Black Americans have a hard time talking about the pain of depression.

In his 1995 book Rage of a Privileged Class, Ellis Cose noted that behind the external trapping of success—good educations, comfortable incomes, nice homes—middle-class blacks are angry and disillusioned.

In her new book, Black Pain: It Just Looks Like We're Not Hurting (Scribner) author Terrie M. Williams warns that over a decade later something's still wrong. A larger proportion of us have "made it," but despite better educations, higher incomes, bigger homes—and even as Sen. Barack Obama is poised to become the country's first black president—we're just as angry. But now, the pain has turned inward.

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"Success hasn't healed our pain and it never will," says Williams, a public relations entrepreneur and founder of the Stay Strong Foundation in New York City. "People who think that a corporate job or a half-million-dollar car or a three-million-dollar house cushions the pain are plain wrong."

Black Pain looks at the largely untold story of depression among African Americans. Her book is both absorbing and enlightening, difficult to read, but hard to put down. Most engaging and heart-breaking are the many, many personal testimonies of both regular folks and celebrities who have battled their demons.

Though Black Pain looks at depression across the class spectrum—from gang bangers to top corporate executives —it is the sorrow of the very successful that Williams understands best. Because she's been there.

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In 1988, Williams launched the Terrie Williams Agency, and grew it into one of the country's top public relations firms. She handled some of the biggest names in entertainment, sports and politics, including Johnnie Cochran, Eddie Murphy and Miles Davis. But in a searing essay that appeared in Essence magazine several years ago, she admitted that despite her outward success she suffered from crushing depression.

Exhausted, in constant pain and even terror, she eventually collapsed, staying in bed for days. She recovered with the help of medication, therapy and lots of TLC. That article received 10,000 responses and led to Black Pain.

"I had everything society tells us should make us happy: success, money, access, but not one thing in my life gave me pleasure," she writes. "The saddest thing about all this is that I was able to go on so long without anyone really noticing."

Wearing that mask, or game face, despite the pain, is a hallmark of depression in African Americans. In her book, Williams points out a number of others. Some are unique to women, others to men:

Too many of us are crying, too many of us are dying—in silence.

Because of centuries of staying strong and silent in the face of the ugliest kinds of brutality, African Americans continue the cultural habit of avoiding painful emotions. No one owns us anymore, but we find it cripplingly difficult to openly acknowledge pain and sadness. "It's very hard for black people to show a kink in the armor," says Williams. "Meanwhile, people to the left, right, in back and front have holes throughout their armor."

Black women continue to pay the price of being superwomen.

Working 24/7 is a primary symptom of depression for black women. Williams says she knows that symptom so well, she could've invented it. "Like many black women, I would work until I dropped, meet unreasonable deadlines, sacrifice weekend days at the office and generally push myself beyond normal endurance," she writes. "In the interest of my business and clients, I didn't marry because I didn't have time to be truly available to my man or kids—I didn't feel entitled to take the time either."

Depression can look like aggression.

We think of depression as sad, lethargic and low energy. But, especially in men, depression can look very active, even hyper. Depressed men often overwork, drive too fast, take drugs, have too much sex or become violent. "If you can't feel it out," says Williams, "you act it out."

Evil = depressed.

Being evil and seeming bulletproof are the female versions of swagger and macho in men. It's a painful, common cover-up for depression. "What we call evil," writes Williams, "is the inability to set boundaries for ourselves, to say, 'I need some help, or some downtime, and preferably both.'"

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Ultimately, Williams hopes her book will provide a cultural healing. "Healing starts with us," she says. "Share your journey with someone. You're not alone. I promise you, you're not alone."

Linda Villarosa is a health columnist for The Root. "Passing for Black" is her first novel. For more go to her Web site.