When a "Good News" Diagnosis Means "Bad News" for the Relationship, Pt. I

We often call ADHD a "good news" diagnosis. Why? Because it offers not only a long-elusive rational explanation for vexing behavior but also effective treatment strategies.  

So, why does a "good news" diagnosis sometimes mean "bad news" for the relationship. That's the topic of this two-part post.

     The reasons run the gamut—and are as complex as the individuals involved and their history together. Let's begin with an e-mail sent to me by a reader.  His situation illustrates a very common example of the ADHD diagnosis and treatment creating new challenges even as it resolves old ones. 

Jack Celebrates His Success: 

Why Can't His Wife? 

Consider Jack, 42, married 12 years and diagnosed nine months ago:

It took about six months for me to get on board with medication, and the doc and I haven't worked out all the kinks yet in that regard. 

But let's put it this way: Before I started taking medication, I was often criticized for being hyper, loud, disorganized and easily distracted. Since the medication, I hear myself as I sound to others and so have much more sensitivity to my own volume. 

I am also now more aware of my tendency to rant. A good argument used to be like food to me.  Now, I don't have to be in the ring with every discussion, and I can focus normally on a discussion that I am engaged in.   

     
So, between medication and therapy, I feel my approach to life has changed dramatically.  I'm also better organized, more focused, and doing better at work.  But has all this helped my marriage?  That's the big surprise. The situation at home has actually gotten worse in many respects. 

When ADHD is All in the Family

What happens when it's not just "you or me" who has ADHD but you, me, and a few of the children? (And maybe the dog, too!)

This month's post is written by Cynthia Hammer, MSW, an advocate who has long and admirably served the ADHD community in various capacities. She is currently an AD/HD coach in the Seattle area as well an avid bicyclist and mother of three. As a longtime fan of her work and her compassionately insightful writing, I'm honored that she agreed to share this essay with you here.   -- Gina Pera

We existed as a family for over 15 years before realizing some of us had AD/HD. How did we do it? Although life post-diagnosis and treatment still isn't always easy, I look back in wonder at what we went through in raising our children and maintaining a family life. Actually, a review of our life has been helpful as I say to myself, "You've come a long way, baby!"


In our family, the mother (that's me), was diagnosed with AD/HD along with my middle son (without hyperactivity) and youngest son (with conduct disorder). Our oldest son does not have AD/HD, while word is still out on the father. I have "diagnosed" him with AD/HD, but he refuses the diagnosis.

Out With The Old, In With The....Wait, Do You Really Need New Clutter?

There Janet was, peacefully washing dishes one evening, when suddenly a loud thumping and banging sounded from the front walkway. The clamor continued through the front door and down the hall. Alarmed, she peeked around the corner with some trepidation.

The source of all the ruckus? Her 6-foot-3 husband Ralph, angrily wrestling the giant outdoor garbage-can-on-wheels through the narrow hallway. Directly into his packed-to-the-gills home office.

"After years of my suggesting that he clear the mounting debris, he finally took action," Janet explains. "But instead of taking his time to carefully sort through it all  -- for example, separating aged pizza boxes from working laptops, brand-new wireless routers from ancient modems -- he was furiously tossing it ALL in the garbage!"

What a sight to behold!  Normally a sweet-tempered guy, Ralph was finally fired up and fed up with the mess. Janet took safe cover in the laundry room until the storm blew over.

Partners in Life, Partners in ADHD Awareness

You share a life together – maybe even a bed, a checking account, and human offspring, too. It might sound surprising (especially to some less-than-savvy physicians and therapists), but ADHD evaluation and treatment outcome also typically benefits from a shared "team" approach. Let's examine the reasons why.

Elaine finally decided to seek professional help for her long-ago diagnosed ADHD. But it still took her three months to actually book the appointment. Unfortunately, that therapist ended up knowing little about ADHD, and Elaine gave up on finding another one on her insurance plan.
     “She gives up easily with most obstacles," boyfriend Brian explains, "and then she also quickly forgets why her ADHD is a problem -- until she loses her next job." For a long time, Brian didn’t push her because he didn’t like the idea of "acting like Big Daddy." Intervening just didn’t seem healthy.

The "Gifts of ADHD": Transforming Humiliation into Humility

A big obstacle faced by couples dealing with ADHD is denial -- that is, either partner refuses to concede that ADHD exists, that it is causing challenges, or that effective strategies truly exist.

The reasons for denial around ADHD are myriad and complex. For some who arrive at the diagnosis in adulthood, though, it's simple: ADHD feels like one more negative label, right down there with lazy, unmotivated, and careless. The temptation then might be to wholly reject the label and instead cling to a more "positive" spin: ADHD is a gift. In this month's guest post, San Diego-based psychotherapist and ADHD expert Lew Mills, Ph.D., MFT (pictured below), offers a nuanced way to reconcile "gift" and "disorder."

(To learn more about denial's psychological and even physiological foundations, check out the August and October 2008 issues of CHADD's Attention magazine, which excerpt my book's chapters on the topic. If you missed these issues, remember that CHADD members can access an online treasure trove of past Attention articles.)

I  look forward to your comments!  --   Gina Pera

You can always start a debate amongst a group of people with ADHD by asking whether ADHD is a "disorder" or a "difference." Is it a curse or a gift? It's everyone's favorite topic, and everyone has an opinion. Actually, I have two opinions. Like many big questions, the answer lies somewhere not just in the middle but at both ends.

Is It "Miscommunication"—or Could It Be Adult ADHD?

With a warm smile and a kiss, Diane welcomed fiancé George at her front door and then noticed fresh mud on his shoes. In a pleasant tone of voice, she asked him to please leave his boots on the stairs. 

Puzzled, he said, "Your suits stare? Huh? What on earth are you talking about?" Despite her clarification, George remained convinced that Diane had said exactly that. Moreover, she'd said it with that tone (presumably, the disapproving kind). 

    
  It wasn't this pair's first tangled communication. In fact, it happened so often, George had his hearing checked but it seemed fine. Their couples therapist suggested that George might bear deep-seated psychological resistance to listening to Diane.

Can You Hear Me Now?

       Fortunately, George's ADHD diagnosis came just as these "miscommunications" reached fever pitch. He and Diane felt relief when the cognitive therapist explained how ADHD has a common traveling companion called Central Auditory Processing Disorder (CAPD). Briefly, it can cause a person to misinterpret content and even tone of voice (more details about CAPD in a minute). The therapist provided the couple strategies for enhancing communications, noting that stimulant medication can often help "strengthen the signal." 

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.”

To Sleep, Perchance to Turn Off That *&$@# Computer

Being new to the area, my husband and I got lost on the way to our first adult ADHD discussion group in downtown San Francisco. Some heated bickering later ("You said to turn left!" and "I didn't mean that left!"), we finally arrived and caught our breath. That's when a worn-out looking man across the table said something that sticks with me, ten years later:

"I've blamed a lot of people in my life for my troubles, but when it comes down to it, I finally realize that I am my own worst enemy. For forty years, I've not only opposed what other people want me to do, I've opposed what I want to do."

      We've all heard that adult ADHD can create problems in relationships, but this man's epiphany struck some foundational truth: Having ADHD can create problems in your relationship with yourself, never mind someone else.