Demand Avoidance in ADHD: Overwhelm vs. Defiance (And What Therapy Does Differently)
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Demand Avoidance in ADHD: Overwhelm vs. Defiance (And What Therapy Does Differently)


If you’ve ever thought, “They can do it when they want to… so why won’t they do it now?” you’re not alone.


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In demand avoidance ADHD therapy, we often start by zooming out: avoidance is usually a signal, not a moral failing. Sometimes it’s the brain hitting a friction point (executive dysfunction). Sometimes it’s the nervous system flipping into threat mode (fight/flight/freeze). And sometimes it’s both—at the exact same time.


🧠 Key takeaway: When you treat demand avoidance like defiance, you often intensify the very stress response driving it.


This post will help you:

  • Understand what “demand avoidance” can mean in an ADHD context

  • Tell the difference between overwhelm vs. defiance (and what to do in each case)

  • See what therapy changes that “more consequences” usually doesn’t

  • Try supports for home/school/work that reduce demand load instead of escalating conflict


If you’re looking for ADHD therapy in Tennessee or a telehealth ADHD therapist, these same principles apply—whether you’re a parent, a college student, or an adult trying to keep life from turning into a daily battle.


Demand Avoidance ADHD Therapy: What “Demand Avoidance” Means in an ADHD Context

“Demand avoidance” isn’t a formal ADHD symptom. It’s a pattern: when a request shows up (a task, a transition, an expectation), the person’s system reacts by delaying, shutting down, arguing, escaping, or doing anything else.

You’ll sometimes see the phrase “pathological demand avoidance” (PDA) in autism conversations. The PDA label is controversial and isn’t included in DSM/ICD diagnostic manuals, but research does describe a profile where everyday demands can trigger intense avoidance and anxiety (2,3,10). In ADHD work, we’re usually talking about something more specific:

  • Demands collide with executive-function friction (planning, initiation, working memory)

  • Demands feel like threat (loss of control, being trapped, fear of failure)


🧩 Key takeaway: “Demand” isn’t just the task—it’s the internal experience of the task.


The “two engines” behind avoidance: executive friction vs threat response

Engine #1: Executive friction (ADHD brain mechanics).ADHD is strongly associated with executive function differences—skills that help you start, sustain, shift, and organize behavior toward a goal (1). If the brain can’t reliably initiate, a “simple” demand can feel like trying to push a car uphill.

Engine #2: Threat response (nervous system protection).Humans have built-in defensive states—arousal, fight/flight, freezing/immobility—especially when a situation feels inescapable or overwhelming (6). When a demand triggers that system, avoidance can become rapid and reflexive.


🛡️ Key takeaway: Threat responses aren’t chosen to be difficult—they’re chosen by the nervous system to feel safe.


Why it can look like procrastination, shutdown, or arguing

Different people show avoidance differently:

  • Procrastination: “I’ll do it later” (until later becomes never)

  • Shutdown: blank stare, withdrawal, “I can’t”

  • Arguing/negotiating: endless debate, “why do I have to?”

  • Escape behaviors: distraction, joking, changing topics, leaving


Sometimes those behaviors are strategic (trying to buy time). Sometimes they’re automatic (a threat reflex). Research on extreme demand avoidance profiles describes avoidance strategies that can include diversion, socially shocking behavior, or intense need for control (2,3). In ADHD, the same surface behavior might simply be: the brain can’t get traction right now.


Why intent matters (it’s not a character flaw)

In therapy, one of the most relieving reframes for clients and families is this:


🌱 Key takeaway: “Not doing it” and “not being able to do it right now” can look identical from the outside.


Intent matters because it changes the intervention. If you treat overload like willful defiance, you’ll usually get more resistance, more shame, and less learning.


Overwhelm vs. Defiance: How to Tell the Difference

Here’s the tricky part: overwhelm and defiance can share the same behavior. A slammed door could be a protest—or it could be a nervous system overload.

Instead of guessing based on tone or attitude, look for patterns.


Signs it’s overwhelm (cognitive load, initiation, time blindness)

Overwhelm often shows up when the task requires multiple executive steps:

  • Getting started (initiation)

  • Holding steps in mind (working memory)

  • Estimating time (time blindness)

  • Switching gears (task shifting)

Research supports that ADHD involves measurable executive-function differences (1). Time perception and timing tasks can also be harder for people with ADHD, which can contribute to “I didn’t realize it was that late” moments (5).

Common “overwhelm cues”:

  • They look stuck, foggy, or slow to respond

  • The task feels vague (“clean your room”) or huge

  • They ask repeated questions (not to be annoying—because working memory is taxed)

  • They improve rapidly with structure or a first step


🧠 Key takeaway: If support (structure, clarity, a first step) helps quickly, you’re probably dealing with overwhelm.


Signs it’s a threat response (panic, trapped feeling, “NO” reflex)

Threat response cues tend to be faster, bigger, and more body-based:

  • Sudden agitation or panic

  • A trapped feeling (“You can’t make me”) even for small tasks

  • A hot “NO” reflex before thinking

  • Escalation with pressure, urgency, or being watched

In the defense-cascade model, states like freezing/immobility can occur when threat feels inescapable (6). That maps onto the lived experience many ADHD clients describe: “I want to do it, but my body is refusing.”


🚨 Key takeaway: If the demand triggers panic/entrapment, the first job is regulating—not persuading.


When both are true at the same time

This is the most common real-world scenario:

  • Executive friction makes the task hard to start

  • The person senses failure coming

  • The nervous system interprets failure as threat

  • Avoidance escalates into shutdown or conflict

Emotion dysregulation is common in ADHD and can amplify how quickly someone tips from “frustrated” to “flooded” (4). Therapy often targets this loop directly.


🔁 Key takeaway: When executive dysfunction + threat response combine, consequences often add fuel, not motivation.


What Therapy Does Differently Than “More Consequences”

Consequences can help when someone has the skills and capacity to comply, but is choosing not to. The problem is that demand avoidance often shows up when capacity is already maxed out.


Therapy changes the question from:

  • “How do we make you do it?”

to:

  • “What’s getting in the way—and how do we remove friction or threat?”

If you’re exploring care through our specialized therapy services, this is the mindset behind building a plan that’s structured, evidence-based, and actually usable day-to-day.


Moving from power struggles to problem-solving

Collaborative Problem Solving (CPS) is one example of an evidence-based, non-punitive framework that shifts conflict into skill-building and joint solutions (7). It’s not “letting kids off the hook.” It’s treating challenging behavior as a signal of lagging skills and unmet needs.


🤝 Key takeaway: The goal isn’t to win the moment—it’s to build the skills that prevent the moment.


Skills + supports instead of willpower

ADHD treatment works best when it targets skills and the environment—not just intention.

For adults, structured CBT approaches have shown benefit for persistent ADHD symptoms, especially when paired with practical planning and organization strategies (8,9). Therapy may include:

  • Task initiation strategies

  • Planning and time supports

  • Emotion regulation skills

  • Values-based motivation (so it’s not all “shoulds”)


🧰 Key takeaway: Willpower is unreliable. Systems are kind.


Building safety, predictability, and choice

When avoidance is threat-driven, “more pressure” can sound like “you’re trapped.” Therapy works on building enough safety and autonomy that the nervous system stops needing to fight.

That can look like:

  • Predictable routines (without rigid control)

  • Choices that preserve dignity

  • Repair after conflict (so the relationship becomes a safe base)

If trauma is part of the picture, addressing it directly can be essential; you can explore how we think about that on our trauma therapy page.


🧡 Key takeaway: Safety isn’t softness—it’s the foundation for learning.


Therapy Tools That Help (Without Turning Life Into a Battle)

Below are tools we often use in demand avoidance ADHD therapy. They’re simple on purpose—because complex systems collapse under stress.


Collaborative goal-setting and “smallest next step” planning

Instead of “do the whole thing,” we find the smallest step that creates movement:

  • Open the document

  • Put shoes by the door

  • Text the teacher one sentence

Then we build momentum.


🪜 Key takeaway: The smallest next step is a nervous-system-friendly form of motivation.


Emotion regulation + distress tolerance for demand spikes

When the demand hits and emotions spike, the skill isn’t “calm down.” It’s:

  • Notice the early warning signals

  • Use a short regulating strategy (movement, cold water, paced breathing, grounding)

  • Return to the task with a smaller demand

Emotion regulation difficulties in ADHD are well-documented and clinically important (4). Therapy treats this as a skills problem—not a personality problem.


🌊 Key takeaway: Regulate first. Reason second.

Communication scripts for “I need a different way to do this”

Avoidance often improves when people have language for what’s happening.

Try scripts like:

  • “I want to do this, but my brain is stuck. Can we pick a first step together?”

  • “I’m overwhelmed. I need a 10-minute reset, then I can try again.”

  • “If you give me two choices, I can choose one.”


🗣️ Key takeaway: A good script turns conflict into collaboration.


Home/School/Work Supports That Reduce Demand Load

A “low demand approach” doesn’t mean “no expectations.” It means lowering unnecessary demand so the person can meet the important ones.


Adjusting how requests are phrased (choice, timing, tone)

Tiny wording shifts can dramatically change nervous system response:

  • Offer choices: “Do you want to start with math or English?”

  • Adjust timing: “In 10 minutes, we’ll transition.”

  • Keep tone neutral: calm voice, fewer words

🧭 Key takeaway: Tone and timing can matter as much as the request.


External scaffolds (reminders, body doubling, visual supports)

External supports aren’t “crutches”—they’re accessibility tools:

  • Visual checklists

  • Timers and alarms

  • Body doubling (working near someone)

  • Short work sprints + breaks


Executive-function coaching can be especially helpful here. Our executive function coaching is designed to build real-world systems that reduce friction and help skills stick.


🧩 Key takeaway: If the brain can’t reliably hold the plan, put the plan outside the brain.


Repair after blow-ups: reconnect, don’t re-litigate

After a shutdown or blow-up, the nervous system is often still tender. Repair is about reconnecting first:

  • “That got hard. I’m on your team.”

  • “Let’s reset and figure out what happened when we’re both calm.”

Then problem-solve later.


🫶 Key takeaway: Repair protects motivation—and the relationship.


When to Get Extra Help (Therapy, Parent Consults, Coaching, Assessment)

Sometimes demand avoidance is a temporary stress response. Sometimes it’s a persistent pattern that needs more support.


Red flags: safety, school refusal, worsening anxiety/depression

Consider extra help when you see:

  • Safety concerns (self-harm, aggression, unsafe elopement)

  • School refusal or chronic absenteeism

  • Rapidly worsening anxiety or depression

  • Family conflict that’s escalating

  • A teen/adult who’s shutting down more often than engaging

In these cases, therapy can help clarify what’s driving the pattern and build a plan that reduces risk.


When assessment clarifies the “why” and guides a plan

If you’re not sure whether you’re looking at ADHD, anxiety, trauma, autism, learning differences—or some combination—assessment can reduce years of guessing.

At ScienceWorks, our psychological assessment options are designed to provide a clear picture and practical next steps, including documentation that can support accommodations.


🔎 Key takeaway: A good assessment turns “What’s wrong with me?” into “Here’s how my brain works.”


What to look for in a neurodivergent-affirming provider

Demand avoidance improves fastest when care is both evidence-based and affirming.

Look for a provider who:

  • Treats ADHD as neurodevelopmental (not a motivation defect)

  • Understands executive function and emotion regulation science (1,4)

  • Uses collaborative approaches rather than power struggles (7)

  • Builds practical supports (not just insight)

  • Welcomes parent consults when appropriate

If you want to see who we are and how we work, you can meet the ScienceWorks team.


Next Steps

If demand avoidance is showing up in your home, school, or work life, you don’t have to solve it with louder consequences or longer lectures.

A more effective path is usually:

  1. Identify whether you’re dealing with overwhelm, threat response, or both

  2. Reduce friction and threat in the environment

  3. Build skills and supports that match how the ADHD brain learns

If you’re ready to explore care (in Tennessee or via telehealth, depending on location), the simplest next step is a brief consult. You can reach us through our contact page.


About the Author

Dr. Kiesa Kelly is a licensed psychologist and the owner of ScienceWorks Behavioral Healthcare. She earned her PhD in Clinical Psychology with a concentration in Neuropsychology and completed extensive clinical training across academic medical and university settings.

Her work is grounded in evidence-based, neurodivergent-affirming care, with specialized training across approaches including CBT-based therapies, trauma-focused modalities, and structured, measurement-informed treatment planning. You can read more about her background and current availability on her profile.


References and Citations

  1. Willcutt, E. G., Doyle, A. E., Nigg, J. T., Faraone, S. V., & Pennington, B. F. (2005). Validity of the executive function theory of attention-deficit/hyperactivity disorder: A meta-analytic review. Biological Psychiatry, 57(11), 1336–1346. https://doi.org/10.1016/j.biopsych.2005.02.006

  2. O’Nions, E., Viding, E., Greven, C. U., Ronald, A., & Happé, F. (2014). Pathological demand avoidance: Exploring the behavioural profile. Autism, 18(5), 538–544. https://doi.org/10.1177/1362361313481861

  3. O’Nions, E., Gould, J., Christie, P., Gillberg, C., Viding, E., & Happé, F. (2016). Identifying features of ‘pathological demand avoidance’ using the Diagnostic Interview for Social and Communication Disorders (DISCO). European Child & Adolescent Psychiatry, 25, 407–419. https://doi.org/10.1007/s00787-015-0740-2

  4. Shaw, P., Stringaris, A., Nigg, J., & Leibenluft, E. (2014). Emotion dysregulation in attention deficit hyperactivity disorder. American Journal of Psychiatry, 171(3), 276–293. https://doi.org/10.1176/appi.ajp.2013.13070966

  5. Toplak, M. E., & Tannock, R. (2005). Time perception: Modality and duration effects in attention-deficit/hyperactivity disorder (ADHD). Journal of Abnormal Child Psychology, 33(5), 639–654. https://doi.org/10.1007/s10802-005-6743-6

  6. Kozlowska, K., Walker, P., McLean, L., & Carrive, P. (2015). Fear and the defense cascade: Clinical implications and management. Harvard Review of Psychiatry, 23(4), 263–287. https://doi.org/10.1097/HRP.0000000000000065

  7. Greene, R. W., Ablon, J. S., Goring, J. C., Raezer-Blakely, L., Markey, J., Monuteaux, M. C., Henin, A., Edwards, G., & Rabbitt, S. (2004). Effectiveness of collaborative problem solving in affectively dysregulated children with oppositional-defiant disorder: Initial findings. Journal of Consulting and Clinical Psychology, 72(6), 1157–1164. https://doi.org/10.1037/0022-006X.72.6.1157

  8. Safren, S. A., Otto, M. W., Sprich, S., Winett, C. L., Wilens, T. E., & Biederman, J. (2005). Cognitive-behavioral therapy for ADHD in medication-treated adults with continued symptoms. Behaviour Research and Therapy, 43(7), 831–842. https://doi.org/10.1016/j.brat.2004.07.001

  9. Safren, S. A., Sprich, S., Mimiaga, M. J., Surman, C., Knouse, L., Groves, M., & Otto, M. W. (2010). Cognitive behavioral therapy vs relaxation with educational support for medication-treated adults with ADHD and persistent symptoms: A randomized controlled trial. JAMA, 304(8), 875–880. https://doi.org/10.1001/jama.2010.1192

  10. Woods, M., & Stirling, L. (2024). Methods of studying pathological demand avoidance in children and adolescents: A scoping review. Frontiers in Education, 9, 1230011. https://doi.org/10.3389/feduc.2024.1230011

  11. National Institute for Health and Care Excellence (NICE). (2018, updated 2025). Attention deficit hyperactivity disorder: Diagnosis and management (NG87). NICE. https://www.nice.org.uk/guidance/ng87


Disclaimer

This article is for informational purposes only and is not a substitute for professional medical, psychological, or mental health advice, diagnosis, or treatment. If you are in crisis or concerned about immediate safety, seek emergency help right away.

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