ADHD Denial Can Be Brain-Based

man in suit with head in sand ADHD deninal


Denial  of Adult ADHD symptoms hurts everyone. But we compound our hurt when we wrongly attribute this denial in our  loved ones to stubbornness or willfulness.  Sometimes, that is the case. Many times, however, “ADHD denial” springs from ADHD neurobiology itself.

No one was talking about this “brain-based denial” in 2000-2008. Including most ADHD specialists, including couple therapists. That’s when I was deeply enmeshed in my own ADHD-challenged marriage and leading support groups to help us all find answers—and hope. I determined that my book would be the first.—Gina Pera

Welcome back to the “You, Me, and ADHD” Book Club!  

Each post discusses a chapter of the book  Is It You, Me, or Adult A.D.D.?

Here, Taylor shares her insights about Chapter 14, about how “denial” can be more than psychological; it can be based in biology.

By Taylor J.

Last weekend, a family member sat at my kitchen table. Her head in her hands, she told me about the latest episode with my uncle.

He’s a bachelor in his sixties, the family’s well-established “eccentric.” He has little patience for social niceties, yet is emotionally hurt very easily. That’s why his siblings didn’t see the warning signs as they trickled in.

For example:

“He started calling me at nine or ten at night, asking me for cookies. I had no idea why he’d had such a sugar craving. But I brought him cookies—every night he called, for about a week. But why didn’t he eat any of them?

“Then a couple of weeks later, he asked if our fire alarm went off because he was sure he’d heard it, clear down the road. He called every couple of hours and had us check our smoke detectors or our neighbors’ because he was convinced we were all in trouble.

The next week, when that polar vortex came, he called at two in the morning, convinced his well pump had frozen. We went out to check on his well pump, and it was fine.

plate of chocolate chip cookies adhd denial

“My God, He’s Had a Breakdown”

“That morning, his two best friends called us, and said he was off his rocker, raving about the well pump, how it was going to freeze, and he was never going to have water in his house again. We went to check on him, and he was sitting out in the well house, in the freezing cold, with no coat or hat or gloves, trying to fix some pipe or another other, with no tools.

“I thought, My God, he’s had a breakdown of some sort. I coaxed him back into the house, put a hat and gloves on him, and called the ambulance. All the while, he was raving about how the busted pipes was going to ruin the hardwood he’d just put in, and that he had to fix the well pump before it cost him ten thousand dollars when it froze.

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“I was so scared.”

My relative was shaky and tearing up. My heart was pounding while I listened to her. After studying Gina’s book and blogs for so long, I had about five thousand theories about what caused this behavior—but I was more worried about her, the caregiver, and how she was feeling at the moment.

“They managed to get him in the ambulance and get him a little bit sedated. They had to restrain him, and I tried to calm him down, but he raved and hollered all the way to the hospital. I’m the one who keeps records of all his meds, so I had to answer a ton of questions, and it took them all day long to figure out what happened.

Mineral Deficiencies Led To This?

“When they told me, I couldn’t believe it. It wasn’t a stroke or a psychotic break. He’d started some new medication for [I don’t remember the medical condition, but I do know it wasn’t brain-based at all] and they told him to drink a lot of water with it. Well, he did. He drank a gallon of water per day. When they ran his blood tests, they found that the meds and all the extra water had completely drained the sodium and the potassium from his body. There was none left.

“Once they hooked up the sodium and potassium to his IV, he started looking around and asking what the heck he was doing here. They released him with strict orders to drink no more than 16 ounces of water per day.

“And when we took him home, he asked, ‘What in the hell are all of these cookies doing here?’”

This is a true story. Identifying details have been changed, but that’s it.

Can you imagine what would have happened to my uncle twenty, fifty, or a hundred years ago? He could have been locked in an asylum. Religious figures may have tried an exorcism. Some people may have been convinced that he was doing this on purpose, to get attention, or at the very least, to get cookies! His behavior, however, had an identifiable, biological cause.

I would never have thought sodium and potassium deficiencies could cause someone to obsess about a well pump.

Then Gina Explains “ADHD Denial”

In the same way, we who loved family members “in denial” of their mental illness mostly have no idea that biology can play a role in this. We think they are just lying to themselves! We’re told by some therapists that they are avoiding the pain of change!

In reality, brain-based problems can keep these family members from seeing that a problem exists at all.

In Chapter 14, Gina shares with us psychologist Xavier Amador’s heartbreaking story, about watching a beloved older sibling trapped in denial of his schizophrenia. Amador’s experience set him on a twenty-year journey to clinically study why denial happens—and what clinicians and family members can do to break through it.

After reading this chapter, you may very well know more than your psychiatrist or therapist knows about the biological causes of denial.

Breakthrough Understandings

Once you’ve absorbed chapter 14:

  • You’ll understand how your ADHD partner’s “lies” can actually make perfect sense to him or her.
  • You’ll see how they can justify making impulsive purchases, or insist that they didn’t make a mistake (but you did!) when a schedule falls apart.
  • Most importantly, you’ll understand that your partner’s behavior may have nothing to do with you, or how much your partner loves you.

When we get to the next chapter, you’ll even start getting some tools that will help you overcome denial, and get you both the help that you truly need.

When I first found Gina’s book, I jumped to this chapter, right after Chapter 11. I was sitting in the back corner of Panera, sipping hazelnut coffee, and trying not to cry my eyes out. Finally, I felt like I could see the connection between the loving man I’d married and the behavior that just might tear our family to shreds.

Let me assure you, learning about these messy neurobiological conditions can truly empower you to make the best, most helpful decisions for your life and for your marriage.

For This Chapter’s Discussion:

1. Which behaviors from the chapter (“confabulation,” lack of coordination, difficulty linking cause-and-effect, and so forth) would be the most difficult for you to associate with a “biological” cause in your partner? Remember, “a fear of frozen well pumps” could be one of them!

2. What part of the chapter gave you the most hope?

3. Even if your partner’s behaviors do have a biological basis, what steps can you take today to lower their impact on you?

To read the next chapter’s essay

Click here:  Chapter 15   New Ways to Broach “The Conversation”

We welcome your comments. 

This book club is always open!

Please see below a list of all the essays in this series.

—Gina Pera


Hyperlinks to  Each Post

And now for the preview of the chapter-by-chapter lineup: the book’s table of contents.  Chapter titles appearing as hyperlinks correspond to an essay in the Book Club. Click to read.

Book Introduction                                                                                                                   

Part One:

From the Tunnel of Love to the Roller Coaster:

Could Your Partner Have ADHD?

Section Introduction

1    Who Has a Ticket to Ride? Spotting ADHD’s Surprising Signs

2    Laying the Track’s Foundation: What Is ADHD, Anyway?

3    Deconstructing Your Coaster: Why Each Is Unique

4    Financial Loop-the-Loops: “It’s Only Money, Honey!”

5    Driving While Distracted: The Roller Coaster Hits the Road

6    Peaks and Valleys: ADHD in the Bedroom

7    More Mystifying Twists and Turns

Part Two:

Roller Coaster Whiplash and G-Force Confusion:

How Many Plunges Before You Say, “Whoa!”

Section Introduction

8    First Plunge: Explaining the Inexplicable

9    Second Plunge: Managing the Unmanageable

10  Third Plunge: Breaking Down in Illness—Or Through to Truth

Part Three

Your Relationship and the Art of Roller Coaster Maintenance:

Four Success Strategies

Section Introduction

Success Strategy #1: Taking Care of Yourself

Introduction: The Amusement Park’s Emergency Room

11  Strategies for Right Now

12  Solving ADHD’s Double Whammy

Success Strategy #2: Dealing With Denial

Introduction: Roller Coaster? What Roller Coaster?

13  Psychological Denial: The FEAR Factor

14  Biological Denial: Not Unwilling to See—Just Unable

15  New Ways to Broach “The Conversation”

16  More Solutions and Strategies

Success Strategy #3: Finding Effective Therapy

Introduction: Calling in a Consultant to Help Retrofit Your Ride

17  Why the Wrong Therapy Is Worse Than No Therapy

18  Therapy That Works for ADHD

19  More Solutions and Strategies

Success Strategy #4: Understanding Medication’s Role

Introduction: Tightening the Brakes on the Roller Coaster

20  Making Connections Between Brain and Behavior

This post from Jaclyn at The ADHD Homestead touches on a range of issues within this section on medication. The “Book Club” essays end here.

21  Rx: Treatment Results That Last

22  Maximizing Lifestyle Choices, Minimizing Rx Side Effects

23 Catch Your Breath and Take Five

Appendix A:

Adult ADHD Evaluation and Diagnosis

Appendix B:

“But I Heard That…”: More Background for the Unconvinced

Appendix C:

Three Views from Decades on the ADHD Roller Coaster






14 thoughts on “ADHD Denial Can Be Brain-Based”

  1. Our 24 son is in denial that meds will help him navigate the Neuro-typical world to have a happy, sustainable future. Meanwhile he’s self medicating, cannot keep a job or housing, has lost custody of his children and has no friends. He’s in love with the idea that his Adhd means his brain is more creative and brilliant and that he “thrives in chaos.” We are despairing of helping him when he doesn’t seem to want to help himself.

    1. Hi Sb,

      I’m very sorry to hear this. I’ve warned the perpetrators of this narrative (that ADHD is a gift, that people with ADHD are more creative, and their only problem is being forced to live in a “neurotypical world”).

      First, there is no “neurotypical world.” The world is full of “neuro-diversity” — humans on all kinds of spectrums, including intelligence, autism, anxiety, etc. There is no perfect human brain.

      Second, the available research points to such traits as intelligence and creativity NOT being pronounced among people with ADHD. Instead, people with ADHD follow the same bell curve in these areas as the rest of the population.

      Third, this is shameless hucksterism, designed to elevate the person and help that person sell something. The people who do this have self-proclaimed ADHD, apparently of the type that doesn’t see consequences and is self-absorbed on a “reward” (e.g. fame, money, etc.).

      The result is that people with ADHD such as your son latch onto this narrative, much to their detriment.

      I encourage you to read my book, and to read it carefully. The more that you understand what is happening, the better you’ll be able to be a bulwark against the nonsense from the hucksters.

      Please understand that “he doesn’t seem to want to help himself” is typical among people with poorly managed ADHD. Don’t expect him to know how life can be different for him until he starts seeing it for himself. And he probably has no idea how to make these changes. Sometimes, the protests about “neurotypicals,”blahblahblah, is just a defense.

      Remember: the brain that is causing him trouble is the same brain he’ll be using to navigate ADHD evaluation, treatment, etc. In other words, it’s just too difficult for some people with late-diagnosis ADHD.

      That means you need to initiate the process. Identify a competent psychiatrist (one who has ADHD expertise). Make the appointment. Read my book’s chapter on “Solving ADHD’s Double Whammy.”

      Also understand that, if you are financially supporting your son, you have a degree of control.

      Good luck!

    2. Joel Sprenger

      New reply to an old post. Sorry. For what it’s worth, I didn’t want to go on ADD medication because I thought I would lose my creativity too. I thought my personality would change. I was afraid that who I was would die and my body would be taken over by a different person. Since taking Strattera, I get just as many brilliant/stupid ideas as I did before. Now I’m able to act on some of them. My personality is the same too except for the parts I don’t like. Like a more normal person I’m able to work on my weaknesses and make them better. That’s my experience anyway.

    3. Hi Joel,

      Thanks for your confirmatory comment. It echoes what I’ve heard from hundreds of adults with ADHD over the years (maybe thousands by now!).

      BTW, I try to keep most of my blog posts “ever green.” That is, they don’t get out of date.


  2. At some point in the lives of people with ADHD, some will deny their disorder for the sake of social acceptance. Hopefully we can get to a point where this kind of thing is as pointless as hiding one’s hair color.

  3. I’m sitting in Panera sipping on hazelnut coffee right now. 🙂

    The difficulty in linking cause & effect is the most challenging because it is SO OBVIOUS to me. DH really struggles with it and it’s maddening. I’m grateful that this chapter reminded me that it is biological otherwise I would continue to be very angry at him for not figuring it out. A couple weeks ago we had an incident due to his poor working memory and I was able to take a step back and say “yep, that was totally his ADHD” and not get too mad at him for it. But the cause & effect is still terribly frustrating for me because it manifests in so many areas of our lives.

    I think the whole chapter gave me hope because it is obvious that many of DH’s behaviors have a biological basis and he’s just not a big fat jerk. 😉

    As noted above, I’ve been able to step back and notice the behaviors for what they are and not get upset or offended. That’s helping me maintain my sanity until I can get him into some appropriate treatment.

    Thanks Gina & Taylor!

  4. Veronica Knaflic

    I have always thought there was something wrong with me but didn’t know what, I saw I was different from other people but I didn’t know how. People had a difficult time having a conversation with me but I didn’t know what was I doing wrong. Nothing made sense until medication came on. More than that it took me more than a year and a lot of ADD studying before I could see the problem. I’m ANNOYING! Who can put up with me! I cannot go around telling people what they are to my eyes when I don’t even know them. Now I perfectly understand why I didn’t make any friends thru all the years I didn’t have medication. Ha, I’m still weird but a little bit less. 🙂
    Lots of thanks to Gina’s labor and her book.

    1. Hi Veronica,

      Bless your heart. Your story is why I am so militantly “pro-medication” for those who want to try it.

      It can truly make such a difference in the ability to be happier and more fulfilled in life.

      I’m so happy my “labor” and my book have been helpful to you!

      Thank you!

    2. Um, I solemnly swear that this ^^^^is not my new pseudonym. 😀 Because I’M EXACTLY THE SAME WAY.

  5. Lol, this is why ADHD hubby and I do not have Any discussion till 30 mins after he takes his meds in the morning.

    Many times he has not taken them cuz he needs to “eat something first or it upsets his stomach”

    “Ok, Mr Sensitive Stomach, theres the toaster, get popping!”
    Said Mrs Sensitive Psyche

    Denial and Delay and Procrastination and Rationalization are ALL
    part of the problem and they
    need to be dealt with…swiftly.

    Focus Factor has minerals in it.

    1. Ha! Nice Job, “Mrs. Sensitive Psyche!” Way to break through that denial!

  6. I had a good laugh at Giselle’s boyfriend rationale that he was ‘on his way to making $50 million’ while barreling impolitely through a crowd as he developed this strategy to overcome his poor spatial navigational skills.

    1. Ha! I’m “Giselle” is glad that someone got a laugh out of that story. 😉


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