Does Living With Racism Cause Post-Traumatic Stress Disorder?

Racial stress and trauma is a significant problem for people of color in the United States. Research suggests that post-traumatic stress disorder (PTSD) is more common among BIPOC children and young adults, which has been attributed in part to exposure to racial trauma, race-based stressors, and discrimination.

Racial trauma is similar to PTSD and can lead to a PTSD diagnosis. However, researchers note that it is also a unique experience in that it leads to ongoing individual and collective psychological injuries, resulting in regular exposure and re-exposure to trauma.  

The COVID-19 Pandemic Highlighted Racial Disparity

Minorities and the poor who already lived on the outer edges of what America claims to be were pushed over that edge by the financial and health fallout of the COVID-19 pandemic. This inspired a critical and overdue public discourse about the relationship between race and health.

Conversations about this important issue lump economics and race together, likely because of the over-representation of minorities among the impoverished. However, the health issues that accumulate in marginalized communities such as Black and Indigenous peoples are not solely economic in origin.

Yes, it is true that higher income usually means greater access to medical care and usually predicts a longer life and better health status. However, in studies, racial health disparities are still evident even after adjustment for income and education.

Can Racism Be Measured?

Health markers, such as blood pressure and cortisol levels, have been used to measure the biological and psychological impact of being Black in a race-conscious culture.

The changes that appear to be caused by exposure to racism are the same changes seen in someone who has had exposure to chronic emotional stress, such as a parent caring for a chronically ill child.

The Effects of Racism Contribute to Poor Physical Health

Racism contributes to allostatic load, which is the cumulative effects that chronic stress has on the body and mind. The pattern that emerges is consistent with the weathering theory of race, which describes how exposure to racism causes actual wear and tear on the body.

According to some research, by the time a Black American reaches the age of 45, their body can show indications of wear and tear equivalent to their 60-year-old White counterpart. This is felt to be the direct result of the psychological effects of belonging to a marginalized group.

Racism and PTSD

Living with racism is a chronic stressor which is biologically burdensome and leads to some of the emotional and behavioral changes consistent with PTSD.

Repeated exposure to videos such as the one of George Floyd's murder would be an example of witnessed violence.

PTSD has previously been associated with catastrophic circumstances such as being a war combatant or being a victim of sexual assault. However, PTSD is increasingly being recognized as a potential consequence of other painful life events, such as divorce or living with financial insecurity.

Overlap of Racism and PTSD Symptoms

Psychological symptoms known to result from exposure to racism that overlap with PTSD include depression, anxiety, and negative beliefs about the world and one’s self. The overlap in the effects can also include other indicators of emotional distress, such as decreased life satisfaction, sleep disturbances, and suicidal ideation.

Discrimination can also lead to social withdrawal, difficulty concentrating, as well as anger and irritability, which are also potential symptoms of PTSD. There is now a substantial body of evidence demonstrating that exposure to racism detracts from an individual’s psychological well-being and ends up being toxic on the cellular level.

Of course, this data cannot fully convey the lived experience of being the object of discrimination. It merely validates and acknowledges those experiences and the negative effects of racism as some can be measured.

The Trauma of Living in Constant Fear

The events of 2020 have made race a pressing issue and have made space for Black Americans, particularly men, to come forward with descriptions of what it is like to live with the unrelenting dread of becoming a victim of police brutality.

They describe how it feels to live without the luxurious assumption that they will make it home safely. They detail innumerable slights and offenses and the word "exhaustion" is unavoidable. They also share of having to shatter their children’s innocence with disturbing realities for the sake of their safety.

A constant, looming, inescapable threat such as this would satisfy criteria for being a precipitant of PTSD and its effects. These effects include hypervigilance of one’s surroundings and an impaired ability to form healthy, meaningful bonds with others.

The Effects of Internalized Racism

Particularly debilitating is the internalization of racism by Black people themselves. Black people are consumers of the same media that non-minorities consume. Media content can be rife with the negative imagery that perpetuates the stereotype of the inferiority of Black people.

This lays the groundwork for an unconscious acceptance as truth of the idea of minorities as unintelligent or prone to violence.

Racism and Children

Children may be particularly susceptible feelings of shame and guilt related to their race because their sense of self is still developing.

If you are Black and grew up prior to 1990s, you might have watched movies or read stories (e.g., Cinderella, Snow White, Batman etc). in which the heroic (i.e., good) characters were all White.

Acceptance of the ideas that are the foundation of racism in a Black person is self-stigma, which is associated with a compromised ability to act in one’s own best interest. This can present as self-destructive behaviors such as problematic use of alcohol and poor dietary choices.

Keep in Mind

It is great that concrete, tangible evidence of racism that shows up in numbers such as increased average blood pressure or life span is becoming part of the conversation about race in America.

The conversation about race and health isn't complete without including mention of racism and health. Continuing to carry out measurable research and having open conversations is crucial for progress and forward movement.