A new study indicates the belief that Black women are naturally strong and selfless is associated with higher levels of depressive symptoms in African American women in the U.S.

Published in Sex Roles, the study highlights the link between depression and the concept of a “Strong Black Woman” as a inhibition of self-expression. Study author Jasmine Abrams, an assistant professor at the University of Maryland, Baltimore County, says she’s been observing the gender roles of Black women and personally interviewing many who inadvertently linked stress and depression with the desire to attempt to fit the identity.

“When we were conducting focus group discussions, many women mentioned being Strong Black Women or looking up to Strong Black Women (in the form of mothers, grandmothers, aunts, friends, celebrities, etc.). What struck me about the discussions was how women discussed embodying this role – it was simultaneously discussed as aspirational and overwhelming,” Abrams, who is also an affiliate professor at the Yale University School of Public Health, told PsyPost.

“Women spoke about how being strong helped their ancestors survive enslavement and Jim Crow and how it helps them navigate present day oppression and personal challenges. In the same breath they mentioned that the expectation of strength meant self-reliance, independence, and being overworked in service of others,” she further explained. “I immediately thought about implications for physical and mental health and decided to design and conduct a new study to determine if women’s identification with being Strong Black women was related to depression symptoms and if so why.”

194 participated in the study, all of whom identified as “Strong Black Women.” Participants who agreed with statements such as “Black women have to be strong to survive” also tended to agree with statements like “In a close relationship, my responsibility is to make the other person happy” and “I rarely express my anger at those close to me,” leading to depressive symptoms and stress.

“Being a ‘Strong Black Woman’ has many benefits — but these benefits can, at times, come at an expense. The benefits are that that the cultural ideal helps women to cope with challenging circumstances, helps ensure survival of families/communities, and makes women feel connected to their culture,” Abrams relayed to the website. “On the other hand, being a ‘Strong Black Woman’ can be related to increased stress and maladaptive coping that can result in depression symptoms. Specifically, the ‘self silencing’ aspect (e.g., holding in negative emotions, pretending to be happy or okay when you are really not) is a pathway from strength to depression.”

Abrams also noted that 20 percent of the participants in her study did not identify specifically as “Strong Black Women” and the results of her study are not relevant to all African American women. The study was authored by Jasmine A. Abrams, Ashley Hill, and Morgan Maxwell.