ADHD and Marriage - Friday's Progress Notes

Editor's Note

In this edition of Friday's Progress Notes, advisory board member Dr. Julie Nelligan provides us with a deep dive into the topic of ADHD and how it impacts marriage. Additionally, you'll find resources below including some gender-specific outcomes related to ADHD.

There is also a great resource provided courtesy of Dr. Robin, who has agreed to share his Marital Impact Checklist with you - keep reading to find out how to access that.

A book review of "The ADHD Effect on Marriage" by Melissa Orlov

Although this book is written for the general public, clinicians would learn a lot from reading it, too. The author’s experience of saving her marriage to a man with ADHD spurred her to do extensive research and consult with some of the foremost experts on ADHD. This easy-to digest but by no means overly simplistic book explains the experience of a person with ADHD to a non-ADHD spouse. Orlov then turns the tables and explains to the person with ADHD the transformation the non-ADHD person has experienced as they tried to cope with the behaviors of the ADHD person. She systematically describes patterns that develop in marriage when one (or both) partners have ADHD.

These patterns include:

• Misinterpretation of ADHD symptoms and motives
• Symptom-Response-Response Cycle
• Hyperfocus Courtship
• Parent-Child Dynamic
• The Chore Wars
• The Blame Game
• Walking on Eggshells, Anger Spurts, and Rude Behavior
• Pursuit and Escape
• Nagging
• Loss of Faith in Each Other
• Sexual Relationship Breakdown

While many of these patterns show up in marriages without an ADHD partner, as a clinician if you are seeing several of these patterns between spouses, it might be worth considering whether one spouse has undiagnosed ADHD.

After describing the patterns that develop she walks through six steps to rebuilding the relationship:

1. Cultivating empathy for your spouse
2. Addressing obstacle emotions
3. Getting treatment for you both
4. Improving communication
5. Setting boundaries and finding your own voices
6. Reigniting romance and having some fun

In each of the steps Orlov talks to both spouses, pointing out dysfunctional patterns and giving practical advice on how to work through them. She emphasizes the importance of both spouses making changes while highlighting the strengths and needs of both parties in a respectful way.

This book would be a good addition to resources for clients and as a practical way to address marital problems arising from ADHD.

We welcome your comments and feedback. Is there a topic you'd like to see covered in a future edition of Friday's Progress Notes? If you'd like to get in touch just click here to send us a message.

Resources

1. The ADHD Effect on Marriage: Understand and Rebuild Your Relationship in Six Steps by Melissa Orlov
   Guides couples in troubled marriages towards an understanding and appreciation for the struggles and triumphs of a relationship affected by ADHD, and to helps them to look at the disorder in a more positive and less disruptive way.
2. The Couples' Guide to Thriving with ADHD by Melissa Orlov and Nancy Kohlenberger, LMFT
   More and more often, adults are realizing that the reason they are struggling so much in their relationship is that they are impacted by previously undiagnosed adult ADHD. Learning how to interact around ADHD symptoms is often the difference between joy together and chronic anger and frustration.
3. The Marital Impact Checklist
   The deficits in executive functioning, inhibitory control, and attentional processes that are the core characteristics of ADHD can have profound effects on intimate relationships such as marriage. This article studies the use of a Marital Impact Checklist - 34 brief statements of potentially problematic behaviors. Note: Dr. Robin has granted permission for us to share a copy of his checklist with you - click below to download a PDF version of the checklist, which includes sections to be completed by each spouse:

   Download the Checklist

4. Attention-Deficit/Hyperactivity Disorder (ADHD) in Adulthood: Concordance and Differences between Self- and Informant Perspectives on Symptoms and Functional Impairment
   This study showed that people with ADHD seemed to be unaware of the causal relation between ADHD symptoms and their impairments.
5. The Romantic Relationships of Adolescents with ADHD
   This study of adolescent romantic relationships show that teens with ADHD have more sexual partners and have sexual relationships sooner than their peers.
6. Attention Deficit Hyperactivity Disorder Symptoms, Comorbidities, Substance Use, and Social Outcomes among Men and Women in a Canadian Sample
   This study of 4014 Canadian residents over the age of 18 years show that ADHD symptoms are associated with adverse medical and social outcomes that are in some cases gender specific.