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Writer's pictureCarla Barrow, LMFT

Understanding the Role of ADHD With Couples



One of the things I love about couples therapy is that no two couples are alike. One unique difficulty facing some couples is their spouse’s neurodiversity, including the exhibition of ADHD (Attention Deficit Hyperactivity Disorder). It is estimated that the divorce rate among an ADHD couple is as much as twice that in the general population.


Elements of ADHD that can impact a couple include:

  • Hyperactivity and impulsiveness

  • Being unable to sit still, especially in calm or quiet surroundings

  • Being unable to concentrate on tasks

  • Excessive physical movement

  • Excessive talking

  • Being unable to wait their turn

  • Acting without thinking

  • Interrupting conversations

  • Sensitivity to rejection, criticism

  • Sensory overload that can lead one to shut down or explode

  • Executive functioning difficulty (flexible thinking, task completion, working memory, self-control)

Perpetual Difference in a Couple Could Be Brain Wiring


In Gottman couples therapy, we learn that approximately 69% of what couples argue about is due to “perpetual differences,” differences stemming from each client’s unique perspective of life based on family of origin, life experiences, culture, preferences and the like.


In the ADHD couple, one perpetual difference arises from how each person’s brain works. Some clients with ADHD are on medication and some are managing symptoms without it, with varying degrees of success and failure. Even the issue of medication can create rifts between the couple.


Although ADHD may be undiagnosed, more times than not in my practice, the neurodiverse spouse struggled prior to the marriage, perhaps in childhood at school, or as a teen with peers, or as an adult in the workplace.


The non-ADHD spouse may be generally aware of their earlier struggles, but sometimes not fully. They may not understand how deeply the difficulties of neurodiversity run and how much frustration, shame, failure and labeling their spouse has experienced, all of which can impact whether a spouse is prone to contest, “turn away” and defend themselves when their spouse logs a complaint.


What was once considered to be the creative, spontaneous side of the ADHD partner may now be considered to be impulsive, inconsiderate and downright intentional. Inattentiveness to the non-ADHD spouse and missed or miscommunication are key themes. While the ADHD spouse may exhibit wonderful traits of enthusiasm and perform well in crisis situations, any inability to provide stability in average daily activities, such as cleaning up, following through on tasks or coming home at a scheduled time can undermine the gifts they bring to the table.


How Conflict Looks inside the ADHD Couple


Indeed, these neurodiverse couples present unique challenges. The spouse without symptoms often complains that conflicts and challenges in married life (be it finances, substance use, parenting or household chores) are never resolved; in fact, one client described the syndrome as “stacking cards.” There is a sense that the communications around problem solving goes in one ear of the ADHD partner and out the other.


The non-ADHD partner, struggling with ways to pick up the loose pieces, may assume the role of parent and interpret actions of the ADHD partner as willfully refusing to cooperate. This, in turn, can lead to negative sentiments that increase the likelihood of conflict and discolor the couple’s prospects for harmony. One struggling wife saw her husband’s talkative, spontaneous nature as aggressive and rude, interpreting his actions as stealing the stage in social situations.


It’s easy to understand how any