All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.Arthur Schopenhauer
ADHD and mental illness affect millions of children and adults all over the world. When I started writing the My Mental Health Series (click the link for my latest post, My Mental Health: Support Systems), I knew from the beginning I would be doing a post about the things that I feel are misunderstood or not well-known about mental illness and ADHD. For clarity, I will sometimes refer to these as a more all-encompassing “brain illness/disorders” or “brain health”. (Dr. W says that advocates should steer clear of the word “mental” because of the negative connotations. I told her that it was bad for SEO. She said it was a good point.)
My brain disorders have caused me to be misunderstood and misread by the people in my life since almost the beginning. I have lost friendships and jobs. I’ve struggled with my family relationships, in some cases. If you’ve ever had the pleasure, you know that being misunderstood is pretty lame and can be very painful. I want this post to be a place where readers can learn something they didn’t realize about mental illness and ADHD; so they can understand their loved ones in a way that mine never could. So that people with ADHD and mental illness know that I see you. I am you, in so many ways.
Let me preface by saying that I am not about to give you facts about mental illness; I am giving you truths. Facts are based on science and I have no scientific evidence to back up what I am about to talk with you about. I only have my experience, which I believed is a shared experience with millions of other humans. They are truths that I know from the bottom of my soul, truths I learned in hard-fought battles with my own brain, and they are true for a multitude of people with disordered brains; no matter the diagnosis or the severity.
8 ADHD and mental illness truths
I’m going to try not to write too passionately here, but there are things that I feel very strongly about and, frankly, some of them really piss me off. I saw a meme the other day that said something to the effect of, “Your anger is the part of you that knows you’ve been wronged.” I just paraphrased, so hard. Anyway, some of these things have hurt me deeply over the years, so forgive me if I get too fierce.
1. You can’t always see ADHD and mental illness.
I know you’ve seen it before. The depressed person who can’t get out of bed for days on end; who sobs and sobs, seemingly in endless existential pain. I know them. I have been them. But even when my symptoms exhibited in a really outward, in-your-face kind of way, I still masked all of the time. When I was with the people that I loved and felt safe with, I could still laugh and have a good time. It doesn’t mean that I wasn’t depressed or that I was getting better amid a crisis. It just meant that I’m still a normal human being and I still feel all of the human emotions, even when my brain disorders are out of control.
This goes doubly for people who have more internal or invisible ADHD and mental illnesses, like apathy and a hyper brain. I walked around for years and I cannot express how broken I was inside. It felt like slowly dying. There were times that I would genuinely believe that they were going to have to put me in a hospital, but I never said a word to anyone but my therapist. No one had any idea. Not even my husband. The very few people that I talked to regularly probably had an idea that something was off. I was spinning out and no one understood how sick I was. From the outside, I was a busy working mother. I isolated pretty badly, but it was interpreted as rudeness and blowing people off. My declarations that I was not okay were met with skepticism and annoyance.
Another point to make is that what you see is not always what is actually happening. Case in point: paralysis of will. Often times if I have a big task (remember, “big” tasks for me might be a small task for you…take laundry for example), I have to mentally prep myself to get up and do it. I absolutely cannot do it until I have jumped several mental hurdles.
Here’s the most important part though; I cannot do the task. My brain will not physically let me move to the task and, if I force myself to start, it will not allow me to maintain focus. It’s not a matter of choice. I can’t simply choose to do the task; my will has been paralyzed by my brain. So, what looks like procrastination or laziness is actually a series of complicated medical processes.
Also note, if someone brings the task to my attention during this process, “Hey, weren’t you going to do the thing today,” my brain starts the process from scratch and I have to jump the hurdles again from the beginning. I swear. Don’t look at me…the brain is running the show, I just live here.
2. They are a big deal.
I don’t know how to stress this enough. It’s something that I have gotten angrier and angrier about as the years go by. Let me be clear: ADHD and mental illness have savaged my life. No matter what good I had going on, no matter how much I had to be grateful for, it was almost always tainted with poor brain health. However, I live in a society that was built to not accept that. My brain health isn’t a “real” reason to miss work or a social function. During the most excruciating pain of my life, I would still get up, put a smile on my face, and act like I was ok. Every day. Because that is what is expected of me.
What I want to convey to anyone reading this is that ADHD, mental illness, and every brain disorder are a HUGE deal. In one way or another, my brain disorders permeate every aspect of my personality and my life, especially ADHD. You would take away the good parts of me, along with the “bad,” for lack of a better term. Anyway, the message is that mental disorders are real and dangerous; people die from this.
Believe your friends who tell you they are suffering. Be kind to them. Please show them empathy and not judgment. The pain, discomfort, and distress that is felt by this community of people is often never seen and, sadly, never expressed. Let’s give them a world safe enough, kind enough, to at least acknowledge that their struggles are real and deserving.
3. Every person with mental illness has a different experience.
No one has the same life experience. We are shaped and molded by each of unique, human experiences and we each react differently to those experiences. My husband and I have a very similar upbringing, but you could not find 2 people more different. Therefore, it stands to reason, that no ADHD and mental illness story is the same as the next. Our symptoms, our coping-mechanisms, our support levels, our circumstances…they all differ. Please remember that. Just because a person is experiencing something that you have been through or have experience with, doesn’t mean their experience is even slightly similar.
I’ll use my husband and me as an example again. He was diagnosed with ADHD-H as a young child. I was diagnosed with ADHD-I in 2020. We do not understand each other, in so many ways. We make it work, but it’s definitely not because we understand each other’s brains. He is super clean and I am…not. He is super punctual and I am…not. He is super, super, super-duper hyper and I am…not.
My experience has led me to a life with depression, anxiety, OCD, and C-PTSD on top of my ADHD. He doesn’t have most of those issues. We have scarily similar backgrounds and the same disorder, but our experience and the lessons we carried out of those experiences could not be more different.
4. Tough love is a no-go.
Look. I get it. In some rare situations, tough love works. I guess. I’m here to tell you, though, tough love can be cruel and dangerous when you are dealing with a person with brain illness. In ADHD, it can even cause symptoms to get worse, creating a vicious cycle. For someone in the middle of a mental health episode, the tough love approach can cause guilt, fear, and anger and that’s on top of the complicated emotions that they may already be feeling.
It can (and will) lead to resentment and your loved one will eventually stop reaching out to you and even avoiding you completely. Try to approach the situation with kindness, empathy, and love. Don’t expect answers about why or how…just be there for them. If they can’t take a shower or leave their bed, being a dick to them is not going to be the thing that makes it click.
Please don’t misunderstand me, I’m not saying that you shouldn’t set boundaries. ADHD and mental illness can be intense. Everyone should have boundaries set to protect themselves. If a loved one is in a situation where it is no longer healthy for them to engage with their person or if their person is actively putting them in danger, then tough love (in the form of a contact break, an intervention, etc.) is a valid option. But telling someone that they stink because they haven’t showered when they already feel like the scum of the earth is neither productive nor helpful.
Again, my common theme in so many of my blogs; just be kind.
5. You are not, in fact, in control of your thought.
This is especially true for disordered brains. I know my brain is not the prime example of a healthy brain, but I know that if I tell my brain to stop thinking, it doesn’t work. Sure, you can train it and practice meditation and mindfulness. You can learn coping skills and even retrain your neural pathways (how cool is that?!), but you don’t control your thoughts. They are spontaneous…it’s why they’re called ideas. It’s like breathing or your heart beating…they just are.
Being happy is not a choice for everyone all of the time and we have to stop holding on to the belief that it is. When someone is struggling with their brain health, it isn’t helpful to remind them to be grateful for all that they have or that they have so much that they should be happy for. We know already. The fact that we have so much and still feel so sick makes us feel guilt and shame. It makes us feel ungrateful, even when we are not.
Recovery from mental illness does depend greatly on your view on life, but that is only a small part of the puzzle and you can’t put in that small piece until you put together all the others. You can’t wish your way out of ADHD and mental illness and you definitely can’t fool your brain into making chemicals that it won’t. Chemical imbalances are not about choice or training your thinking.
Also, keep in mind, that a common symptom of many mental illnesses (especially OCD) is intrusive thoughts. If you recall from My Mental Health: Obsessive-Compulsive Disorder, they are ego-dystonic, which means they aren’t in line with your wishes or values. I have intrusive thoughts and while I do have some control over them now that I know what they are, I still can’t stop them from happening. Once they happen, then I can drive them off, but there have been periods where my life was rocked by them and I had no tools to stop them from happening. You can’t control your thinking.
6. Stop with the toxic positivity.
That’s right, I said it. This sort of goes hand in hand with number 5 on the list. Phrases like, “Happiness is hard and sadness is hard. Choose your hard,” or, “Good vibes only,” telling people that happiness is a choice and that they can get over their mental illness by being grateful are all examples of toxic positivity. It’s toxic because it isn’t true for anyone, especially not someone who is struggling. Taking a walk in nature doesn’t cure depression and my ADHD won’t go away if I just stay looking on the bright side. That isn’t how life works.
There is good and bad in everyone’s life and phrases like this set unrealistic expectations for people who are brain ill. We should be realistic with each other and be honest that life is full of ups and downs for everyone, not just people with mental illness. It is unhealthy to believe that we can solve our health issues and our problems with a toxically positive attitude. Though, I do love a “good vibes only” sticker for my planners.
7. Your friends with mental illness aren’t always capable of being good friends.
I am a good friend, I think. I try to be and it’s really important to me that I am. However, there are times when I am an absent friend. People with ADHD and mental illness sometimes don’t have the strength, energy, or wherewithal to be at every party or to return every call. Here’s the thing…we really are trying and we feel awful about our absence. Try not to make your friends feel bad for their absences and don’t put undue pressure on them to do things they aren’t comfortable doing.
I can appear selfish when I am obsessing over something, often turning the issue back to me or my obsession. I certainly don’t mean to…I love and care about my friends and their lives. Because of ADHD, it doesn’t even occur that I’m doing it. If it does occur to me, I will immediately clam up. I once had ADHD shutdown in the middle of a first friend’s date. Luckily we were already aware of each other and she is *super* cool so it worked out, but can you imagine? I could barely speak I was so dissociated. Sometimes our brains betray us and we can’t be good friends.
During those times, we need the utmost understanding. Please know that we are unwell. We want to be there more, but our brains won’t let us. I haven’t talked returned anyone’s calls for 3 weeks, please don’t take it personally, I’ve been in self-imposed isolation. Sorry, I clammed up like a weirdo on our day at the park, but my brain glitched out and shut down. I’m sorry that I forgot about your birthday party and, by the time I remembered, my brain convinced me it was “too late” to go, even if I knew a full day ahead. In reality, I’ve developed horrifying social anxiety around strangers.
We know it’s a lot to ask and, I promise, we will never forget it and we will pay it back in friendship times 10 when we are well enough again. On the flip side, we have to be understanding when people choose to walk away. You have a right as a human to draw your boundaries. It is your right to know when you have had enough. But be decent and upfront and try not to be mean. Be kind.💜💜
8. For people with chronic mental health issues, there will be relapses.
When I was younger, I used to tell myself nice stories about how I’d only stay on the medicine for “as long as I needed it.” That is exactly what I did, too. I would go on it for 6 months or a year and then I’d wean myself off. I’d be off of it for a couple of years and then go back on. The honest truth is, I needed it all the time; I was in and out all levels of depression for…well, forever it feels like. But I had to tell myself the beautiful lie. That it was only temporary; this hell that had slowly crept up my back my whole life couldn’t possibly be real life forever. Now, I accept it for what it is and, because of that, I am finally on the path to recovery.
Recovery is not without its bumps and bruises. With mental health recovery, there is almost always relapse. Meds and therapy, it’s a give and takes. You have to stay on top of it and you can’t give it an inch. Mental illness has grown and morphed itself into whatever it needed to be to disrupt my life. I just had a severe episode a couple of months ago. I was lucky that I was able to get almost immediate help, but it was scary and I was starting to feel out of control. My brain just took over. It happens. We right the ship and we start forward again.
Never feel like a failure and never let it steal your hope. There is always hope, no matter how bad it feels at the time.
It is important for our loved ones to educate themselves on our disorders if they want to be a part of our lives. We should educate them and point them to resources as often as possible (I’m planning a Resource Round-up in just a couple of weeks!) and try to be patient with them while they try to learn and understand. We have grown up in a world that was not made for and does not fully understand ADHD and mental illness. It is up to us to change the discourse, to speak our truths. The above are some of my truths and I hope that they resonate with you.