The Impact of ADHD on Intimate Relationships: An Introduction
As a clinical psychologist specialising in adult ADHD, I see firsthand the unique challenges that this condition can present in various aspects of life, including personal relationships. This is particularly the case in intimate relationships where one or more partners have ADHD. By understanding the challenges that arise, obtaining appropriate treatment for ADHD, and learning how to approach difficulties in new ways, it can be possible to have healthier, more fulfilling relationships.
Types of Difficulties
ADHD is characterised by fluctuating attention, which can manifest as inconsistency in romantic relationships. One partner may feel ignored or overlooked when their partner with ADHD seems distracted by other activities or disinterested.
People with ADHD can act on impulse, which can lead to rash decisions or remarks that might upset their partner. Impulsivity can also lead to financial difficulties.
Forgetfulness is another common trait in individuals with ADHD. A person may forget important dates, tasks they had agreed to, or conversations, which could lead to feelings of disappointment or resentment in their partner.
When tasks or responsibilities are continuously postponed, it can lead to feelings of frustration and disappointment in the partner, potentially causing them to question their significant other's reliability and commitment. Additionally, it can create an imbalance in the relationship if one partner feels they are shouldering more responsibilities.
Emotional Regulation Difficulties
Those with ADHD can have trouble regulating their emotions, which can result in mood swings and heightened emotional responses. A minor disagreement could escalate quickly, or emotional reactions might seem disproportionately large relative to the situation. This can be confusing and overwhelming for both parties involved. Emotional dysregulation is often worse in the evening when people are feeling more tired and have less self-control. Also, if a person is taking stimulant medications for ADHD, these will wear off in the late afternoon or evening, which can exacerbate emotional dysregulation.
A Parent-Child Dynamic
In relationships where one or more partner has ADHD, a "parent-child" dynamic can inadvertently develop. This occurs when the partner without ADHD (or the one with less impairing symptoms) takes on an excess of responsibilities and starts to manage the other's tasks and routines due to their difficulties with focus, memory, or organisation. While this may initially seem helpful, it can create an imbalance in the relationship, leading the non-ADHD partner to feel more like a parent than a romantic partner, and the ADHD partner to feel patronised or infantilised, or to simply stop trying. It's crucial for both individuals to be aware of this dynamic, as it can lead to resentment and anger...
Anger can be an issue for either partner, whether they have ADHD or not. Frustration can arise on either side of the relationship due to the above difficulties posed by ADHD. The non-ADHD partner can feel angry and resentful about performing more than their fair share of household duties, money-earning, or child-rearing. The ADHD partner can feel angry that their partner is so critical and angry all the time. Anger can lead to contempt, which has been shown by the research of psychologist John Gottman to be the single biggest predictor of divorce.
What To Do About It
If you are used to reading my blog posts you can probably intuit that I think the most important thing is to diagnose ADHD when present, and to receive optimised medication treatment, preferably with a stimulant medication. Stimulant medication can assist in all the issues listed above, and many more.
Then there is therapy. I talk about relationship issues with many of my clients. Often it's about how their ADHD affects their relationship, but sometimes their partner is also neurodivergent, which makes the equation more complicated. For some of my clients, I recommend they see a couples therapist. It's important for the therapist to be neurodiversity-informed, as otherwise the difficulties of the ADHD partner could be misinterpreted as intentional or immature. In some situations it is useful for each partner to have their own individual therapist to work on their own issues, and a shared couples therapist to focus on the relationship.
Education and self-help can also be really important parts of treatment. If ADHD is diagnosed in an already established relationship, there ideally should be a desire to understand how this presents and what to do about it for both the ADHD and non-ADHD partner. I have listed a few educational resources at the bottom of this blog post.
Learning how to communicate effectively can make a big difference in allowing partners to hear each other out and make plans. This can take the form of regular meetings to touch base on what is happening and what plans are coming up. Planned discussions can also be important. These focus on planning to talk about a topic at a time of the day where the participants are not tired, are medicated, are not hungry, and are therefore able to focus and less likely to become emotionally dysregulated. Then there is Nonviolent Communication, where a person describes a situation without evaluation or judgement, expresses their feelings, identifies and communicates their needs, and makes a specific request for action to meet the expressed needs.
Every person and every relationship is unique, so what works for one couple may not work for another. ADHD doesn't define a person or their capacity to have a loving, intimate relationship, but it does make it more challenging.
An excellent pair of books by Melissa Orlov take an in-depth look at the workings of ADHD relationships, some of the major pitfalls, and how to go about changing things for the better: The ADHD Effect on Marriage, and the Couples Guide to Thriving with ADHD.
The ADHD and Marriage website run by Melissa Orlov includes blog posts, resources, and a community forum where you can read about other people's difficulties, and perhaps even post a difficulty of your own.
An educational book about what it can be like to have a loved one with ADHD is When an Adult You Love Has ADHD: Professional Advice for Parents, Partners, and Siblings by ADHD expert clinician and researcher Dr Russell Barkley. This book can be a little brutal in its honesty, which I like, but may not be for everyone.
The ADDitude blog post 5 Common ADHD Relationship Hot Spots — and Solutions provides links to multiple other blog posts around a range of topics relating to ADHD and relationships.