Why ADHD is Overlooked in Black Women – and What We Can Do About It

Bridgette Hamstead

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed neurodevelopmental conditions, yet it remains widely misunderstood—especially when it comes to how it presents in different populations. Black women, in particular, are significantly underdiagnosed and overlooked when it comes to ADHD, leading to a lifetime of struggles that often go unrecognized and untreated. While ADHD is typically associated with hyperactive young white boys, this stereotype ignores the ways in which the condition manifests in women, especially Black women, whose experiences are shaped not only by gender bias but also by racial disparities in healthcare and education.

One of the major reasons ADHD is overlooked in Black women is due to the long-standing stereotype of the “strong Black woman.” This cultural expectation demands that Black women be resilient, self-sufficient, and capable of handling anything that comes their way. While resilience can be a positive trait, it often leads to Black women internalizing their struggles rather than seeking help. When a Black girl struggles with inattentiveness, forgetfulness, or executive dysfunction, these challenges are more likely to be dismissed as laziness, irresponsibility, or a lack of discipline rather than recognized as symptoms of a neurodevelopmental condition. The result is that many Black women grow up believing they are simply not trying hard enough, rather than understanding that their brains work differently and require support.

Compounding this issue is the racial bias present in both the medical and educational systems. Studies show that Black children, particularly Black girls, are far less likely to be referred for ADHD assessments compared to their white peers. Instead, they are more likely to be disciplined for behaviors that would be recognized as symptoms of ADHD in white children. A Black girl who talks too much in class or struggles to sit still may be labeled as “defiant” rather than evaluated for hyperactivity. A Black girl who daydreams, forgets assignments, and struggles with organization may be seen as careless rather than recognized as someone with inattentive ADHD. By the time these girls grow into adulthood, they have often spent years believing they are simply “bad” at life, without ever receiving an explanation for their struggles.

Even when Black women do seek help, they often face additional barriers to diagnosis. ADHD in women is already underdiagnosed due to differences in symptom presentation. Many women with ADHD experience predominantly inattentive symptoms, such as chronic forgetfulness, difficulty focusing, and executive dysfunction, rather than the externalized hyperactivity that is more easily recognized in boys. Black women, in particular, are often misdiagnosed with anxiety, depression, or personality disorders, while the underlying ADHD remains undetected. Medical racism further compounds the issue, as Black women are less likely to have their symptoms taken seriously by healthcare providers, and their concerns are more frequently dismissed.

Another factor that contributes to the underdiagnosis of ADHD in Black women is the way Black communities have historically approached mental health. Due to systemic mistrust of medical institutions, which stems from a long history of medical racism, many Black families prioritize self-reliance over seeking formal mental health care. Within many Black households, symptoms of ADHD may be misunderstood as personal failings rather than neurological differences. A Black girl who struggles with time management or impulse control may be scolded for “not being responsible” rather than provided with accommodations or support. As a result, many Black women do not even realize they may have ADHD until adulthood—often after years of struggling with work, relationships, and mental health.

The consequences of late or missed ADHD diagnoses in Black women can be severe. Many Black women with undiagnosed ADHD suffer from chronic burnout, anxiety, and depression, often blaming themselves for their difficulties. Executive dysfunction makes it harder to maintain a consistent work schedule, manage finances, or keep up with household responsibilities, leading to feelings of inadequacy and low self-esteem. Relationships may suffer due to forgetfulness, emotional dysregulation, or difficulty managing conflict. Without a diagnosis, many Black women continue to push themselves harder and harder to meet societal expectations, often at the expense of their well-being.

So, what can be done to address this issue? The first step is increasing awareness of how ADHD presents in Black women. This means challenging the stereotypes that ADHD is a disorder that only affects young white boys and educating both medical professionals and the Black community about the signs of ADHD in women. Healthcare providers need better training on how ADHD manifests across different racial and gender identities so they can recognize symptoms in patients who do not fit the traditional profile. More Black women sharing their ADHD experiences can also help break down stigma and encourage others to seek diagnosis and support.

Another crucial step is advocating for equitable healthcare. Black women deserve access to providers who take their concerns seriously and who understand the intersections of race, gender, and neurodivergence. Culturally competent care is essential, and more Black mental health professionals specializing in neurodivergence can help bridge this gap. In addition to professional support, community spaces for Black neurodivergent individuals—whether online or in-person—can provide validation, resources, and a sense of belonging.

It is also important to push for systemic changes within education. Schools must do a better job of recognizing ADHD in Black girls, rather than allowing racial and gender biases to dictate which children receive support and which children are punished. Black girls who struggle with focus or impulse control should not be disciplined out of their potential but should instead be given the tools and accommodations they need to thrive. Parents and educators should be informed about the differences in how ADHD manifests in girls so that more Black girls receive early interventions rather than being forced to navigate life without understanding their own brains.

For Black women who suspect they may have ADHD, self-education and self-advocacy are key. Learning about ADHD from neurodivergent-friendly sources can help women recognize their own symptoms and understand that their struggles are not personal failures. Seeking a diagnosis—if accessible—can provide clarity and open doors to treatment options, including therapy, coaching, medication, and accommodations in work or school settings. However, a formal diagnosis is not always necessary to start making changes. Implementing ADHD-friendly strategies, such as externalizing memory through planners or apps, creating routines that accommodate executive dysfunction, and seeking community support, can make a significant difference.

Ultimately, addressing the underdiagnosis of ADHD in Black women requires a cultural shift. Black women deserve to know that their challenges are real, that they are not alone, and that their brains are not broken. ADHD is not a failure of character, and seeking support is not a weakness. By challenging the biases in medical and educational systems, fostering open conversations about neurodivergence in Black communities, and prioritizing self-compassion, Black women with ADHD can begin to access the resources and validation they have long been denied. Recognition is the first step toward empowerment, and every Black woman who finally understands her ADHD is one more voice in the fight for visibility and change.