ADHD and Death by One Thousand Cuts

Is your spouse unresponsive to your gains in ADHD treatment?

Posted Sep 15, 2011

If you are a spouse with ADHD, you may be disappointed or angry that your non-ADHD partner hasn't noticed all of the improvements you've been making in your relationship and ADHD treatment. "You've been asking for me to be more attentive and more organized. Now that I am you're still not happy. Not fair!" you may think. "I'll never be good enough!" Before you jump to conclusions or consider giving up, consider these options:

Your partner has changed after years of discord, and hasn't yet found out how to move in a more positive direction. One woman recently described it this way:

"...many of the ADHD symptoms my husband was exhibiting when he was untreated are no longer the key hot points in the relationship. As you have pointed out in your book, it's symptom/response/response, and in my case it appears the responses go on long after the symptoms have gone away. In some ways I think the damage was so widespread and relentless that I changed without realizing it–like death by thousands of paper cuts."

This woman can heal and overcome the damage, but it takes time, sympathy from her partner, and significant effort (and effective strategies) to leave the past in the past.

You may be overestimating the impact of your changes on your partner. One man recently told me that starting medications had vastly improved his focus, particularly at work, but that he was disappointed that his wife wasn't responding much. But his wife isn't at work, so improvements there don't affect her much. Furthermore, improved focus is something he "sees" or feels but isn't something she experiences until he takes that focus and uses it to improve problem behaviors at home.

You may not be measuring accurately. Research suggests that while all people overestimate how well they do things (think "text and drive"), those with ADHD overestimate even more. Put some objective, measurable goals in place and see if you're really meeting them (i.e. "take out the trash 5 times this week").

ADHD = "Present Focused." For reasons that have to do with executive function areas of the brain, most with ADHD live very much in the present. One of the benefits of this is that they are often quick to "forgive and forget" and able to emotionally move along quickly. Adults without ADHD can take longer to process hurt – so empathy and patience with this process is warranted.

Your partner is afraid to compliment you. In the past, compliments may have caused you, the ADHD partner, to "let up" a bit, leading to a reversal in progress. This roller coaster of progress interspersed with backsliding happens when you make gains by "trying harder" (which works temporarily) rather than by "trying differently" and finding a long-term system for making change.  You can find out if your partner is afraid you'll lose ground if she acknowledges your progress simply by asking her.

The bottom line is this – it takes time for both partners to heal from the long-inflicted problems that undiagnosed and unmanaged ADHD introduces into a relationship. It's critical that the ADHD partner take optimizing his or her treatment seriously, make it a long-term effort, and be patient with his or her spouse's wariness at "coming around."