While African Americans suffer from depression at rates similar to the general population, they may express the illness differently and may be less likely to seek help, according to Maryland psychiatrist Marilyn Martin. Martin has written "Saving Our Last Nerve: The Black Woman's Path to Mental Health" (2002, Hilton Publishing) to challenge myths that serve as barriers to treatment among blacks with depression.

How do African Americans experience depression differently from whites?

African Americans may be more likely to suffer somatic symptoms rather than describing feelings or emotions. We might talk about our headaches, chronic back pain or how tired we are. We might describe irritability. We won't say, "I'm depressed," but rather: "I'm stressed" or "I'm on my last nerve."

Why is that?

Because we've been taught to be strong, to endure. In our community, we've got serious stressors, but we feel we don't have time to be depressed or to go see a therapist. Also, there is a feeling that if we don't keep our problems confined to our community -- only talking to each other -- people will say: Oh, so all black people are depressed.

When do African Americans seek treatment then?

We don't come into the mental health center saying, "I want to see a therapist." Instead, we come into the ER through a crisis because we have been trying to hold out, as opposed to getting help.

Is this changing at all?

I think the recent traumas in our society -- Sept. 11, ongoing crime -- are causing us to focus on coping strategies, realizing there will always be traumas in our lives, but that we can do a better job at managing their effect on us. The word is spreading.

-- Suz Redfearn