Racism and Mental Health: Understanding the Hidden Wounds

I need to tell you something that’s been sitting with me.

A few weeks ago, I was sitting with a Muslim woman in her thirties. She’d come to therapy seeking help for trauma, but here’s what stopped me in my tracks, the trauma she described wasn’t a single event. It was a lifetime of moments. The sideways glances at the airport. The job interviews where she could feel them looking at her hijab instead of her CV. The casual comments from colleagues about “those people” as if she wasn’t standing right there.

She kept asking me: “Is it me? Am I just too sensitive?”

And I remember thinking, no. No, this isn’t about being too sensitive. This is about something much bigger than any of us, something that’s been woven into the fabric of society for centuries. But here’s the thing: even with my psychology training, I didn’t fully understand how to name what she was experiencing. Not really.

Here’s what I want you to understand by the end of this piece: racism isn’t just about bad people doing bad things. It’s a system. A structure. And when we only look at the obvious moments, the slurs, the explicit hate, we miss how it actually gets inside us. How it affects our mental health in ways we’re only beginning to understand.

A quick disclaimer before we dive in: I’m Maryam, a digital journalist with a background in psychology and counseling. This newsletter? It’s just me, no corporate sponsors, no agenda, just someone obsessed with understanding why people are the way they are. What I’m sharing here comes from my research and my psychological lens. It’s an interpretive framework, not the final word. But I hope it gives you a new way to see.

First Things First: What Are We Actually Talking About?

Let me ask you something. If I said the words “culture,” “ethnicity,” and “race,” would you be able to tell me the difference?

Most people can’t. And honestly? That’s not your fault. We use these words like they mean the same thing, but they don’t. And when we mix them up, we end up having the wrong conversations entirely.

Think about it. We talk about “race” like it’s biological, like there’s something real and measurable that separates people into categories. But here’s where it gets interesting: scientists have known for decades that race isn’t biological. There’s more genetic variation within so-called racial groups than between them.

So if it’s not biology… what is it?

And why does something that isn’t “real” in a scientific sense have such devastatingly real consequences?

Here’s the breakdown I wish someone had given me years ago:

Culture is about shared ways of living, the food you eat, the holidays you celebrate, the stories your grandmother told you. Culture is beautiful. Culture is real. Culture is something to hold onto.

Ethnicity sits somewhere in between, it’s about shared ancestry, language, history. It’s “where your people come from” in a way that’s about heritage, not hierarchy.

But race? Race is different. Race is a social construct and  I know that phrase gets thrown around a lot, but stay with me because this matters.

Here’s what “social construct” actually means: at a specific point in history, for specific reasons, someone decided to invent categories of people and rank them. It wasn’t about science. It was about power.

Scholars like Theodore Allen have shown this in painstaking detail. When Africans first arrived in the US in 1619, there was no such thing as a “white” person. Not as a social category. That word didn’t show up until 1691, when the ruling elite needed a way to divide workers who might otherwise unite against them. So they invented “whiteness” as a privilege and  the consequences, as Allen documents, were terrible for both Black and white workers.

Race was created to maximise profit and maintain control. Full stop.

How Race Got Invented (And Why It Matters Now)

So if race is invented, does that mean racism is just… in our heads? Something we could think our way out of?

I wish.

Here’s the thing about social constructs, money is a social construct too. So is government. So is marriage. They’re not “real” in the way a rock is real, but try telling someone who’s lost their life savings that money isn’t real. Try telling someone going through a divorce that marriage is just a concept.

Social constructs have real consequences because we’ve built our entire world around them.

This is where Jones and Carter’s definition from 1996 becomes crucial. They defined racism as:

“The transformation of racial prejudice into individual racism through the use of power directed against racial group(s) and their members, who are defined as inferior by individuals, institutional members and leaders and  which is reflected in policy and procedures with the intentional and unintentional support and participation of the entire race and dominant culture.”

Let me translate that into regular human language:

Racism = Prejudice + Power

Anyone can have prejudice. Prejudice is just pre-judging, making assumptions about someone based on their group. That’s ugly and we should all work on it. But racism is different. Racism is when that prejudice gets backed up by systems, institutions and  power.

This is also why we need the concept of racialisation, the process by which groups get labeled as “other” based on whatever conflicts are happening in society at the time.

Think about who gets racialised in different eras:

• During waves of nationalism → it’s religious minorities
• During economic anxiety → it’s immigrants
• During the War on Terror → it’s Muslims
• During the War on Drugs → it’s Black communities

The groups change. The mechanism stays the same.

The Old Racism vs. The New Racism: Same Problem, Different Mask

Here’s where it gets psychologically interesting.

If I asked you to picture a racist, what do you see? Maybe someone in a hood? Someone shouting slurs? Someone obviously, visibly hateful?

That image is comforting, isn’t it? Because if racism only lives in obvious hate, then the rest of us are off the hook. We’re the “good ones.” We’d never do that.

But racism in the 21st century has gotten… sophisticated.

Scholars distinguish between two types:

Old illiberal racism is the one we recognise, the “traditional” version. It’s based on ideas about biological superiority. It’s hatred and demonisation. It’s “those people aren’t like us.”

But then there’s something called new liberal racism and  this one is trickier because it doesn’t look like racism at all.

New liberal racism says:

• “We’re post-racial now. Racism is over, except for a few bad apples.”
• “I don’t see color.” (Colorblindness)
• “It’s not about race, it’s about culture.” (Cultural racism, “they just don’t value education” or “their culture is more violent”)

Here’s what makes this psychologically dangerous: when racism gets abstracted like this, it becomes invisible. And when it’s invisible, we can’t address it.

I keep thinking about that Muslim woman I mentioned earlier. She wasn’t experiencing old racism, nobody was calling her names to her face. She was experiencing liberal racism. The job applications that went nowhere. The way people’s eyes would slide past her. The feeling of being invisible and hyper-visible at the same time.

That kind of racism doesn’t leave bruises. But it leaves marks.

What Happens to Your Body and Mind When Racism Is a Constant

So let’s talk about those marks. What actually happens to your mental health when you’re navigating racism day after day, year after year?

Most research on health inequities focuses on individual experiences, someone called you a name, someone discriminated against you, that specific moment hurt you. And that research is important. But it misses something.

What about the times when it’s not one event, but the whole atmosphere? What about the structural stuff, the fact that South Asian women in the UK are the least likely to find work matching their education? What about the neighborhoods that get less funding, the schools with fewer resources, the healthcare system that doesn’t take your pain seriously?

Bailey and colleagues (2017) mapped out the pathways through which racism affects health and  it’s broader than most of us realise:

Pathway 1: Psychosocial trauma – This is the interpersonal stuff. The slights, the discrimination, the moments that trigger your stress response.

Pathway 2: Economic injustice and social deprivation – When you can’t get a job that matches your qualifications. When housing discrimination means you live in a neighbourhood with fewer resources. When the wealth gap means your family has no cushion.

Pathway 3: Inadequate healthcare – When doctors don’t believe your pain. When treatments are designed for other bodies. When you avoid seeking care because you don’t want to be judged.

Pathway 4: State-sanctioned violence – When police target your community. When the system is something to fear, not trust.

Pathway 5: Political exclusion – When you don’t see yourself represented. When your voice doesn’t matter in decisions that affect your life.

The research is clear: all of this adds up. A major meta-analysis by Pieterse and colleagues looked at 66 studies with over 18,000 Black Americans. The finding? The greater the exposure to racist events, the greater the likelihood of mental distress. And here’s what’s crucial, the effects were strongest for psychiatric symptoms and general distress. Not just feeling a bit down. Real, measurable impacts on mental health.

This is why some researchers are calling for racism to be understood within the context of trauma.

Think about that. Trauma isn’t just what happens to soldiers in war or survivors of abuse. Trauma is what happens when your nervous system is constantly on alert because the world isn’t safe for people like you. The somatisation (when psychological distress shows up as physical symptoms), the interpersonal sensitivity, the anxiety, these are classic trauma responses.

The numbers are staggering:

• People who experience racist verbal abuse have 3 times the rate of psychosis
• People who experience racist physical abuse have 5 times the rate of psychosis
• Even believing that most British employers discriminate against your ethnic group is linked to 1.5 times the prevalence of psychosis

When It’s Not Just Racism, It’s Gendered Racism

Now let me complicate things further.

What happens when you’re not just navigating racism, but also sexism? When the two can’t be separated?

This is where intersectionality stops being an academic buzzword and starts being a lifeline.

Kimberlé Crenshaw coined the term to describe what happens when someone experiences multiple forms of oppression simultaneously and  how the combination is different from just adding them up.

Lewis and colleagues (2017) studied gendered racial microaggressions among Black women. They found that experiencing a greater frequency of these microaggressions was significantly related to more negative mental health.

Think about what that means in real life:

• The Black woman in a corporate job who’s told she’s “aggressive” when she’s just being direct
• The Muslim woman whose competence is constantly questioned because of her hijab
• The Asian woman who’s sexualised or stereotyped as passive

It’s not racism-plus-sexism. It’s something else entirely, a specific kind of harm that only exists at the intersection.

The Spillover Effect: When State Violence Affects Us All

I want to tell you about a study.

We know that police in the US kill more than 300 Black Americans each year, at least a quarter of them unarmed. But here’s the question researchers asked: does this violence affect only the people directly involved or does it spill over?

Intuitively, we might think: if you’re not the one being killed and  you’re not the family of the person killed, you’re probably fine. Sad, maybe. Disturbed by the news. But not personally affected.

But that’s not what the data shows.

Bor and colleagues (2018) did something brilliant. They combined data on police killings with a massive national survey of mental health in the US. They wanted to know: when police kill an unarmed Black person, does it affect the mental health of other Black Americans who weren’t directly involved?

The findings are devastating.

In the 1-2 months after a police killing of an unarmed Black person, there was a measurable decline in the mental health of Black Americans across the entire population. Not just in that city. Not just among people who knew the victim. Across the country.

And here’s what makes it ironclad: there was no similar effect after police killed armed Black people. No effect after police killed unarmed white people. No effect among white respondents at all.

This is what researchers call the “spillover effect.” State-sanctioned violence against one member of a community sends a message to the entire community: you’re not safe. You could be next.

That’s not paranoia. That’s pattern recognition.

Where Do We Go From Here?

So here we are. We’ve traced how race was invented as a tool of control. We’ve seen how racism operates on multiple levels, interpersonal, institutional, structural. We’ve looked at the research showing how this gets inside our bodies and minds. We’ve seen how state violence affects entire communities.

The natural question is: what do we do with this?

And I’ll be honest with you, I don’t have neat answers. Anyone who tells you they have a simple solution to something this complex probably hasn’t understood the problem.

But here’s what the scholars I’ve been reading suggest.

Nazroo and colleagues (2020) call for an anti-racism that recognises interpersonal and institutional racism as “reciprocal moments of a unified social process.” In other words: we can’t just focus on individual prejudice OR systemic change. We need both.

Think about the events of recent years:

• Grenfell Tower, where class and race intersected in a deadly fire
• Windrush, where people who’d built their lives in the UK were told they didn’t belong
• Stop-and-search practices that target specific communities
• Counter-terrorism policies that racialise entire religions

These aren’t separate issues. They’re all expressions of the same underlying structure.

For those of us who want to understand and  maybe even help change, this dynamic, it starts with seeing clearly. With understanding that racism isn’t just about bad people doing bad things. It’s a system. And like any system, it can be understood, challenged and  ultimately changed.

This deep dive, by the way, is fully powered by my own nerdy fascination, no corporate sponsor, just me and my Journo Box-fueled curiosity. If you’re still here, thanks for geeking out with me.

Conclusion: The Psychological Cost of Not Seeing Clearly

I keep coming back to that woman in my therapy room. The one wondering if she was “too sensitive.”

Here’s what I wish I could tell her and  everyone navigating this reality: you’re not too sensitive. You’re responding, appropriately, to a world that isn’t always safe for people like you.

The psychological cost of racism isn’t just in the obvious moments. It’s in the constant calculus. The hypervigilance. The exhaustion of wondering whether this rejection was about you or about their stereotypes. The grief of watching your children learn, too early, that the world sees them differently.

But here’s the thing about understanding the psychology: it doesn’t just show us the damage. It shows us the resilience. The communities that hold each other up. The joy that persists despite everything. The people who keep showing up, keep fighting, keep hoping.

That’s the full picture. Not just the wounds, but the healing. Not just the trauma, but the survival. Not just the system, but the people who keep believing it can change.
A small action you can take is to practice asking “what is happening around this person?” before assuming internal fragility. This reframes both self and others with greater compassion.

Continue reading in the next blog: Culture, Diversity, and Mental Health: Why Your Mind Doesn’t Exist in a Vacuum.

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