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How can married couples thrive when one partner has adult ADHD?

How can married couples thrive when one partner has adult ADHD?

Does your relationship seem plagued by broken promises, chronic distraction and anger? Do you or your partner often feel lonely or disconnected? Has one of you taken to nagging the other in an effort to get things done? Does it feel as if no matter how hard you work on your relationship, things don’t seem to get better?

These are some of the hallmark traits of relationships affected by adult ADHD. Millions of adults have ADHD, but almost 90 percent of them are currently undiagnosed, often leading to significant relationship dysfunction. The good news is that when couples learn about ADHD and undertake specific strategies to manage the hot spots in their special kind of relationship, they can literally turn their relationship around.

It is very important that both partners be involved, as both partners play a role in relationship dynamics. However, managing the symptoms of ADHD is the responsibility of the person who actually has the disorder.


Do

Do learn about ADHD in relationships

The presence of adult ADHD creates specific and identifiable patterns in relationships, which are often followed by characteristic negative emotions in each partner. For example, chronic distractibility is the number one symptom in most adult ADHD. Its presence typically results in an ADHD partner paying less attention to his or her partner than is needed to sustain a healthy relationship.

Requests to pay more attention by either spouse or by a therapist do not solve the underlying issue. The biology of the adult with ADHD limits his or her ability to focus and attend until the ADHD is treated. Non-ADHD partners frequently experience emotions, such as loneliness, sadness and anger in the face of this repeated distraction and will express it openly. ADHD partners typically respond to the anger or loneliness in ways that compound the problem.

Seeking in-depth information about the impact of ADHD in adult relationships can be life changing. Once couples understand what is going on, they can apply the techniques shown to improve their relationship when ADHD is present. For example, couples who are aware of ADHD know that distraction does not mean the ADHD partner doesn’t love his or her significant other. Rather, the ADHD partner has an unmanaged ADHD symptom. Instead of feeling unloved or rejected--and arguing about it--the couple can schedule time to be together when there are fewer distractions, such as going on regular dates, setting aside weekend afternoons to focus on each other or scheduling sex. Learning to spot ADHD-related relationship patterns helps couples avoid troublesome emotional hot spots.

Do get a full evaluation

It may be ADHD--or it may not. In adults, other issues can mimic ADHD, such as undiagnosed celiac disease, bipolar disorder, sleep deprivation or even a life that is simply way too busy. Furthermore, individuals with ADHD often have other diagnosable issues they are managing. The most common include depression (more than 50 percent will experience this in their lives) and anxiety (about 24 to 43 percent). Other issues include alcohol dependence (21 to 53 percent across their lives, depending upon the research study), oppositional defiant disorder (24 to 35 percent) and various processing disorders and learning disabilities. Understanding everything you are dealing with is an important part of finding the most effective treatment for you and your relationship. A quick diagnosis of ADHD may not be accurate, which can lead to years of incorrect and ineffective treatments.

A full evaluation for ADHD will usually take multiple hours. This will certainly include an in-depth discussion with your doctor of your symptoms and issues, as well as your history. In addition, it often includes computer tests of focus and response time. Psychologists and psychiatrists will most likely do in-depth testing, though general practitioners also can do this testing. With a full evaluation, partners can make well-informed decisions about how to deal with whatever issues they face.

Do treat ADHD if you have it

Thanks to the media and the fact that diagnosing ADHD is an art and not a science, controversy abounds about ADHD and its treatment. However, a large body of research demonstrates that ADHD is real--and often very difficult to live with for those who genuinely have it, as well as for their partners.

Good treatment helps the majority of those with ADHD make significant progress. And new research being published in 2014 suggests the most effective treatment is that which combines low doses of medication (to help with the physiological aspects of ADHD without side effects) with behavioral therapy (to help with the behavioral problems, such as disorganization).

If you choose to medicate, there is not one that works for everyone with ADHD. So finding the right one is a matter of testing different brands and doses under the supervision of a doctor. This process can take one year or longer. Some adults are wary of medications or find that they don’t tolerate them well. Happily, there also are many effective non-medicinal ways to treat ADHD, which everyone should use. For example, exercise, behavioral therapy, mindfulness training, the addition of omega-3s and dietary changes have been shown to improve ADHD symptoms. For a more complete overview of ADHD treatments important to couples, see the online treatment guide at http://www.adhdmarriage.com/treatment_guide/adhd-effect-treatment-guide.)

The bottom line is that if you have ADHD, you owe it to yourself and to your partner to pursue appropriate treatment to improve both of your lives.

Do identify your relationship hot spots

Because ADHD symptomatic behaviors fit certain patterns, the responses in non-ADHD partners are usually predictable. For example, if an undertreated ADHD partner repeatedly promises to complete household tasks and then gets distracted or forgets, a non-ADHD (or other ADHD) partner will typically fall into patterns of frustration and anger. Many will choose to either resentfully do the task themselves, or badger the ADHD partner with reminders--in essence taking control of the ADHD partner’s project deadline.

Once an ADHD partner has a history of missing commitment deadlines, this becomes a hot spot for the couple. The non-ADHD partner may come to consider the ADHD partner untrustworthy and uncaring, while the ADHD partner generally starts to feel managed and diminished by the non-ADHD partner’s actions and feelings. The hot spot quickly escalates to anger, frustration and poor interactions each time it is broached. And this becomes symbolic of larger emotional issues, such as, “I can’t trust you” and “You don’t love me.”

Over time, ADHD-affected relationships develop many different emotional hot spots. Some include feeling unloved, having many hurtful fights, sensing a non-ADHD partner feels superior to the ADHD partner, and chronic issues with anger, lying and disconnection. But once ADHD is identified, and once both partners understand that it is both ADHD symptoms and responses to ADHD symptoms that create the problem, couples can learn how to discuss these hot spots and start to work through them.

Do always treat your partner with respect

Chronic anger in ADHD-affected relationships means that couples fall into patterns of disrespectful interactions, perhaps yelling at each other, stomping out of the room, repeatedly criticizing or belittling each other. And the excuse, “My partner makes me so mad, I can’t help it!” is not an excuse that holds water. The simple fact that you are committed partners means that you should express whatever feelings you have in a respectful way--even if these feelings are difficult. You would want the same from your partner, and your partner deserves no less. Remember to lead by example.


Don't

Do not assume that it is only about ADHD

So you know that one partner has ADHD. And that ADHD can encourage significant problems in relationships. Therefore, the ADHD is the problem, and the ADHD partner just needs to fix it, right? Not so fast!

ADHD symptoms cause more problems than most people with ADHD understand. But aside from a few basics, such as not paying the minimal amount of attention needed to sustain connection, most of the problems in ADHD-affected relationships are caused by both partners together. Destruction comes from the full pattern--one that includes the symptoms, the response to the symptoms and the response to the response. It is this complete symptom-response-response cycle that creates pain.

The example above about finding ways to connect to counteract distraction in ADHD partners is a good example. The response of the non-ADHD partner is just as important in connecting in positive ways as the person with the ADHD. So that means that ‘fixing’ a relationship affected by ADHD is not about sending the ADHD person off to fix themselves and learn to do better. It is about both partners learning to live successfully with ADHD.

Do not believe it is just about your partner’s anger

ADHD partners see how frustrated and angry non-ADHD partners get after years of requesting more attention and improved behavior. Therefore, ADHD partners often make the mistake of thinking, “It’s not about my ADHD. It’s about my partner’s anger. My life was just fine before I met my partner. If she/he would just be nicer, everything would be fine.” This assumption is just as wrong as assuming it is completely about the ADHD. It is actually about both ADHD and responses to ADHD. And the symptom-response-response cycle starts out with an ADHD symptom.

Do not ignore your relationship

Couples spend too much time rationalizing why their poor behavior is understandable, even while they adamantly request that their partner curb his or her own problems. The reality is that every person in a committed relationship has an obligation to contribute his or her best self to a relationship. There are a few behaviors that must be exhibited for your relationship to be healthy. These include respectful interactions, paying enough attention to communicate you care and being willing to engage--even if you disagree, rather than avoiding difficult topics.

Do not overlook your emotional hot spots

There are at least 21 common emotional hot spots in relationships affected by ADHD. You probably experience many of them. The problem is that they don’t go away without intentional effort by both partners. The specific strategies that couples use to manage emotional issues when ADHD is present are different from those other couples might use.

This is one reason why working with a therapist who does not understand ADHD can be counterproductive. For example, being told to “try harder” to pay attention to your partner when you have ADHD might sound good, but this is bad advice. Overcoming ADHD issues is not about trying harder. It is about trying differently. This means adopting ADHD-specific strategies to succeed.

You may wish to ignore the hot spots and hope they go away. In most cases, this would be wishful thinking that will not work in your favor.

Do not give up

Learning to thrive in a relationship affected by ADHD is a marathon, not a sprint. Partners who have faith that they can find a way to succeed are often right. With perseverance, patience, lots of ADHD-oriented tools, the right treatment program and good, clear information about adult relationships affected by ADHD, couples can learn to thrive again. But just like a marathon, it takes hard work and time to succeed.


Summary
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It is possible that you are one of the millions of couples whose relationship is on the rocks because of undiagnosed adult ADHD. If you think you detect symptoms of ADHD, such as chronic distraction and difficulty following through on promises, get an evaluation. Understanding ADHD is the first step in being able to manage it and turning your relationship around.


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Melissa OrlovMarriage Consultant

Melissa Orlov is the author of the award-winning book, The ADHD Effect on Marriage (2010) and, The Couple's Guide to Thriving with ADHD (2014) and is considered one of the foremost authorities on ADHD and relationships. A marriage consultant, ...

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