Help! My Partner Doesn’t Seem Motivated to Change

When you are married you have a partner -– a partner in life, a partner in parenthood if you have children, a partner who you support emotionally and who supports you in the same fashion.

Unfortunately, if one of the individuals has ADHD, the non-ADHD partner sometimes has to overcompensate to do their partner’s part, as well as their own. The partnership becomes lopsided and unhealthy. Why does this happen and how can the partnership be reinstated?

Dr. David W. Goodman, M.D., assistant professor of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine and Director of the Adult Attention Deficit Disorder Center of Maryland, notes that it is very important for the non-ADHD spouse to develop an understanding of the impact ADHD can have on an individual’s daily functioning.

“When the non-ADHD spouse doesn’t understand this, she (or he) may assume their ADHD partner is being passive aggressive when he (or she) is late, procrastinating, or forgetful,” notes Dr. Goodman. “It may look like the ADHD partner is unmotivated to change or trying to annoy, when in fact the ADHD individual is impaired and unable to perform at the required level.” It is not uncommon for the non-ADHD spouse to grow resentful, angry, critical and accusatory. Frustrations and tempers become more and more difficult to control. The marriage may begin to unravel.

It can become exhausting having to “parent” not only the children, but also one’s own spouse. The non-ADHD spouse may feel they don’t really have a partner, instead they have someone to corral, organize and direct like a child. It is easy to see how these non-ADHD spouses begin to feel isolated, distant, overwhelmed and resentful.

Most often the problematic behaviors of the ADHD partner are a function of an inability and impairment rather than a motivation issue. With this insight and understanding the non-ADHD spouse is often less frustrated.

Adult Symptoms of ADHD

Adult symptoms of ADHD are similar to what we see in childhood symptoms – inattention, distractibility, taking longer to get things done, problems with time management, scattered-ness, forgetfulness and procrastination. These symptoms are chronic since childhood. They don’t develop in adulthood, rather they persist into adulthood. Symptoms also tend to escalate as an individual’s environment becomes more stressed and as demands in life increase.

“Many adults incorrectly assume or have inaccurately been told that an individual cannot have ADHD as an adult. This is simply not true,” says Dr. Goodman who also explains that ADHD is highlygenetic. For some adults, a diagnosis is made after their own children are evaluated and diagnosed with ADHD. As the parents learn more and more about ADHD, they may begin to recognize the ADHD traits in themselves. It is often a huge relief to finally understand and put a name to the condition causing the problems.

Treatment Issues

“If the ADHD spouse is receptive to diagnosis and treatment, functionality typically improves fairly dramatically,” notes Dr. Goodman. Treatment is not only critical; it is often a real eye opener for individuals.

“The larger challenge for the non-ADHD spouse,” says Dr. Goodman “is when their partner has never received evaluation or treatment, is prejudiced against psychiatry, or has had no exposure to psychiatry and is reluctant or afraid of being labeled, or afraid of having to take medication.”

If these are adults with children who are receiving treatment for ADHD, sometimes the dramatic improvements seen in their child has an effect on the ADHD adult’s perceptions. Most people want to get better and improve their functioning. When they see their child is functioning so much better with treatment, the adult begins to wonder whether they couldn’t do better, too.

When Dr. Goodman encounters reluctant patients, he takes a “let’s just sit down and talk” approach. If medicine is indicated, he encourages patients to try it for a month or two. At the end of that period if the individual is not seeing any improvements or doesn’t like how he or she is functioning, the individual can chose to simply discontinue the medicine and throw the remainder of it away.

This approach gives the patient a better feeling of control over treatment. For some individuals there is anxiety or worry about losing control. In order to maintain that control, they may resist treatment. “People want to feel in control of their psychiatric treatment, especially in regards to how it affects their mental functioning,” explains Dr. Goodman who typically first provides education and accurate information about adult ADHD and works hard to make an in-road and engage reluctant patients.

Treatment is a partnership with the doctor, but the ultimate control is held by the patient. “Most people understand that when they come into treatment they are functioning ‘less than’,” says Dr. Goodman. Generally, people want to get better. If they are able to experience the improved quality of life resulting from treatment, most individuals become invested in continuing. “Few people chose to function at a lower level once they experience the benefits.”

Source:

Dr. David W. Goodman, MD. Personal correspondence/interview. 12 Feb. 08 and 15 Feb. 08.

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