If you have been online recently, then you are aware that the topic of ADHD (Attention Deficit Hyperactivity Disorder) has exploded in recent years. The growing awareness of the impact of ADHD on lives, parenting, career, utilization of psychiatric services, etc., continues to grow and evolve as we learn more about the prevalence and impact of neurodivergent experiences and needs. As a therapist, helping individuals manage their, or their loved ones, ADHD has become front in center of my practice. I find that many individuals that come to me for counseling services either have undiagnosed ADHD, have a partner or child with ADHD, or have struggled with their management of ADHD, despite being diagnosed and treated with medication for ADHD. This, combined with my own experiences with ADHD (my husband and two of my daughters struggle with ADHD), have inspired this article, in which I compile 6 of the most important observations and relational aspects of ADHD that I think are game-changers in managing relationships and helping individuals with ADHD thrive in life and in love.
1. Understand ADHD
The single biggest challenge that I regularly observe in the therapy setting, in terms of relationships with individuals with ADHD, is an overall lack of understanding of the impact of ADHD on individuals. Most of us have a general understanding of ADHD as children who are hyper or who can’t focus in school. These symptoms are merely the tip of the iceberg with ADHD. In addition to struggling to sit still or focus as children (or adults), individuals who have ADHD commonly have co-occurring anxiety and depression, issues with emotional dysregulation and impulsivity, and are negatively impacted by many of the 18 schemas that I treat in Schema Therapy. This is especially true if they have had undiagnosed or untreated ADHD. Additionally, individuals with ADHD are often developmentally delayed, particularly in the area of executive functioning. All of these factors combine to make it challenging to understand and support loved ones with ADHD.
Any time I am doing therapy work with a client who has a loved one with ADHD, I am struck with how little of an understanding of ADHD people actually have. This misunderstanding and lack of awareness is often central to the challenges in the relationship. Because neuro-typical individuals are often interpreting and ascribing meaning to their loved one’s behavior through a neuro-typical lens, devastation occurs in those relationships. For example, one problematic area that often arises relationally is related to the inattentiveness that individuals with ADHD often experience. Partners and parents of individuals with ADHD often believe that if their partner or child cared more, they would address the problems in the relationship. Because there is a lack of understanding the full impact of inattentiveness in their loved one, they ascribe the damaging meaning of “they don’t care”, which is usually the exact opposite of the truth. Most individuals with ADHD are extremely sensitive to criticism and already feel like a failure or defective (more on schemas later), making them care more, not less, about what you think and feel. Understanding that inattentiveness is one problematic aspect of ADHD, and that it isn’t their fault, will help you change the way that you interpret and respond to inattentive behaviors in the relationship.
2. Change Your Interpretation of ADHD Symptoms and Behaviors
Inattentiveness
If you want to have a healthier relationship with someone with ADHD, it is crucial to change your interpretation of certain behaviors and symptoms. Inattentiveness is one of the primary challenges that people with ADHD experience. Memory impairment and difficulty suppressing stimuli in order to focus make it extremely challenging for individuals with ADHD to remain attentive or remember conversations and details. If every time an individual with ADHD forgets or misremembers – or flat out doesn’t pay attention to you – you experience that as them “not caring”, the relationship is likely to quickly erode. However, if inattentiveness is understood and discussed, it doesn’t need to end a relationship. Focus on ways to improve the chances of remembering is helpful, such as having conversations in a quiet place that is free from distractions and when the individual with ADHD is not overstimulated, hungry, or tired.
Emotional Dysregulation
Emotional Dysregulation is another problematic aspect of ADHD which results in individuals with ADHD having a hard time managing their own emotions. This often results in relationship problems with a parent or partner when the person with ADHD can’t tolerate feedback, or another person’s feelings, because they become so overtaken with their own reaction to what someone is saying. This can show up as anger, frustration, sadness and withdrawal, and can trigger depression and anxiety over time. Because individuals with ADHD wrestle so much with managing their own emotions, it can sometimes feel that they don’t care about their partner or parent’s feelings or that they are self-absorbed. Self-absorbed behaviors in individuals with ADHD are often more about self-preservation and overwhelm than about narcissism or entitlement, though some might experience it as such. If you as a partner or parent see the behavior as narcissism or entitlement it may lead to more disappointment, discouragement, or hopelessness than is necessary because the meaning ascribed to the behavior is worse than the behavior itself.
One emotion that individuals frequently struggle with is frustration. From a schema perspective, individuals with ADHD often score high on Insufficient Self-Control schema, which is a fancy way to say that they have low frustration tolerance. Often, individuals with ADHD have struggled their entire lives with focus and executive functioning and have become increasingly intolerant of feelings of frustration. This often leads them to quit things frequently. One mistake that is often made when parenting is when parents remove children from situations that are frustrating them or causing them to be emotionally dysregulated. Unfortunately, when this repeatedly happens, these individuals don’t develop the coping skills necessary to tolerate strong emotions like frustration, which is really needed in order to persevere in life and in challenges. If you are a parent with a child that has ADHD, this is an important aspect to understand. Helping your kids name their frustration and coaching them through their frustration will help them develop the skills necessary to notice their frustration, manage it, and not allow it to derail their goals or plans. In the long run this work helps to prevent the formation of a Failure schema. If you are an adult with ADHD, recognizing the discomfort that you have with frustration and coaching yourself through the feelings will help your tolerance grow. Take breaks, pace yourself, and get help, but don’t quit when you’re frustrated. This will help you learn to tolerate frustrated feelings and not let them dictate your life.
Executive Functioning
Executive Functioning is another challenge for individuals with ADHD, often negatively impacting others relationally as issues arise with follow-through, planning, timeliness, and communication. Improving executive functioning skills is one of the primary focuses of therapy services for individuals with ADHD. Therapy is often focused on helping individuals with ADHD create good habits, utilizing tools such as planners, alarms, and reminders, and finding ways to reduce avoidance and procrastination. If you or a loved one experience executive functioning issues, finding an individual therapist who specializes in ADHD can help you develop new skills and habits that improve your day-to-day life and your relationships.
Impulsivity
Impulsivity is also frequently taken for granted when addressing problems in relationships with individuals with ADHD. Impulsive behaviors are often misunderstood as not caring, just like inattentiveness. For instance, people who are impulsive might suddenly purchase something with no discussion, negatively impacting the family budget, or might suddenly decide to go do something other than what they have previously committed to do with or for you. They might spontaneously tell someone something that was told to them in confidence, breaking trust, or impulsively shoot you a text that feels brash or insensitive. These impulsive behaviors can all come off as selfish or uncaring, but usually have more to do with impulsivity than anything else.
Sensitivity to Criticism, Shame, and Rejection
Sensitivity to Criticism, Shame, and Rejection often results in un-repaired relationships, avoidance, and lack of accountability. Because so many individuals with ADHD grew up struggling in school, disappointing parents, or frustrating other children, many adults with ADHD are hyper-sensitive to criticism and rejection and perceive it in any feedback they get. They may even imagine it when it isn’t even present, which may cause an over-reaction due to triggering painful feelings they have experienced in the past. Many times, because feeling defective or ashamed of themselves has been such a big part of their lived experience, they can become extremely reactive to their partner or parent’s disappointment or anger, escalating conflict into a much bigger problem, especially if their partner or parent reacts in kind. If you have someone in your life with ADHD, managing your own emotions and reactions is extremely important. Engaging in individual therapy may be helpful for you to recognize your own triggers and the triggers of your loved one and can help you develop the skills to manage your own feelings in way that reduces conflict.
Easily Overwhelmed/Task Paralysis or Decision Making Paralysis
Individuals with ADHD often feel more easily overwhelmed than neurotypical individuals, which can result in them feeling paralyzed when it comes to making decisions or executing tasks. It can be very tempting as a parent or partner to label your loved one with ADHD as lazy or uncaring, when in reality this is a very common impact of having ADHD. Helping to reduce overwhelm or helping to apply external motivation is much more impactful than criticizing or shaming.
Schema Formation
Individuals with ADHD often score high on Early Maladaptive Schema assessments in schemas that have to do with impaired autonomy and performance or poor self-concept, Dependency, Disconnection/Rejection, and Insufficient Self Control. This means that they have received many messages throughout their lives that they are failures, defective, socially isolated, incapable, rejected, and have often internalized these messages as truths. They struggle with regulating emotions, particularly frustration, which often perpetuates experiences that reinforce these messages. Because of these schemas, individuals are easily triggered and often feel shame and humiliation and fear of abandonment or rejection. Individuals with ADHD have often been sent the message that they are not capable or efficient and thus can avoid challenges or be overly dependent on others. Understanding your child or partner’s triggers and beliefs and addressing them with kindness and reassurance can go a long way when having difficult conversations and managing defensiveness, anxiety, and depression in individuals with ADHD. Allowing your loved one to take responsibility for their own lives, even if this results in making mistakes, will help combat feelings of dependency and help them to become more independent. Helping your loved one to make their own decisions, take responsibility and accountability for their actions, and utilize supports other than you at school, therapy, work, etc. will help them to develop confidence, gain skills, and reduce the feeling that you need to parent them constantly.
3. Accept the ADHD and have Realistic Expectations
Something that I see frequently in therapy with individuals who have loved ones with ADHD, is the tendency to gain awareness about what ADHD is and then proceed to have unrealistic expectations of the person. Individuals who have ADHD are not going to operate as if they don’t, even if they are on medication and in therapy. Looking for signs of improvement such as improving executive functioning and improving ability to manage big emotions is realistic. Expecting someone with ADHD to never forget, never show their emotions during conflict, or never become triggered when being corrected or criticized is not realistic. Holding someone to an impossibly high standard for them is never helpful but holding them accountable is. Attempting to not to take these struggles personally is the best thing that you can do for your relationship.
4. Make Room for Your Feelings and Needs
When a parent or partner of someone with ADHD starts to fully understand that ADHD is going to continue to be a challenge in the relationship, and that blaming the person with ADHD for their ADHD isn’t fair, there is inevitably a shift where the partner or parent says, ‘if they can’t help it, then how can I hold them accountable?” or “it isn’t fair of me to have strong feelings about their behavior if they can’t help it”. Neither of these things is true. In any relationship, in order to have emotional intimacy, both parties must practice open and honest dialogue and emotional vulnerability, and both must be accountable for their own stuff. What this means is that there needs to be ongoing conversations about how both people are feeling and what both need, while understanding that it is not a conversation that is going to end. This will be an ongoing conversation, just like conversations about most chronic problems. It is important to acknowledge that the person with ADHD didn’t intend to hurt or disappoint you, but that doesn’t mean it didn’t happen. Emotional intimacy only happens when both parties are able to speak up about how they are feeling and what they want to see happen, even if there is a realistic expectation that progress might be slow and problems aren’t likely to go away entirely. Talking about the impact of a person’s behavior on you in the kindest way possible, without ascribing additional meaning or intent, is a necessary component of any healthy relationship.
5. Utilize Systems to Prevent Problems
One of the most helpful changes that families and couples can make is to start looking for systems to prevent problems and reduce resentment. For instance, if a partner with ADHD frequently overspends and causes a joint account to overdraft or a bill not to get paid, create separate accounts. Put limits in place by having a budgeted amount of money in a designated spending account and turn off the overdraft option. This will reduce overspending and overdraft fees, but most importantly it will reduce resentment or financial crises. If forgetting dates and times, or who is picking up who, utilize a joint shared calendar and designate who’s doing what in the calendar. That way, if the person with ADHD forgets, they can reference the calendar rather than being dependent on your to remind them. Put communication systems in place, such as having a brief meeting at the end of the day to go over details of the next day and to make sure everyone is on the same page. Utilize chore charts so that everyone knows who is responsible for what and to reduce the likeliness of forgetting. If your partner has ADHD and is too overwhelmed or too inconsistent with something that is super important to you, outsourcing might reduce relationship resentment. For example, getting extra help with deep cleaning your home or hiring someone to mow the lawn can provide the consistency and support you need while reducing some of the pressure on the person with ADHD. Managing your own resentment plays an important part in having realistic expectations and preventing future conflict.
6. Focus on the Positive
Whenever there is a chronic problem or challenge in a relationship it can be easy to become fixated on it. It is important to take the time to notice and acknowledge the positives in the relationship. If the person with ADHD is your child, try to balance negative feedback with positive affirmations. Be intentional about labeling ADHD as the problem, not your child. If the person with ADHD is your partner, try to remember what attracted you to them in the first place, and focus on what you love about them. What individuals with ADHD lack in attentiveness they often make up in personality. Many times individuals with ADHD are empathetic, sensitive, loving, open, spontaneous, fun, and warm. They are often playful and present and care a lot about their relationships. Focusing on the positives in moments of frustration or disappointment can bring a sense of hope and closeness and motivate you to keep connecting and pushing forward.
Moving Forward with Hope
Although relationships between neurotypical individuals and individuals with ADHD often have challenges for both parties, those challenges don’t have to define or end the relationship. If communication is open and kind and steps are taken to understand and manage the challenging aspects of the ADHD, relationships can improve and connections can be strengthened.
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