DR Quratulain Zaidi of MindNLife discusses strategies for adult relationships where one or both partners have ADHD and how to spot ADHD symptoms. The meaning of ADHD is Attention Deficit Hyperactivity Disorder. It is a neurodevelopmental disorder that involves problems with attention, concentration, impulse control and increased activity levels. Millions of people are affected by the disorder, and it has many faces.
Boys were once thought (incorrectly) to be more commonly affected – and that they would just “grow out of it”. In fact, boys, girls, men and women can all live with the effects of ADHD, across every age, ethnicity and socioeconomic status. And, it can cause significant impairment at work, in school and in the lives of those affected by it. So is adult ADHD affecting your relationship?
ADHD symptoms differ from person to person, but there are three basic types:
#1 Primarily Inattentive: The main symptoms are inattention, distraction, and disorganisation.
#2 Primarily Hyperactive/Impulsive: Symptoms of hyperactivity and impulsiveness are evident, especially in childhood.
#3 Combined: This type has ADHD symptoms from each of the other two.
Adults and ADHD
With adult ADHD, symptoms vary from person to person. Sometimes, the person isn’t even aware of their ADHD; or, their child has been diagnosed first and they’ve only started to recognise it in themselves. Often it’s missed in women, specifically, because of their lack of presentation of physical hyperactivity.
This being said, I am finding an increasing number of adults are being identified and diagnosed with adult ADHD in 2023 than at any time over the last five years. This means clinicians are more aware of it and are recognising it more readily. Indeed, research in the area is booming.
Despite this, there remains a lack of awareness around how ADHD is affecting relationships. And it has a significant impact on interpersonal relationships.
Here are just some of the common issues that can arise in daily life for couples.
Inattention: Losing focus during conversation can make a partner feel devalued, and lead to frustration and resentment.
Excessive talking: One-sided monologues can come across as selfish, leading to other people feeling their opinions aren’t considered important.
Hyperfocus: The inability to shift focus manifests itself as being stubborn or not taking your partner’s perspective into account.
Forgetfulness: If a person misses birthdays and anniversaries – even the details of a recent conversation. It can seem like they’re unreliable, incapable or just don’t care.
Easily bored: The constant need for stimulation can be draining for the partner, and he or she may find themselves needing some downtime.
Getting their own way: Making important decisions without consultation can have a huge impact and really make a partner feel their opinion doesn’t matter.
Disorganisation: A lack of organisation leads to daily life chaos. This causes frustration for the partner, who might feel like they do more of the work in the relationship.
Emotional regulation: Adults with ADHD have difficulty regulating their emotions, leading to angry outbursts that can leave partners feeling hurt or fearful.
In addition to these, one of the most common challenges I hear in my couples work where ADHD is affecting their relationship relates to hypersensitivity to criticism. That is, the person with ADHD doesn’t feel valued, or they feel embarrassed or ashamed.
It’s so important to understand that people with ADHD grow up feeling criticised throughout their childhoods. This occurs either through misunderstanding ADHD symptoms, a lack of a diagnosis or simply by “not fitting in”. The fact that they’ve exhibited various behaviours that parents, teachers and friends have found frustrating leads to hypersensitivity to any form of perceived criticism. For them, criticism can feel unbearably enormous and at times even traumatic. Even from just a simple question like, “Why did you miss your appointment?
Moving forward together
ADHD and adult ADHD take up mental and emotional bandwidth. It’s exhausting for the person with the disorder and their partner. So, how do we move forward if ADHD is affecting your relationship? Identifying and understanding what’s having the most impact on the relationship is the first step.
#1 Communicating better
Communication often breaks down when one partner has ADHD or adult ADHD. Surface behaviours (for example, she’s always late for dinner) often mask a deeper issue (he feels under-appreciated because she never shows up on time). One thing I reinforce with all the couples is that “communication” is not what you say, it’s what the other person hears. So, it’s important that you ask your partner what they heard. Don’t create a feeling of blame by starting a sentence with “You…”. Instead, start with “I feel that…”, followed by a description of the situation and how to improve it. And remain engaged: hold eye contact, avoid allowing your mind to wander, repeat what your partner says, and rephrase or ask relevant questions for clarification.
#2 Focusing on teamwork
To create balance in a relationship, both partners have to work together. Having ADHD or adult ADHD doesn’t mean that you can’t find balance. It means you have to rely on open and honest communication and feedback to find ways to help one another.
#3 Renegotiating and delegating
If ADHD interferes with your ability to pay bills on time or manage money, ask your partner to handle those tasks. When couples divide tasks based on their strengths, they get through their to-do lists without feeling overburdened or resentful.
#4 Checking in
Set up a weekly check-in at a predetermined time with your partner to find out what’s going on in their world and share your world with them. This allows people to slow down and reconnect with each other.
#5 Having structure
Routines, schedules and visual planners (using whiteboards or sharing Google calendars, for example) can allow the partner with ADHD to know what to expect, stay on task, and complete important tasks.
#6 Educating yourself
It’s not only critical for those with ADHD to be aware of the effects of their diagnosis on others and to develop skills for building stronger social ties. It’s equally important for loved ones to be cognisant of ADHD-related challenges and the meaning of ADHD. Also to understand that, in many cases, the person with ADHD is aware of and often struggling to manage their frustrating behaviours. If you’re in a couple, educate yourself about ADHD and adult ADHD. Openly discuss the challenges, and work together to address those challenges to strengthen the partnership.
Every relationship requires sustained effort. An ADHD relationship can, at times, require a little more acceptance, understanding, patience, compassion and “letting go”. In my experience, what sees any long-term relationship through are the basic tenants of honesty, commitment, mutual respect and genuine care and love. With this strong foundation, if two people can learn to accept the imperfections of self and partner and recognise each other’s strengths, they’re on a road to a long, successful and meaningful relationship.
My 23-year-old was recently filling out a form for her new job in the UK. Her 16-year-old sibling noticed a reference to a disability on the form. “It’s not a ‘disability’,” he said. “it’s just different abilities – they need to change the wording.” I wish more people would look at ADHD from this lens of difference in abilities. It might help in showing understanding, patience and acceptance towards these differences, frustrating as they may be.
Dr Zaidi is a British-registered clinical psychologist who works with individuals, couples and families in her private practice in Central, and as a mental health consultant for a number of NGOs and international corporations.
2521 4668 | info@mindnlife.com
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This article first appeared in the Summer 2023 issue of Expat Living magazine. Subscribe now so you never miss an issue.