Check Your Bias: Dr. La Keita Carter Answers Our Audiences Most Pressing Mental Health Questions
Photo by Annie Spratt on Unsplash
It was a whirlwind to discover I had Major Depressive Disorder (MDD). From struggling with depression and anxiety without help for what felt like ages, it felt good to have a name for it. In 2021, I was put on Lexapro by my Primary Care Physician (PCP) and instructed to see a therapist regularly. After a year on this regimen, I wanted to learn more about MDD.
Not only was I having problems managing it, but the medication part seemed to be very yay or nay. To understand what to do and what not to do when it comes to approaching your mental health—I decided to ask a psychologist. Dr. La Keita Carter is a Black licensed psychologist based in Maryland. She has a good understanding of mental health disorders and how living in a capitalistic society can feed those disorders.
Dr. Carter explained that depression is one of the most common mental health disorders out there, and therefore training includes a lot of symptoms connected to MDD. For the Q&A, I gathered questions from myself and my followers on social media to learn more about mental wellness and how we can find support in a society that values capitalism over people.
What can MDD be mistaken for?
MDD can be mistaken for a few things. One is anxiety. For example, social withdrawal is a symptom of both anxiety and depression. Somebody withdrawn could be depressed, but they could also just be so anxious in a social setting that they are not interested in putting themselves in social situations.
So they just withdraw. Trauma can be mistaken for depression. And vice versa. Hypervigilance, nightmares, or flashbacks can sometimes be part of depression. You see it differently in children. Sometimes conduct disorder can be disguised as depression.
As a professional, I like to do a complete diagnostic evaluation before labeling people because those labels matter. There are quite a few mental health disorders that can be mistaken for depression, or depressive symptoms can be misleading and lead you to a diagnosis of depression when it could be a diagnosis of something else.
Do you recommend going directly to a psychiatrist or your Primary Care Physician for concerns regarding your mental health?
The most important thing is getting treatment, no matter how you approach it. Our primary care physicians are usually people we trust because we have relationships with them. And they're also people that we see as well connected.
When I see primary care physicians prescribing psychotropic medications, I cringe a bit. This is because they may not have the specialized training required to understand the complexities of the brain.
One is that you really want an expert to look at it. Just like you don't want your dentist prescribing heart medicine, you don't want to go to someone who doesn't know much about the brain. One reason is that they’re not dealing with someone who does this every day. That's the specialist. It's someone who's knee-deep in their field. They can pick up on things quicker and therefore, it can be diagnosed more accurately.
Another concern is that if you specialize in something, you know the most efficient way to get the job done. Patients can struggle with stacks of drugs being thrown at them to see which ones work.
Psychiatrists are trained to make more educated guesses about the brain than other doctors. This does not mean that these other doctors are useless or not needed. But I've seen that people have a lot less trouble figuring out what's right for them when they go straight to a specialist.
I would say starting with your PCP is a good route. And most great PCPs will say, “I'm going to give you 30 days of [blank] Zoloft, for example, it's a pretty commonly used drug for depression. In 30 days, I need you to get in with a specialist I'm not going to keep prescribing this for you because you need an assessment. I'm going off of the symptoms that you're sharing. You do need a full assessment, and a specialist will be able to do that.”
Who is at most risk for depression in the Black community? (Including women, children, LGBTQIA+, men)
It's not easy to answer because women certainly have their own life experiences that can trigger depressive symptoms, but so do nonbinary people...and children too. When we talk about these marginalized groups within marginalized groups, we are talking about layers of powerlessness, layers of inequality, layers of oppression within the system, at the individual level, and the smaller community level. Your genes can make some people more at risk than others.
We know that poverty, such as living in an area with food deserts, combined with crime-ridden neighborhoods that are perpetually disrupted at night, can make this community at high risk for psychosis. There is research showing that constant nighttime disturbances like sirens interfere with sleep and actually affect performance. There are many studies on how air quality affects our lungs, but also how it affects our mental health.
Do you believe that capitalism plays a role in our mental health struggles, particularly with the rise in the cost of food without the increase in wages?
Yes, I believe that money underlies everything in this country. Even the good we do comes with some kind of benefit. For example, the interests of the non-profits we want to support. Their purpose is to make money, and how they spend it is certainly different from private companies. But their goal is to raise money, which will be used for payments, benefits, office space, and whatever else the team needs to function. Everything is thought of with money in mind because profit is at the core of a capitalist society.
Running off of that, in terms of someone like myself trying to function in society, if there was a moment where capitalism was just completely eradicated, and everybody got all of the resources that they needed, would mental health issues still exist?
Absolutely. Because there is a genetic component to mental health. So your genes or your genes, you get them honestly. And just because money is not a factor doesn't mean that you don't still have experiences that create dysfunction in your life.
Do you believe that finding the right psychologist or therapist provider of any type can either heavily influence how you improve or regress?
Absolutely. I like to tell people that finding a mental health provider is like finding a pair of jeans. Some people can go to the store and pick out a pair and they are a perfect fit. Other people have to go to 8 different stores or shop online to find their fit.
The same goes for choosing a therapist. The difference between therapists and other doctors is the intimacy of the relationship. You go to your OB/GYN once a year and get very intimate with you to make sure your cervix and uterus are okay. However, that is only once a year.
Therapists know things our best friends, mothers, sisters, and brothers don't know about us. And that's why fit matters. The therapist's style is important, as are location and availability. How do they understand you and what is your communication style? All are important in finding the right treatment.
What are some ways people with mental health conditions can find support from their friends, families, and even their jobs? Especially when the HR department isn’t really looking out for them, but for what is best for the company.
We have to fight through the stigma. You don't want to be seen as something you're not don't want to be seen as crazy because you are struggling. Because everybody struggles in their lives. So I would say that we can't just you know, say “push the stigma to the side” we have to fight through it. And some of us aren't up for that fight. And that makes sense. It's a tiring fight.
You must advocate for yourself. And sometimes you have to advocate for yourself with people who love you dearly because they don't understand. They don't understand the headspace that you keep and they don't really have to understand to support you.
It is important to advocate for yourself. Make people see how ridiculous it is for them not to recognize having a kidney disease is just as serious as having a mental illness. It is important to keep in mind that disease processes happen in our bodies, it is just a function of having a human body. Where that disease occurs is different for everyone.
So how should someone go about finding a psychologist to match with them? I know that it like takes time. But how long should someone continue sessions before they're like this is not a good fit?
Well, I think in some ways, you can use your diagnostic interview and ask questions, right? Because the providers are there to ask you questions to figure out what's going on. But you're also there to find out you know about that provider? And certainly, you don't want to ask personal questions that have nothing to do with your treatment. But you can ask questions like, what kind of therapy techniques do you use to treat whatever it is you think I have? How much experience do you have treating the LGBTQ+ community or people who identify as Caribbean American? How much experience do you have with people treating people my age? You can ask those cultural identity questions.
In what ways can our community support each other in our mental health struggles? For example, sometimes I don't have the energy to emotionally support others. And my friends may have the energy to support me in ways that I can’t support myself and vice versa. We kind of balance each other out. But I noticed that particular people in my family don't reciprocate that. There’s no balance there. I would just like to know, in what ways can we do more to support each other?
I think you need to find out where your own prejudices lie so you don't inadvertently convey harm in your words. To help each other, we must examine our own biases around mental health. You don’t have to understand what someone is going through to support them.
Tell the person who is struggling: "I don't know how to support you, but I'm willing to learn. I don't want you to do the emotional work to teach me. But I don't want to harm you by going in without a guide. I will do some research and read on to see how I can support you. And I will try some things. However, they may not work for you. So be honest and tell me this doesn't help. And please trust me to take this feedback and try something different."
Compassion is an important part of this, and you can certainly communicate your desires even if you don't have the will or ability to do so. Let the person know how you can show up and support them. Or tell them you can't. Be honest and compassionate about what you can and can't do.
Is there anything else that you would like to say to anyone struggling with mental health?
If you are suffering from mental health symptoms and want to be tested, plan early because there is a long waiting list. Make the appointment now, because they could not have something free until three-six months later. If you think you have symptoms you want to check, then you have that appointment waiting for you.
If you find yourself saying, “I don't think I have any serious mental health issues, and this was just a normal up and down.” you can just cancel the appointment. Most people can cancel for free if you cancel 24 or 48 hours in advance. But if you find that you do need that appointment, then you know it’s there waiting for you.
Dr. Carter told me that research shows, it takes the average person ten years before seeking treatment. That's a long time to suffer and drift on the verge of drowning. This comment made me realize that I had been fighting to swim for a very long time, and it was that final wave that pushed me to seek help. Some people could be under the impression that you just have to sink or swim, but the point is to find a place to rest.
One of the biggest lessons learned from this interview is that you don't have to understand to support someone. You don’t have to be depressed to help someone with depression. First, understand that your words can be harmful and that your actions may be discriminative towards a group of people.
You need to work out those biases so that you can help someone without causing harm. Second, mental health is just as important as any other issue on the body. It should be treated with the same level of care and compassion. What other things do you want people to know about your mental health struggles?
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