Adult ADHD Education and Treatment
For adults struggling with undiagnosed, untreated ADHD, life often feels like an unpredictable roller coaster ride — too many surprising twists, turns, drops, and sometimes even whiplash. This has been the subject of many books and articles. Less talked about, though, are the loved ones of these adults — stuck on the roller coaster with them, not knowing why the ride is so wild and feeling helpless as to how to calm things down.
“These adults and their family members face the ‘AD/HD roller coaster’ in every facet of life: disorganization and clutter, underemployment and unemployment, forgotten tasks and obligations, unpaid bills, neglected home repairs and lost jobs, hot tempers and erratic parenting styles, traffic accidents and citations, and more,” explains Gina Pera, author of Is It You, Me, or Adult A.D.D.? Stopping the Roller Coaster When Someone You Love Has Attention Deficit Disorder. “Moreover, ADHD’s very symptoms (including poor working memory and difficulty linking cause with effect) mean that many adults with ADHD fail to perceive their role in creating the chaos.”
Understanding Adult ADD/ADHD
For eight years, Pera, a veteran journalist, has been a strong advocate of ADD/ADHD awareness, education, research and improved treatment standards. “Everyone knows someone with adult AD/HD, but we often misattribute the symptoms to anxiety, depression or even laziness, willfulness, selfishness, moodiness, additions and worse,” Pera points out. “We simply don’t make the connection to a brain condition, perhaps because AD/HD symptoms do resemble the human condition in exaggerated form.”
In other words, most humans procrastinate, become bored by repetition, misplace their keys and act impulsively without thinking of the consequences. The difference is the greater frequency and severity with which people with ADHD exhibit the behaviors. For some couples, however, the familiar "human-ness" of these behaviors forms a type of camouflage that keeps whipping them around on the roller coaster — sometimes for decades — until they learn about adult ADD/ADHD.
Adding to the Confusion in Adult Relationships
Oftentimes adults with unrecognized ADHD have lived with these behaviors for many years, and lacking any other explanation (namely ADD/ADHD), they've learned to attribute their challenges to other causes, such as a dysfunctional childhood, a poor economy, a difficult time in school, and the like.
Additionally, low self-observation by the individual with ADHD can conspire to throw everyone off track. Pera offers an example: "If you don't remember that you forgot to take out the garbage the last four weeks, you don't appreciate why your partner grows upset when you do the same thing on the fifth week. You might simply decide your partner is a control freak. And, your partner might accept the criticism, because he or she is acting like a control freak, just to keep home and family afloat, and doesn't like the feeling."
Sometimes the adults are the first to discover that their challenges may have a medical explanation (that is, ADD/ADHD), only to find that their partners are unwilling to consider the possibility. More often, though, it seems to be the partners who connect problematic behaviors to ADHD symptoms — and then figure out how to convince their reluctant mates.
Partnering in ADHD Education and Treatment
“One of the most important messages I'd like to share is that, in many cases, both parties (the adult with ADHD and mate) need to be involved in the adult’s ADHD evaluation and treatment. Unless you both understand the nature of ADHD and what to do about its more problematic aspects, you’ll just stay stuck on the roller coaster. In fact, the roller coaster might grow even wilder,” cautions Pera.
With education, there can finally be movement toward treatment and coping strategies. These strategies include:
- Finding effective therapy for the adult with ADHD
- Learning how medication can help in managing ADHD symptoms
- Improving self-care
- Dealing with any lingering denial on both parts
Tips for Improving the Relationship
In her book, Pera offers these additional tips for improving the partnership, based on the work of ADHD specialist and psychologist Arthur Robin of Wayne State University:
For the Partner
- Transform blame into empathy.
- Correctly attribute ADHD behavior to a neurological slip-up, not to malicious intent or lack of caring.
- Understand that it may be very hard for your ADHD partner to start accepting responsibility for actions until he or she knows why they happen (psychoeducation) and receives tools for changing those behaviors (medication and other strategies).
- Realize that your partner may have withstood a lifetime of criticism before meeting you and may therefore be hair-trigger sensitive to your negative judgments. Even as you hold your partner accountable, strive for patience and kindness.
- Learn the difference between “enabling” or “codependent” behavior and accommodate your partner’s differences in a way that enhances you both.
For the Adult with ADHD
- Acknowledge how ADHD has affected the partnership.
- Accept responsibility for poorly regulated actions.
- Agree to stop denying, minimizing and avoiding the issues.
- Learn how to respond nondefensively to negative feedback about ADHD behavior.
Gina Pera. Is It You, Me, or Adult A.D.D.? Stopping the Roller Coaster When Someone You Love Has Attention Deficit Disorder. Alarm Press. San Francisco, CA.
Gina Pera. Email Correspondence/Interview. Oct. 15 and 19, 2008.