So Your Spouse Has ADHD

Here in North America we’ve become pretty conversant with ADHD as a culture. How it impacts kids at school, in the home, and so on. But it’s time to start the conversation around how ADHD impacts marriage. Did you know that your marriage can be a place that fosters a reduction in the problematic symptomatology of ADHD?

What is ADHD?

Just in case this is a new term for you, ADHD is a mental health condition normally diagnosed in childhood.

ADHD impacts the brain’s executive functioning ability, so that people with ADHD show reduced decision making ability, attention control, impulse control and memory. Impairments to concentration, low impulse control and difficulty regulating your emotions can also lead to social and communication problems in people with ADHD[i].

Here are the specific diagnostic criteria from the DSM, which is the mental health handbook for diagnosing disorders.

1. 1. Often fails to give close attention to details or makes careless mistakes in schoolwork, work or other activities
   2. Often has difficulty sustaining attention in tasks or play activities
   3. Often does not seem to listen when spoken to directly
   4. Often does not follow through on instructions and fails to finish schoolwork, chores or duties in the workplace
   5. Often has difficulty organizing tasks and activities
   6. Often avoids, dislikes or is reluctant to engage in tasks that require sustained mental effort
   7. Often loses things necessary for tasks or activities
   8. Is often easily distracted by extraneous stimuli

About 3% of the adult population are diagnosed with ADHD. A further 16% show sub-clinical levels of ADHD: they have some of the symptoms but not enough to meet the criteria for diagnosis[ii]. Up until fairly recently ADHD was thought to only affect children, so there are likely a lot of adults with ADHD out there who are currently undiagnosed and therefore unable to work out why they think and act in a way that’s so different to other people.

Everyone gets a bit distracted sometimes, or acts impulsive and disorganized. But if these are common features of your daily life and they significantly impact the way you function, it might be worth booking a discussion with a doctor or mental health professional just to see if ADHD has been affecting you without your knowledge. The fact that ADHD is undiagnosed in so many adults means that this is a potential factor in marital distress that may be unrecognized in many, many cases.

How Does ADHD Affect Marriage?

Common Challenges

The symptoms of ADHD can create difficulties in marriage. Some of the more common challenges include[iii]:

1. 1. Being forgetful and disorganized: failing to meet commitments or remember to do things
   2. Inattentiveness to your spouse’s emotional state and needs
   3. Difficulty attending to or communicating effectively with your spouse
   4. Emotional overreactions: saying or doing things impulsively which hurt the marriage

Then there’s the whole issue of perception or interpretation by your spouse. Your spouse may come to see your ADHD inability to stick to commitments or remember agreed on actions as a sign that you don’t care about the relationship.

Further, ADHD also impairs communication and listening skills, reducing intimacy and potentially leading to conflict.

Marital Quality

Sometimes these issues can impact the quality of a marriage, for either the spouse with ADHD or the other. A study in 2004[iv] compared couples where one spouse had ADHD to control couples where neither spouse had ADHD. They found that marital satisfaction was often lower for the spouse with ADHD than in control couples. But people married to someone with ADHD did not differ in marital quality to the control groups.

So having ADHD may decrease your own marital satisfaction but does not necessarily impact your spouse as much. “The ADHD adults’ perceptions of the health of their marriages and families were more negative than their spouses’ perceptions.[v]”

However, more recent research shows that the spouse married to someone with ADHD can also suffer, especially when the ADHD affects intimacy levels. A study in 2017[vi] found that when intimacy was low, spouses of people with ADHD reported lower marital satisfaction than control couples.

Remember that studies often have problems with replicability. We are not asking anyone to have a problem with their marriage because you or your spouse has ADHD. If anything, we just want to normalize that it is possible that you may face extra challenges or it is possible that things are going fine. That’s ok too!

How To Help Your ADHD Spouse

Usually when we’re talking about marriage issues we’re really keyed in on everyone taking responsibility for their own stuff and that’s always a good principle. But: there are some things to be aware of that give you some leverage in the marriage as the spouse of someone who experiences ADHD. If you want to come at this from the other direction and find out what you can do as an adult with ADHD to support your marriage, check out our bonus guide.

Mediating Factors Around ADHD and Marriage

Research identifies several mediating factors which determine whether ADHD will negatively affect marriage quality. Working on these specific issues will reduce the effect ADHD has on marriage:

Intimacy. ADHD can reduce intimacy for the non-ADHD spouse by impairing communication and listening skills, and this then negatively affects marital quality. Finding other ways to increase intimacy can reduce this effect.

Emotion regulation. ADHD makes it harder to control how you feel and express emotions. A study in 2015[vii] found that this emotion regulation difficulty was a strong mediating factor between ADHD symptoms and relationship quality. So practicing healthy expression of emotions can reduce the impact of ADHD. This can look like a daily check-in with each other on feelings. Sharing one positive, one negative feeling every day.

Conflict resolution tactics. Research in 2010[viii] found that the conflict resolution style of the non ADHD spouse was a strong mediating factor between ADHD and relationship quality for both spouses. Since people with ADHD show poor impulse control and emotional control, they can sometimes be prone to creating arguments and conflict. Having a spouse who is also prone to using hostile or aggressive conflict styles will create a very volatile marriage where satisfaction is likely to be low. A spouse who can use more positive conflict resolution skills will be able to create a happier marriage environment for both spouses.

ADHD and Negative Beliefs

The problems experienced by people with ADHD often lead them to form negative beliefs about themselves and their lives. These include things like[ix]:

1. 1. Self-mistrust: e.g., “I cannot rely on myself”
   2. Failure: e.g., “I let other people down”
   3. Instability: e.g., “My life will always be chaotic, so why bother trying to fix it?”
   4. Dependence: e.g., “I cannot cope without other people helping me”
   5. Shame: e.g., “I am useless”

Since people with ADHD are very impulsive and quick to act, they will often act based on these beliefs before they really think it through. This often creates negative and self-defeating behavior (e.g., thinking you are a failure, believing that you will never be able to hold down a job and so giving up on job hunting).

The spouse can therefore help by spotting when their ADHD spouse is acting based on negative beliefs, challenging these underlying beliefs and encouraging them to act in a more positive way. Make sure you ask their permission to do this. But eventually this form of support will help improve the beliefs the ADHD spouse has, leading them to think and act in more positive ways[x].

Help Them Slow Down

Spouses can also help their ADHD husbands/wives to slow down, think things through and fight their natural tendency to be impulsive. For example they can help with:

Setting goals: deciding on specific things they want to work towards as a couple, rather than continuously jumping from one thing to the next. Spouses can also help by helping break these goals down into a step by step process and keeping their ADHD spouse on track with it.

Regular “check in” times: help keep the ADHD spouse grounded and focusing on the right things

Encourage regular practice of skills and coping strategies: e.g., time management and daily planning strategies to help them stay focused throughout the day, and mindfulness and meditation exercises to “train” their ability to focus and control their thoughts[xi].

I hope this has given you hope! All of us bring dysfunction and baggage to our marriages — even if there’s not a label for it — but it’s great to know that a lot of the same basic principles still apply: working on intimacy, using good communication skills and conflict resolution skills.

As always, if you’d like help from one of our marriage therapists feel free to reach out through our website.

_________________________________________

References

[i] Fatma Gül Cirhinlioğlu and others, ‘Mediating Role of the Conflict Tactics between ADHD Symptom Levels and Dyadic Adjustment’, Child Psychiatry & Human Development, 2010.

[ii] Cirhinlioğlu and others.

[iii] Arthur L. Robin and Eleanor Payson, ‘The Impact of ADHD on Marriage’, The ADHD Report, 10.3 (2002), 9–14 <https://doi.org/10.1521/adhd.10.3.9.20553>.

[iv] L. Eakin and others, ‘The Marital and Family Functioning of Adults with ADHD and Their Spouses’, Journal of Attention Disorders, 8.1 (2004), 1–10 <https://doi.org/10.1177/108705470400800101>.

[v] Eakin and others.

[vi] Shiri Ben-Naim and others, ‘Life With a Partner with ADHD: The Moderating Role of Intimacy’, Journal of Child and Family Studies, 26.5 (2017), 1365–73 <https://doi.org/10.1007/s10826-016-0653-9>.

[vii] Kristin N. Lopez, ‘Attention-Deficit/Hyperactivity Disorder Symptomatology in College Students: Emotion Regulation Deficits and Romantic Relationships’ (Hofstra University, 2015).

[viii] Cirhinlioğlu and others.

[ix] Gina Pera and Arthur L. Robin, Adult ADHD-Focused Couple Therapy: Clinical Interventions (Routledge, 2016).

[x] Pera and Robin.

[xi] Tatja Hirvikoski and others, ‘Reduced ADHD Symptoms in Adults with ADHD after Structured Skills Training Group: Results from a Randomized Controlled Trial’, Behaviour Research and Therapy, 49.3 (2011), 175–85 <https://doi.org/10.1016/j.brat.2011.01.001>.

Podcast: Play in new window | Download (Duration: 19:38 — 18.4MB)

Subscribe: Spotify | RSS | More