What is behind ADHD’s under -diagnosis in black women?

What is behind ADHD’s under -diagnosis in black women?

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July is Bebe Moore Campbell National Minority Mental Health Awareness Month.

As a child and young adult, Stephanie Robertson seemed to be the ideal student. She achieved almost perfect figures in high school and went to some of the best universities in the country. In the mid -1920s she graduated from the law studies and started her career at a law firm in New York City.

However, Robertson fought internally to keep it all together. She found it difficult to suit colleagues and classmates and struggled with managing fixed schemes and routines. She hyperfixed on specific topics before she lost interest, a pattern that made it difficult for her to stay focused in some classes and at work.

While Robertson could channel the racing thoughts in her head in her school work as a child, those coping strategies no longer stopped as an adult. She struggled to keep jobs and paying her bills. During a certain period she started drinking heavily to suppress the endless thoughts through her head and the overwhelming feeling of frustration that she felt about her life.

In 2009 a therapist suggested that she could have Attention deficit/hyperactivity disorder, or ADHD. Robertson rejected the idea because she had never met a black person, let alone a black woman, with ADHD. She would see several doctors for another 13 years and experienced just as many incorrect diagnoses before she received an official ADHD diagnosis in 2023.

Robertson knows if she had more examples of black people with ADHD, she might have identified her own symptoms and sought help. That’s why she came to the National Alliance on Mental Illness (NAMI) As director of innovation in mental health care to tackle differences in mental health care.

“When I was diagnosed with ADHD, I went through this period by feeling so excited that everything started to click and be logical,” said Robertson. “Knowing and being able to understand the reasons for these things makes a huge difference.”

Differences in ADHD -diagnoses

Robertson had a good reason to initially reject the ADHD suggestion. A 1997 study, the year that she graduated from high school, noticed how Only 16 articles or studies from ADHD among thousands focused on black children.

Black women and girls were the least likely to be diagnosed with ADHD, while white women and girls were the least probably a diagnosis of behavioral disorder.

A more recent Review of racial and sex differences in ADHD and behavioral disorders thought that white people were 26% more likely to get the diagnosis of ADHD, And 61% less likely to receive a diagnosis of behavioral disorders than their black counterparts.

The authors suggested that differences can be related to teachers and providers who regard ADHD symptoms as intentional misconduct in black children, leading to the label for behavioral disorders. Under diagnoses can also arise from social and cultural differences – such as lack of consciousness on ADHD symptoms, lack of access to treatment, misconceptions about the condition and treatment And Stigma about looking for help for psychological problems.

Read: Do you think you know what ADHD is? Think again. >>

ADHD symptoms also seem different in women than men, making them easily diagnosed incorrectly or completely missed. For example, Women’s behavior is rather inattentive than hyperactive. Robertson said she directed her impulsive tendencies in educational institutions by hyperfixing on certain goals or tasks, such as making jewelry or immersing the German language.

“Because they were always quirky and/or educational things that I was obsessed with, nobody really questioned it,” said Robertson. “I was a calm person who loved himself, so the reaction was just” she’s doing well “when it was absolutely not in order.”

Although Robertson obtained her bachelor’s degree at Duke University, ending with an average of 3.4 grade point, more cracks began to appear at the university. For the first time in her life, she achieved a bad grade, although she looks back, she knows it was because she was not interested in the subject and could not concentrate. At the law study she did not succeed in a class during her first year and struggled to manage the whirlwind of lessons and interviews with jobs.

Stephanie Robertson, 2025 (Photo/Corey Pilson)

After completing the law study, Robertson bounced more than a decade through jobs, relationships and responsibilities and burning bridges en route. She would start a job and intensely focus on her tasks in the beginning, but after losing interest she would have difficulty completing tasks. She often chose to stop before she was possibly fired and treated fear and depression.

“That is a piece of ADHD that I learned about,” she said. “You get really intense and if you lose interest, you forget and stop.”

The spiral took place when Robertson started drinking heavily. Healthcare providers thought she had manic episodes and had diagnosed her Bipolar II disorder. She started to take a mood -changing medicine that had potential for dangerous side effects, but still felt no better.

Robertson was angry – angry that the treatment did not help, angry that her life fell apart and angry that employers did not seem to understand why she had trouble doing work. Well aware of the “Angry Black Woman” Trope That portrays black women as abnormally hostile or aggressive, Robertson wonders how many black women are unfairly stigmatized with that label because their mental health needs are not met.

“I was probably angry because I was just unable to communicate the way I wanted and people were not willing to listen,” she said. “I was angry with the lack of accommodations in society in general.”

Eventually Robertson gained the confidence to become more open with her colleagues about what she experienced and someone suggested that her symptoms sounded more like ADHD than on bipolar. Finally, in 2023 she underwent a psychological assessment that resulted in an ADHD diagnosis.

Fight for yourself

Robertson is still struggling with daily activities that may seem simple to others and wishes to have had the opportunity to develop better management skills and strategies earlier in life. That is why she is in favor of a greater consciousness of ADHD symptoms in people of color, especially women.

“I am miserable half the time because my mind is everywhere,” she said. “I always wonder” did I pay this? “Do I have to get this?” “I forgot 10 items in this store.” “I have 10 million things to do.” “I have 10 million tabs open.” It is so overwhelming and it is tiring. “

Medication can also be useful, together with mindfulness exercises, exercise and techniques such as cognitive behavioral therapy To help with dealing with racing thoughts and overwhelming tasks. Finding support in the workplace is crucial and Robertson now tells employers that she is able to do great work, but not always within a traditional 9-to-5 period. She has always been that way – in high school she often woke up at 4 hours to complete schoolwork.

Robertson has also been open in recent years about her experiences to help others better manage their own mental health and to seek treatment if necessary. Before she came to NAMI, she was an assistant who is at Duke and worked to create space for students to share their worries at ease.

“Fight for yourself,” said Robertson. “If you feel that something else is and you are not listened to, you learn about ADHD and other mental health problems and become a supporter of yourself and your needs.”

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