ADHD and Sex: No Shame, No Blame

"Gina, sex is difficult for people with ADHD; it's tough to stay focused!" says a female Facebook friend, responding to my query on this topic.

     What, you say, ADHD affects sex? Who knew? Yes, it's one of those areas, like sleep, where we often fail to connect the dots to ADHD symptoms.  In fact, I open the chapter on sex in my book, Is It You, Me, or  Adult A.D.D.?. with this quote:

Who knew so many women were begging their male partners for sex? It must be the world's best-kept secret. -- Rory

Later in the chapter, I write:

When ADHD does create significant sexual problems, it usually falls into two categories: The ADHD partner initiates sex all the time or almost never. Again, it seems, we encounter these pesky ADHD-related challenges in self-regulation and summoning motivation.

The truth is, ignorance about this critically important connection between ADHD and intimacy creates so much unnecessary hurt. Left with no other rational explanation for sexual difficulties, partners sometimes blame themselves—or each other. In a blog post on Sex and ADHD at Jeff's ADD Mind, the author first considers it as the “problem with no name” and finally “the problem that carries a lot of shame.”

Consider these comments I've collected over the years:

• “My wife is so easily distracted that boom, in the middle of a romantic interlude, she's suddenly talking about the cat! Talk about a mood killer."
• "Both my brother and I have ADHD, and what we've concluded is that thinking about sex is pretty exciting. But the reality? More often than not, boring. That's a hard thing for a guy to admit."
• “My husband, who was just diagnosed with ADHD, has always said I had to have sex with him twice daily in order for him to know that I love him. But we’re married 20 years now. I’m getting tired! In fact, I don’t it's about love at all. I think it's about self-medicating."
• "Our sex life is great! If only everything else in our life together was so easy."
• "If ADHD presents known challenges to 'self-regulation,' it makes sense that some of us could have a problem with regulation of intensity here along with everything else in life? My wife and I both have ADHD and are living proof of opposite ends of the ADHD spectrum when it comes to sex."

These quotes speak to just a few of the ways that ADHD might affect sexual intimacy. For the record, though, almost one in five ADHD Partner Survey respondents report having a great sex life. Moreover, many of them are in long-term partnerships that are challenging enough to send them scurrying to a support group. In fact, almost half say their ADHD partner is a skilled and considerate lover. I offer these findings not as scientific evidence but as a reminder that, as with most things ADHD, "your mileage may vary."

     For those whose sex lives aren’t so sexy or lively, though, it might help to know that brain function can affect sexual expression. Though not in itself a solution, knowledge can at least relieve psychological pressures, hurt feelings, and unnecessary blame and shame on both sides. Moreover, knowledge paves the way to realistic problem solving.

     Briefly, let's consider how these ADHD-related traits might pave a bumpy path to bliss:

Hyperactivity and Impulsiveness

People with a high degree of hyperactivity or impulsiveness might rush to start—either the relationship or sexual engagement—and quickly grow bored.

Distractability and Inattention

These two traits can generate challenges in getting the party started, paying attention to details, avoiding distractions (air-conditioning hum, scratchy sheets, dog barking, menacing thoughts of uncompleted chores) and maintaining interest through to, um, completion.

Low initiation and motivation

“My wife is always willing to have sex with me and seems to always enjoy it,” says Alex. “Yet, she never initiates. I’m sure this isn’t social or gender conditioning. She simply initiates very little in life and tends to respond to what's in front of her.”

Hypersensitivity to sensory stimulation

If you find a shirt label irritating, imagine how foreplay involving delicate areas might feel unnerving, if not downright irritating. It's called sensory integration disorder (also tactile defensiveness). Consider it a “filtering” problem within the nervous system.

Difficulties in cooperating and taking turns

Lovemaking is sometimes described as a dance that depends on following subtle back-and-forth cues. But what if you have trouble "transitioning" from one activity to the next or "sequencing" steps (that is, first comes this and then comes that, not vice versa)? This can create obstacles not only in your work life or at four-way stops but also in romantic pursuits.

The boredom factor

"Sex is boring," Bryan Hutchinson announces on his blog, AdderWorld. "We’d rather be doing something else while in the act of having sex, something more exciting, like, well, fantasizing about sex, putting together a good story about our sex life, and while we do that we miss out on something important: the reality of sex."

If any of these points resonate for you, know that there are strategies for overcoming their adverse impact on your relationship. For starters:

Adults with ADHD:

Learn about how ADHD symptoms might be affecting your experience of sexual intimacy. That way, you can avoid

• trying to hide the fact that your attention is wandering
• unfairly blaming your partner for your attention wandering
• deciding that you are an inept lover
• avoiding sex entirely without ever explaining why (but still feeling a certain amount of shame about it)

Next, be forthcoming with your partner about what's going on in your head. Otherwise, your behavior can lead your partner to feel sexual rejection, and that can be extremely destructive to a person's self-esteem, not to mention the relationship. It helps to be tactful, though. For example:

Don't say this: "For some reason, I just find debugging software code in my head (or, thinking about the half-yearly Nordstrom sale coming up, etc.) so much more compelling than having sex with you."

Say something like this: "Honey, you know I love being with you and want to please you, but I don't know what to do about this darn distractability. It hits when I least expect it—or want it. Will you work with me on finding some solutions that work for both of us?"

Partners of Adults with ADHD:

Don't make a difficult situation worse by translating your partner's ADHD-related bedroom issues into "You don't love me!" That line of thinking simply doesn't end well.

Both Partners:
1. Set aside time for intimacy

Consider this both a logistical strategy (schedule romantic weekends away or a weekly date night) and a mental one (leave your unfinished to-do list at the bedroom door).

2. Turn off the distractions

Robbie complains that her ex-husband was so distractible and hyperactive that he simply couldn't stay in bed long enough to have sex: “He was constantly jumping up to turn off distracting things—the lamp, the clock radio, the heater, and, eventually, me! I was very turned off!” Anticipate these ambient noises being a problem before getting started and counter them.

3.  Learn all you can about evidence-based strategies for treating ADHD, including specialized therapy and medication.

Consider this closing paragraph from the chapter on Sex and ADHD in Is It You, Me, or Adult A.D.D.?:

ADHD Partner Survey respondents who reported an improved sex life after their ADHD partners started taking stimulant medication attributed the uptick to a better domestic life in general--co-parenting, employment, driving, managing finances, and the like. In other words, increased good will and cooperation outside the bedroom often translates into better intimacy -- and vice-versa.

Please share your strategies, experiences, and "a-ha" moments on this topic. Reader comments to the previous blog on sleep and ADHD were so helpful to other readers. Thank you!


Gina