ADHD/ADD (Attention Defiict Hyperactivity Disorder) Relationship Advice

Re-Tie the Knot: ADHD Relationship Advice | ADDitude - Attention Deficit Information & Resources (click to read the article)


Although all married couples have to navigate challenges, communicate effectively, and work cooperatively, ADHD places extra strain on a relationship. In the article above (just click the article to find it) this clinician points out that “many clients with ADHD (Attention Deficit Hyperactivity Disorder) have partners who are so highly organized that they are jokingly accused of having Attention Surplus Syndrome, or ASS. Over time, it seems, the “opposite” qualities that originally attracted the two to each other lose their appeal.”

I couldn’t agree more, and this article contains a nice and simple little rating scale used to help you out with these issues. ADHD is often a major factor in pushing a couple over the edge. As a Registered Marriage and Family Therapist I often see couples who are having numerous problems, but taking the steps necessary to salvage their relationship really means taking a step towards dealing with one (or sometimes both) spouses ADHD. Sometimes one parent has ADHD and one or more of the children, and the remaining spouse ends up being a “parent” to everyone...until his or her energy simply runs out.

So here are some hints on how to handle your partner if you suspect ADHD is underlying a great deal of your issues:

1. Get a comprehensive diagnosis. This means not relying on inconclusive evidence. Short forms and tests (very similar to those you often see on ADHD web pages ...and I urge you to STOP reading those!) often only look for symptoms of ADHD. And the problem is that those symptoms are sometimes caused by ADHD, sometimes by OCD, sometimes by focused memory problems, sometimes by specific learning disabilities or depression or anxiety or a language disorder...the list is really pretty long. Individuals get these quick diagnoses and then get medication, then time goes by and nothing happens. Nothing changes. Often it’s because the diagnosis is wrong.
Trying medication to see if it works! I don’t know what to say, some people try their kids medication, or their brothers, and sometimes the medication helps with a particularly difficult task (like taking a test). Don’t do this, get a decent psycho-educational evaluation. Your choice of medication may just be masking a more serious problem.

2. Taking current problems to mean life long problems you didn’t discover. Lots of people do this. What appears to be ADHD is really the result of temporary anxiety and stress, working beyond your capacity and ability. ADHD is chronic and long term. It starts fairly early in life, and can manifest itself in different ways. (Yes, there is an inattentive type, and a “slow processing” type that many people would never think of as “ADHD.” But they are. A clinical history is necessary to understand the nature of your problems.

3. Failing to consider co-existing conditions. This is a common mistake. Some patients have ADHD, but their anxiety is very high, and dealing with the anxiety is just as important, if not more important, than dealing with the ADHD. The anxiety, or depression or anger management issues need to be addressed systematically, usually with Cognitive Behaviour Therapy or CBT. This is why I often recommend to clients that they see a Registered or Licensed mental health professional rather than someone who is a “certified coach” or “professional organizer.” These individuals are not trained or prepared to help you with a diagnostic clarification or with the complex interventions that are part of CBT. See a professional, and that means someone who is Registered or Licensed by the Provincial government or your state.

4. Don’t leave your spouse/partner out of this! Psycho-education is a critical component of ADHD treatment. This is especially important in a situation that involves a relationship because many people don’t accept the diagnosis of ADHD, think the person with ADHD is doing what they are doing purposefully, with intent, and mistake many behaviours such as the variability of attention and focus as proof that the behaviours are controllable. Nothing could be further from the truth. The variability of symptoms from day to day, if not hour to hour, are part of the diagnosis and the disorder itself. The ability to focus on something an individual finds interesting, for long period...long periods...is part of the disorder. It isn’t just your spouse who thinks your “simply lazy” but lots of people I’m afraid, and THEY need to be educated. (My web page suggests a great book by Mel Levine called “The Myth of Laziness” and one by Kate Kelly and Peggy Ramundo called “You Mean I’m Not Lazy, Stupid or Crazy.” The answer is “Yes, that’s exactly what I mean ...... and now we have to teach you to get this across to important people in your life.

5. Looking for Quick Fixes to Immediate Problems. Well, I do want to help you find quick, immediate and useful strategies to immediate problems. That’s a good idea. But a well structured ADHD intervention will cover a wide area of topics and skills, some of which you may already have. We do this so that we can make use of your cognitive/behavioural strengths to make up for cognitive/behavioural weaknesses. A structured treatment approach is best.

6. Expecting miracle cures from those “magic pills.” Medication is the first and most important intervention for ADHD/ADD. Research is clear about this, and there are specific ways medication should be given. One medication that helped your brother may not help you, and the one that help the neighbor’s kid may make your kid a little jumpy. Having a comprehensive diagnosis helps get the medication right. And once you take it, well most people report significant and positive changes. But remember: ADHD/ADD is a developmental disorder. If you have severe ADHD/ADD and can’t organize your way out of a paper bag, medication isn’t going to help you get organized. It will prevent your brain from preventing you from getting organized. But organization is a behaviour skill you should have learned as a small child, when learning to be organized was fun and reinforcing. Learning to organize your room, homework time, paperwork or schedule is not going to be fun at age 12, 18 or 35. You may need both the medication AND some behaviour techniques to learn the skills you never really learned very well, and maybe learned to do in ineffective ways.

6. Anger Management. This is often the last thing someone wants to deal with, and is the most damaging to a relationship. Poor impulse control often has done a lot of damage to a relationship and you will need help undoing that damage and learning skills to control your emotions. Often, to the surprise of many, this involves learning some self control techniques AND getting some assertiveness training.

7. Finally, there is communication. Communication problems often have developed over time, with both partners becoming frustrated with the lack of appropriate responses, the lack of skills and taking what seems like the best path...communicating less. When you find a professional to work with make sure they have basic skills in working with couples, and communications training is a critical part of that.

I hope this isn’t an overwhelming list. I often try to make these posts short and direct. But here I’ve tried to outline as many of the essential components to a properly implemented treatment program for ADHD/ADD when there are others involved. Actually, as I look it over, this isn’t too different from what we always need to do with ADHD/ADD. Find a professional who has experience in mental health, assessment and relationships, not just ADHD/ADD. A minimal program usually involves a few months of treatment. If it’s too costly you can find a professional to guide you through one of the many structured self-help books for individuals with ADHD/ADD. I use an 8 week structured program, and we go from there. What important to remember is that when you are involved in a relationship the treatment of ADHD/ADD can become complicated but for most treatment leads to significant, positive and long lasting changes. The outlook is bright! Go back to the top of this page and read the short article I’ve suggested on communication. You’ll see a simple and effective technique you could start using today.

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The ADHD blog is not offered as medical advice or as a means of diagnosing or treating ADHD or any other disorder. My recommendations: Don't go on-line and take an ADHD "test." The diagnosis of ADHD is complex and involves not just looking for symptoms of ADHD, which is all that those “tests” do, but also involves ruling out other disorders that might look just like ADHD. Often individuals who think they have ADHD have other disorders, and may have co-morbid disorders such as depression, anxiety or OCD. A simple check off sheet of “symptoms” doesn’t differentiate these. So avoid these on-line "tests" which are nothing more than a collection of symptoms. You need to see a licensed or registered professional for a real diagnosis. Medical doctors can diagnose ADHD, but the diagnosis is complex and often they will make a referral to a Registered Psychologist for a full understanding of a patient’s symptoms. You can obtain a referral for a psychologist with expertise in ADHD from the British Columbia Psychological Association (BCPA).

In my practice I offer Attention Deficit Hyperactivity Disorder (ADHD) assessment and treatment services for individuals, couples, families, children and adolescents in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education, cognitive rehabilitation for problems with memory and concentration and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.

My web page lists a number of resources you can make use of yourself in dealing with Attention Deficit Hyperactivity Disorder (ADHD). Please visit it at www.adhdhelp.ca or one of my other sites at either Psychology Today, AAMFT, PSYRIS or my professional site. Please feel free to call if you have questions about ADHD or other cognitive issues.


Dr. Jim Roche
Registered Psychologist, British Columbia 01610
778.998-7975
www.relatedminds.com