Melissa Orlov, author of The ADHD Effect on Marriage, explains the treatment options in part two of our two-part series of ADHD marriages. Last post, we looked at the signs and showed you how to diagnose the issue.
Q: What are the treatment options for someone with ADHD?
A: First, I always recommend that both partners make sure they are getting any treatment they may need. Non-ADHD partners may be suffering from depression or other health issues as a result of the stress they’ve been under. Treatment for the ADHD partner in a committed relationship can be thought of as a three-legged stool – you need all three legs to be fully successful.
Leg 1 – Physiological changes: Treatments that increase the levels of dopamine in your brain, such as medications, fish oil and aerobic exercise.
Leg 2 – Behavioural or habit changes: Creating external structures to support getting things done well and on time. There are a huge variety of these. Putting a key rack near the garage entry so your keys don’t end up in the refrigerator is one example. Teaching yourself not to retreat from conversations, but to engage, is another.
Leg 3 – Interaction changes: Develop specific ways to interact with your spouse that are ADHD sensitive. I teach couples how to slow down conversations and listen to each other better, how to keep repetitive conversations from spiraling out of control, how to be more empathetic and supportive of the predicaments ADHD places them in, and more.
The first two legs of the treatment have been reviewed in numerous research studies that show that doing both together is more effective than either one alone. The third leg of treatment I add because we are talking about marriage, and getting past anger, defensiveness, denial and other negative interactions takes two.
Q: What’s your best relationship advice for someone who believes that she or her spouse has ADHD?
A: 1. Broach the subject with sensitivity. Many with ADHD will feel as if you are trying to blame them or tell them they are broken when you first approach them. Their hidden shame about their difficulties might make them defensive.
2. Get educated. Learn as much as you can about ADHD, how it might affect your relationship, and how the ADHD partner can better manage ADHD symptoms. Also, there are specific patterns that ADHD introduces into a relationship – learn to identify them in your partnership and then combat them.
3. Get help from professionals for: 1) A full evaluation of the medical issues for each partner; 2) Marital counselling; 3) ADHD coaching if it makes sense. Make sure to work with people who really understand ADHD, particularly for marital counselling, or it can hurt more than it will help.
4. Take responsibility for your own behavior. I guarantee you that if your marriage is in distress both partners hold some responsibility. Don’t just ask your partner to change things, change yourself. This includes stopping ALL nagging (find a different way to get things done) and any verbal abuse that may be going on. It also includes taking responsibility for treating ADHD symptoms. If your partner is telling you that your symptoms are making him miserable, believe him. Hold yourselves to a high standard of behavior.
5. Measure your results. Intentions and actions do not always match up when a marriage is affected by ADHD. Take time to set measurable goals, then see if you reach them.