By the time we are adults the condition we call ADHD in children morphs into a particular style of living and relating that the term itself does not imply at all. What was formerly a childhood lack of attention, distractibility and poor impulse control can manifest as emotionality, anger, and a restlessness impatience as an adult. Based on one’s life experience, circumstances of living, socioeconomic status, and gender, these could pose either opportunities for growth or severe barriers to personal advancement.

Within marriages and relationships, most of these characteristics are challenging and could lead to separation, divorce, and severe interpersonal pain. Many couples seeking therapy will find the process to be useless, since one of the hallmarks of ADHD style is inability to connect insights into action to formulate a sustained change of behavior. Understanding the ADHD brain's functioning and the individual experience of the affected person is the key to transformation and empathic communication. Here are some of the main points that I have witnessed throughout the years as causing major problems, paired with some possible solutions:

Scenario one :

The non-ADHD spouse feels on edge, judged, unheard and unable to relax as the ADHD-affected partner projects a pervasive sense of impatience, short temper, rush to judgment and inability to relax. If the problem is framed this way and the couple is educated around the dynamics of the ADHD pattern, the ADHD individual usually leaves the session with a sense of shame, guilt and powerlessness over changing the behavior. The non-ADHD partner feels good for a short period with hopes of a pending change in the behavior, only to witness resumption of the same patterns the next time the circumstances arise.

Solution: Address the shame head on, and acknowledge that the changing of behavior is not going to take place based on insight only. Give each other permission to give nonjudgmental corrective feedback as the behaviors arise and set some rules to the game so the feedback is not interpreted as put downs or judgment. Reminders will need to be repeated over and over till in new equilibrium is reached. A sense of acceptance on both sides also helps to set realistic goals and not to strive for an imaginary perfect method of communication.

Scenario two:

The ADHD-affected partner feels trapped, judged and bored in a relationship as she/he continues to attempt to please the partner without ADHD at the high cost of changing everything about themselves.

Solutions: Realistic compromise and acceptance are the key in this situation. Most of the time the traces of personality that have become annoying in a relationship were the ones who caused attraction in the first place. Reminiscing over these memories of courtship paired with pruning behaviors that are most egregious and problematic is the way to approach this dilemma. The goal here is not to completely suppress ADHD style but to harness it, and celebrate its positive aspects such as creativity, spontaneity etc. No one enjoys staying in a relationship where one sees herself/himself as a burden. Devaluing comments on both sides must be stopped intentionally.

Scenario three :

Cultural biases allow men to act out their ADHD brain circuitry with more ease! Boys are considered playful, active, and spontaneous with their ADHD symptoms. Many girls and women are called lazy, ditzy, and spacey for their core ADHD symptoms.

Solutions: The inattention aspects of ADHD are as debilitating and problematic as hyperactivity and restlessness. Many women internalize this sense of restlessness, which is manifested as anxiety or inconsistency. The internalization of these traits, with the accompanying sense of shame and guilt, must be addressed therapeutically by cultivating an awareness of their biological components. The goals I have seen used successfully include developing individualized styles of task completion such as parallel work tracks and shorter periods of sustained activity, followed by breaks.

These are just a few examples, and with proper perspective, approach, and patience, couples can utilize these techniques to create successful families.

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