ADHD and Its Effect in Marriage

Interview with Melissa Orlov

Melissa Orlov / Specialty Press

Melissa Orlov is the author of The ADHD Effect on Marriage: Understand and Rebuild Your Relationship in Six Steps. She also writes the "Your Relationships" column for ADDitude Magazine, runs the popular blog at, and is a contributing author to the book Married to Distraction with Ned Hallowell, MD, and Sue Hallowell, LICSW. Orlov was kind enough to answer questions that impact many of our own readers' lives when one or both partners in a relationship or marriage has ADHD.

Q: What are some of the ways symptoms of ADHD can disrupt a relationship?

A: ADHD symptoms add consistent and predictable patterns to marriages in which one or both partners have ADHD. As long as the ADHD remains untreated or undertreated, these patterns can leave both partners unhappy, lonely, and feeling overwhelmed by their relationship. They may fight frequently or, alternately, disengage from each other to protect themselves from hurt. A common response for the non-ADHD partner is to become overly controlling and nagging ("the only way to get anything done around here") while the ADHD partner becomes less and less engaged ("who wants to be with someone who is constantly angry?")

If your relationship is impacted by ADHD, you may see any of the following patterns:

  • Chronic nagging and/or anger
  • Distribution of household tasks is wildly uneven
  • One spouse plays the role of always being responsible (a "parent" role) while the other is consistently inconsistent or irresponsible (a "child" role)
  • Your courtship was amazing and you couldn't get enough of each other, now one partner just isn't paying attention at all
  • You argue all the time, even over stupid things
  • One partner doesn't seem to remember agreements well or is tuned out
  • One partner has great trouble following through on things that have been agreed to
  • Sexual relationship has broken down

The unfortunate result is that the divorce and marital dysfunction rates for couples affected by ADHD is almost double that of couples not impacted by ADHD. The good news is that understanding the role that ADHD plays in a relationship can turn your marriage around.

Q: What's it like to be an ADHD spouse in marital crisis?

A: There is a spectrum of ADHD symptoms. Some people have no trouble with ADHD in one or more realms of their life, such as at work, but have difficulty in others, such as relationships. Those with the most severe symptoms find that ADHD interferes with just about everything.

Among other things, a person with ADHD who is in a troubled marriage may feel:

  • Secretly or overtly overwhelmed, since keeping daily life under control when you have ADHD takes much more work than others realize
  • Subordinate to a spouse who is "running things," particularly if parent/child dynamics are in place
  • Unloved or unwanted, because he or she keeps hearing the message that he should "change" or do better
  • Afraid to fail again. As a relationship worsens, typical ADHD inconsistency contributes to anxiety about what may happen the next time one fails
  • Different. People with ADHD understand that the world doesn't work for them in the same way that it does for others. Their minds are often "racing", "noisy" or "cluttered," and so they see experience the world in ways that others often don't relate to well. One young man described his ADHD brain as "having the Library of Congress in your head with no card catalogue."

Q: What about the non-ADHD partner? What is helpful for the ADHD partner to understand about the experiences of his or her non-ADHD partner?

A: As with the ADHD spouse, the non-ADHD experience runs along a spectrum from mildly problematic to unmanageable. At the milder end of the spectrum is a spouse who finds herself surprised and unhappy that her ADHD husband isn't paying much attention to her. At the unmanageable end is the partner who feels completely overburdened by the responsibilities she has assumed because she thinks her spouse can't do them. She dislikes herself and her husband and is chronically angry and frustrated by her plight.

The non-ADHD partner's experience is generally a progression from happy to confused to angry to hopeless. He or she might feel:

  • Lonely because her spouse is too distracted to pay any attention
  • Angry and emotionally blocked - anger at the untreated ADHD partner's inability to change their interactions or follow up on responsibilities can permeate many interactions. In an effort to control this, a non-ADHD partner may "bottle it up inside."
  • Stressed out - too many responsibilities, not enough help, and too much anger can make the relationship toxic for a non-ADHD partner
  • Exhausted, hopeless and sad - it can be a real struggle living with a person who is not managing his ADHD. After a while, the repetitive nature of how unmanaged ADHD symptoms show up in the relationship leads to feeling as if nothing will ever change.

Interview continued on page 2

Q: In your book you talk about the destructive symptom-response-response cycle. Can you explain what this is, the ways it can be hurtful in a relationship, and how to break this negative pattern?

A: The tendency is to blame ADHD symptoms for all of the problems in the marriage but this is not the case. Both partners play important roles in their marital distress. ADHD symptoms create unexpected, often insidious, stresses on a marriage, as well as many misunderstandings.

The destruction comes from the full pattern, though -- one that includes the symptoms, the response to the symptoms, and then the response to the response.

A classic example is around the symptom of distraction, one of the most prevalent and important symptoms of ADHD. A distracted ADHD partner often is simply not paying any attention to his or her spouse. If the spouse doesn't know about ADHD then she will likely interpret the lack of attention as "he doesn't care about me any more." She becomes progressively more resentful at his lack of attention and starts to be short and angry with him. He hears the anger but doesn't know its origins, so is hurt and angered by her anger…and they head into a downward, reinforcing cycle. On the other hand, if the couple does know about the ADHD, an ignored spouse can say "you've been distracted lately and I'm feeling lonely. Can we go out on a date and spend some special time together?" You can see how fully understanding the situation, and responding in a way that acknowledges the presence of the ADHD symptom, makes a big difference.

But don't misunderstand me -- the symptom is at the beginning of the cycle, so the symptoms need to be managed, or worked around if a troubled couple is to improve their relationship for the long term.

Q: You also explain to couples that it is not a matter of trying harder, but of "trying differently." What does this mean?

A: You can take your knowledge about ADHD and choose tactics that will help you succeed. I call these "ADHD sensitive" tactics. For example, just trying harder to remember to do a chore sometime in the future probably won't work because the symptom "distraction" will get in the way and the chore may well be forgotten. On the other hand, setting an alarm on your cell phone that reminds you of the chore at the time that it needs to get done will probably work very well. The ADHD spouse may be distracted in the interim, but the alarm brings the chore back into his or her mind at just the right time.

Q: For couples who are still struggling with the "ADHD Effect" in their relationship, but who are understanding more about the patterns that are occurring, what are some key points that they need to know in order to move forward, repair and rebuild their marriage?

  • This is a two-person effort. You both must take responsibility for your own issues and changes in order to succeed. Conversely, you cannot be responsible for your partner's changes, including whether or not to try medication for ADHD.
  • Learn everything you can about how different you are and what your partner's experience is. It will give you greater empathy, patience and even motivation.
  • Optimize the ADHD treatment. Medications alone don't do it. I write about the three legs of treatment for an ADHD partner in a relationship in my book, and while it's too much to cover here I suggest couples think in terms of a multi-pronged approach to treatment.
  • Think about improving your relationship rather than saving your marriage. This will keep you focused on what's really important -- how the two of you relate to each other -- rather than on the logistics of your relationship. Logistics (who is doing what) is where most troubled marriages are focused.
  • Ultimately, marriage is about joy. As you work through the six steps for rebuilding your relationship that I outline in my book, remember to find something to celebrate or laugh about as often as possible. Set aside time to create joy, not just time to fix things. You both need relief from the effort it takes to change habits that have been built up for years.


Melissa Orlov. Interview/email correspondence, Nov. 4, 2010.

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