Lee Crespi, LCSW

Since my earlier entry on this topic I have been really focusing a lot on the subject, both seeing more and more couples with this issue and doing much reading and research.  I'd like to share some more information for those who might be struggling with this. 

 Often, the problems caused by ADHD in a relationship don't become evident for a very long time. First, because the ADHD partner may have the ability to hyperfocus and during the early days of the courtship and dating (do people still date?) he or she will be hyperfocused on the partner which can be great. ADHD people are often very fun-loving, spontaneous, creative, and intense.  This is very attractive in the early stages of a relationship.  As the couple continues, some of the problems may start be noticed.  Either a seeming withdrawal, as the ADHD partner hyperfocuses on something else - work, or a project. Or, an imbalance in household or familial chores and responsibilities.  Forgetfulness, losing things, not following through on promises, all gradually begin to add up.  At first, the non-ADHD partner may think this is a phase, or something that will change over time. Often the non-ADHD partner will start picking up more and more responsibilities to keep things on track.  Eventually, and this can take a long time, the non-ADHD partner reaches his or her breaking point.  The relationship may start to look like a parent/child one instead of a marriage.  The non-ADHD partner may be feeling increasingly overwhelmed, angry and or lonely. The ADHD partner may either be unaware of the impact of their ADHD on their partner or may be feeling very ashamed and demoralized and defensive. 

This is because, untreated, ADHD symptoms will not go away no matter how hard the ADHD partner tries to "do better" and the non-ADHD partner nags.  It is really necessary to get treatment for the ADHD - possibly medication or a non-medication natural intervention as well as some coaching and /or therapy with some familiar with ADHD.  Couples therapy can be extemely helpful at this point. 

For those open to medication, there are several different types and a good psychiatrist with knowledge of ADHD can help decide which is the right one and the right dose. This will require trial and error but most people report significant improvement from medication.

Non- medication approaches include fish oil, physical exercise, adjusting sleep patterns and diet.  Ned Hallowell in "Delivered from Distraction" provides much information on this area as well as on medication.  

Coaching or therapy will need to focus on helping the ADHD person to develop structures and strategies for remembering things and becoming more organized and focused.  There are many ways to do this and it takes work but it can be done.

Couples counseling will help the couple understand the impact of the ADHD on their relationship. Help the ADHD partner understand the effect on the partner and push through their denial or obliviousness ( people with ADHD tend to live in the moment and easily forget yesterday's fights or unhappiness and need to realize that the partner is still feeling them).  For the non-ADHD partner, a better understanding of the neurological causes of the problems in the relationship can go a long way toward overcoming the anger and despair they may be experiencing.  Often the non-ADHD partner's work is in learning to let go - not do everything - let the partner struggle - stop being a parent - take better care of themselves.  

I hope this information is useful.  I'm going to keep posting on this subject as new ideas occur to me.