A new study published in Nursing Research found that Black women often describe less common symptoms of depression, including sleep disturbances, irritability and self-criticism, resulting in underdiagnosis  and undertreatment.

Stereotypical symptoms of depression include feelings of hopelessness, loss of interest or pleasure in activities, mood swings, loss of appetite, sadness, anxiety or guilt, according to the Mayo Clinic. However, these are only some of the many possible symptoms of a depressive disorder.

Led by researchers at NYU Rory Meyers College of Nursing and Columbia University School of Nursing, the study intended to address the lack of research on how depression symptoms vary between white people and racial and ethnic minority populations. Studies on depression symptoms have predominantly focused on white people, making it more likely that depression in minority populations will be missed.

For the study, researchers analyzed data on 227 Black women who were screened for depression and involved in the Yale Intergenerational Blood Pressure study, which examines Black mothers and their children to examine how genetic and environmental impacts affect blood pressure.

Black women with increased depressive symptoms reported feelings such as fatigue, insomnia, decreased libido, self-hate and self-blame, which differ from the stereotypical symptoms associated with the mood disorder. Some women also reported irritability and an inability to experience pleasure.

Researchers acknowledge that their findings cannot be generalized to all Black women.

In an NYU news release, lead study author Nicole Perez, PhD, RN, a psychiatric-mental health nurse practitioner and postdoctoral associate at NYU Rory Meyers College of Nursing, said she hopes “that these findings contribute to the growing dialogue of how depression can look different from person to person and raise awareness of the need for more research in historically understudied and minoritized populations so that we can better identify symptoms and reduce missed care and health disparities.”