ADD Symptoms Affecting Her Relationship: What to Do?

“My partner shows all the signs of ADHD, yet when he saw a therapist who referred him to a psychiatrist he was "diagnosed" with depression and anxiety and given medication. This has helped a bit with his anger but the medication hasn't helped his disorganization, forgetfulness or lack of ability to follow through. He still gets very angry and can "shut down" if he feels slighted, misconstrues someone's comment or if the neighbors make any sort of loud noise!
We are in marriage counseling but have not been helped much. We have recently started seeing a new counselor and I hope this will make the difference. The last therapist rebuked me for bringing up the idea of ADD. And my partner laughs at me too.
Do you have any suggestions how to handle this? I would like things to be better.”

Very frequently, depression and anxiety are “co-existing conditions” with ADHD, though the fact that your partner is depressed and anxious does not indicate the presence of ADD.  He may have it, he may not.

The issue for you, really, is that he is behaving in a way that reminds you of ADHD, presumably in a negative way.  His behavior, ADHD-related or not, is putting destructive pressure on your relationship – both in what he is doing and how you are reacting to it.  It would make you feel better if you could put a label on his behavior and thus understand it better.  Perhaps, given your current situation, you should put the label of “depressed and anxious” on things right now and then move forward against that.  You can return to the issue of ADHD in the future, when things improve somewhat.  At that time, when the two of you are relating to each other better, he might be willing to pursue further investigation of whether or not he has ADHD.  (Note, one of the hallmarks of ADHD is that the behavior has dogged him all of his life, particularly in school as a child.  If he is acting differently now but didn’t used to have so much trouble focusing, etc, it could be other things that are affecting him.  For diagnostic criteria for ADHD, and for Dr. Hallowell’s own list of “clues” to ADHD, see “Delivered from Distraction”.)

You may wish to ask yourself why it is so important for you that he conclude that he has ADHD, rather than the depression and anxiety already diagnosed.  You say that he is taking medications to relieve some of his symptoms, and that it has helped his anger somewhat.  While it may not be the final edict, this seems as if it would be an improvement to celebrate.

Are you struggling over how much he takes on around the house?  Whether or not he can hold a job?  Whether or not he stays focused during sex?  Whether he is pleasant to be around?  It is not clear from your note, but perhaps you could ask yourself these questions:  “Why is it so important for me that he be diagnosed with ADHD?  What do I gain from it?  What would he gain from it?”

A natural tendency is to think that if you can identify ADD in your relationship you’ll be able to blame the person with the ADD for the problems you are having.  This is actually one of the biggest roadblocks to getting the diagnosis in the first place.  The person who is accused of having the ADD resists being labeled in a way that could be held against him.  Furthermore, the diagnosis provides insight, but it does not provide a “cure”.  It is only a starting place from which both people then move to improve how they relate to each other, grow in understanding of their own individual strengths and weaknesses, and re-learn how to love each other.  You can take the steps you would if he had ADHD, whether or not he has an official diagnosis, and your relationship will benefit.  Here are some ideas to start with:

1. Assume that he currently has little control over his lack of focus, forgetfulness, etc.  Compassionately and gently try to help him find strategies that will improve his ability to complete those tasks most affected by these behaviors.  Don’t judge him if he can’t immediately improve.  Don’t mother him.  Don’t bully him.  Remember that your partner can work on some of the habits that bother you – disorganization, forgetfulness and inability to follow through – but won’t do so as long as he feels under attack or threatened.  Rather, he will work on these things only when he feels that the two of you are once again adult partners (NOT parent/child), working in the same, positive direction.  (It is an unfortunate aspect of human nature, I think, that when feeling under attack – real or perceived – many people simply dig in and resist as a way of fighting back whether this is logical or not!)
2. Your anger, frustration, and (probably) a sense that you are being mistreated/not well enough supported, are getting in the way.  (His are, too, but you can’t control his behavior and feelings, only your own.)  Find a way, such as meditation, reading about how anger affects the brain, solo counseling, etc., to diffuse your anger and let it go.  This is the first step to forgiving your partner and, ultimately, yourself for whatever you've contributed to your problems.  Forgiveness and letting go of your past will be critical to the healing of your marriage.  (This is hard work and you’ll need to take it very seriously to really let go of your frustrations and anger.)
3. If your partner lacks focus, you may well be feeling neglected because he hasn’t been focusing on you, either.  Try to separate his lack of focus from his feelings about you.  Chances are that even if he doesn’t like the way the two of you are relating to each other right now, he still loves you (else he wouldn’t be spending the time, effort or money to try marriage counseling).  Approach your conversations and interactions with the assumption that he does love you, but because of his lack of focus, is having trouble showing you that.  Talk with him about the importance of his focusing positively on you at regular intervals, then set up ways that this can happen (for my husband and I, “focused” periods include bike rides together, dinners at nice restaurants, and visiting new places where we don’t have the distractions of home).  Just as important as his focusing on you in a positive way, is taking time to focus on him in a positive way.
4. Try to stay in the present – don’t carry the anger or baggage from the past into today.  This may be easier for your partner than for you but you should both work on it.  For that matter, try to get your therapist to work on “staying in today”, too.  If he/she won’t, consider another therapist.  (Read our entry on “The Importance of Now and Not Now in the ADHD Marriage” for some more insight into why this is important.)

Good luck to you both and write back to let us know how it is going!