A sexless marriage because he won’t initiate and she’s tired of doing so … a husband who promises to set up a date but hasn’t done so 10 months later…an inability to communicate because he talks “with his head” while she talks “from the heart”; a wife who says “it’s hard to be attracted to a partner who thinks about sex but doesn’t ever act upon those thoughts”; a marriage about to dissolve. This is the description a woman recently gave me of her relationship with a husband diagnosed with ADHD within the last two years.

Couples affected by adult ADHD live this awful scenario all too often.  As the marriage breaks down under the stress of unmanaged or undertreated ADHD, a couple's sex life can simply cease completely.  This woman’s description is incredibly moving:

“I have asked my husband to initiate sex for many years. Although he says he wants to have sex with me and never refuses my advances, he doesn't initiate.  I plan, organize, manage and initiate so many things around the house that I don't feel like I should have to do that too.  So I stopped initiating sex and told him that I would gladly resume when he was able to initiate sex. I thought that communicating my sad, lonely feelings to him would ignite his empathy and move him to action. I thought that appealing to his sense of responsibility as a partner who desires a monogamous relationship would encourage him to initiate. I thought that biological need would motivate him to initiate sex with me. Nothing seems to motivate him to initiate so I stopped. Years have passed and we are in a sexless marriage. I would almost be relieved to find out that he is cheating on me but I am pretty certain that he is not.”

She has fallen into a classic ADHD relationship trap—she is equating his inability to initiate (an ADHD symptom) with his feelings for her.  She has asked him to overcome his symptom in order to prove he loves her…yet the symptom RULES here until such time as he identifies it as a symptom and puts specific behavioral habits in place (such as setting aside time in the calendar to plan a date at the instant he agrees with her that he will plan it). In order to succeed in changing this pattern, he needs a specific support structure that he doesn’t currently have.  An ADHD coach could really help here. In the meantime, he agrees he’ll “try harder” to remember to do this…and nothing changes because his ADHD symptom remains unaddressed.

Here’s another problem with this couple’s response to this issue. Lack of sex is such a hot topic in the household that by now both partners are likely either afraid to initiate sex or too angry to do so.

This couple needs to:

  • Hire a great ADHD coach who can help him set up the external structures he needs to overcome his inability to organize, plan and initiate. Note that, with his agreement, she will probably need to locate and find the coach. This is a one-time intrusion into his business—but if she doesn’t, she’s relying on him to plan and initiate finding a coach whose responsibility it will be to help him learn how to plan and initiate. You can see how this might be a lost cause!
  • Find a couple’s therapist or sex therapist who can help them overcome the other barriers to sex they’ve now created
  • Start to learn each other’s communication “language” so they can converse both “with the head” and “with the heart.’ Communication is about understanding, not about “imposing” your style on another.

This woman interprets her husband’s lack of initiation as 'he doesn’t care enough to initiate'. But a truer picture is that he isn’t well enough treated to initiate. She interprets this personally and it certainly feels that way…but it’s not personal…really!  It's a symptom. Time for the two of them to get him the professional help he needs before this marriage ends. And note, treatment for ADHD isn't just medication. Good treatment includes a spectrum of approaches within three specific areas: The physiological (medication, exercise, diet, sleep, meditation); the behavioral (structures such as reminder systems, new habits, alarms, master lists and the like); and the inter-personal (such as learning the wife's communication language in the story above).

This doesn't have to be a sexless marriage - but until the ADHD symptom that is interfering with their sex life is addressed, things will continue to deteriorate.

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