Black women’s mental health & the “strong Black woman” pressure
You have been strong for so many people. You also deserve softness, rest, and someone who holds space for you.
By the numbers
What U.S. data show about Black women, health care and care gaps.
Health care
Care gap
Young women
Seen in full
More than strong: whole, complex, and worthy of care.
Black women hold families, churches, workplaces and movements together. That strength is real. But being seen only as strong can mean your pain, tiredness and needs go unseen, sometimes even by you.
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Black women in the U.S. include African American, Caribbean, African, Afro-Latina and mixed-heritage women; lesbian, bi, trans and straight women; and women of many faiths and none. Take what fits here, and leave what doesn’t.
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Researchers call this gendered racism. A scale built with Black women found common themes such as being judged by assumptions about beauty and the body, being silenced or pushed aside, and the “angry Black woman” stereotype.
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Women of colour & mental health explains the “Superwoman” role, its benefits and its costs. This guide picks up from there, with newer research and more on health care, motherhood, sisterhood and rest.
Beyond “strong”: what newer research shows
Some parts of the Superwoman role may protect you. Others may wear you down.
In 2019, researchers studied 208 African American women aged 30 to 50 in the San Francisco Bay Area. They looked at racial discrimination, five parts of the “Superwoman schema”, and allostatic load: a measure of wear and tear on the body from long-term stress.
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For women facing a lot of discrimination, feeling you must present strength and hold back emotions was linked to lower allostatic load. The lead researcher suggested this may be because anger, the most common reaction to discrimination, is hard on health.
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An intense drive to succeed despite limited resources, and feeling obliged to help others, seemed to make the health effects of discrimination worse.
Questions to ask yourself
- Am I saying yes out of love, or out of fear of letting people down?
- When did someone last help me?
- What would “enough” look like this week?
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The researchers were clear that the problem is not that Black women need to cope better with racism. Changing unfair systems is the real fix. In the meantime, you deserve support for what you carry.
Weathering: how stress adds up in the body
Years of strain can show up as early wear and tear.
Researcher Arline Geronimus coined the word “weathering” to describe how the ongoing stress of racism can wear down health over time. A 2006 study using national U.S. health data found Black adults were more likely than White adults to have high allostatic load at every age.
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Black women, whether living in poverty or not, had the highest and second-highest chance of high allostatic load scores. The gap was not explained by poverty.
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The authors suggested weathering may be strongest for those who cope by pushing hardest against barriers. Your effort is admirable, and your body deserves recovery time too.
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Ideas
- A short walk after work to let stress settle
- Keeping regular checkups, including blood pressure
- Protecting sleep like an appointment
- Time with people who make you laugh
Being believed in health care
Bias in care is real. You have the right to be heard.
Many Black women describe going into appointments ready to be doubted. Research shows those worries are grounded in real bias, not oversensitivity.
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A 2016 study found that about half of the White medical students and residents surveyed believed at least one false idea about biological differences between Black and White people, such as Black people having thicker skin. Those who held these beliefs rated Black patients’ pain as lower.
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Phrases that can help
- “I know my body, and this is not normal for me.”
- “What else could this be?”
- “Please note in my chart that I asked about this.”
- “I’d like a second opinion.”
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In 2024, 14.7% of Black adults received mental health treatment, compared with 22.9% of all adults.
Motherhood and maternal mental health
Pregnancy and new motherhood deserve safe, respectful care.
In 2023, the maternal death rate for Black women was 50.3 per 100,000 live births, compared with 14.5 for White women. Knowing this can bring real fear to pregnancy, on top of the usual worries.
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In a 2023 CDC survey, 30% of Black respondents reported mistreatment during maternity care, such as having requests for help ignored or being shouted at or scolded, and 40.1% reported discrimination.
What can help
- Bring a partner, relative, friend or doula to appointments
- Write down questions and warning signs beforehand
- Say clearly when something feels wrong, and repeat it
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Many new mothers feel tired and emotional. If sadness, worry or numbness last more than two weeks, or you have scary thoughts, tell your clinical provider. You are not a bad mother for struggling.
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Ways people can help
- Bring meals or do the dishes
- Hold the baby so mom can shower or sleep
- Ask, “How are you feeling?” not just “How’s the baby?”
- Help find a therapist if she’s struggling
Carrying everyone: family, church and work
The kinkeeper, the caregiver, the one who handles it.
Many Black women are the person everyone calls: for rides, money, advice, funerals, church programs and care for elders. Being needed can feel meaningful, and also exhausting when no one asks what you need.
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African American family caregivers give over 31 hours of care a week on average, and about a third care for more than one person.
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Black women often lead ministries, cook for every event and care for the grieving. Faith can be a deep source of strength. It is also okay to step back from a role when you’re running on empty.
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Being the only Black woman in the room, being talked over, or having your tone policed adds daily strain.
Sisterhood and sister circles
Healing in the company of women who understand.
Black women have long gathered to support each other: in church groups, sororities, book clubs and kitchens. Psychologist Angela Neal-Barnett and colleagues have studied “sister circles” as a culturally fitting way to help anxious Black women.
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Sister circles build on existing friendships and community ties among Black women. Research so far is early, but women described feeling less alone with their worries.
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Try this
- Invite three to six women you trust.
- Agree that what’s shared stays in the room.
- Pick a simple topic, like rest, work or mothers.
- Take turns sharing; listen without fixing.
- End with one small thing each person will do for herself.
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Friends can listen; a therapist can help you untangle patterns and plan changes. Many therapists also run groups for Black women.
Listed by NAMI and the Maryland Department of Health
- BEAM (Black Emotional and Mental Health Collective): a Black Virtual Wellness Directory and healing circles
- Therapy for Black Girls: a therapist directory, podcast and community for Black women and girls
Safety in relationships
Love should not hurt. Your safety matters, too.
Black women may face extra barriers to getting help with abuse: not wanting to expose a partner to police, worry about being judged, or pressure to keep family business private. You deserve safety without having to choose between yourself and your community.
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Abuse can be emotional, financial, sexual or digital, as well as physical. Feeling scared of a partner is a sign to take seriously.
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The National Domestic Violence Hotline is free, confidential and open 24/7. Call 1-800-799-7233 or text START to 88788. Talking to an advocate does not mean you have to leave or call the police.
Rest, joy and saying no
Putting yourself on the list is not selfish.
Rest and joy are not rewards you earn after everyone else is taken care of. They are part of how you stay well enough to keep loving the people and causes you care about.
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Phrases to try
- “I can’t take that on right now.”
- “I can help with this part, not all of it.”
- “Let me check and get back to you.”
- “Not this time, but thank you for thinking of me.”
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Ideas
- A bath, a nap or quiet tea with no phone
- Dancing to music you love
- Letting one thing be “good enough”
- Time outdoors, even 10 minutes
- Asking someone else to cook
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Black joy has carried communities through hard times. Making room for it is part of caring for your mind.
When and where to get help
Signs it’s time to reach out, and free places to start.
Reach out to a clinical provider or therapist if…
- You feel exhausted, numb or low most days for two weeks or more
- You can’t remember the last time you felt rested
- Racism, a loss or a hard event keeps replaying in your mind
- It’s affecting your sleep, eating, work or relationships
- You feel hopeless, or have thoughts of not wanting to be here
Free help
- 988 Suicide & Crisis Lifeline: call or text 988, or chat at 988lifeline.org (24/7)
- Crisis Text Line: text HOME to 741741 (24/7)
- National Domestic Violence Hotline: 1-800-799-7233, or text START to 88788 (24/7)
- National Maternal Mental Health Hotline: call or text 1-833-852-6262, for pregnant and new moms (24/7, English and Spanish)
📝 Worksheets for this guide
Fill these in privately in the app. Your answers stay on your phone.
Sources
- Centers for Disease Control and Prevention (CDC) (2023). Vital Signs: Maternity Care Experiences — United States, April 2023 (MMWR 72(35))
- National Center for Health Statistics (NCHS), CDC (2025). Maternal Mortality Rates in the United States, 2023 (Health E-Stat)
- U.S. Department of Health and Human Services, Office of Minority Health. Mental and Behavioral Health: African Americans
- Woods-Giscombé (peer-reviewed), via PubMed Central (NIH) (2010). Superwoman Schema: African American Women’s Views on Stress, Strength, and Health (Qualitative Health Research 20(5): 668–683)
- Lewis & Neville (peer-reviewed) (2015). Construction and initial validation of the Gendered Racial Microaggressions Scale for Black women (Journal of Counseling Psychology 62(2): 289–302)
- Annals of the New York Academy of Sciences (peer-reviewed), via PubMed Central (NIH) (2019). Racial discrimination, the superwoman schema, and allostatic load: exploring an integrative stress-coping model among African American women (Allen et al., Annals of the New York Academy of Sciences 1457: 104–127)
- UC Berkeley School of Public Health (2019). Does being a “superwoman” protect African American women’s health?
- American Journal of Public Health (peer-reviewed), via PubMed (NIH) (2006). “Weathering” and age patterns of allostatic load scores among blacks and whites in the United States (Geronimus, Hicken, Keene & Bound, American Journal of Public Health 96(5): 826–833)
- Proceedings of the National Academy of Sciences (peer-reviewed), via PubMed (NIH) (2016). Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites (Hoffman, Trawalter, Axt & Oliver, PNAS 113(16): 4296–4301)
- National Institute of Mental Health (NIMH). Perinatal Depression
- National Alliance for Caregiving (NAC) (2025). Voices of Care: Recognizing African American Caregivers (citing Caregiving in the U.S. 2020, NAC and AARP)
- Clinical Psychology: Science and Practice (peer-reviewed), via PubMed Central (NIH) (2011). Sister Circles as a Culturally Relevant Intervention for Anxious African American Women (Neal-Barnett et al., Clinical Psychology: Science and Practice 18(3))
- National Alliance on Mental Illness (NAMI) HelpLine (2025). How can I find a mental health provider who is part of or has experience working with the African American/Black community?
- Maryland Department of Health, Behavioral Health Administration. Mental Health Resources for the Black Community
- Therapy for Black Girls. Therapy for Black Girls
- BEAM. Black Emotional and Mental Health Collective (BEAM)
- National Domestic Violence Hotline. National Domestic Violence Hotline
- Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau. National Maternal Mental Health Hotline
- American Academy of Family Physicians (AAFP). New Maternal Mental Health Hotline Launches
- 988 Suicide & Crisis Lifeline. 988 Suicide & Crisis Lifeline
- Centers for Disease Control and Prevention (CDC). Get Help Right Now (How Right Now)
- Crisis Text Line. Crisis Text Line: Text HOME to 741741
- Substance Abuse and Mental Health Services Administration (SAMHSA). Crisis Text Line (Behavioral Health Information Series)
This guide is for education and self-care. It is not a diagnosis or a substitute for professional care. Please talk to a counselor or clinical provider about your health. Reviewed October 2026.

