, it was maybe from grades one to six…there might have been ten Black people. And when I went to regular school, public school, I was scared out of my mind, I’d never seen that many Black people in my life. 

And I know that’s sad to say but, I had never seen that many Black people. And I have never seen people act the way that they did, you know. I got picked on for the clothes that I wore, my hair was long and thick and they thought I had on the wig. And it was awful.

Stephanie Moore 

That was a little bit of my experience growing up because my dad is retired Air Force. And you know, a lot of times we had to move, but a lot of the areas that we lived in and the schools that I went to were predominantly white or they were diverse. So the only time that it was kind of like a culture shock within my own culture was when I went to charter school in DC. Going to charter school, it was nothing but Black kids. It was a shock for me because I was very quiet. I was reserved. I definitely had those people that told me that I talk white or that I was proper. 

I definitely had a range of being picked on or being, you know, told, “Oh, you think you’re better than everyone.” But that was never the case.

So it kind of felt like I had to dim my light a lot as a child or even growing up just for the sake of, you know, I don’t want to seem like I’m being arrogant or I’m being cocky. 

So, the next question I have is, you know, what has been your family’s relationship to your mental health journey? Because I know you mentioned too, that you come from the Catholic faith. So what has been that relationship with your mental health in your family?

Crystal Smith 

Well, first of all, Black people don’t talk about their business. We don’t go to the white folk and tell them what was going on. What goes on in the house stays in the house. And count your blessings. How can you say you’re Christian and be depressed?

Stephanie Moore 


Crystal Smith 

So there’s a lot of guilt associated with it. Because I was a good girl. I was doing everything I was supposed to be doing. But I was still depressed. And my mother didn’t believe in depression. She said everybody has a bad day. Get over it. 

I finally got my mama, 75 years old now. She is on Zoloft. 

She was having chest pains and she was having this and she was having that I said, mama, you’re depressed. You need to talk to the doctor about getting you on some anti-depressant. 

She just lost a brother. She’s the last one in the family. And she was feeling down and didn’t realize it. And now she’ll call me, she says, “Have you taken your happy pill?” because we’re both on Zoloft. 

So, she understands depression now. Now she’s not gonna go to counseling. But she understands depression now. Which it took her all this time, because I was always told I was lazy and I couldn’t concentrate in school. 

Access to Black therapists, who already understand some of the traumas of Black life, is often difficult to find in some communities. (iStock photo/Getty Images Plus)

With this diagnosis, I’m actually trying to recognize a lot of things that goes on day to day with me. 

I’m sitting here waiting on disability. I felt like you know I need a job. I need a job and then someone said, “Slow down…are you in manic mode? Or do you really want a job?” 

So, I had to talk with my husband because I’ve been feeling inadequate not being able to contribute to the household. It’s been seven months since I’ve had a job. He said, “Don’t you think we’re doing all right?”

I said, “But you have to do everything…you have to buy my medicine.” 

He said, “Baby, maybe one day you’ll have to do it for me.”

So that dispelled that hurry-up-need for a job because I’m always wondering what other people are thinking instead of coming out and asking, “Hey how do you feel about such and such?” 

Stephanie Moore 

And you also have to think too, like you said earlier, you’ve always been there for other people and it’s time now for other people to be there for you. 

So as you mentioned earlier, you know, you said you’re the only Black woman in the community that you’re in right now. And you see the disparities of how it is to have access to care. As it pertains to your mental health, what are your thoughts on how America handles mental health when it comes to Black women, but also Black people as a whole?

Crystal Smith 

Well, it’s not an open gambit, because we don’t express the need. So nobody’s looking at us, as that niche to even come for. 

Stephanie Moore 

That’s so true. I feel there is a strong population within the Black community where, like you said earlier, a lot of times, we hide ourselves behind religion. And we hide ourselves behind these, quote, unquote, traditional ways of, of generational raising and living. “What happens in this house stays in this house.” You know, like you said earlier, “Everyone has a bad day, just get over it, you’ll feel better tomorrow.” Tomorrow comes and I’m still feeling the same way or for some people, tomorrow never comes because you didn’t listen. 

And a lot of people feel like, you can just pray your way out of depression and pray your way out of situations. But, you know, to me, that’s, that’s living in ignorance, in the sense of prayer cannot always solve what is an imbalance in our mind or our bodies. You know, when we have doctors, we have therapists, we have psychiatrists for a reason.

So as we close out, the last question that I have for you is, do you have any advice for those who are navigating their mental health right now? Or who may feel like they need just some words of encouragement, as you think about your own journey and what you have learned? 

Crystal Smith 

Fight for yourself. Fight for yourself. Mental health is not going anywhere. You’re going to have to learn to deal with it. Find out what, what your diagnosis is. Do your research. And take your medicine.

Stephanie Moore 


Thank you so, so much, Crystal. This has been a beautiful conversation. I truly appreciate it.

If you, or someone you know, is having a challenging time, please visit

For iPondr, I’m Stephanie Moore. 

Audio story edited and co-produced by Annie Sinsabaugh

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Episode Mental health disparities in Black communities