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ADHD in Black Women: Cultural Perspectives and Insights

Black Women Neurodivergence


By: Michelle Tillman-Cureton, LCMHC PsychoTherapist


Adult ADHD is increasingly prevalent in our population. Symptoms of ADHD, including distractibility, impulsivity, disorganization, and emotional sensitivity, significantly impact everyday life, work, and personal behaviors. These symptoms typically fall into two categories: one concerns inattention, which includes being easily distracted, struggling to organize tasks, an inability to pay close attention to details, and failing to follow through on instructions; the other relates to hyperactivity and impulsivity, characterized by fidgety behavior, excessive talking, a tendency to interrupt conversations, and difficulty waiting for one’s turn.


There are significant delays and clinical gaps in care that frequently lead to diminished self-esteem, increased anxiety, and self-doubt. Such gaps often stem from entrenched gender biases and outdated stereotypical thinking patterns. Stereotypes that typically define us include the “Angry Black Woman” or the notion that we wear the “Superwoman Cape,” which minimizes the crucial self-care, nurturing, and understanding we need to seek medical expertise for what has been deemed “ordinary” or simply “that’s just her.” Black women often lead lives that are tremendously heavy, lacking self-compassion. We hold ourselves to a higher standard because we have been taught that we must do more, go further, learn more, and be more. This relentless pursuit of excellence can overshadow our own needs, reinforcing the belief that we should endure pain without complaint and prioritize others before ourselves.


Overcoming the stigma of an ADHD diagnosis is often challenging in Black families; acceptance is difficult in a culture that has historically emphasized the need to “focus” and to “be seen and not heard.” There have always been painful consequences or shame tactics implemented when individuals are perceived as different. The most significant struggle often faced is the acceptance of the ADHD diagnosis. Neurodivergent symptoms are similar in each individual, yet the impact of those symptoms affects Black women differently: task inertia, fatigue and burnout, impulsivity, emotional dysregulation, rejection-sensitive dysphoria, self-judgment, and shame.


Different Complexities

The diagnosis of ADHD continues to rise rapidly, and while it presents many strengths—such as courage, creativity, spontaneity, energy, sociability, and originality—it also brings various challenges. Strategies to scaffold executive functioning, break through task inertia, and develop quick and easy mindfulness practices are essential for clients who struggle to sit still, maintain focus, or find meditation exceedingly difficult. Additionally, addressing the diverse needs of neurodivergent clients is crucial, including considerations of minority stress theory and the differences between medical and social models of disability.


With monumental efforts, mental health care has made tremendous strides toward equality, yet minority groups continue to experience various sources of stress that are intricately complex and conflicting: prejudice, discrimination, social rejection, victimization, socioeconomic inequality, and housing and employment discrimination. This leads to higher levels of stress and deficiencies in physical and mental health compared to their peers.

Cultural Sensitivity


In my clinical experience, the client profiles I encounter include a limited number of neurodivergent Black women. Those I have had the privilege of providing therapy for share experiences of “internalized shame” and often find themselves caught in a “trauma trap” they have intellectualized. As licensed therapists, we must continue to educate ourselves and embrace neuro-affirming language while meeting our clients at their individual levels, remaining mindful that we treat the whole person rather than a siloed population. Regardless of your clinical approach to serving neurodivergent Black women, prioritize affirming and supporting their differences over their symptoms.


I will continue to be culturally attuned and clinically intuitive about our future.


In Health & Wellness,


Michelle Tillman-Cureton, LCMHC PsychoTherapist

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