A few years ago, as my daughter was in the middle of a crisis, I completely lost it. I was scared, reactive, and couldn’t tell where my fear ended and hers began. As a therapist with more than 20 years of experience treating ADHD and emotional regulation, I couldn’t access a single clinical insight at that moment.
That’s emotional dysregulation for you — it doesn’t always care about what you know about ADHD and coping strategies.
What pulled me back wasn’t a breathing exercise. It was one question I’ve come to rely on in my clinical work and in my own life: What else is true?
The Either/Or Trap
If you have ADHD, you know these thoughts:
I can’t do this because of my brain.
I ruined it again.
This is just who I am.
These all-or-nothing thoughts are quiet, familiar, and feel completely true. That’s what makes them so powerful and so worth examining.
[Read: You Are Not the Sum of Your ADHD Challenges]
ADHD brains are particularly vulnerable to the either/or, black-or-white trap. Not because of a lack of intelligence or insight, but because of how the ADHD brain is wired. When emotional dysregulation hits, it hits fast. The brain goes from 0 to 100 before the prefrontal cortex even registers what happened. There’s no pause, no filter, no gradual build. Just the emotion and the story that comes with it.
That story is almost always either/or. Either I’m capable or I’m broken. Either I handled that well or I failed completely. Either ADHD is destroying my life or it’s a superpower. No middle ground, no complexity, no room for both things to be true at once.
And that rigidity makes everything harder; the shame, the self-criticism, the sense that nothing will ever really change.
The AND Reframe
There’s a concept in dialectical behavior therapy called dialectical thinking. It’s the ability to hold two opposite truths at once without one canceling the other out. A simple question that gets to this concept is the same one I asked myself in that moment with my daughter: What else is true?
Not as a way to dismiss the hard thing. Not as toxic positivity. But as a genuine cognitive interruption. It’s a way of seeing the bigger picture when the ADHD brain has narrowed it down to one painful story.
[Read: Has ADHD Warped Your Sense of Self? It’s Time to Reclaim Your Story — and Power]
This is harder for my brain AND I can find a way through.
I acted impulsively AND that doesn’t define the whole relationship.
I’ve struggled with this for years AND I’ve also figured out more than I give myself credit for.
The AND doesn’t erase the first part. It refuses to let it be the only part.
Reframes Are Essential for ADHD Brains
Even after the ADHD emotional dysregulation storm has passed, it doesn’t mean the stories we tell ourselves have gone, too. In fact, they’re often left behind.
That’s exactly where the AND question does its work. Not during the spike (that’s often too early), but in the aftermath, when the emotion has settled but the story is still running. That’s when the prefrontal cortex can finally participate. That’s when “What else is true?” creates just enough pause to interrupt the either/or narrative before it hardens into identity.
I lost my cool AND I can still apologize.
I forgot AND I can still build a system that helps me remember.
I ran late this time AND my time management is getting better overall.
This is genuinely hard for my brain AND that’s not the whole story.
The next time you catch an all-or-nothing thought, challenge yourself to identify what else is true. You don’t need a perfect answer. You just need one more true thing. Something that makes the picture a little bigger, a little less rigid, a little more like reality. Because while the story your ADHD brain tells you in a hard moment seems like the truth, it’s not the whole truth.
All or Nothing Thinking with ADHD: Next Steps
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Nathaly Pesantez
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