Does Living With Racism Cause Post-Traumatic Stress Disorder?

BIPOC woman crying


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Being Black in America is a psychological trauma with proven physical, emotional, and behavioral consequences.

The negative effects of the organized social system that is racism leads to a mental picture that has much in common with post-traumatic stress disorder (PTSD).

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 for longer life and better health status. However, in studies, racial health disparities are still evident even after adjustment for income and education.

There exists over 30 years of research demonstrating that racism, in and of itself, independent of other factors, is harmful to one’s physical and psychological well-being.

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

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. 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.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), PTSD results from exposure to trauma or feeling under threat of assault. It can also be a product of witnessing violence, particularly if it is happening to someone with whom you feel connected.

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.

The mental health community is accepting a more inclusive idea of what defines trauma based on how it affects the person, instead of a preconceived idea of how big of a deal an incident was.

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.

If you are Black, your Blackness is inescapable and is a part of your daily life. Living with this emotional burden manifests itself as wear and tear and premature aging of the body.

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 hyper-vigilance 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.

Internalized racism can erode a Black person’s perception of themselves. It could contributes to the development of shame, guilt, compromised self-esteem, and depressive symptoms.

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.

This is an exaltation of Whiteness itself, in other words, these images can lay the seeds of prejudice in a child of any race. 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.

A Word From Verywell

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.

4 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Paradies Y, Ben J, Denson N, et al. Racism as a determinant of health: A systematic review and meta-analysisPLoS One. 2015;10(9):e0138511. doi:10.1371/journal.pone.0138511

  3. Trauma-Informed Care in Behavioral Health Services. Treatment Improvement Protocol (TIP) Series, No. 57. Center for Substance Abuse Treatment (US). 2014.

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By Margaret Seide, MD
Margaret Seide, MS, MD, is a board-certified psychiatrist who specializes in the treatment of depression, addiction, and eating disorders.