Anxiety Therapy for BIPOC: Addressing Mental Health Needs

Anxiety is the most common mental health diagnosis. It typically shows up as a feeling of anticipation about future concerns, muscle tension and avoidance. Anxiety occurs among Black, Indigenous, Latine, Asian, Multiracial/Multicultural, People of Color (also referred to as BIPOC). Our experiences of anxiety are largely exacerbated by social and systemic factors. For example, systemic racism puts our BIPOC community members at higher risk for anxiety disorders relative to White people, according to published research by Doctoral Student M. Macintyre and colleagues. Early in the COVID-19 pandemic, BIPOC individuals were also more likely to report high levels of anxiety. Many of us continue to live with anxiety in the midst of navigating continued social unrest, systemic oppression and uncertainty. Specialized anxiety therapy for BIPOC that understands our experiences and honors us can help manage anxiety.

Research shows that Black Americans, especially Black women, are at higher risk for anxiety and depression compared to White Americans. Age also plays a factor. Younger Black women are more likely to have more severe anxiety than older Black women, according to a recent article by Dr McCall and colleagues. Latinx Americans, Indigenous/Native Americans, and Asian Americans also experience high levels of anxiety and other mental health disorders. These are influenced by experiences like acculturation stress, fear and systemic oppression, colonization, historical and present trauma. Anxiety can also be related to acculturation pressures, family expectations, identity struggles and a lack of belonging among BIPOC teens and young adults.

Our BIPOC communities face significant challenges to care. Intentional and culturally thoughtful interventions by providers who understand our experiences can address some of these barriers.

Challenges Faced by BIPOC with Anxiety

Stigma: A Barrier to Accessing Therapy

Stigma, or negative and unfair beliefs from society and groups of people, prevents accessing therapy and mental health help. It can discourage us from seeking or considering treatment. We may also avoid voicing our needs and challenges with our support people due to fear of judgment. Unfortunately, this stigma can compound our pain and make it feel more difficult to get the help needed.

Mental health providers who mirror racial/ethnic and other intersecting identities may empathically understand of our experiences, relationships and worldviews. This type of connection can challenge stigma, including internalized stigma, and create healing interactions that benefit our mental health.

Effects of Systemic Racism on Mental Health

Experiencing racism, discrimination, microaggressions and racial trauma contribute to high levels of stress, anxiety, and a greater likelihood for disordered eating among BIPOC.

Experiencing racial profiling, police violence, discrimination and racism can contribute to anxiety. Similarly, concerns about the likelihood of these harmful and hurtful experiences can, understandably, be topics of our anxiety. This, and other experiences of chronic stress, can contribute to a higher risk for experiencing mental health issues.

Biases from healthcare providers can hinder seeing our mental health distress. The historically oppressive structures in these systems also affect understanding and sensitively responding to our needs. As a result, BIPOC with anxiety are less likely to be formally diagnosed, guided towards anxiety therapy or other supports.

Importance of Culturally Sensitive Anxiety Therapy

Culturally sensitive therapy is vital for addressing our anxiety symptoms, and the unique cultural, social and systemic factors that contribute. Through culturally sensitive therapy, we can access greater mental health, improved quality of life, and connection with our cultural identities and strengths. Many clients describe this as a process where they learn to partner with themselves, live in alignment with who they are and their values, while tending to their needs. Greater understanding, self-advocacy, and self-compassion arise when we work with ourselves, instead of against.

Culturally sensitive therapy offers several advantages in treating anxiety. A culturally sensitive therapist will intentionally seek to understand your cultural context, co-create a safe space to reduce mental health stigma, and address racial and cultural stresses in your life. Processing trauma, historical injustices harming you and your community, and adopting additional coping strategies may be discussed. Additionally, strengthening connections with social supports, improving how you relate to yourself and advocacy can also be topics of therapy.

Benefits of Anxiety Therapy for our BIPOC Communities

Through culturally sensitive therapy, you have the opportunity to work with a mental health professional or treatment provider who understands the specific challenges we face as BIPOC with anxiety. You’ll have the chance to co-create a space to safely unpack and breakdown the heaviness of experiencing anxiety in a world of systemic racism, racial discrimination, microaggression and interactions that minimize our humanity. Therapy can be a place to normalize conversations about mental health and expand our support networks.

Many therapists teach techniques as coping strategies for reducing and managing anxiety. These can include skills like awareness of patterns, mindfulness, deep breathing and relaxation practices. For spiritual individuals, skills may include meditating on a phrase, connecting with a higher or spiritual power, or practicing gratitude. These and other anxiety management tools can be resources for responding to difficult situations and minimizing the likelihood of overwhelm.

Therapists also help identify and regulate emotions. Experiencing chronic stress, racial trauma, high levels of acculturative stress and societal pressures may push us outside of our window of tolerance. Knowing and using emotion regulation skills can help us. Supportive loved ones can also bring us back to our internal wealth of resources for getting through these challenging moments. Emotional regulation can also enhance well-being and challenging social situations.

Effective Therapeutic Approaches for BIPOC with Anxiety

Relational & Community-Centered Therapy

Anxiety often pulls us away from the present moment and our relationships. Social support is a vital factor in managing anxiety. Therapy focused on (re)building relationships and strengthening community connections can help us feel less isolated and overwhelmed when anxiety arises. Through relational and community-centered therapy, we learn to identify and advocate for relational patterns that better support us in our times of need. Relational therapy can also decrease anxiety triggers as we, and our loved ones, practice new ways of relating. Improved communication and emotional expression can strengthen our support networks with family, friends, romantic partners and loved ones.

Relational therapy is customized to address our experiences and challenges. It incorporates the strengths we bring to the healing journey as individuals, family, and community members. Extended family and community members can be valuable assets in our healing journeys. For some, relational therapy may incorporate loving statements previously offered by ancestors and mentors. For others, maybe it includes comforting looks from pets, movement, and sounds found in nature. Over time, these may become part of supportive self-talk and soothing actions we adopt for managing periods of heightened anxiety.

Incorporating Cultural Practices in BIPOC Anxiety Therapy

Incorporating cultural practices in alignment with an individual’s beliefs and values can benefit anxiety therapy, enhancing the relevance and effectiveness of therapy. This cultural attunement can foster connection and trust between you and your therapist, and improve the therapeutic process. Weaving client’s cultural practices, values, beliefs and traditions into therapy in a respectful and consensual way can facilitate clients feeling seen, heard and understood.

Therapy is most effective when a therapist understands the client’s cultural practices and how cultural factors influence anxiety. This includes exploring cultural norms around emotions, what support looks like within relationships, views about mental health. Coping mechanisms, our worldviews and responses to anxiety are both culturally informed and reflective. Therapists might also ask about specific cultural practices, like meditation, prayer, rituals, community support systems and activities that we value.

Body and physical practices, such as movement through yoga, tai chi, qi gong, acupuncture, and breathing exercises, may be culturally relevant healing practices. Some therapists may collaborate with traditional, contemporary or alternative healers to offer a more integrated approach to managing anxiety.

Group Therapy and Peer Support for BIPOC with Anxiety

Group therapy can be a valuable treatment option to share and address common experiences of anxiety and mental health challenges. These settings offer professional guidance and a sense of community, validation and understanding from interacting with peers navigating anxiety. Group therapy is often available in community centers, non-profit organizations, clinics and can be more cost-effective than individual therapy. In some groups, peers may share similar cultural, social and personal experiences.

The opportunity to discuss stresses and anxiety triggers within an understanding and validating collective can be incredibly healing and empowering. Group therapy members can offer empathy, encouragement, and perspectives from similar and diverse lived experiences. This can foster a deeper sense of connection and community. The collective openness of group therapy can also create an atmosphere of acceptance and mutual respect, break down stigma and reduce shame about seeking anxiety and mental health help. Group therapy can also foster accountability. Peers support one another in setting goals, making progress and actively engaging in the therapeutic process.

Psychoeducation and Personal Agency

Many BIPOC with anxiety and other mental health conditions have learned to minimize or silence our voices in response to discrimination, societal oppression and interactions that have disregarded our humanity. Therapy can be a supportive environment for developing assertiveness and self-advocacy skills, empowering us to express our needs and wants. We and our loved ones can learn to hear and respond to each other better through therapy.

Discussing the importance of safe and supportive relationships is often a topic of psychoeducation over the course of therapy. Family expectations, cultural norms and unspoken rules may conflict with our experiences of anxiety and create additional stress. Discussing these tensions, managing family dynamics, and navigating family pressures, cultural traditions and expectations can be beneficial.

Anxiety and how we’ve learned to manage it may also be related to past traumas. Intergenerational traumas related to colonization, historical oppression, violence, and compounding present-day traumas can make conversations about emotions difficult. As the silence around these traumas is broken through the course of many psychoeducation and therapy sessions, our mental health outcomes and those of future generations is improved. This type of healing can also open doors for better understanding. With time, we may also have greater compassion and forgiveness for previous generations’ responses (or the lack thereof) to mental health needs.

Overcoming Mental Health Stigma in Our BIPOC Communities

Breaking down mental health stigma in our BIPOC communities is essential for promoting our individual and collective well-being. Present day stigma is largely rooted in the long history of trauma from centuries of slavery, colonialism, and forced assimilation that many BIPOC have experienced, compounded by present day experiences of systemic racism and oppression. Many of these experiences have led to an understandable distrust in institutions, including healthcare, which have abused, mistreated, neglected and overlooked many of the needs of our BIPOC communities.

Seeking Therapy is Not a Sign of Weakness

In the face of multiple layers of trauma, many of our BIPOC communities have normed the idea of silent strength, reliance on ourselves and our communities only, and keeping issues “in the house”. In some respects, these narratives have created some protection in the midst of serious concerns about safety. However, they may also make it difficult to go against the grain and ask for help.

Generational factors can play a role, particularly if our elders’ mental health struggles have repeatedly been disregarded or shamed. Misconceptions that mental health issues are moral failings or personal weaknesses can make seeking therapy or discussing mental health difficult. Mental health struggles are not the fault of an individual. Healing options are available and beneficial.

As we address and dismantle these stigmas, we reduce isolation and shame. We create a healthier, more supportive environment for seeking help and improving our well-being.

Education: Increasing Mental Health Awareness

Mental health care providers, including therapists, counselors, social workers, psychologists and mental health coaches, play an important role in increasing mental health awareness. Seminars, articles, webinars, and media written by healthcare providers can demystify mental health issues, share information about treatment options and ensure that accurate information about mental health is readily available.

As we continue to learn and become educated about mental health issues, including the prevalence of anxiety in BIPOC communities and culturally sensitive therapy options, we are better equipped to engage in conversations and get help for those in need. Sharing our lived experiences of anxiety as BIPOC can have a profound impact on helping others feel less alone. As leaders, we can work within our communities to create culturally relevant mental health programs, community activities, dispel myths about mental health and reduce stigma and shame. We can also lead advocacy and policy efforts to break down barriers to mental health care.