He came to the office in search of help as many patients do, but the circumstances that compelled him to seek medical attention were all too similar to me. I’ve seen it time and again. He said that he couldn’t sleep at one visit. At another, his blood pressure was high.

At a visit after that, he’d share more information, and his wife would attend with him. He wasn’t making enough money and was working long hours. He felt like his wife didn’t understand. Those at his job didn’t understand. His sleep deprivation was so bad that he would only sleep one or two hours at night, and given the extent of this for several months, he started to have seizures as a result.

I interviewed him extensively at each visit, always appreciating his wife for being present when she was to help provide historical facts that he would and could not. I screened him for depression. He was not depressed. I believe he had anxiety, but his GAD-7 results were not entirely convincing. He was conspicuously stressed by life, by work and by occurrences at home. To him, it seemed as if no one could understand just what he had to endure every day to take care of his wife, his daughter, and even his ailing mother.

Those at work with whom he shared his struggles didn’t seem to care that he was working his “behind off for them.” They denied a request for a raise when he asked after years of diligent service. Quite frankly, he felt as if the weight of several worlds — his world and our world — was on his shoulders. It was hard to press through and forward.

I — visit after visit and conversation after conversation — with his wife attempted to reassure, counsel, and provide him with answers and avenues to help attain some degree of reprieve.

“Consider finding another job that would treat you better,” she’d say. “It’s not worth you killing yourself,” I’d add. Yet, she seemed to understand that and, unfortunately, that didn’t appease him.

Those gestures of support didn’t seem to alleviate his burden, cool his fever, and ease his fears. That is what was frightening to me the most. He knew what he had to do, but at the same time felt that he couldn’t do it. He surmised it wouldn’t help enough, because the problems that he dealt with, the societal constructs that made the battles more difficult, would be insufficiently handled by just finding another job.

There was no textbook definition for this kind of anguish that was both debilitating and disheartening for those around the patient to watch. The truth is, I’ve seen it before — time and again — in countless men who look like me who are working hard to take care of their families but feel as if for everything that they are doing right there are countless pressures to combat in the midst of it, and they feel as if they have nowhere to turn.

I imagine it’s like being in a consistently elongating tunnel and seeing the beautiful light at the very end that you are never able to reach.

I don’t really know the diagnostic criteria for “Black Man Syndrome,” but that’s what I call it.

It’s a denotation merely reaped from being the physician of refuge for many black men like me who are faced with pressures in this life that no one else has to face.

The distinct truth is that many of them who are dealing with this in silence consider it to be normal. Therefore, they don’t talk about it. They don’t feel a need to deal with it until something catastrophic happens to their physical persons such as hospitalization, an acute illness, or a mental breakdown, and they are forced to deal with it at that time. It’s an unfortunate truth, but it happens, and it does exist. The mind drives the body.

I do not contend with this piece to disregard the indomitable means of medical experimentation, study, and research in presenting this as I do. This is not a case series. This is not even a case study. I attempt here to share just an observation I’ve noticed of a trend.

The recent suicide of Bryce Gowdy, a Georgia Institute of Technology football recruit who killed himself by walking in front of a train, shows what Black Man Syndrome is and what influences it the most — psychosocial constructs in place that make a young black man feel the need to care about, think about and worry about the needs of the ones he loves all the while existing in a world of oppression.

It comes in various forms and fashions, but that’s the very basis of it. For the black man in America is always struggling to overcome — to overcome an evolving definition of his place and his power, dilemma and quagmire.

If we do not start to recognize the mental pressures due to societal constructs in place that black men face and black men only, then we will be faced with a future full of black men who are dying much too soon, either from committing suicide or dying from organic etiologies brought on by the proverbial practice that we are supposed to employ of “holding it all in.”

I write about this because there is stigma.

We don’t talk about it often until it is much too late—as in the case of Bryce Gowdy. I write about this because we learn via our medical education that the demographic most likely to commit suicide and be successful (which is an adjective I loathe in this context) at it are elderly, white men.

I write about this because it, indeed, hits very close to home. I write about this because I am a black man who, himself, feels the pain and pressure at times of wanting to please everyone, wanting to take care of my family and provide for them, all the while trying to escape the grasp of poverty and the racist specters of the past now lurking around the corner in this present day.

You, all the while, want to do better and be better, but you also feel like the weight of the world is on your shoulders.

More often than not, others just do not understand — even those who are closest to you and love you the most.

I see myself in Bryce Gowdy. I contend every black man does, despite socioeconomic achievement, and is somewhat haunted by what happened to him. If you don’t, you should.

I see myself in Don Cornelius.

I see myself in my late Uncle Kenny.

It’s an interesting dichotomy of sorts that we face. Ours are the faces of strength, fortitude, leadership, and provision, but deep down, we are drowning in the pressure of trying to make everyone happy and asking that question over and over again like Bryce Gowdy reportedly would ask: “Are you alright? Are you OK?”

All the while, we are not alright or OK ourselves because of what we see around us, and we feel somewhat helpless in trying to fix it and everything else. That is the nature of who we are as black men — desiring to care for all and fix everyone else’s problems. However, we must always recognize that before healing others, we must first heal ourselves — mens molem agitat. The mind drives the body.

When there is no one else around to do it or to take control of it, we are made to do it and do it quietly and without recompense. When everyone else declines it, we raise our hands.

When no one else is there to take care of Mama, Daddy, or an ailing loved one, we step in. When no one else has enough money to help, we are compelled to help.

We are the lifeblood of our families, and they need us, but we cannot be all to all and fix everyone’s problems.

A part of being a leader is knowing when to delegate and share responsibility. Oftentimes saying no to something is the answer to everything.

Other times, not being apprehensive about asking for help is the answer.

Everybody’s problem is not everybody’s problem.

We, as black men, must talk about the pressures we face and how those pressures are mentally and physically affecting us.

There is nothing effeminate about that.

There is no weakness in talking about one’s mental health. There is a weakness in not talking about it.

When we are silent, we die, and with our deaths comes a world and generations who are faced with not experiencing or even knowing the strength that we possess and the beauty of all that we offer the world.

Earl Stewart, Jr. is an internal medicine physician in Atlanta, Georgia, a 2023 Doximity Digital Health Fellow, and a 2023 Climate and Health Equity Fellow (CHEF) with the Medical Society Consortium on Climate and Health. He can be reached on E.S.J., M.D., LinkedIn, Twitter @EarlStewartJr, and Doximity.

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