The Hidden Struggle: Black Women and ADHD

The Hidden Struggle: Black Women and ADHD 

ADHD doesn't discriminate by gender or race and its symptoms can be huge challenge. It can impact education, professional life, and personal relationships. However, there is an additional layer of difficulty for people of colour, especially Black girls and women. They are far less likely to receive an ADHD diagnosis than their White male counterparts. 

This can obviously create challenges from school onwards, with Black children (girls and boys) often not getting the support they need. The fact that White children are more likely to be diagnosed and treated can mean they have an advantage. They may benefit from more positive feedback, more freedom to move around or more time allowed for exams. 

Why the Disparity? 

There are a number of reasons why Black children may be less likely to be diagnosed with Attention Deficit Hyperactivity Disorder. 

• Cultural Bias in Diagnostic Criteria 

Researchers have conducted many studies on ADHD diagnoses, focusing mainly on White participants. As a result, people may misinterpret or overlook symptoms of ADHD in Black children. This can lead to cultural biases. 

• Stereotypes and Misdiagnosis  

Young Black boys and girls with ADHD are often regarded as simply being naughty. Black children are far more likely to experience adultification. Adultification bias is a form of racial prejudice where children of minority groups, typically Black children, are treated by adults as being more mature than they actually are. Figures obtained by the charity Agenda found Black girls are two times more likely to be excluded from school as white counterparts (1).

Studies have shown that Black children with symptoms of ADHD are treated more negatively by teachers and other adults, or even misdiagnosed altogether. In other cases, access to testing, treatment, and even specialists of colour are hard to find, putting Black children at a disadvantage to their White peers with similar symptoms. 

In 2021, the Guardian published an article about school exclusion rates. For Black Caribbean pupils in parts of England, these were five times higher than for White children. 

• Access to Healthcare 

Black families often face barriers to accessing quality healthcare. There are a number of reasons why this might be, for example financial constraints. For those in the US, this may be due to a lack of medical insurance. In the UK, waiting lists for ADHD assessments can be long, but doing this privately can be prohibitively expensive.  

Black families may also have a fractured relationship with the healthcare system. Evidence in the The Ethnic Inequalities in Healthcare Review (2) by the NHS Race and Health Observatory also shows that Black children were 10 times more likely to be referred to Child and Adolescent Mental Health Services (CAMHS) via social services rather than their GP service, in comparison to White British children.  

Cultural Stigma 

In many Black communities, there is often a stigma surrounding mental health conditions. This can discourage parents from seeking help for their children. Some Black parents may feel that the label of ADHD will stigmatise their child.  Although this may be well-intentioned, it can make children’s lives much harder in the long run. 

Children from ethnic minority backgrounds are also often raised with the ‘work twice as hard narrative’ - i.e. that they must work harder than white children to succeed. This can put enormous pressure on a child who is already struggling with undiagnosed ADHD, and they may feel they are failing to live up to their family’s expectations. 

Black Women and ADHD 

Official figures in 2014 showed that Black women were the highest percentage to screen positive for ADHD. This suggests that those who had not received a diagnosis as children were now coming forward. 

One reason there may be a reluctance for Black women to seek a diagnosis is the Superwoman Schema. This refers to the cultural expectation that Black women must be strong, self-reliant, and resilient in the face of adversity.  

This schema has historical roots, shaped by the necessity for survival and the ongoing struggle against systemic oppression. Whilst traits such as strength and perseverance are admirable, it also imposes unrealistic standards. These standards can mask underlying issues such as ADHD. 

The Impact of the Superwoman Schema on ADHD Diagnoses 

• Masking Symptoms 

Black women, driven by the need to meet the Superwoman standards, often develop coping mechanisms that hide their ADHD symptoms. They may overcompensate for their inattention or hyperactivity through meticulous organisation, excessive effort, or working longer hours. These strategies can lead to burnout and other mental health challenges, but may prevent the identification of ADHD. 

• Delayed Help-Seeking 

The Superwoman Schema discourages showing vulnerability or seeking help, as doing so can be perceived as a sign of weakness. A Black woman with ADHD may avoid discussing their struggles, fearing judgment or stigmatisation. This reluctance can delay diagnosis and treatment, exacerbating the condition over time. 

• Internalised Pressure  

The internal pressure to live up to the Superwoman ideal can lead to significant mental health challenges. Black women with ADHD might feel guilt and shame for not meeting these high standards, contributing to anxiety, depression, and low self-esteem. The constant battle to appear competent and composed can be mentally and emotionally draining. 

• Healthcare Provider Bias 

The Superwoman Schema can also influence healthcare providers' perceptions. Medical professionals might overlook ADHD in Black women, attributing their symptoms to stress or personality traits rather than considering a neurodevelopmental condition. This bias further contributes to the under diagnosis of ADHD in Black women. 

Navigating ADHD with the Superwoman Schema 

Addressing ADHD in Black women requires acknowledging and challenging the Superwoman Schema. Here are some strategies to navigate this complex interplay: 

• Promoting Self-Compassion 

Encouraging Black women to practice self-compassion and recognise that needing help does not equate to weakness is crucial. It's important to understand that ADHD is a medical condition, not a personal failing. This can help to foster a healthier self-perception and reduce the stigma around seeking support. 

• Culturally Sensitive Care 

Healthcare providers must be educated about the Superwoman Schema and its impact on Black women with ADHD. Culturally sensitive care involves recognising the unique challenges faced by this demographic and providing empathetic, tailored support. 

• Building Support Networks 

Creating spaces where Black women can share their experiences and support each other can be empowering. You may wish to check out the following: 

ADHD Babes - This is a support group for Black women and Black non-binary people with ADHD. 

Black Girl, Lost Keys - A brilliant blog from René Brooks about her experiences as a Black Woman with ADHD. 

Adulting with ADHD - Rachel Idowu – shares her personal insights as a late diagnosed Black woman with ADHD. She provides insights into navigating ADHD at work and has designed a set of flashcards to help people better understand ADHD traits  

About the Author 

Abigail Agyei MBE is an award-winning Senior Policy Advisor, Diversity, Equity and Inclusion Champion and Neurodiversity Advocate.  

In her Tedx Talk, 'Yes, Black women have ADHD too and need your attention!' she talks openly about her own experiences as a late diagnosed Black woman, and why early diagnosis is so important for everyone in society. You can check it out here.

More information about her can be found here abigailagyei