How Should We Recognize BIPOC Mental Health Awareness Month?
Written byCreative Continuum. Creative Continuum is founded by Marina Doering, ATR-BC, a board-certified art therapist and neurodivergent-affirming therapist based in Phoenix, Arizona. Marina and her team specialize in adult ADHD, including the later-in-life diagnoses and years of masking that are especially common among Black women and other adults whose symptoms were overlooked or misread growing up. Using creative, evidence-based approaches tailored to each client's nervous system, the practice offers in-person sessions in Phoenix and telehealth across Arizona, Massachusetts, Vermont, and Pennsylvania.
Updated: 07/27/26
The most meaningful way to recognize BIPOC Mental Health Awareness Month is to talk honestly about what gets overlooked in communities of color, and ADHD is one of the clearest examples. Traits like masking, high achievement, and being told "you're just not trying hard enough" rarely get connected to ADHD in Black children. Many don't get a real answer until decades later, after building a whole adult life around coping alone.
Key Takeaways
BIPOC Mental Health Awareness Month exists because the mental health system has historically excluded, misdiagnosed, and underserved people of color. ADHD is one of the most visible examples of that pattern.
ADHD presents differently in Black adults than in the textbook version built on white, male, hyperactive presentations. That mismatch is why so many Black adults reach adulthood without a diagnosis.
Masking, the effort to appear neurotypical in environments that do not accommodate how your brain works, is exhausting and eventually produces its own symptoms.
Neurodivergent-affirming therapy does not ask clients to fit into systems that were not built for them. It builds from where they are.
Table of Contents
What is BIPOC Mental Health Awareness Month, and why talk about ADHD?
BIPOC Mental Health Awareness Month is observed each July as a dedicated time to address the unique mental health challenges faced by Black, Indigenous, and People of Color communities, including the systemic barriers that have historically limited access to accurate diagnosis and culturally responsive care.
Mental Health America's BIPOC Mental Health Month resources document the intersection of racial identity and mental health experience: the ways that racism, discrimination, intergenerational trauma, and cultural stigma around help-seeking all shape who gets support and when. For many BIPOC communities, therapy has been inaccessible not only because of cost but because of a long history of the mental health system causing harm, misdiagnosing, or simply not recognizing the experiences of people of color.
ADHD is one of the most documented examples of this gap. The research on ADHD has historically been conducted on white, male, hyperactive children. The diagnostic criteria were developed from that research. The teachers and clinicians doing the referring were predominantly seeing that presentation. Anyone who did not look like that prototype, including Black children, and especially Black girls, frequently went unrecognized or was misidentified as having a behavior problem, a learning disability, or an attitude issue, rather than a neurodevelopmental difference.
Why does ADHD look different in Black adults than the textbook version?
Because the textbook version was not written with them in mind.
The most commonly recognized ADHD presentation is the hyperactive-impulsive one: the kid who cannot sit still, who blurts out answers, who seems to be in constant motion. That presentation is more common in males and is more likely to be flagged by teachers and parents because it disrupts the classroom. It is also more likely to be recognized across racial groups because the behavior is visible and cannot be easily attributed to something else.
The inattentive presentation of ADHD, which involves difficulty sustaining attention, forgetfulness, internal disorganization, and difficulty initiating tasks, is less visible, less disruptive, and significantly more likely to be missed. It is also the presentation that more commonly affects Black girls and adult women of color. A Black girl who is daydreaming, who forgets assignments, who struggles to organize her work but is not acting out, is much more likely to be described as spacey, unmotivated, or not living up to her potential than to be referred for an ADHD evaluation.
Research published in PMC on racial disparities in ADHD diagnosis documents that Black children are significantly less likely to be diagnosed with ADHD than white children, even when presenting with comparable symptoms, and that when they are identified, they are more likely to receive inadequate follow-up care. The gap is not explained by lower prevalence. It is explained by bias in the systems doing the identifying.
What is masking, and why do so many Black professionals do it?
Masking is the effort to conceal neurodivergent traits, to perform neurotypicality in environments that punish deviation from it.
It involves monitoring your behavior constantly, suppressing impulses, preparing extensively to compensate for executive function challenges, mirroring social expectations that do not come naturally, and working twice as hard to produce results that others produce with less effort. For many neurodivergent people, masking is not a conscious choice. It is what happens when the cost of not masking, the stares, the judgments, the professional consequences, feels too high.
For Black professionals, masking operates at multiple levels simultaneously. There is the neurodivergent masking that many ADHD adults do regardless of race. There is also the code-switching and self-presentation work that most Black professionals navigate in predominantly white professional environments. These two layers of performance are not the same, but they compound. The cognitive and emotional load of managing both is significant, and many Black professionals who are eventually diagnosed with ADHD describe the relief of finally having a name for why everything has felt so much harder than it should.
The masking eventually stops working. What follows is often described as burnout: the depletion of the resources that sustained the performance. By the time many Black adults reach a mental health provider, they are often carrying years of accumulated masking exhaustion alongside the ADHD itself.
How does racial bias affect who gets diagnosed and treated?
At multiple points in the system, and in ways that compound over a lifetime.
In childhood, Black children are less likely to be referred for ADHD evaluation by teachers, who are more likely to attribute their difficulties to behavior or attitude. In clinical settings, they are less likely to be taken seriously when they describe their symptoms, and more likely to receive diagnoses that reflect stereotypes, such as conduct disorder or oppositional defiant disorder, rather than an accurate neurodevelopmental one.
The stigma around mental health care in many Black communities adds another barrier. Seeking help has historically been coded as weakness, as airing family business, as something that happens to people who cannot handle their problems. These beliefs are not irrational. They developed in communities that had real reasons to distrust institutions, including the mental health system. That context does not make seeking help less important. It does make it more complicated.
Many Black adults who eventually pursue an ADHD evaluation describe feeling like they have to prove their symptoms are real, to work against the assumption that they are fine, that they are overreacting, that they should just manage better. Neurodivergent-affirming care that centers the client's experience rather than requiring them to fit a diagnostic mold built from a different population is one of the ways the system can do better.
What does neurodivergent-affirming therapy look like?
It starts from the assumption that the client's brain is not broken. It is different, and the systems around it have often not been built for how it works.
Neurodivergent-affirming therapy does not try to train the client into neurotypical behavior. It helps them understand how their brain works, what accommodations and strategies fit their specific nervous system, and how to build a life and work environment that works with their brain rather than against it.
At Creative Continuum, this means using art therapy as one of the primary modalities, because the creative process is often a more natural access point for neurodivergent clients than traditional talk therapy. It means taking the client's sensory, emotional, and attentional experience seriously. It means genuinely usable building tools, not systems borrowed from a framework designed for a different brain.
It also means holding the cultural context. For Black clients who have spent years being told their struggles were character flaws rather than neurodevelopmental differences, the therapeutic work includes making sense of that history, processing the grief of what was not recognized earlier, and building self-understanding that does not require adopting a narrative of deficiency.
Creative Continuum's therapy services and ADHD-focused resources are designed specifically for adults navigating these experiences.
How do you tell the difference between burnout, anxiety, and undiagnosed ADHD?
The honest answer is that without a proper evaluation, it is hard to tell, and the three often coexist.
Burnout is the depletion that follows sustained overperformance. It tends to follow a period of pushing through, and its primary feature is the absence of the capacity that was previously present. Anxiety involves persistent worry, a nervous system that is oriented toward threat, and often physical symptoms of activation. ADHD involves a regulatory difference in attention, impulsivity, and executive function that has been present since childhood, even if it was not recognized.
The overlap is significant. ADHD produces anxiety because the chronic experience of underperforming relative to effort, of forgetting things, of struggling to organize and initiate, is stressful. Burnout in a high-masking ADHD person looks like burnout from the outside and feels like collapse from the inside. Anxiety can suppress ADHD symptoms in some contexts and amplify them in others.
What a proper evaluation can do is create enough clarity to understand which of these is primary and which is secondary, so that the treatment addresses the actual driver rather than only the surface symptoms.
Book a consultation to talk through what you're noticing. No diagnosis required to start the conversation.
Start by documenting specific examples of accommodations that are not being implemented as outlined in the plan. Clear, factual records can help create more productive conversations with the school team.
Begin by communicating with the classroom teacher, as issues may sometimes result from misunderstandings, staffing changes, or a need for additional clarification. If concerns continue, request a meeting with the school's special education team or administrator to review the plan and discuss next steps.
Most schools share the goal of helping students succeed and are open to collaborative problem-solving. If concerns remain unresolved, parents can explore the procedural safeguards available under federal law.
FAQ
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Yes. Adult ADHD diagnosis is increasingly common, particularly for people whose presentations were not recognized in childhood. The diagnostic criteria require that symptoms were present before age twelve, but they do not require that the person was diagnosed at that time. Many adults, particularly women and people of color, receive a first diagnosis in their 30s, 40s, or beyond.
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Yes. Research consistently documents that Black girls and women are among the least likely groups to be diagnosed with ADHD, despite comparable prevalence to other groups. The reasons are well-documented: the diagnostic prototype was built from white male presentations, the inattentive subtype that is more common in women is less visible and less likely to be flagged, and racial bias in clinical settings affects who is taken seriously and who is referred for evaluation.
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Yes. Art therapy provides a mode of engagement that often works more naturally for ADHD brains than purely verbal approaches. The hands-on, creative dimension of art therapy supports attention and engagement. The process of making something externalizes internal experience in ways that can be explored and worked with. And for clients who have spent years explaining their experience verbally without feeling fully understood, art therapy often opens different kinds of insight.
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A diagnosis is generally private health information protected by HIPAA. Whether to disclose it to an employer is your choice, and there are legitimate reasons both to disclose and not to disclose depending on your situation. A diagnosis does not appear on background checks or in most insurance records in ways that would be visible to employers. If you have specific concerns about disclosure in your professional context, discussing those with your therapist is a useful part of the pre-diagnosis conversation.
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Both can involve difficulty concentrating, restlessness, and feeling overwhelmed. The key distinction is in the mechanism: ADHD involves a neurological regulatory difference in attention and executive function that has been present consistently over time. Anxiety involves a nervous system oriented toward threat, with worry as a central feature. In practice, both are often present together in adults with ADHD, which is why accurate evaluation matters. Treating anxiety alone when ADHD is also present often produces incomplete results.
About Creative Continuum Therapy
Creative Continuum helps adults make sense of a brain that's been managing more than anyone realized, often for years, often without a name for it. Through art therapy and neurodivergent-affirming care, we help clients build tools that fit how their mind works, instead of forcing it into a system that wasn't built with them in mind. We work with adults navigating ADHD and executive functioning challenges, in person in Phoenix or virtually across Arizona, Massachusetts, Vermont, and Pennsylvania. If you've spent years wondering whether it's you or something else, we'd love to help you find out.
