ADHD & Marriage: An Interview with Gina Pera

Learn from the author of Is It You, Me, or Adult A.D.D?

Posted Jul 09, 2012

Gina Pera is the author of the award-winning book Is It You, Me, or Adult A.D.D.? She speaks internationally on adult ADHD and writes three blogs, including one devoted to relationships: You and Me - and Adult AD/HD.

What are some common issues couples experience when one partner has ADHD and the other does not?

First, I’ve never seen the issue as “ADHD vs. non-ADHD,” Why? Because, in 12 years of close observation, I’ve observed that dual-ADHD couples experience largely the same range of challenges as “mixed” couples — and often to a greater degree.

Logically speaking, we cannot separate “ADHD relationship issues” from “ADHD issues.” Single adults with ADHD face challenges in many areas of life, from education and employment to managing money and driving an automobile. When these adults enter a relationship, they bring their ADHD-related challenges with them.

Moreover, committed relationships often mean sharing finances, time schedules, household responsibilities, and sometimes parenting — all of which exacerbate ADHD “hot spots.” So, you could say that relationships shine a spotlight on ADHD-related challenges and sometimes even turn up the heat on them. The other factors that influence these couples issues: The type and degree of ADHD symptoms, the individual’s ownership of them, and a partner’s reactions to them (as well as the partner’s own idiosyncracies or even diagnoses).

The common issues these couples face depend on whether or not the ADHD is diagnosed, symptoms are well managed, and both partners make an effort to work on joint solutions. If ADHD has not yet been identified or isn’t well-managed, both partners can feel misunderstood, disrespected, and disconnected in a variety of ways.

If ADHD has been identified and is well-managed — with a team effort and mutual consideration — it becomes simply another “difference” that couples must work out in their own way, along with every other possible difference between two individuals.

What are some reasons traditional approaches to relationship issues might not be as effective for a couple where one of the partners has ADHD?

For years before my husband was diagnosed, I pored through relationship-theory books. None helped us (some even inflamed conflict) because none of them were informed by ADHD knowledge.

For one thing, traditional relationship theory typically relies upon a “systems” model, which maintains that if one partner changes behavior the other partner will change in response. Such therapists often zero in on the higher-functioning partner, with admonishments to “stop nagging” and “stop compensating.” In other words, they miss the underlying ADHD symptoms in one partner and focus instead on the other partner’s reactions to the symptoms, as if these reactions were causative of the couple’s problems. They fail to realize that the higher-functioning partner might nag for a reason – because if they don’t, nothing will happen.

Of course, there are many scenarios. The partners of adults with ADHD can of course have their own problems. But unless a therapist understands the “ADHD piece,” the rest of the puzzle will remain unsolved.

How should household chores be dealt with in an ADHD/non-ADHD couple?

With any couple, ADHD-affected or not, the key issue around household chores is equitable distribution. How that plays out for each couple depends upon clear-headed examination of the tasks at hand — making lists and timelines, jointly deciding how to divvy up the tasks so that neither partner is doing all the “grunt” work or the “fun” work, and deciding how to be accountable to each other.

In general, I encourage couples to simplify as much as possible. Streamline furnishings and chores. Cut down on “decorative” clutter. Forget about perfection.

It often helps to develop an organizational system that supports household-chore completion with visual clues; as Dr. Russell Barkley advises, build in supports at the “point of performance.” For example, in the early days of my husband’s diagnosis, I discovered that his apparent “malingering” around loading the dishwasher actually reflected true bewilderment at knowing how to load items so as to not block water flow. Once I realized this, I simply took a photo of a properly loaded dishwasher and posted it on a nearby wall. He loved not only the solution but also the fact that I understood his dilemma.

What suggestions do you have for a partner or spouse who is having difficulty with the messiness of his or her ADHD partner or spouse?

“Messiness” is typically a problem for anyone living with it, including the person with ADHD who freaks out every morning looking for a misplaced cell phone. Sometimes, though, the partner with ADHD is hyper-organized and thrown off by a mate’s clutter. It just depends on the individuals involved.

I would encourage couples to embark upon tactics that minimize mess for the entire household. Sometimes an ADHD-savvy professional organizer can help a couple develop mutually beneficial solutions. For example, compromises must often be made between “visual” people who like to see their stuff and the “out of sight” people who relish clean lines and bare surfaces.

How does the ADHD partner's impulsivity affect a couple's financial status?

Stephanie, I think you should be the one telling us about that — along with offering the solutions from your book!   Thanks for the plug, Gina!

Definitely, impulsivity as well as other ADHD symptoms can wreck an individual’s or a couple’s finances. I remember years ago attending a lecture by Dr. John Ratey where he explained that for “shopaholics” dopamine is released in anticipation of buying something, not actually having the thing. Hence all the ADHD-inspired closets full of great stuff purchased on eBay, which is clever enough to stretch out that dopamine flow for days at a time while bidders excitedly await “winning” that new collectible or, in the case of one person I know with newly diagnosed ADHD, a $16,000 house purchased sight unseen!

How could a person with ADHD respond to a non-ADHD partner/spouse that doesn't consider ADHD to be a valid diagnosis?

Again, sometimes both partners have ADHD, and even then “denial” can be an issue. In fact, I’ve noticed that some of the strongest denial of ADHD as a valid medical diagnosis comes from people who themselves have ADHD. But yes, of course people who don’t have ADHD also can minimize its legitimacy or even existence. As I like to say, understanding ADHD requires higher-than-average intelligence and empathy, and half of the population is below average in both.

When people with ADHD write to me asking for advice in reaching a skeptical partner, here is what I suggest:

First, if the relationship is long-term and ADHD only newly recognized, consider that your partner might simply feel worn down. He or she is tired of hearing excuses or believing in promises that you will “do better.” In particular, requests for more “accommodation” of your newly discovered ADHD from a partner who feels they’ve been accommodating for years might fall on cranky ears. Don’t even try presenting the “ADHD is a gift” thing if you have bankrupted the family or otherwise acted irresponsibly and with grave consequences.

Second, if you have spent many years blaming your partner for your problems or in other ways invalidating your partner’s complaints, take some time to honestly own past problems and apologize. Sometimes the partners of people with ADHD just cannot open their minds or hearts to new information until their old hurts have been acknowledged.

Third, focus on “showing, not telling.” If you want your partner to believe that ADHD is real, start showing how this new information translates into permanent positive improvement – for more than two weeks at a stretch. As the old saying goes, “Seeing is believing.”

How can the knowledge of ADHD as a neurobiological disorder help couples?

By understanding the foundational neurobiology of ADHD, couples can short-circuit the blame game and cease personalizing behaviors, which only ratchets up hurt and alienation on both sides. For example, when the partner with ADHD breaks an agreement and impulsively spends, that can now be seen as a symptom to target rather than proof of selfishness or lack of love.

What recommendations would you give to a partner/spouse that is feeling guilty about getting upset with their ADHD partner/spouse?

In my presentations, I share a quote: “A happy marriage is the union of two good forgivers.” Having empathy and compassion for each other is vitally important in these relationships. I recall the early days, when my own husband was diagnosed with ADHD and just beginning treatment – and finally we had an explanation — we finally felt we could start stepping back from our own simmering hurts and better appreciate each other’s. “Poor you,” I would say. “I’m so sorry for the awful things I said.” And my husband would say, “Poor you! The thoughtless things I did deserved your saying awful things.” “Poor us!,” we would say in unison. We hadn’t known. Once we did know, we changed our reactions.

When would you recommend that a couple seek counseling?

Fortunately, adult ADHD awareness in the therapeutic community has skyrocketed in recent years. Still, I strongly encourage couples to first educate themselves on adult ADHD and its evidence-based treatments before taking any steps towards treatment or even diagnosis. (I included in-depth explanations of medication and therapy for ADHD in my book so that readers can be smarter mental healthcare consumers.)

This “educate yourself first” message is one that some people don’t want to hear. They like to think they can find a “turnkey” professional or clinic that will take them by the hand and methodically help solve all their problems. I wish such a thing existed, but I’ve yet to see a good treatment outcome that did not involve pro-active clients.

What are three things can couples with ADHD do now to improve their relationship?

1. Educate yourselves about all aspects of ADHD, and draw from solid source of information. Factual knowledge helps you to stop reacting emotionally and start acting rationally.

2. Take charge of your situation by, as I say in my lectures, “being detectives in your own lives.” Identify the chief trouble spots in your life together — whether it’s inequitable chore sharing or lack of intimacy — and start working as a team in brainstorming solutions.

3. Maximize ADHD treatment strategies, including medication, exercise, sleep, diet, and organizational support.

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