It is one thing to feel down or have a tough day. When the sadness stretches into weeks of feeling sad most of the time for most days and those feelings come with other things like changes in sleep (more or less than usual), changes in appetite (more or less than usual), crying spells, trouble enjoying things, decreased energy, negative thoughts about oneself, or hopeless thoughts a depressive disorder may be present. Sometimes people who have major depressive disorder will have frequent thoughts of death, wishing they were dead or even thinking of ways to end their own lives. The lifetime prevalence of major depressive disorder in Blacks is estimated to be 10.4%; however, this may be an underestimate because Blacks are less likely to seek treatment and may be more likely to be given another kind of diagnosis when they do. Studies show lower or similar rates of depression in Blacks compared to the rates in the overall population; however, when Blacks have major depressive disorder, it tends to last longer and be more severe. Less than half of Black people who could benefit from depression treatment receive it. This is particularly concerning because many serious medical conditions more common in blacks, including type II diabetes, hypertension and cardiac disease, have worse outcomes when someone is also depressed.