We’re Not Crazy, We’re Grieving: Black Women, Mental Health, and What Gets Missed in Therapy

Let me tell you what I’ve seen in my therapy chair.

A Black woman shows up for help. She’s doing everything: working, caregiving, showing up for her people, trying not to fall apart. Maybe she’s crying in session, or maybe she’s just tired. Like… bone-deep tired. And when she finally gets the courage to talk about it, the words that come out sound something like:

“I don’t feel like myself.”

“I think I’m losing it.”

“Maybe I’m just crazy.”

But let me say this clearly, and I say it with love: You are not crazy. You are grieving.

And I don’t mean just grieving a person (although, yes, that too). I mean grieving everything that Black women are constantly asked to carry and lose—without acknowledgement, without pause, and without help.

What We’re Actually Holding

We’re grieving the loss of softness.

The loss of safety.

The loss of being mothered, nurtured, and allowed to fall apart.

We’re grieving the years we spent pretending we were okay.

The ways we silenced ourselves in jobs, in relationships, in our own families.

The friendships that faded because we were always the strong one.

And some of us—let’s be real—are grieving the things we never had in the first place: a present parent, a stable home, a childhood without fear, a therapist who actually got it. And when that grief doesn’t get named, when it doesn’t get held, it starts to sound like anxiety. Like rage. Like apathy. Like panic attacks in the middle of the night. Like “I’m fine” said through gritted teeth.

Diagnosis Doesn’t Always Tell the Whole Story

I’m a therapist. I know what the DSM says. But sometimes, the truth is bigger than a diagnosis.

What looks like “high-functioning depression” might actually be a lifetime of emotional suppression.

What gets labeled as “generalized anxiety” might be a survival response from growing up in chaos or carrying intergenerational trauma.

What’s written down as “adjustment disorder” might really be I just lost everything I thought I could count on, and no one’s talking about it.

And when it comes to Black women, especially, I’ve seen how quickly our grief gets misread—minimized, pathologized, or intellectualized.

What Black Women Need in Therapy

We don’t need to be told to “reframe” before we’ve had space to feel. We don’t need to be handed breathing exercises when what we really need is a moment to sob without being seen as weak. We don’t need another coach, fixer, or savior. We need to be witnessed.

Therapy, when it works, is not about fixing you. It’s about honoring the grief that you’ve never had time, space, or safety to hold. It’s about saying: “I believe you. I see what it cost you to keep going. You don’t have to carry it alone anymore.”

If You’re a Black Woman Reading This…

Please know: you are not broken. You are not behind. You are not too much. You are grieving. And your grief is valid, sacred, and deeply human.

You’re allowed to be tired.

You’re allowed to not know what’s next.

You’re allowed to want more than survival.

And if you’re ready, there are spaces, real ones, where you can bring all of it: the exhaustion, the ambition, the rage, the tenderness, the confusion, the hope.

You don’t have to earn rest. You don’t have to prove your worth to begin healing.

We’re not crazy.

We’re grieving. And we’re finally making room for it.