Breaking out of ADHD relationship dysfunction — after not breaking a fall? That sounds all kinds of painful, right? It was, but not as painful as remaining on an ADHD Roller Coaster gone wild.
I’ll tell you my personal story in a minute. It might help shed some light on your own ADHD relationship troubles. But first some background.
ADHD Relationship Dysfunction Junction
Here’s how ADHD couple conflicts typically develop —and become entrenched:
- You’re several years into a relationship before discovering that one or both of you have ADHD.
- By that time, you both have developed misinterpretations of the other’s behavior and counter-productive coping responses.
- Not to forget: the lifelong misattributions and poor coping of the newly diagnosed ADHD partner, since childhood.
Once there’s a diagnosis and maybe medication on board, it can still take enormous effort to overcome these entrenched patterns and emotional responses. Especially if you don’t know what they are or how to do it.
Moreover, how do you distinguish ADHD symptoms, which should respond to medication, from these entrenched poor coping responses? This is an often-overlooked essential challenge. In my long-held observation, it’s why even the best attempts at medication don’t create results folks are hoping for.
I’ve tackled this topic for years, in my writing and in my presentations to the public and clinicians, from San Francisco to Turkey. Now you can find ADHD couple interventions in my online training. For more information: Solving Your Adult ADHD Puzzle
Could I Depend On Him?
Yes, I’ve hard-earned the status of “ADHD Expert” from my own original research and writing. Yes, thousands of adults with ADHD and their partners or spouses, too, have shared their stories with me. But rest assured: I’ve had plenty of opportunity for “walking the talk” at home.
One particularly negative repetitive pattern involved my fear that my husband (the ADHD partner in our marriage) would be incapable—and even disinterested—in caring for me should I become sick or disabled, even temporarily.
I am not alone. This is a recurring fear expressed in my online group for the partners of adults with ADHD. This fear has a basis in reality. A commonly repeated phrase in the group is: My ADHD partner is unreliable. This is not offered as a criticism so much as a statement of fact. Many have learned to live with it. But still, they fear that moment when they might be incapacitated and have to rely on their ADHD partner.
“Good Intentions” Go Only So Far
In our case, my husband was reliable on some level. At least, he meant to be. But what do you call it when good intentions still fall flat?
- How do you know if you’re fooling yourself, knowing the difference between your spouse being incapable—or unwilling?
- More importantly, at what point does it matter which it is?
- When you’re dropped on your head, metaphorically speaking, it still hurts.
In fact, there was an incident just yesterday.
Let me tell you about it. But first, turn on your speakers, because there are sound effects.
Injured, Stranded, Heartbroken
Over our first years together, I had plenty of “evidence” to support this not-so-irrational belief. That is, I’d be on my own if I were ever to become sick or incapacitated. He might mean to be attentive but, you know, distraction and disorganization.
For example, I had foot surgery. The doc issued strict orders to keep my foot elevated and move as little as possible. My husband, who worked at home then, swore he would be a regular Nurse Nightingale—the 6’2″ and 230# version.
His tenure started post-surgery: He steered my wheelchair careening through the hospital hallways and into the elevator. Mr. Toad’s Wild Ride-style. Whee!
A little bit fun, yes. But I was holding on for dear life, praying he didn’t knock my foot into the elevator doorframe—or catapult me out of the chair entirely!
Once home, I saw he had dutifully set up my bedstead with a land-line phone and his cell phone. That way, I could be sure of reaching him upstairs in his office, on the other side of the house, should I need him. Great start.
When it came time to use it, though, the land-line phone had a dead battery. The “pay as you go” cell phone had no more “go”.
I lay there marooned for too many hours, him out of shouting distance. He didn’t think to come check on me, either. Once he gets absorbed in his work, he tends to stay there. As a result, I felt helpless, hurt, duped, and frightened.
“ADHD relationship dysfunction” patterns might have been clear to me—if we’d truly understood ADHD.
Warning To Self: Never Trust Him Again
I made a mental note made to my subconscious: Be very careful in trusting him again with your welfare. No matter how much he professes to trust him. And seriously ask yourself, why do you remain married to him?
It was complicated.
Remember, this was early days in Adult ADHD awareness. We were on the “bleeding edge,” you might say. There were no books to guide us—especially none on ADHD relationship issues.
My first book, Is it You, Me, or Adult A.D.D.? was only the third book available on Amazon about Adult ADHD, published in 2008. It broke new ground in detailing the importance of acknowledging the impact of ADHD on both partners and emphasizing the importance of teamwork with evidence-based treatment strategies. This blog is the oldest continuing website of any kind of Adult ADHD, since 2008.
But we were dealing with ADHD in the mid-90s. Adult ADHD had been made an official diagnosis only in 1994. Most professionals had not yet received the memo.
Our attempts at couple therapy were so disastrous they motivated us to double-down on cooperation. Anything to avoid facing that again. Besides, we were paying good money to, by turns, entertain and horrify the therapist. My memory of their faces always features a dropped jaw.
Only one mental-health expert I found then acknowledged the potential impact of ADHD on the spouse. Fortunately, he was local to the Bay Area then: Daniel Amen, MD. Bless him.
In fact, happening upon his Change Your Brain, Change Your Life at the local library is how I first learned about Adult ADHD. I clung to Dr. Amen’s paragraphs of validation like a lifeline. Then I extended that lifeline to others in the ADHD Partner online group. We were all feeling our way. On our own.
Gradually, our own “ADHD relationship dysfunction” improved. But it was often one step forward, three steps back. And I never knew when things would shift and I’d feel dropped on my head. Metaphorically.
“Nurse NightinGoat” with Ice Cream—And Barbiturates
Several years after the foot-surgery fiasco, I had another outpatient surgery. Dr. Goat (my husband’s nickname) accompanied me to the appointment. As we left, I was still groggy. The doctor gave the instructions to him. Once home, I staggered to the bed and fell asleep.
A few hours later, I awakened to Nurse Nightingoat plying me with two Vicodin pills and a bowl of French Vanilla ice cream: “The doctor said every 2-4 hours. The ice cream will prevent nausea.”
Like clockwork, he showed up with the pills and the ice cream every four hours—or was it 2? I don’t know. I was in a semi-stupor. Finally, I said, “Stop! You’ll turn me into poor Marilyn Monroe!”
He showed me diligence, compassion, and care. I updated my fear scenario around being unable to rely upon him in an emergency. But I had not entirely forgotten. Survival instincts have memory.
ADHD Relationship Dysfunction: A Big Dip On the Coaster
Yesterday, I took a protracted, very ungraceful, and rather painful fall in the garage.
I tripped over a bicycle pedal and tried to avoid tripping over an air purifier. In the process, I ricocheted myself in and on several directions and hard surfaces before finally landing with a thump on the raised kitchen doorstep.
It sounded like this:
My husband is working at home again these days, after 6 years of working in an office. He was right overhead (at least I thought so).
Surely he heard the cacophony. If not that, surely he couldn’t miss my whimpering and calling out to him. Something like this, though not quite as energetic:
Lying there in a crumpled heap, my mind ran through all the likely scenarios: He had heard the calamity but figured “She’s okay. She’s the self-sufficient type.” Or, worse, he heard it and didn’t want to interrupt his work. But damn, I might have actually broken something.
I finally got to my feet and limped Quasimodo-like back to my office, calling out as I went. I held out hope that he might actually be elsewhere in the house, out of earshot during and after my fall. Then, I discovered. He was in the bathroom. On the other side of the house. Shew. That explains it.
“What’s happening!?” he said.
“Goat!” I called, “I just had a bad fall!”
Through the closed door, I heard it: profound annoyance at being interrupted. A sigh something like this:
He, however, recalls his sigh more like this:
My worst fear triggered: He was annoyed that something bad had happened to me that required his help. Is it starting to sound like I’m “in denial” of abusive behavior? I get it. But hang on a minute.
Caring “Deep Down”? Exactly How Far Down?
It’s hardly my first encounter with this scenario.
In more than a decade of leading the ADHD partners support group, I’ve heard it too many times. That is, an ADHD partner seems to view a partner’s temporary illness not with compassion but as an….inconvenience. Among the many potential ADHD relationship issues, this is one of the most hurtful.
Yes, I can explain the range of alternate explanations—for example, how ADHD neurobiology can interfere with even the most compassionate person’s ability to organize appropriate responses. ADHD relationship dysfunction issues present only one of the many sets of challenges that adults with ADHD face every day.
But we cannot ignore the fact: When you come against such from your intimate partner, it’s frightening. Your first response might be denial. You don’t want to believe that the person you fell in love with can be that cold, callous, or selfish.
You’ve heard that ADHD treatment can improve functioning. So, you hold out hope against all evidence. You might tell yourself, “My partner cares about me deep down.”
The fact is, some intimate partners absolutely can be that cold, callous, or selfish—ADHD or not. If that’s the case, we better face it. Humans come with variable capacities, especially when it comes to higher-order brain functions such as empathy. There is nothing monolithic about ADHD, either.
The Gray Area of ADHD Relationship Dysfunction
How do we know, though, if it’s ADHD creating this undesirable response or something else? Sorry, but there are no easy answers.
When we talk about the ADHD effect on marriage and relationships, we are talking a huge array of variable issues. Not 10 easy tips and tricks. It’s for each person to assess and make the call.
We can get into real trouble, though, if we believe that with enough love and caring—and medication—a true sociopath can change. ADHD relationship strategies can go only so far in some cases.
The complicated truth, however, is this: Sometimes you know for sure what you are dealing with only after medical treatment for ADHD and any co-existing conditions, such as bipolar disorder, anxiety, or depression.
Yes, ADHD medication treatment often improves empathic functioning. To learn more, read ADHD, Empathy, and Dopamine.
Educate Yourself on ADHD—and Be Realistic
Granted, this is true for some; ADHD symptoms and poor coping strategies can stymie their ability to express or act upon what’s in their hearts. Psychoeducation is a must for both partners.
But we must be ready to tread the gray area. There’s only one thing that the 10-30 millions of adults with ADHD in the U.S. alone have in common: variable aspects of this highly variable syndrome. Then there is the rest of “personality” and background.
We must consider the complicating co-existing conditions (e.g. conduct disorder, antisocial personality disorder, autistic-spectrum disorders, and more).
It’s easy to toss around “cookie-cutter” platitudes about people with ADHD. But, they don’t help anyone—and can do great harm. We must see people diagnosed with ADHD as individuals, not clones. The same is true for their partners.
So, I want to be very clear: With someone other than my husband, my story could have turned out very differently. The best decision might have been to leave.
There’s “we can work on this” relationship dysfunction. Then there is “impossibly toxic, destructive, and irreparable relationship dysfunction.” As you learn more about ADHD, especially the emotional baggage of late-diagnosis, you’ll be better equipped to know the difference.
Beware the Professional Gaslighting
I feel I should mention an observation here: Many Adult ADHD specialists act very protectively toward their clients. I understand this. I feel the same way toward the folks in my local Adult ADHD group.
Unfortunately, this too often means that these specialists feel little empathy for the partners. That’s putting it mildly, I’m afraid.
In fact, some specialists view the partners/spouses more as annoyances—perhaps even the core of their client’s problems—more than ADHD itself. They want them to “get with the program” and throw all their support behind their ADHD partners. NOW. They also imply — and so does a plethora of websites by non-experts claiming expertise — that they are responsible for the so-called parent-child dynamic. In short, they shame them.
It goes against all reason, against all of what they should understand about ADHD. But it’s there. I sometimes get that reaction by proxy. Simply by talking or writing about our evidence-based model of ADHD couple therapy. Not from preeminent Adult ADHD experts, who fully grasp this, but more at the clinical level.
The truth is, some clinicians and certainly the non-experts online routinely “gaslight” the partners of adults with ADHD. I’ve seen a marked difference in the last 5 years online. I could explain why, but I’ll leave that for another post!
“You must be more compassionate,” they say. “You must understand what your ADHD partner is struggling with.” No matter if that’s how they started out, 20 years ago, with them being understanding and helping. Now they are exhausted.
They need legitimate help, not platitudes. Moreover, their ADHD partners deserve better, too.
Learning to Draw On Newer Memories
After almost 20 years together, I’m clear that there is a “deep down” kindness in my husband.
Too often in the past, poorly managed ADHD obscured or sabotaged his innate empathy. He’d fail my expectations—and his own. Instead of reacting with contrition, he’d react with anger.
Later, he could say, the anger was directed at himself (“I failed again!”). But that came as cold comfort to me, caught in the cross-fire.
Happily, Things Are Different Now
That morning, as I limped to the back of the house, seeking solace, I decided to momentarily ignore my husband’s put-upon-sounding sigh. I put aside all the old painful patterns around it. Instead, I drew upon the more recent memory with Nurse NightinGoat and the reliable Vicodin/ice-cream routine.
With that memory in mind, I mentally stepped back and gave him a minute or so to “transition”—not to mention finish whatever he was doing in the bathroom. Something like this:
I flopped on the bed and finally said, “Hey, I hurt and I need some comfort.” At that point, he hepped to—speedily fetching a selection of cold packs, sitting with me on the bed, petting my head, kissing my banged-up wrist, and saying, “Poor you.”
This was a much better outcome than we both might have experienced in years past. To wit:
- I’d react with hurt and anger to his imposed-upon-sounding sigh, accuse him of being the most selfish man I ever knew—”and I was stupid enough to marry you!”—and storm out of the room feeling horrible about my marriage and plotting my escape.
- He’d react by withdrawing to the safe confines of manipulating databases, feeling stunned that he screwed up again, that his intent so badly translated into actions, and, finally, in perhaps a subconscious effort at ego-protection “what the hell is wrong with her anyway?”
Will this strategy help your relationship? Are you learning how your challenges might be common ADHD relationship dysfunction patterns?
Will stepping back and allowing for your ADHD partner, now on board with treatment strategies, to have a moment’s transition help to heal past counter-productive patterns?
Will you be able to build enough new patterns, enabling you to let go of some old ones?
I can’t promise it. But it might be worth a try.
Postscript: This morning I went to load the clothes into the washer. What did I find? An absolutely clear and wide path, free of bicycle, humidifier, and other flotsam and jetsam. Thank you, Dr. Goat!
We Hope Our Story Helps You
We both believe in sharing our story—and our lessons hard-won—so that other couples can better enjoy the ride on their own ADHD Roller Coaster. To help heal your ADHD relationship dysfunction, you might find these resources helpful:
- Adult ADHD-Focused Couple Therapy: Clinical Interventions (with Arthur L. Robin, PhD): the first clinical guide based on the evidence of what works for Adult ADHD and for couple therapy
- ADHD Success Training: online training and support for adult ADHD-challenged individuals and couples; professionals welcome, too.
- Is It You, Me, or Adult A.D.D.? Stopping the Roller Coaster When Someone You Love Has Attention Deficit Disorder: the book that required 8 years of in-depth research and support groups facilitation
- My YouTube channel: ADHD Success Training —view my 9-part presentation on ADHD & Relationships, given at a Toronto CADDAC conference.
Thank you for reading this long, but important, post. I’d love to hear your experiences in ADHD relationships.
ALSO: I am entirely self-funded, with no outside support of any kind, including pharmaceutical industry.
A version of this post appeared May 24, 2015