ADHD in Black Women: Why It’s Overlooked and How to Get Help
When you think of ADHD (Attention deficit hyperactivity disorder), who typically comes to mind?
Is it a young boy who just can’t seem to sit down?
ADHD is typically portrayed through a narrow lens — most often as a condition affecting young, primarily white boys, who present as though they’re “running on a motor.” This is a misconception that has shaped the way that people discuss ADHD as well as diagnostic trends, which has left women — especially Black women — under-diagnosed.
In childhood, ADHD diagnoses are given to boys anywhere from 2 to 16 times more than they are to girls. There are many reasons this happens, and, in this post, we’re going to go into why, as well as how to identify traits of ADHD in yourself and how to best get support.
Why is ADHD is Under-diagnosed in Women?
Gender differences in the way ADHD affects people: Attention Deficit Hyperactivity Disorder is a broad disorder that encompasses both hyperactive and inattentive traits. Hyperactive traits tend to be more common in boys while inattentive traits tend to be more common in girls. This means that you’re more likely to catch a girl with ADHD that presents as being “lost in her own world” than you are to catch her bouncing off the walls. This inattentive aspect is typically overlooked because it is not as “disruptive” which results in boys getting evaluated much more often than girls.
Societal understanding of ADHD: Society has long had its model of ADHD as “hyperactive little boy”. Parents frequently overlook 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.
Pressure to mask: Girls are socially conditioned – and expected – to be better behaved than boys. This causes girls to feel excessive pressure to mask and subdue their ADHD traits, making it harder to get diagnosed or to even recognize those traits in themselves.
Why is ADHD under-diagnosed in Black Women?
Black women have even more challenges when it comes to ADHD. In many Black cultures, mental health is either not taken seriously or is heavily stigmatized. 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 to be had 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 are also systematic barriers that Black people experience when it comes to mental health advocacy. There’s little research done on the impact of cultural experiences/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, at The Cognitive Corner, we prioritize both trauma-informed and culturally responsive care to make sure that intersection is not only acknowledged but also integrated throughout the therapeutic journey.
Signs of ADHD in Women
So, what should you even be looking out for when it comes to ADHD in women? Here is a non-exhaustive list of common signs broken down by inattentive and hyperactive traits.
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
Here’s a simple breakdown of the two main ADHD types — Inattentive and Hyperactive/Impulsive — to help you understand how they differ in everyday life:
Women with undiagnosed/late diagnosed ADHD typically get diagnosed (and often misdiagnosed) with depression, anxiety, eating and mood disorders. This happens because many traits present similarly/overlap with these disorders and, because the diagnostic criteria for ADHD has historically developed around boys and men professionals unfortunately often miss the signs in women, especially Black women, and instead misattribute those traits to other disorders. Additionally, masking (suppressing or covering up ADHD traits to meet external expectations) for prolonged periods of time can cause these disorders (or traits of these disorders) to manifest.
Aside from the risk of developing some comorbidities, here are some other signs/traits of masking:
Fear of rejection/rejection sensitivity
Hypervigilance, especially in social settings
Overthinking
Perfectionism
Physical and mental fatigue
Low self esteem
ADHD Support for Black Women in Canada
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.
Show up for yourself: This is the first step in becoming your own advocate. You can start from within 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 day-to-day life to make living with ADHD a bit easier (like creating physical notes/reminders and creating routines that work for your neurodivergent brain).
Confide in others: Whether friends or an online support group, finding somewhere that feels safe (bonus points if it’s with people that can relate) 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.
Seek professional support: Finding a professional who helps you feel safe, heard and seen can be revolutionary. At TCC, we have multiple licensed BIPOC professionals with experience helping people navigate their neurodiversity and feel at peace with it.
Getting assessed by an informed professional: Getting a formal assessment opens up doors both internally through acceptance and validation and externally through access to resources and professional support/interventions. While there are still obstacles holding Black women/girls back from getting properly assessed, programs like the “Yes to Assess” program via Black Mental Health Canada and Her ADHD Assessment via The ADHD Centre for Women offer more nuanced and informed ADHD assessments, helping to bridge that diagnosis gap.
Start your healing journey: Ash or Sydney are therapists at TCC whose 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.
TL;DR
ADHD is frequently underdiagnosed in BIPOC women because of gender differences in trait expression, societal pressure, stigma and systemic barriers. It’s important to understand what ADHD could look like for you and how to manage it.
Hyperactive traits tend to be more common in boys while inattentive traits tend to be more common in girls.
Women with undiagnosed/late diagnosed ADHD typically get diagnosed (and often misdiagnosed) with depression, anxiety, eating and mood disorders.
Black women have even more challenges when it comes to ADHD. In many Black cultures, mental health is either not taken seriously or is heavily stigmatized.
If you find yourself relating to a lot of the traits around ADHD, it’s important to find a specialist who can provide a relevant assessment and knows about ADHD in women and especially BIPOC women.
Starting your healing journey by treating ADHD can be life-changing.
References:
https://www.endeavorotc.com/blog/what-is-adhd-masking-in-women/
https://my.clevelandclinic.org/health/diseases/24741-adhd-in-women
