As protests in Philadelphia over George Floyd’s death at the hands of Minneapolis police continue into the weekend, the emotional trauma that many black people are suffering must be recognized and addressed, mental health experts say.

Racial discrimination has long been linked to negative effects on mental health, and police killings are the most severe example. A 2018 study by researchers at Boston University’s School of Health and the University of Pennsylvania found that police killings of unarmed black Americans were associated with worse mental health among other black Americans. A 2019 study found that when black adolescents are exposed to traumatic events online, such as police killings, they experience more post-traumatic syndrome disorder (PTSD) and depressive symptoms.

Huge public protests, especially when they devolve into violence and looting, are stressful to everyone. But what most white people are feeling at watching the news is far different from what their black neighbors are experiencing, said Marquita Bolden, the executive director of Therapy Center of Philadelphia in Center City.

“In essence, non-black people’s exposure to property damage is a short-term stressor resulting in increased anxiety and possible reduction in sense of safety, which is a valid response,” Bolden said. “Eventually property can be restored, and people are likely to recover from that stress quickly.”

But for black people, Bolden said, “the threat of police violence is a long-term and ongoing stressor.” Watching the violence sends their nervous systems into overdrive due to the real sense of danger they feel.

Over time, this stress “increases the risk of PTSD, depression, anxiety disorders, obesity, diabetes, heart disease, cancer, strokes, and ultimately early death,” she said.

The chronic nature of stress from racial trauma is what makes it different from stress that people have been dealing with due to COVID-19, said John Granger II, a therapist based in Center City. He noted that scientists around the world are working to find a cure for the virus, but the same thing isn’t happening with systemic racism.

“There’s a correlation between perception of control and mental health,” Granger said. “With COVID, you can limit your exposure, wear a mask and gloves and try to interact with fewer people. With racism, you have no control over how you experience it, giving people a higher level of anxiety."

Howard Stevenson, a professor of urban education and Africana studies at the University of Pennsylvania, said that even when black people work with allies, “we underestimate the negative effects of swallowing our feelings during racial moments,” he said. “Research is showing more and more that if we don’t manage racial stress and trauma, it comes out in our health and bodies and sleep.”

On top of this, the black community cannot gather to mourn Floyd due to COVID-19 — a pandemic that disproportionately affects black and brown people — and that makes this experience even more emotionally taxing, said Ebony White, an assistant clinical professor in the counseling and family therapy department at Drexel University’s College of Nursing and Health Professions.

“Black people have a collectivistic culture, which means that we’re communal,” White said. “We not only celebrate but also mourn in community, and that’s been taken away from us.”

The large numbers of people who have turned out at protests doesn’t alleviate that pain, she said, pointing out that no laws have changed since the protests started.

“We’ve been here before,” White said. “Everyone has to at least seem like they’re behind the issue, but a lot of statements are just statements. In regards to actionable stuff, there has not been a lot of that. ... We want to be hopeful that this is different, but it’s not like we haven’t been here.”

She also noted that the black community already deals with a negative stigma on mental health and fewer available resources, making it even harder for people to seek help when they need it.

“It’s hard to trust the system that has let us down for a long time, but if people need support, they should reach out to a black provider,” White said. “Whoever it is for them to get what they’re looking for to feel safe.”

To make progress, Stevenson said, people need to start having hard conversations about race to improve racial literacy — the ability to read, recast, and resolve a racially stressful moment. He said the complication of having these conversations is that it’s stressful for both parties — the people explaining their issues and the people listening. And if the stress isn’t managed properly, then it’s hard to make any sort of progress.

“Black people are tired of having to say stuff people should know,” Stevenson said.

The first step is to figure out what emotions the conversation holder is feeling in the moment and how strong that emotion is, he said. This is called a “progressive revelation” and can be helpful when someone is trying to educate another person on something that is stressful to them.

“It’s one way to read yourself, and if you know that bit of information, you’re way ahead of people,” Stevenson said. “Then you can take a break, step out of the room, and figure out what you need instead of spiraling.”

While many therapists recommended limiting news intake as a way to deal with COVID-19 related stress, White said that likely won’t help much for the black community, even though it’s important to practice self-care in this moment. Instead, she recommended that black communities focus on their resilience.

White also said that connection — in many forms — is an effective tool for healing.

“Black people have not been allowed to feel, so I always encourage them to do a check-in with themselves,” she said. “It’s really difficult to address your emotions if you don’t know what they are. Once you recognize them, allow yourself to feel it instead of pushing it down or hiding it.”

It may also be helpful to lean on loved ones right now, albeit virtually, White said. And she emphasized a connection to the environment, saying that black people have as much right as anybody else to “take up space here.”

Granger said he has been encouraging clients who are feeling a lot of anger to channel that energy into something that aligns with their values, whether it’s protesting or donating to organizations that support causes they believe in.

“I ask them, ‘How do we channel these emotions into something positive?’” he said. “I challenge them to make choices based on their values, to do something that will make it better for the next generation.”