puberty at an earlier age are more likely to be exposed to trauma, stress, and bullying, which can cause disruptions in cortisol and the hypothalamic-pituitary-adrenal axis, placing them at higher risk for the development of depressive disorders,” says Dzirasa.
African-American women may be at special risk. Data from the Pediatric Research in Office Settings, the National Health and Nutrition Examination Survey, and the Bogalusa Heart Study all show that African-American girls start menstruating earlier than their white counterparts – anywhere from a few months to almost a year sooner. As a result, according to Dzirasa, these women may also be at higher risk for developing depression.
“We know that African-American girls and young adults are less likely to be diagnosed or treated for psychiatric conditions due to factors such as stigma, lower access to resources, provider/diagnostic biases and other implicit biases,” explains Dzirasa. “This is why it is imperative for primary care providers to screen all girls, regardless of race or socioeconomic status, for such conditions.”
Overall, only 25 percent of African-Americans seek mental health care compared to 40 percent of whites, according to the National Alliance on Mental Illness, the disparity thought to be due to distrust and lower socioeconomic status. Snell’s experience was similar.
“I heavily frowned on speaking openly about my depression to doctors or therapists until my early twenties,” says Snell. “Back then, I conformed to the stereotype that black people don’t trust doctors and certainly don’t talk to therapists about your mental health issues. I told my gynecologist that I ‘felt off’ when I was 16 years old, but she never asked any further questions.”
Dzirasa says early puberty also predisposes girls to other influences that affect their mental health.
“I have found that females who have an earlier onset of puberty tend to be treated as though they are older than their peers, and they are also faced with higher expectations without