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Social Media Is Making Racial Trauma Worse. The DSM Needs an Update.

Demonstrators hug during a march in response to George Floyd’s death on June 2, 2020 in Los Angeles, California.

Brent Stirton/Getty Images

I don’t know if my anxiety disorder began before or after a police officer shouted “Keep your hands where I can see them!” as he pulled alongside my parked car.

I only know that the following months were filled with sleepless nights, including many spent replaying every sound from the incident: the whoop of the siren—shrieking as it spun in red flashes; the slam of the police car door as the officer approached my window; and the bark of his criminalizing question, “What are you doing in this neighborhood?”

Just when I thought my restless routine was done after so many weeks, I’d close my eyes and see four angry furrows etched into the officer’s forehead. Then, I’d feel sweat drip down mine as I recalled the way his fingers trailed his belt—inching closer to his pistol grip as he waited for my trembling reply: “I live here, officer. I live right across the street.”

By the time I watched George Floyd shout “Momma!” as the suffocating knee of a Minneapolis police officer dug into his neck, I was well aware of why some days I couldn’t sleep through the night, or I didn’t want to leave bed, or I’d lost my appetite, or I couldn’t focus at work, or I felt a stabbing pain in my stomach every time I scrolled through Twitter.

To many Americans, news of Floyd’s death simply marked another viral police killing—tragic, but like most trending topics, fleeting and inconsequential. But for me, and black people across the United States, every tweet, headline, and image sharing news of Floyd’s murder builds into a daily deluge of trauma—flooding our psyche, leaving us afraid to drown.

I’ve felt this pain each of the several times I’ve been racially profiled by the police. And more commonly, I’ve felt it with each traumatic post I’ve read about Floyd, Breonna Taylor, Ahmaud Arbery, David McAtee, and other innocent black people who lost their lives at the hands of the police.

This familiar pain is a symptom of black people’s shared posttraumatic stress disorder—a uniquely American epidemic, 400 years in the making. And as viral police killings force black Americans to repeatedly endure secondary trauma—or the emotional stress that results from witnessing the trauma of others—this country must reckon with not just its policing crisis, but also the hidden cost: the unjust spread of a black American stress disorder that is undiagnosed, untreated, and—in the age of social media—ubiquitously spread.

While secondary racial trauma is still a nascent research topic, firsthand experiences with racism have long been proven to cause higher rates of PTSD for people of color as compared to white people. It should come as no surprise that black people, who are the most likely victims of police violence and hate crimes in America, are also most likely to live with this mental illness.

Following Michael Brown’s death, researchers began surveying Americans to understand the national impact of viral police killings, and proved their measurable impact on the black American psyche. According to one 2018 study in the Lancet, about half of the black Americans surveyed had been exposed to one or more police killing of an unarmed black person in their state in the previous three months. According to this research, black Americans are exposed to two additional poor mental health days each year due to this police violence. That is 55 million poor mental health days per year collectively, not far from the mental health impact of chronic diseases like diabetes. Conversely, white survey respondents experienced no discernible mental health impact after being exposed to news of unarmed black people killed by police officers.

While white Americans can typically endure news of police brutality unscathed, black Americans are forced to tend to wounds many of their co-workers or friends may never see, including those that grow to become anxiousness or depression.

The wounds you cannot see are always the slowest to heal. And in this case, they reopen every time black Americans learn of one of the hundreds of black people killed by police each year—many of whom are memorialized as trending topics across Twitter, Instagram, and Facebook, transforming social media into a boundless source of secondary traumatic stress.

“We already know that engaging in social media, whether it’s race related or not, yields higher rates of depression and anxiety,” Riana Anderson, a professor at the University of Michigan who focuses on black mental health, told me. “This is especially true for black children, who face far more discrimination than other young people on the Internet.”

Anderson described research released earlier this year showing that black adolescents experience discrimination five times every day—compounding the secondary trauma of seeing innocent black people die on film. When I asked Anderson how black people across ages should care for their mental health following a death as widely broadcast as Floyd’s, her advice was simple: “Stay away from social media.” She continued: “We’re at war right now. And just like in war, your body must do what it can to protect itself from the environment. Survival is the goal, so you must focus on being psychologically well.”

While millions of traumatic headlines, images, and videos fill social media feeds each minute, the American Psychiatric Association has yet to qualify such distressing content as a diagnosable cause of PTSD. According to the APA’s fifth Diagnostic and Statistical Manual of Mental Disorders , the effective bible of psychiatric diagnoses, secondary trauma as caused by electronic media shared outside of the workplace is not a sufficient determinant of PTSD. But many black psychiatrists across the country are demanding that social media’s endless deluge of brutalized black bodies be taken into account.

“Such a stipulation just doesn’t make sense for the black experience in America” said Danielle Hairston, a psychiatrist at Howard University and the president of the APA’s Black Caucus. Hairston compared media-based distress to witnessing loss in your own family. “If every day, you’re seeing a video of someone who looks like you—someone who could be you or your family member—murdered or beaten, what’s the difference between that and you experiencing it in your own family?”

Since 2015, Hairston and her colleagues have urged an update to DSM-5 that recognizes such traumatic media exposure, and called for cultural sensitive treatment for media-based re-traumatization. She has also encouraged the provision of community resources for patients following viral police brutality, supports that rarely reach black communities—even for the black adults who are diagnosed with a mental illness, only 30 percent receive treatment compared to 49 percent of white Americans.

All corners of society should be identifying ways to equitably bolster the mental health of black people right now. Company leaders should offer paid time off for their black employees, and if possible, offer free or subsidized counseling for them and their families. Schools, whether they serve young children or adults, should create spaces for black students to gain mental health support and treatment.

Without treatment, the anxiety and depression born from PTSD risks transforming into anger, sometimes righteous and useful and sometimes not. As James Baldwin put it in words that have in recent weeks—like the images of George Floyd’s murder—spread across Instagram, Twitter, and Facebook: “to be a Negro in this country and to be relatively conscious, is to be in a rage almost all the time.”

Those who tweet or post Baldwin’s quote often omit the following critical sentence of the passage. The challenge of that anger is  “how to control that rage so that it won’t destroy you.”

Baldwin’s sagely reflection on rage is meaningless without his subsequent call for self-preservation. In the war against racial injustice, our mental health is our greatest armor. If we want to do good, we must be well.

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