by Angela Neal-Barnett, PhD

Anxiety disorders are the most common mental health disorder in the United States. Data show that for Black women, anxiety is more chronic and the symptoms more intense than their White counterparts. This description, however, only tells half the story. What it does not tell us is how anxiety is perceived and experienced daily by Black women. 

Images of Black Women 

To fully understand anxiety and Black women, we must understand how Black women are viewed in this country. Research and history tell us that three basic images exist-the Strong Black Woman, the Angry Black Woman, and the Jezebel/Video Vixen. These images affect how other people see Black women and how they see themselves. They also play a role in the development and maintenance of anxiety. 

Strong Black Women are legendary. Harriet Tubman, Sojourner Truth, and every Black grandmother is renowned for her persistence and perseverance. There are many positive aspects about being a Strong Black Woman, but there are negatives as well. A Strong Black Woman “keeps on keeping on “even when she knows she should stop, placing her mental and physical health at risk. 

An Angry Black Woman will “cuss” you out before hearing you out. Tyler Perry’s Madea is a classic example of the Angry Black Woman. Our work with these women has found that many of them are anxious. The anger is an outward expression of their discomfort with negative affect associated with anxiety. 

The Jezebel/Video Vixen represents the sexualized Black woman. The term Jezebel comes from the Biblical Queen who turned her husband against God. Since slavery, Black women have been sexualized in derogatory ways, often represented in rap and hip-hop videos. Black women, particularly professional Black women work hard to dispel the Jezebel/Video Vixen image. 

Social Anxiety 

In workplaces, college and professional school settings around the country, Black women often find themselves the only one or the first one. In these situations, they have been taught that they have to be twice as good to go half as far, that they are representing the race and that they are being watched more closely than their white counterparts; beliefs that  are not necessarily inaccurate. These beliefs coupled with the Strong Black Woman image increase risk for social anxiety. 

Another social anxiety risk factor in the workplace and college/graduate/professional school setting is the acting white accusation. As the images attest, far too often we forget that there are more than three (3) ways to be a Black woman in this country. The acting White accusation, has nothing to do with wanting to be White and everything to do with what it means to be Black. In other words, it is an attack on one’s racial identity which in turn, can create anxiety. 


The rate of sexual assault among Black women is 3.5 times higher than that of any other group in this country. Black women are also less likely to report their assault. Many suffer in silence for years, never sharing with anyone what has happened to them. Thus, the trauma remains unnamed, unknown and untreated and the symptoms worsen. 

Racism is a form of trauma that disproportionality affects Black women (and men). Trauma in the form of racism can be directly or indirectly experienced. Driving while Black, shopping while Black, and everyday racial micoraggressions are direct examples of racial trauma. The most common indirect examples are the viral videos of unarmed Black women and men being killed. Vicariously witnessing race-based trauma, can be as devastating as the direct form. 

Help Seeking 

Slowly, the stigma associated with seeking help for anxiety is disappearing. Women have begun to understand that an anxious Black woman is not crazy, she is simply anxious and with assistance can reclaim her life. Black women who seek help want a therapist who understands their issues. Imagine telling you someone you are tired of being a strong Black woman and they recommend you stop working out. It’s happened! Therefore, it is important that therapists enhance their cultural competence and be open to culturally adapting anxiety interventions. Cultural competence involves, but is not limited to, familiarity with stereotypical images of Black women, racism as trauma and the acting white accusation. Cultural adaptation can include assessment and discussion of racial trauma and the deconstruction of images of Black women. 

Another form of cultural adaptation involves how an intervention is delivered. In our program, we use sister circles, an indigenous form of healing. Within the circles, we adapt CBT for a Black female populations. As example, rather than use cognitive restructuring to replace erroneous thoughts, we teach musical cognitive restructuring. Research has found both the method and content to be feasible and effective. 

This blog post was written April, 2018.

About the Author

Angela Neal-Barnett.jpgDr. Angela Neal-Barnett is a professor of Psychological Sciences and director of the Program for Research on Anxiety Disorders among African Americans at Kent State University. She is the author of Soothe Your Nerves: The Black Women’s Guide to Understanding and Overcoming Anxiety, Panic, and Fear (Simon & Schuster). Dr. Neal-Barnett is the recipient of numerous grants and has authored numerous journal and  general public articles on Black females and anxiety. Dr. Neal-Barnett is a member of ADAA's Multicultural Advances SIG and the Women's SIG

Sorry but no as a combat veteran I cannot imagine these ladies have any idea what PTSD is really like. Shopping while black and driving while black really? I think there are very good points in this article but please do not talk about shopping while black and PTSD.

I read your comment before reading the paragraph. You missed the entire point. In fact, it was laid out quite well and you took it apart and misunderstood another person’s experience. When you take out your personal experience, you’ll learn and understand that PTSD comes from anything that is traumatic to the human mind and body. The key is it changes your brain and your behavior in addition to whatever else that goes on in your life. A reminder that no two lives are the same. A veteran’s everyday experience with PTSD will not be the same as a a black individual who has experienced racial trauma and has PTSD from it. You truly don’t know what goes on in ones head and it is not a competition.

Thank you for your comment... Systematic oppression is real... and no one is saying veterans don't have PTSD but is the veteran thinking about his black counterpart that is considered even less than him that is a white veteran.... my grandfather served


June 16, 2020

In reply to by blondie fesser

I am a 38 year old black woman and I have dealt with ptsd for years with little help due to the cost of treatment. I can’t afford to se someone. My trauma goes back into my childhood with sexual abuse physical abuse foster homes adoption and the list goes on. I may not have served in the military but I know very well what it’s like to suffer in silence with this issue


June 20, 2020

In reply to by blondie fesser

You're misled and confused. Driving while black, shopping while black and being black are very real issues -which create trauma and can result in PSTD. I believe you're responding without information.

I saw a video of a 7 or 8 year old black girl crying hysterically with her hands in the air as a police officer drove past her, because she thought she might lose her life. You don’t think experiences like that over the span of 20 years or so will lead to PTSD?


July 2, 2020

In reply to by blondie fesser

Karen you will never understand any of the issues we face because you are not us. You know how much I’ve seen in my life that is far worse then shit military soldiers have seen. I wouldn’t expect you too.


July 3, 2020

In reply to by blondie fesser

PTSD is not just a military issue. And everything she said, I believe I valid. A person can develop ptsd after seeing all the traumatizing things going on in the world. I too am a combat veteran, Marine Corps.


July 13, 2020

In reply to by blondie fesser

Are you a Black woman? Because there are different ways to get PTSD, and while it may not be compared to going into combat. Black people, specifically women, definitely suffer from PTSD from being victims of systemic racism. It's not only about shopping, that is an example of challenges that we go through. It's only a small part of a much larger picture that does cause PTSD.

Trauma Doc

July 20, 2020

In reply to by blondie fesser

Dear Blondie—I’m a licensed clinical psychologist who specializes in trauma. I’ve treated several combat veterans, MST survivors, and many victims of racial trauma. Trauma is trauma. I recommend you read the book The Body Keeps Score.


August 27, 2020

In reply to by blondie fesser


You don’t have to experience only combat to have PTSD. Judging by your username, I really don’t expect someone like you to understand the daily struggles of being a black woman in America. You totally just disregarded the issues in this article.

Any no mouse

September 19, 2020

In reply to by blondie fesser

The PTSD the author was referring to is from sexual abuse and other forms of child abuse. Please educate yourself self on their long standing effects before dismissing them simply because you did not experience that type of abuse.

Veteran and Black

October 6, 2020

In reply to by blondie fesser

Blondie fesser,

You are absolutely wrong! You should know better than anyone that you cannot marginalize someone else's PTSD. You are trying to equate you specific PTSD to someone else's. Yes, really...driving and shopping while black has caused PTSD in Black people. Just as civilians cannot understand your experience in the combat zone, you CANNOT understand the every daily life of a black person. I am a black combat veteran and I also have PTSD from driving and shopping while black. I am also a current federal law enforcement officer; however, whenever I am off duty and living my law abiding life, my heart rate increased every time I see a policeman driving behind me or when I am in a store shopping and I notice someone following me even though I know I am doing nothing wrong. Don't you dare tell anyone those things are not PTSD just because yours is different or you think your PTSD is more serious just because you were in a combat environment. I've seen people die over there and sure I have PTSD, but I am more affected by what happened to me here than there. Educate yourself! Ask clarifying questions before making uneducated assumptions.

A young BLACK woman

October 12, 2020

In reply to by blondie fesser

How do you feel after you have said that? Do you believe you were being inconsiderate- I mean everyone is entitled to their own opinion but how would you know if you are a "blondie fesser" implying that you are a white woman? Ma'am, if you are not in a black woman's shoes, going through oppression by people of your skin color, then you might want to not want to say stuff like that. We (as in myself and the black community) are not cared for and privileged like y'all are (the white community)- y'all have everyone and we only have ourselves and our families. We are just now coming up in life now just to be pulled down by police shootings and police brutality. On the other hand, what I'm trying to say is that you do not have the right to say what you said and that you shouldn't be speaking that way on things you have nothing to do with. Oh, you should ask what some living shooting victims are experiencing after their family/friends have been shot down by cops.

Living Beautif…

October 29, 2020

In reply to by blondie fesser

Clearly.... you have “issues” deeper than your unawareness and ignorance. Frankly, it is people like you who are perpetuating the inequities in healthcare and social reform... and stress me the hell out. Data and facts invalidate your opinion. So you can stay wrong and ignorant as a part of the problem... or go read a book.

Jose' P.

November 2, 2020

In reply to by blondie fesser

Correct b.f., it's messed up when those of a different ethnicity follows us around, or pull us over near a stop sign for nothing other than the color of skin gets a pardon with the PTSD game. Many black females have been schooled to think everyone including their own is obligated to accept her obnoxious behavior for compensation for what their ANCESTORS had gone through. That's beyond mind blowing!


November 3, 2020

In reply to by blondie fesser

You should not think your trauma is worst than someone else’s. That’s not your say. Trauma is trauma. The definition of ptsd doesn’t change because of the type of trauma they deal with. PTSD is still PTSD. A lot these women are sexual abused at a young age or experience violence within and outside of the home. I didn’t serve in the war but I’ve witnessed 3 people get shot in front on me. 2 of them are dead. You may have seen more but my trauma is still my trauma. Being black in itself is a traumatic experience to plenty. A lot of individuals live in an environment they refer to as the “trenches”. Just imagine what goes on there.


November 8, 2020

In reply to by blondie fesser

First I just want to say thank you for your service. I have no clue what your experience is and therefore cannot speak on it-but you also cannot understand the experience of others and shouldn't speak on it. There are many ways to experience PTSD and it doesn't just come in the form of combat. Please keep in mind that everyone has triggers and their own lived experience and traumas.

Think before y…

November 11, 2020

In reply to by blondie fesser

You sound real ignorant. If you've never experienced either of these, then you can tell someone they aren't experiencing PTSD. As a Black woman, I get nervous anytime Im pulled over by a police officer. I practically have an anxiety attack and Im more mindful of my actions. PTSD is not just for people in the military. It's for ANYONE that has experienced a trauma in their life that changes how they react in life. PTSD can come from car accidents, sexual assaults, domestic violence or being a witness of domestic violence.

SGT Dave

November 29, 2020

In reply to by blondie fesser

I am a combat vet with PTSD also, and am white, and in grad school for social work. I work with nearly all black students from Baltimore. Most of them have signs of PTSD, and all have trauma. If you look at the diagnosis of PTSD and then the individual, you can see it. Imagine being 11 years old and seeing a police officer or a drug dealer on your street and legitimately fearing for your life. Think of all the terrible circumstances that come with generations of poverty and incarceration. Most of us vet had it easier. We go overseas and experience/witness extremely traumatic events. The worst year in Afghanistan saw 496 deaths, followed by 412, 310, 301, and it sharply drops before and after that. Baltimore is as follows starting at 2019 and going down: 348, 309, 343, 318, 344. So, I see where you are coming from but if you just look at these numbers it is clear. The other systemic traumas are valid, but for someone who has been to combat I understand why they appear too subtle, at first.
Semper Fi


January 10, 2021

In reply to by blondie fesser

Everybody's world view is different. I was diagnosed with PTSD after giving birth to my only child 27 years ago. See, I carried him full term not knowing that he was in distress. He stayed in the NICU for the first 55days of his life. He's healthy now but he's mentally disabled. I was diagnosed with PTSD in lieu of postpartum depression due to the traumatic birth. I'm sure by now reading all these comments you have now discovered that there are many causes for PTSD. Being in the military is just one of many causes for this disease.

In the final paragraph, the author writes, "In our program, we use sister circles, an indigenous form of healing." Is there a link available to the program referenced? Are there additional resources and/or readings available regarding how, specifically, the program referenced--or the author herself--finds, establishes, or supports these sister circles to engender healing in multiple locales?

Thank you for any assistance you're able to provide.

Provide the source to the data that shows black women have more chronic anxiety and more intense symptoms then their white counterparts.

Why wouldn’t black women have more chronic anxiety and intense symptoms than white women? Do white women have to deal with anti-black racism AND sexism at the exact same time? What is your problem? And stop demanding information that any kindergartener could look up on google. Why don’t you google information on black women and anxiety so you won’t have to “ask” inane questions about why black women would be more anxious than white women in a racist country.

This article hit the nail right on the head. These are things that even myself go through daily. Black women can't even wear their GOD given hair without stares from all other people. So we have to try and fit into other peoples image instead of GODS image.

thank you having a place to share my story a former military spouse low income not able to work an apartment not in good condition I was homeless for several years in tampa fl I am in treatment now its going well now

I like how this article pointed out three different general directions that are choices for black woman. I also like how the state of being of a black woman was discussed and organized. There is a sense of understanding and compassion that seeps through in different scenarios that a black woman could find herself. It would be nice to view additional options for solutions with an equal amount of exploration.

So many women can benefit from these therapies. I hope to see an expansion soon. Often we hear of the 'superman' syndrome; however many rarely comment on the 'superwoman' expectation in Black women; often connected to the Strong Black women, partly because we get less credibility for the work that we do.

I have some comments here within several articles on AfricanAmerican women that I have written.


Perhaps they will helpful in your therapy sessions as well.

Mrs. Carolyn Clavon

October 5, 2019

I really appreciate and respect your article. It is an honor to congratulate you on all of your life achievements. When there is a time convenient for you, would you be able to help the black community understand why black women steer more into the direction of tearing each other down vs the path of equality, respect, encouragement, wisdom, compassion and spirituality?

This is prevalent and very destructive. I feel we are like cats in a world of dogs. As cats fight each other on site and dogs form packs in order to survive.

Thank you so much for this. I would carry this article with me anytime I was going into therapy, having a bad day at work, and in routine checkups too. Therapy was horrible experience after horrible experience. Being misunderstood. Touted as 'strong and brave' but treated as mentally ill/crazy because I 'intimidated' the medical professional from my look or my backstory alone. I was often told that I seemed intimidating and I haven't even spoke. This is on the first visit. I wish they just would have say then that they can't handle me and my struggles, instead of refusing to stop mishandling me altogether.

Since I didn't show the typical sign of depression or anxiety, I should have quit while I was ahead. It would have saved me so much money on unnecessary meds and counter side effect meds, ineffective thus harmful therapy, and inpatient hospitalizations, because none of the other things were working. The time and effort trying to lose all the weight and rebuilding my professional from such a trial and error process. I'm still reeling from it and I am only in my 30s. I can see why we hold it in, It's like the don't even try and because of that we get hurt. Really bad. Too much medicine so we can 'calm down' or complete dismissal of any pain we have. Seeking professional help? Damned if you do, damned if don't. why even bother? But, I am hopeful since articles like this are more prevalent and more POCs are in members of the medical community. It's motivated me to in psychology in someway. I can't imagine letting this kind of substandard care happen to anyone else that is so deserving of relief and compassion instead. Thank you again!

Thanks so much. It's so appreciated that someone understands, this article really helped me to calm down and experience the love and peace that I asked the universe to send me today. I see articles like this as an act of love because some of us really are out here hurting and living in so much fear at times while also feeling isolated. I live in a black where the black population is less than one percent and it's here where I've learned so much more about racism and it's origins. It's empowering to know that we can experience such things and still thrive. I will say I have experienced a lot of what I've read in the comments here, especially the re traumatizing therapy and medication stories. This morning I was doing some meditation and visualization excercises and I was imagining being in a circle of black women swaying and healing using our vocals to release the pain and trauma and show support, so I know it's not a coincidence o came across this. A lot of us crave that kind of interaction with other black woman and I believe we have a subtle remembrance of those customs. I'm really glad the circle exist, and as a black woman who has been primarily self managing her mental health since childhood I super appreciate you for writing this and I wish you and ever woman on here infinite love and blessings.

Thank you for the article. As a multicultural woman, I was recently diagnosed with depression and anxiety(social anxiety). At the request of my mother, I am seeing a life therapist whom referred me to start seeing a psychologist.

What a relief to know that what I experience almost daily is actually a thing— it exists! Anxiousness. Social Anxiety due to racism and cultural stereotypes. I’m 24 and I've pretty much been dealing with this all of my child, teenage life and early adult life. I don’t deal with crowds anymore. I don’t deal with PEOPLE anymore because they can be quite mean. — And yes, racism and cultural stereotypes are a big part of that. I’ve found writing and art to be a good outlet when I’m feeling the worst of my anxiety and won’t go out of the house for days to weeks. I know this isn’t healthy but I do tend to feel better after I write my stories or craft something during my social hiatus. I don’t have a job because it is quite difficult to find one especially for our generation. I know this isn’t mentioned in the article but it’s also harder for us (especially BW) to find stable jobs. You pretty much have to look a certain way or know someone simply to get a stable, decent job now. Just having a college degree doesn’t seem to cut it anymore.

I’m a 23 year old black woman dealing with social anxiety and also felt a ton of relief reading this article. It makes me feel like my feelings are valid and that I’m not alone. I’ve struggled with social anxiety since I was about 13 but having recently graduated college and entering the workforce have struggled even more-so with isolation and loneliness which ultimately has lead to self-destructive coping mechanisms. I’ve tried therapy in the past but didn’t feel understood and am desperate to find healthy coping mechanisms. Finding articles like this one help me get through the bad days.

I just wanted to say that I've been dealing with the same. Albeit, my self-destructive tendencies have landed me in several psyche wards over the years and have totally delayed my academic/career endeavors. I'll finally be graduating with a tech degree next spring at age 34. I've truly felt completely isolated. I haven't met any black women that have admitted to being able to relate to what I'm going through which has made it so much harder. And my social anxiety makes it really difficult to potentially meet black women that I can relate to. So I have an idea of how you feel. Good luck.

Thank you so much for writing this article. It really means a lot to me to have someone that I don't know understand my situation. I've been a trailblazer as far as paving the way for other Africa American's but unfortunately it comes at a very high price that I realize now I couldn't afford (PTSD). Nothing major but steps taken to help our people by representing myself well and being a stern speaker. Now, I'm just tired with bad memories residing in my head unable to see any accomplishments just sacrifices. Thank you.

Cry me a river. PTSD? Did you have your friends blood spattered all over you in combat? Thank you for trying to make a difference. But please don't tell me you suffer from PTSD because of your bad memories.

Trauma is trauma no matter what name it is given. Every experience is different that's why we all need to come together and share. It's having to deal with those bad memories over and over again no matter where, why, how or who it comes from.
There is a trauma, an ongoing trauma, that we have to go through even in today's world because there are people in our society that don't want us to have a LIFE just because of our skin colour. If racial discrimination didn't occur, then there wouldn't be young people dealing with such trauma now. There aren't systems in place protecting us from experiencing trauma based on how dark our skin is. People need to start talking about how everyone can make situations better when they see someone being treated unfairly in society. It's nice when someone sticks up and empathises with us when we least expect it and to not have to defend ourselves all of the time.

Blondie's expi…

August 30, 2020

In reply to by blondie fesser

By your logic, rape victims don't experience PTSD. Kidnap victims don't experience PTSD. Prisoners don't experience PTSD. A child finding a dead relative doesn't experience PTSD. Unless you've specifically seen a military comrade get blown up/shot up and have their blood all over you, PTSD can not and does not apply.

Read a book, love. Seriously. There are probably black kids in America that have seen and experienced more violence and death in the ghetto by age 16 than you have seen and experienced as a trained combat veteran.


September 30, 2020

In reply to by blondie fesser

There are always going to be people like Blondie or whoever that come on forums to stir the pot. How brave do you really think that person is in real life? Ignore...

Check Yourself

November 16, 2020

In reply to by blondie fesser

Yes. PTSD. Have you ever grown up in a hood community that was once a flourishing black neighborhood a couple of generations back that was ruined by gerrymandering and gentrification and overrun by poverty and people drowning themselves in drugs to function so much so that you can count more people not depressed than you can depressed? Have you had to move for testifying against neighbors dealing drugs, or almost got shot by a stray bullet coming into your apartment as a kid. A couple of times? You ever been coming home to where you folks can afford to live and accidentally walked into a gun fight and had to run to duck some bullets? Have you ever lost friends in drive by shootings? Or had to rush your kid brother home at age 9 and he was 4 after playing outside with kids and so you can look him over after you catch him pick up a drug needle on the ground. Have you ever spent an entire life fighting to escape this environment for a better life and constantly told by employers or college advisors that you are simply not good enough after earning scholarships and awards and conquering top notch grades to get to one of the most competitive universities because they don't understand that you have to work to put your way through college and you can't take all the required classes during the day because you have to work a job at 18 to supplement what the scholarships do not and your expected family contribution is $0?? Do you know what it's like being able to interpolate functions and make adders and multiplying switches out of electric circuits and still have to consider being a stripper to finish school? Do you know what it's like having parents that were once pretty solid but the pressure of life left them both mentally unstable with Bipolar and Schizophrenia by the time you were 18 and you have no mental health issues, but you feel just trying to rise above the BS is going to give you one? Had siblings locked up while their white friends be dropped off safely at home and have their drugs planted on your brother and blamed for their crime? Have you ever been harrassed as an assailant simply on your way home from work getting off the bus in a predominately white neighborhood, picked up without being read your rights or arrested, forced into the car and driven PAST your home to be ID'd on the spot by a victim, who of course, said it wasn't you? Wrong black person? Have you ever sat in an emergency room and lost the ability to control bodily functions and be looked coldly in the eye, shrugged off, and told to see a specialist while the white woman beside you who fainted even though they couldn't really find a reason why be held for a few days for observation to be sure she's alright? Have you ever watched a doctor's demeaner completely change when he walks into a room and looks at you and then do a 180 when he sees your white boyfriend posted up behind the door? Have you ever been humiliated by colleagues and vendors- professional sales people- at a career conference because they want to touch and judge the texture of your hair when you want to talk business to see if it feels as 'rough as it looks'?? And experience all the usual dehumanizing things that also go along with being a woman on top of all that?? It's not bad memories. It's trauma. You talking about 1 bad incident. This is one life I've just summarized here. And I keep my mouth shut amongst others I know like me cause their stories are far worse. So YOU cry me a river. This is not a comparison. So please don't go there.