Marriage and ADHD Help!

My Partner Doesn't Seem Motivated to Change

ADHD marriage
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Getting married usually means you have a partner in life. Someone to share the ups and downs of life with, including parenthood, running the household and providing each other with emotional support.   

However, if your partner has ADHD, the partnership can become lopsided as you find you are taking care of your partner's responsibilities as well as your own. As the non-ADHD spouse, you may feel you don’t have a partner, but instead have someone to corral, organize and direct like a child.

 

It is easy to see why non-ADHD spouses begin to feel isolated, distant, overwhelmed, resentful, angry, critical and accusatory while the ADHD spouse can feel nagged at, rejected and stressed. When frustrations and tempers become more difficult to control, the marriage may begin to unravel.

Adult Symptoms of ADHD

Often neither partner realizes that ADHD is the cause of these problems.

Dr. David W. Goodman, M.D., assistant professor of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine and Director of the Adult Attention Deficit Disorder Center of Maryland, says  “Many adults incorrectly assume or have inaccurately been told that an individual cannot have ADHD as an adult. This is simply not true,”

 Dr. Goodman who also explains that ADHD is highly genetic. For some adults, a diagnosis is made after their own children are evaluated and diagnosed with ADHD. As the parents learn more and more about ADHD, they may begin to recognize the ADHD traits in themselves.

Adult symptoms of ADHD are similar to childhood symptoms – inattention, distractibility, taking longer to get things done, problems with time management, scattered-ness, forgetfulness and procrastination. They don’t develop in adulthood, rather they persist into adulthood. Symptoms also tend to escalate as an individual’s environment becomes more stressed and as demands in life increase.

It can be a huge relief to finally understand and put a name to the condition causing the problems.

Treatment Issues

“If the ADHD spouse is receptive to diagnosis and treatment, functionality typically improves fairly dramatically,” notes Dr. Goodman. Treatment is not only critical; it is often a real eye opener for individuals.

Not all adults with ADHD are open to treatment, which can be frustrating for their spouse who sees treatment as a way for their relationship to improve.

“The larger challenge for the non-ADHD spouse,” says Dr. Goodman “is when their partner has never received evaluation or treatment, is prejudiced against psychiatry, or has had no exposure to psychiatry and is reluctant or afraid of being labeled, or afraid of having to take medication.”

If these are adults with children who are receiving treatment for ADHD, sometimes the dramatic improvements seen in their child has an effect on the ADHD adult’s perceptions. Most people want to get better and improve their functioning.

When they see their child is functioning so much better with treatment, the adult begins to wonder whether they couldn’t do better, too.

When Dr. Goodman encounters reluctant patients, he takes a “let’s just sit down and talk” approach. If medicine is indicated, he encourages patients to try it for a month or two. At the end of that period if the individual is not seeing any improvements or doesn’t like how he or she is functioning, the individual can chose to simply discontinue the medicine.

This approach gives the patient a better feeling of control over treatment. For some individuals there is anxiety or worry about losing control. In order to maintain that control, they may resist treatment. “People want to feel in control of their psychiatric treatment, especially in regards to how it affects their mental functioning,” explains Dr. Goodman who typically first provides education and accurate information about adult ADHD and works hard to make an in-road and engage reluctant patients.

Treatment is a partnership with the doctor, but the ultimate control is held by the patient. “Most people understand that when they come into treatment they are functioning ‘less than’,” says Dr. Goodman. Generally, people want to get better. If they are able to experience the improved quality of life resulting from treatment, most individuals become invested in continuing. “Few people chose to function at a lower level once they experience the benefits.”

Advice for the Partner

Dr. Goodman says it is very helpful for the non-ADHD spouse to develop an understanding of the impact ADHD can have on an individual’s daily functioning.

“The non-ADHD spouse may assume their ADHD partner is being passive aggressive when they are late, procrastinating, or forgetful,” notes Dr. Goodman. “It may look like the ADHD partner is unmotivated to change or trying to annoy, when in fact the ADHD individual is impaired and unable to perform at the required level.”

Most often the problematic behaviors of the ADHD partner are a function of an inability and impairment rather than a motivation issue. With this insight and understanding the non-ADHD spouse is often less frustrated.

 

Source:

Dr. David W. Goodman, MD. Personal correspondence/interview. 12 Feb. 08 and 15 Feb. 08.

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