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ADHD, Personal Hygiene, and the COVID-19 Pandemic

What used to be a quirk can now be catastrophic. Here's how to fix that.

You might not normally comment if your partner with ADHD doesn’t remember to wash hands, brush teeth or shower. But at the moment, some people are feeling pretty vulnerable due to their spouse’s poor hygiene. Here are two comments I’ve received in the past week:

“I have a partner with ADHD and finding it almost impossible to live with him during this time as his hygiene is incredibly poor ... normally I wouldn't notice and it wouldn't be such an issue ... however the state of the world at the moment and this virus is causing immense disruption in our marriage.”

The second woman writes, “I feel because of the ADHD my partner will not be diligent being in the outside world with this virus. He already is very relaxed about hand washing and this virus. This is the ultimate test for any couple, but add in the relaxed nature of ADHD during a pandemic and it creates a very unsafe environment.”

One of these women is immune-compromised, and so, “It is imperative that I do not get this virus! My husband loves to touch anything and everything!!!! Handrails, doors, equipment, benches ... It is driving me nuts when he is constantly touching his face and putting his fingers in his mouth!! We've had many many, many discussions, but being more aware doesn't come naturally and impulsivity is the drive of everything. He just doesn’t notice. Or remember. We will discuss the issue and then 5 seconds later he does exactly the same thing that we discussed and agreed that he would try to curb.”

In my couples consulting practice, I’ve noticed that when ADHD partners lack good hygiene, it stems from a number of places, often simultaneously. Lack of awareness; distraction (the number one symptom of adult ADHD); a brain that is running so fast that there feels no time to slow down and consider; forgetfulness; and difficulty envisioning what the outcome of poor hygiene are the most common.

Sometimes feelings of defiance can also add to poor hygiene, particularly if the other partner keeps mentioning it. This “you’re not the boss of me” attitude comes about when partners are engaged in ‘parent-child dynamics’ and the partner with ADHD feels that the partner without ADHD is being too demanding.

As is often the case with ADHD, even good intentions don’t override the actual actions until a thoughtful, compensating strategy is created, treatment is started, or both.

That means that addressing the current pandemic fears is not as easy as simply asking for change. Neurology, habits, and sometimes attitudes may interfere. Instead, couples need to create a structure in which it is easier to comply without having to remember to do so.

A little psychology helps, too. There are ways to approach a recalcitrant or distracted partner that will improve one’s chances of getting buy in. For example, start by reminding your partner how important the two of you are to each other and how much you love each other. Tell him how scared or anxious you are and ask for his help. Suggest that a few weeks of assistance is what you are asking for, not a lifetime of change. You’re asking for the gift of his attention to help make your life easier during this difficult time.

That’s a lot more likely to motivate empathy and action than “I can’t believe you aren’t listening to the experts and taking this more seriously!” This will put your partner on the defensive, instead.

Given the neurology of ADHD, it’s wise to work with the ADHD rather than against it. People with ADHD often live very much in the present moment. Bringing something into mind at the time it needs to be implemented can really help improve performance. Here are some ideas that work with this aspect of ADHD:

  • Put a very obvious "WASH YOUR HANDS NOW" sign on the main doors of your house and on the fridge. Ask him to wash his hands every time he runs into one of these signs. That brings the idea into the "now" regularly for him, and reinforces that this is a small thing to take a moment to do, but could save your life. (Hint: Add a smiley face to the sign to remind him of the gift this is and that you are happy about his doing this.)
  • Immune compromised partners may wish to request the partner with poor hygiene wear a clean bandana, scarf or mask around his nose and mouth. These will remind him every time he goes to touch them that he shouldn't. Though an unusual look, bandanas are pretty easy to breathe with if the bottom part is still open. By keeping him from touching his nose and mouth, this will lessen the chance he will get the virus, and it's relatively easy to do.
  • Take control of what you can. Make yourself responsible for cleaning all of the door, fridge, and cabinet handles with anti-bacterial wipes or cleaner regularly if either of you has been out. This way, if the virus comes into the house, you may still be able to eradicate it.
  • Get a video account such as Zoom, and ask that he set up "virtual get-togethers" with his pals to lessen the amount he wants to leave home. He can still be together with people as much as he wants... just in a mode that is healthier for the time being. If the two of you socialize together, consider being the one to initiate an online group party.
  • Set out two sets of hand towels that are different colors at each sink — one for each of you. Put one in the standard place for him (so he doesn’t have to think about it) and another one a bit further away for you. Wash your own hands regularly, too.
  • If you are worried that your partner may already have the virus, consider sleeping in separate rooms until everyone is healthy. Practice reasonable social distancing in your home. Remember it’s only temporary. You can still tell each other how much you love each other and do fun things together.
  • Make keeping COVID-19 out of the house more interesting. As one woman put it, “I am trying to get him excited about keeping COVID-19 out of the house as a science/engineering experiment. To fight the boredom and restrictive feeling, and to counter impulsivity.”
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