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Melissa Orlov is a marriage consultant and one of the top experts in how ADHD affects relationships. She has been writing and speaking about the topic since 2007, researching it since 2005. She has worked with Edward Hallowell MD since 2004, writing ADHD articles and newsletters, and assisting with educational programs delivered by Dr. Hallowell and John Ratey MD. She teaches couples, therapists, counselors and coaches about how ADHD impacts relationships, blogs for Psychology Today and writes the Your Relationships column for ADDitude Magazine. She also consults privately with couples who wish to improve their ADHD-impacted relationships. She is the author of TheADHD Effect on Marriage, which was awarded "Best Psychological Book of 2010" by ForeWord Reviews. Orlov's website is www.adhdmarriage.com.
What are the main concerns couples face when one or both partners have ADHD?
Over 80 percent of adults with ADHD are undiagnosed, so most couples are not aware that ADHD is impacting their relationship. What they see is one partner (the one with ADHD) is chronically distracted or is "consistently inconsistent" when it comes to completing agreed-to tasks; may not remember agreements well or has significant difficulty financially - seeming to underperform his or her potential. Planning is often difficult for this person. In addition, an ADHD partner often isn't aware that they aren't paying as much attention to their spouse as their partner would like. The non-ADHD partner becomes frustrated and angry at the lack of reliability in the ADHD partner, quite possibly misinterpreting the symptom of "distractibility" as "my partner doesn't care about me anymore." Non-ADHD partners often report feeling unloved and lonely, as well as very angry and frustrated. It's almost impossible to understand how an adult can promise to do something, then not do it...over and over again...never seeming to "learn" to do better.
With these kinds of issues (and more) certain predictable patterns develop. For example, the non-ADHD partner tends to become a "parent" figure - controlling and nagging in order to remind the ADHD partner to get things done, while the ADHD partner becomes a "child" figure who lacks authority or responsibility in the relationship. In all, ADHD symptoms encourage 12 specific patterns in relationships and there is very good news about this - once couples know about the patterns they have the power to dramatically improve their relationship.
How often do couples experience challenges when one or both partners have ADHD?
Research suggests that almost 60 percent of relationships that include an ADHD partner are clinically dysfunctional. I want to emphasize, though, that my experience working with couples is that many of these couples can turn their relationships around...it's just that they have neither known about the fact that ADHD is an issue nor have they typically been able to find professional help from someone who is aware of how to help them. This is a very new area of couples work.
What issues do couples face when both partners have ADHD? Are the issues different than when just one partner has ADHD?
Many of the patterns can remain the same and, in fact, I sometimes see the more organized of the two partners taking on a non-ADHD spouse type of role, perhaps feeling "I got my ADHD under control, why can't you?" However, my observation is that two ADHD couples can experience things a bit differently. For example, one issue for many with ADHD is they have trouble putting the brakes on their emotions, so they can become emotional quickly. If you have two people with this characteristic, it means fights can escalate quickly. Also, someone in the relationship has to be organized enough to keep the family safe, and get things done "well enough" to get by. This could feel a bit overwhelming. If both partners have severe ADHD, they might have a very chaotic relationship and life, possibly with less financial stability, as well. On the more positive side of things, they will be more likely to be empathetic to their partner's issues, perhaps laugh more, and maybe even notice their mutual mess less.
When should couples consider talking to a mental health professional about their relationship issues?
Any couple, ADHD or not, should consider getting professional help when they feel as if their communication has broken down to the degree that their needs simply aren't being heard. In fact, the sooner the better, so that problems don't compound to an unmanageable level. For those who suspect that ADHD might be an issue, it's helpful to get a professional opinion, though it can be very hard to find a therapist with ADHD counseling experience. There is a small but growing list of these kinds of professionals on my website (www.adhdmarriage.com). Another good source of names might be any local clinic that is dedicated to the treatment of ADHD, if you have one near you.
What should couples look for when seeking out a professional for consultation, coaching, or counseling?
First and foremost, experience working with ADHD. Interview the person you are considering working with and ask them what proportion of their practice is dedicated to adults with ADHD. Most of the people who find me have been to several other counselors and had little success getting at the core issues in their relationship because the counselor didn't really understand ADHD and its impact. With coaches or counseling, measure your progress over time. Are you making progress? Have you learned new skills?
How does parenting impact the ADHD relationship?
Becoming a parent is wonderful, but it puts huge stress on relationships. Among other things, it takes a great deal of logistical coordination to manage a family...and planning and follow through are not the strong points for those with undiagnosed or undermanaged ADHD. Resentment can follow ("Can't you even remember to feed the kids when I ask you to?!") In addition, new parents in particular get very little sleep, which really exacerbates ADHD symptoms. So just when you need your partner the most is when he or she is most distracted and hard to rely on.
If you have a child with ADHD, this can motivate a family to learn as much as they can about ADHD, which is great (in fact, many adults find out they have ADHD after a child is diagnosed when they realize how familiar the symptoms are). In addition, I've had many non-ADHD partners tell me how great their ADHD husband is when playing with the kids ("he's just like a kid himself!") and how much they appreciate and love that.
What are some ways that couples can refocus on the positives in their relationship?
The best way to start this process is to get educated about how ADHD impacts your relationship. If you are really struggling, as many couples are, it's pretty hard to stay focused on the positives while you're having so much trouble. In my book, I suggest couples work through six specific steps, starting with learning about how much more different their partner is than they currently realize. Having a better understanding of where your partner is coming from can really help you see their stronger points
What would you recommend for couples with ADHD who want to communicate, but want to stop fighting?
Education is really important here, too. It's easier to communicate well when you understand the role ADHD symptoms play in your relationship dynamics. It's important to understand, also, that it's not just the ADHD partner - but the specific (and very predictable) responses that non-ADHD partners have to ADHD symptoms that create problems. Non-ADHD partners need to learn that these symptoms aren't personal. Your ADHD partner loves you a lot, but is distracted.
Listening is also critical. Usually, the fighting isn't just about the current topic, but also about emotional issues that run through the relationship. For example fighting about why an ADHD husband didn't do the dishes as his non-ADHD wife requested is not just about dishes, but is also probably about the wife's frustration with his lack of reliability and her feelings of abandonment ("He can see how busy I am! if he really loved me he would help out!") and about the husband's resentment that his wife is always nagging him ("I never get a break around here! Who made her my boss?") So, to communicate well you must first listen to these types of sentiments.
There is one specific type of conversation I try to teach all the couples I work with - a Learning Conversation, which is structured in a way that helps couples listen better and not escalate into anger, even if the topic is difficult
What are three things ADHD couples can do right now to help their relationship?
1.) Learn more about ADHD and its impact on relationships - I have a book on this (The ADHD Effect on Marriage) and also give phone and recorded seminars on the topic. Do some research - you'll be amazed. In this situation, knowledge really is power. (One of the things you'll find is that you are not alone - many couples struggle with this, which can be very reassuring.)
2.) Set aside some time to attend to each other (and nothing else). Don't leave this to chance - schedule it! Research suggests that connections can be most easily made when doing "challenging and new" activities together, but a romantic date night or even creating a regular routine to get into bed together and read for a while can help you feel closer.
3.) Get an evaluation for ADHD, if it seems possible there is undiagnosed ADHD in the couple. An evaluation is the gateway to a wide variety of resources that can help you improve your lives together.
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