ADHD in Black Women: What We Miss When We’re Told to Just Try Harder

Although a substantial portion of girls and women are affected by ADHD, most people typically picture a hyperactive boy. Extending that to race, historically White children have been more likely to be diagnosed and treated for ADHD compared to racial and ethnic minority youth, and research suggests that those racial disparities extend into adulthood. Being both female and a minority leads to even higher hurdles to getting properly diagnosed and treated for ADHD, and delays in diagnosis can have serious consequences such as low self-esteem, anxiety, eating disorders, and self-harm.

A lack of understanding in how symptoms of ADHD present in girls and women can be particularly challenging for minority females. For example, boys with ADHD often show more hyperactive behaviours while girls are more likely to display inattentive symptoms. These inattentive symptoms are less apparent and often lead to these girls and women being labeled as “lazy,” “not smart,” or “having a poor attitude.” The inattentive aspect is also typically overlooked because it is not as “disruptive” which results in boys getting evaluated much more often than girls.

The societal understanding of ADHD has long had its model as a “hyperactive little boy.” Parents frequently overlook the signs of ADHD in their daughters simply because it doesn’t cross their minds that ADHD exists in girls. This leads to frequent misdiagnosis of girls into more societally “expected” disorders that share similar traits like anxiety, eating disorders, or mood disorders.

These preconceived judgments and cultural differences can result in additional misinterpretation of ADHD behavior in minority girls. For example, non-compliant behavior in Black girls and women is typically viewed as a disruption and/or a threat rather than a sign of the medical condition of ADHD, resulting in people missing the opportunity to recommend Black females for evaluation. Rather these girls and women are told to just “do better” and act "proper" which can result in masking their ADHD symptoms and making them even harder to diagnose in later years. Girls and women are socially conditioned – no, expected – to be better behaved than boys and men.

Most research studying ADHD is taken from White boys; females, particularly minority females, are often not included in research samples. When underrepresented groups of women and girls are not included in research studies, study results may not apply to them. As a result, racial minority women and girls can experience damaging misdiagnosis and delayed or inappropriate treatments.

Previous negative experiences and mistrust of the health care system can also result in minority women being less likely to pursue care for mental and physical health conditions. The stigma associated with mental health and behavioral health disorders, as well as fear of addiction to medications, have been found to be highly prevalent concerns in the Black populations. Black parents are significantly less likely to get their children assessed than White parents are. They are also less likely to create spaces for conversations surrounding mental health. This makes it even more difficult for Black children with ADHD to get access to resources or even gain an understanding of what could be causing their struggles.

Outside of stigma within the household, there is also a medical stigma as well as systematic barriers that Black people experience when it comes to mental health advocacy. There’s little research done on the impact of cultural experiences and expectations on the presentation of ADHD symptoms. Additionally, there are much fewer culturally responsive practitioners who are knowledgeable about the intersections of culture and mental health, and there are even fewer practitioners who have lived experiences with that intersection making it difficult to feel fully understood in therapeutic spaces. That’s why if you are a Black woman struggling with or believe yourself to be struggling with ADHD you should come to Blue Sage Wellness where we not only prioritize culturally responsive care but also have BIPOC practitioners who can empathize with you throughout your therapeutic journey.

The challenges Black women with ADHD are complex; addressing these issues will take changes at both the individual and systemic level. Taking steps toward change is vital to ensuring that racial and ethnic minority girls and women get the support they need to reach their full, vibrant potential.

ADHD in women has long been considered a “hidden disorder,” and this is especially true for racial and ethnic minorities. Increasing awareness about ADHD and educating others will help to ensure they obtain the resources and support they need to not only survive but thrive.

Signs of ADHD in Women

Inattentive traits in ADHD:

• Frequent daydreaming

• Spatial awareness issues (being clumsy)

• Difficulty maintaining attention

• Forgetfulness

• Not eating enough

Hyperactive traits in ADHD:

• Frequent talking

• Fidgeting

• Impulsiveness

• Hyperfixating

• Binge eating

Traits of Masking:

• Fear of rejection/rejection sensitivity

• Hypervigilance, especially in social settings

• Overthinking

• Perfectionism

• Physical and mental fatigue

• Low self-esteem

If you find yourself relating to a lot of the traits above, you’re not alone. Here are some ways to make life with ADHD feel more manageable and less daunting.

The first step in becoming your own advocate is showing up for yourself. You can start by not dismissing your experiences and offering yourself some grace. From there, you can go on to creating safe spaces to unmask and making accommodations in your daily life to make living with ADHD a bit easier (i.e. creating physical notes/reminders/routines that work for your neurodivergent brain).

Don’t be afraid to confide in others. Whether friends or an online support group, finding somewhere that feels safe (bonus points if it’s with people who can empathize with you) can really make a difference in the way you’re able to navigate these traits and the way you view yourself. Support groups are especially helpful in giving tips to manage the more stressful aspects of ADHD.

Seeking professional support is also important. Find one that helps you feel safe, heard, and seen. The effect can be revolutionary. At Blue Sage Wellness, we have multiple licensed BIPOC clinicians with experience helping people navigate their neurodiversity and feel at peace with it.

Getting a formal assessment opens up doors both internally through acceptance and validation and externally through access to resources and professional support/interventions. 

Start your healing journey at Blue Sage Wellness where a majority of our PHMNPs’ specializations include ADHD. They can support you in finding assessments, navigating and managing your routines, teach you to self-regulate, and improving your life with ADHD.

If you’ve spent years being misunderstood, misdiagnosed, or dismissed, you deserve someone who actually sees you. Take this quick quiz today to see which clinician best suits you or contact Blue Sage Wellness.