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. 

What is attention deficit disorder?

Attention Deficit Disorder (ADD, also referred to as ADHD – the H being Hyperactivity) is a broad syndrome, usually identified in children, and believed to be a neurological developmental difference characterized by hyperactivity, impulsivity and distractibility as well as problems reading visual social cues.   In more recent years, it has been increasingly understood to continue into adulthood and more adults are being identified as having some features of ADD .  Adults with ADD may be highly disorganized, chaotic, and forgetful, often lose things, are impulsive and distract easily. Their social skills may be compromised by their inability to read visual cues, and they may sometimes seem inappropriate or self involved.  Many adults with ADD, despite these challenges, may be highly successful but usually need to work harder and longer hours to be productive. Others, however, may find their work life suffering as a result of their ADD and consequently their self-esteem as well.  Secondary related problems may also include dependence on alcohol and drugs, or depression related to the difficulties in self-management.

What type of impact does attention deficit disorder have on relationships?

ADD can put a great deal of stress on a relationship.  It is easily mistaken for a lack of sensitivity or caring for one’s partner.  Forgetfulness may seem inconsiderate and even hostile.  Disorganization in the home can result in fights over “messiness” and “clutter” and also be seen as inconsiderate, indifferent and passive-aggressive.  Often, adults with ADD marry partners who are competent and efficient and this may result in either the non-ADD partner taking over many of the other’s tasks and responsibilities and feeling resentful and alone in the relationship.  Partners of people with ADD often complain that they cannot ever count on or depend on their spouse and that is a very lonely feeling.   The partner with ADD may feel devalued or experience low self-esteem as a result.  In couples that I have treated in therapy, the ADD is often a major source of conflict in the relationship.

How does a therapist help a person who has attention deficit disorder have a healthy relationship?

First of all, it is very important for both partners to fully understand the nature and impact of ADD.  For the person who has it, there may be some resistance to facing the reality of it because it is so much a part of one’s personality and it is has many positive features such as spontaneity, liveliness, adventurousness, creativity and extroversion.  Behind this reluctance to face the ADD may be fears of inadequacy and shame.  Most people with ADD have had to struggle to do what others take for granted, and blame themselves for being lazy, stupid, messy, etc.  However, by fully understanding the nature of ADD as a neurological difference, the individual may feel a sense of relief and greater empowerment to take steps toward improving their functioning.  This might mean working with an ADD coach who can help with tools and strategies for organizing one’s time and compensating for distractions and memory problems.  It might also mean taking ADD medication such Adderall or Strattera, which help improve focus and concentration. 

Equally important for the relationship, the partner of the person with ADD needs to understand that many of the characteristics that are so frustrating  are not really in the ADD partner’s control and are not the result of unconscious hostility, or a lack of caring, but result from a genuine inability to process information in an organized way.  This doesn’t mean that they shouldn’t or won’t have feelings about being let down, or burdened, or frustrated, but rather that the root of those frustrating behaviors is not a lack of love, but rather a genuine disability. 

What advice do you have for someone who has attention deficit disorder and is having difficulties in their relationship partly because of the disorder?

I would recommend that both partners learn as much as they can about ADD – “Driven to Distraction” is a good book with which to start - and also to visit some websites such as www.drheller.com/spouse_add.html.   I would also encourage them to consider couples counseling with a therapist who has experience working with couples where one partner has ADD - both as a way of expressing and processing pent up feelings and also to strategize and find ways to work together to address the ways that the ADD is interfering in their lives. 

I grew up in a family where everyone had several kids and loved being parents but noone ever claimed  it was easy or pleasant.  Oh yes, there are moments of bliss.  Holding a sleeping infant in your arms, smelling his damp, sweet scalp, celebrating accomplishments, or just basking in tender family moments.  But, any parent will tell you that those are peak moments in the midst of a lot of stress, distress, heartache, frustration, tedium, and smelly chores.  This is no secret!  Never was! Like any big job - being a surgeon, landscaping, fishing, building things - it is mostly hard work, lots of risks, and a great feeling when it all works out ok.

That brings me back to my earlier question, how do we measure happiness?   I'm "happy" when I get a legal parking space in front of my house.  I'm "unhappy" when I have three inches of water in my basement.  But those feelings are shortlived and don't compare to how much I love my home in total.  I have to walk my dog in all kinds of weather, and fight with him to let me clean his ears, and those vet bills! OK, so you know what comes next...yes, I have a picture of him on the desktop of my computer. 

Love and happiness are so complicated and changeable, but we know when we have them, even when we are on the downside of their cycles.  They cause the deepest pains, and the greatest joys, the worst anxiety and the greatest contentment. 

I guess this article really got to me because I am a year away from an empty nest and the hardest parenting days are over.  My house already seems quieter and I find myself staring into strollers longingly.  This is another hill on the parenting roller coaster.  Loss.  Loss of the baby, the toddler, the pre-schooler, the sixth-grader, the teenager. They never come back.  And all I can remember are the good times, the busy times, the feeling that my life was not my own and that was a good thing.

I guess that's why so many people look forward to being grandparents.  No one ever asks "Are grandparents happy?

                                                                                         L.C.,