Advice for Couples Living with Attention Deficit Disorders

Source: photo by L. Grande

 Accept the reality of the problem and own it.

      Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) are characterized by difficulty in three critical areas of functioning: focusing one’s attention, being easily distracted, and being impulsive. These three features are the minimal requirements for the diagnosis of ADD as well as ADHD. (Any one of these behaviors taken apart from the others may be a sign of various other problems, including but not limited to, anxiety, depression, bipolar disorder, compulsive disorders, or conduct disorders.)  ADD and ADHD also share a biochemical cause: low levels of specific neurotransmitters, including dopamine and norepinephrine. Stimulant medications such as Ritalin and Adderall increase the activity of dopamine in the “reward centers” of the brain. Non-stimulant medications have the effect of increasing levels of norepinephrine.

      One way in which clinicians confirm the diagnosis of ADD/ADHD is to evaluate whether or not one of the standard ADD/ADHD medications results in improved attention and concentration.  For the individuals who do not have a lower than normal level of dopamine and/or norepinephrine, these medications will lead to agitation, restlessness, and hyperactive behavior.  They are subjecting their brain to an excess of those biochemicals. For those who do have a reduced level of dopamine or norepinephrine, attention and concentration improve, without causing hyperactive behavior.  Those who need the medication are not achieving any type of high in terms of elevated mood or energy level. They are simply helped to achieve their personal potential for maximum focus and sustained concentration.

Consider the severity of your symptoms and get an expert opinion about whether or not medication may help you.

      There is a wide range of symptoms within both ADD and ADHD.  ADHD is experienced as a more severe problem, since it by definition includes hyperactive behavior. The hallmark sign of ADHD is a heightened level of motor activity, perhaps constant fidgeting or difficulty sitting still. As children we have all witnessed classmates with these behaviors. It is not unusual for some type of restlessness to continue into adulthood, although many people do outgrow the most severe levels of hyperactive behavior.

      Beyond this common feature of ADHD, there are a variety of other behaviors which may or may not be present. Each person is different in the ways that attention deficit may affect their everyday lives. Common complaints of people with either ADD or ADHD include: difficulty completing tasks, making plans (requires focus), carrying out plans (avoiding distractions) and managing time. For example, a simple task such as feeding the dog may be interrupted by noticing that the dog’s muddy footprints have covered the floor, requiring you to feel compelled to wipe the floor, which leads to noticing that you have run out of paper towels, which leads to adding “paper towels” to your shopping list, which also should have orange juice listed because you had none left after breakfast; now “where is that list?”, followed by “oh yeah, the dog has still not been fed”, and so on. This may sound humorous to those of you without an attention deficit, but it is the frustrating reality of everyday when you struggle with ADD or ADHD. When you consider this type of experience occurring daily, it is not hard to understand the chronic frustration that comes with attention deficit. 

      Add to those daily frustrations the emotional toll of un-diagnosed ADD; constantly wondering “What is wrong with me?” “Why can’t I just get things done the way most people seem to? Am I stupid?” “Why is it that I feel so inadequate?” Feelings of shame are too often another consequence, especially in un-diagnosed ADD. Many of these individuals were teased or laughed at during childhood by those who were ignorant about the causes of the behavior. Feelings of rejection, loneliness, and isolation may be common.

Seek help from knowledgeable professionals.

      Many mental health professionals are familiar with both the causes and consequences of ADD/ADHD. In addition to professional knowledge, many of them probably have a family member or a friend with attention deficit, which gives them a personal understanding of the challenges. Whether or not you decide to use medication, there are many coping skills which can be learned and practiced (see references below).

Avoid using your diagnosis as an excuse to leave excessive amounts of responsibility on the shoulders of your partner.

      Keep up your effort to cope with your own symptoms and be optimistic. Your ADD/ADHD related symptoms are probably adding a challenge for the person partnered with you. By accepting the reality of the problem and working on making your life more manageable, you will also relieve the stress on your relationship.

If you are partnered with someone who has ADD/ADHD: maintain compassion.

      His/her daily life is difficult in ways that you may not be able to truly understand. As mentioned above, I am not suggesting that you accept the diagnosis as an excuse for leaving you over-burdened.  Accepting the reality, getting a diagnosis (if not already done), and getting professional help (with or without meds) will make a positive difference.

      One of my clients is an 80 year-old woman who tells me that living with her 82 year-old ADD husband of 60 years has often been ” like living with a teenager”. She has taken on more responsibility within their home than she expected to manage. She sometimes feels overwhelmed and even resentful. However, they have lived contentedly together for 60 years, partly because she appreciates all of the wonderful traits that he brings to their partnership. He is much more than the sum of his ADD-related symptoms. Likewise your partner is so much more than the sum of those problematic behaviors.

Source: photo by D. Grande

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