ADD - what help do I need next?

January 1, 2020 6:46 AM

Diagnosed with ADD a year ago at age 45. I’ve been trying to make some changes in my life / marriage for 10 years without much success.

My partner is a therapist, which means she has significantly more developed relational skills than I do. I’ve been able to make changes in some areas but not in the areas that are most important to my partner.

I’ve seen a couple therapists, each for 2-3 months, I’ve been on three ADD medications in the last year, each of which caused side effects that were as bad as the original problems. I just stopped Strattera a week ago (with my doctor) and the lack of focus and intentionality that has come back has already caused problems. I want to make these changes and am not sure what kind of help I need next.

I’m an intelligent person but I don’t have the skills I need to make the changes I need to make. I’ve worked hard for 10 years on this and it hasn’t been successful, which has left me feeling incompetent and like a failure and with a marriage that is suffering.

The problems I’m having are made significantly worse by ADD, but I don’t know if ADD is completely responsible.

I’m thinking I need another therapist (someone with both ADD expertise and relationship experience) that I can work with more long term, but I would love to hear any other advice or input. (My partner is not willing to consider couples therapy, so that’s out.)

I don’t want to be in the same position and feeling terrible again at the end of another year. I love my wife and our relationship and family are the most important thing in my life and I want to do everything I can to be a better partner and rebuild our relationship.

Thanks for any advice.

posted by anonymous to Human Relations (8 answers total)

Think of your ADD like a rip tide: fighting it makes it worse, you need to figure out the ways in which it benefits you and use those to accomplish the goals you have in mind here. For me, list making, alarm setting, and strictly scheduling my time (both leisure and work wise) work well. I’d advise you to start by sitting down at a quiet time (and asking that you not be interrupted) and making a list, NOT of problems to overcome (like “stop getting distracted in the middle of doing laundry”), but of end goals (like “make sure I vacuum floors, empty dishwasher, and clean bathroom once per week; make sure I pay electric bill by last weekend of every month”).

Then, think through what’s happening at the times you do succeed in getting something done: what do they have in common? Late nights when everything is quiet? Times when you’re home alone? Weekends when you have plenty of leisure time? So much of managing ADD well depends on understanding and accepting yourself! For me, I notice I get chores done best when I put on a long podcast on a day when I’m home alone and I have no events scheduled later. I know I won’t put the podcast on without an alarm telling me to get my butt up and do it. I know I won’t listen to the alarm on the first try, so I make sure when it first goes off that I hit snooze rather than turning it off.

Much of this depends on your partner’s willingness to work with you. First, you and your partner need to divvy up as much concrete work as possible. (Part of your work is going to be relationship stuff as well, like setting a calendar notification that will go off before you leave for the office saying “partner has big presentation today, wish her good luck before work this morning.” The fact that you have to remind yourself does not mean you lack sentiment or care, it’s just the way your brain works and that’s ok.)

A lot of times, conflict comes about because people in our lives without ADD get frustrated not just about the end goals, but about the process. You may realize that getting requests throughout the day (“can you pick this up at the store tomorrow?” then two hours later “make sure to return that book to the library by Sunday”) is counterproductive for you. You may need to say “hey partner, I want to carry my weight here, but unless it’s an emergency can you please send me a single list at the end of the day with all the requests you have for me so that I have it in one place?” That means partner needs to take on some of the work of compiling and thinking through the tasks instead of firing them off in the moment—but I think that’s fair to ask for from your partner. So is the extra time you may need to get things done. With my ADD, I’m never going to be a last minute person. If I’m having a dinner party, I sit down a week ahead and plan everything out, and if someone calls me two hours before the party with a special request, an item I would need to leave the house to pick up, or extra guests, I’m incredibly inflexible about it. Once I manage to get the train on the track and running, I’m not risking it being derailed. Some people can’t stand that about me and that’s ok!

Ultimately, your partner needs to decide: do I care more about him getting the end goal done (and if so, let him do it in the way he can!) or do I care more about getting to decide how he functions? A lot of what works for some of us with ADD is maybe not common in a family setting: alone time, leisure time, low pressure, ability to get sucked into a task. It requires arranging and it requires a partner who will be ok with accommodating you. If your ADD is causing tension in your marriage, your partner may feel at first like “so now I have to give you even MORE slack?” But if your partner cares most about you pulling your weight on life task stuff, and you can show improvement in concrete ways (like the bills being paid on time), your partner may learn to be ok with some more unconventional ways of getting things done.
posted by sallybrown at 7:28 AM on January 1, 2020 [10 favorites]

It may be time for an ADD coach rather than a therapist. You would have to ask around for personal referrals from clients because this is a field filled with... less than qualified people.
posted by DarlingBri at 7:41 AM on January 1, 2020 [3 favorites]

I was diagnosed with adhd two years ago, at age 55. The most illuminating thing I learned about myself through the diagnostic process was that I have difficulty with audio input, like understanding verbal commands, following the thread of conversations (especially phone calls), learning via lectures, etc. Any input that comes in through my ears is very hard for me to process. This went a long way toward explaining why I felt so frustrated having any kind of conversation (deep, not deep, on the phone, in person, anything) with my partner. So, one of the structural things we've changed about our communication style post-diagnosis is that we try to include more written communication. So, everyday-life things like to-do requests are written down. Important thoughts like "I love you" and also "You are acting like an asshole and here's why" are also often written down. Writing things down gives me the chance to organize my thoughts before I blurt out something mean or inappropriate, or some random half-finished thought that should have never been said out loud.

So, if the problems you are having in your relationship are due to communication issues, my suggestion is to try a different type of communication. Write letters to each other. Record videos that you send to each other. Take (or draw?) pictures that express what you're trying to say. Go for walks where you don't necessarily have to look at each other while you're talking.

If you can get a follow-up to your adhd diagnosis that gives you some idea of which type of sensory input might be stronger or weaker for you, that might help narrow down the possibilities of things to try.
posted by SuperSquirrel at 8:12 AM on January 1, 2020 [4 favorites]

Are the changes you need to make specifically practical ones--doing more of the household labor, planning, or other work--or are they more relational ones--listening better, being kinder, reacting more positively to stress? Is the ADD actually causing the problems in your relationship, or is it getting in the way of you making other kinds of changes?
posted by gideonfrog at 8:53 AM on January 1, 2020 [1 favorite]

There are both legit and skeevy ADD coaching services out there. I think you might first see if you can find a therapist (this might be a traditionally certified counselor, social worker, occupational therapist, possibly also a group run by a therapist) who specifically focuses on executive functioning (in adults - harder to find than specialists for children, but they're out there).

If you can't find anyone doing that in your area, then maybe start looking at the coaching services. They'll be focusing on productivity and exec function.

It seems a little disheartening that a professional therapist won't go to couples counseling. You may need to examine more closely whether the issues here are 100% yours. You can't improve a marriage when the other person won't do their part.
posted by Lyn Never at 10:05 AM on January 1, 2020 [5 favorites]

I think you’re carrying a lot of shame and guilt, and your partner may be contributing to that by (unintentionally) emphasizing her organizational and relational skills as superior. Giving her the benefit of the doubt: is she saying she won’t go to couples counseling til you work through some more issues in individual therapy? Because being a therapist doesn’t mean she wouldn’t benefit from therapy herself. Does she have her own walls up?

It sounds exhausting to feel bad at marriage and parenting. That must be some very heavy emotional weight.

I’m hearing you talk a lot about what she wants and how you want to change for her. What do you want? It can’t be that you want to feel this way you’ve felt for your whole marriage.

Here are the questions I have: you said you haven’t been able to change what’s most important to your partner. Why did she marry you, and is she truly committed to this marriage too? Is this all on you? Is she somehow benefiting from you being down?

This sounds like a super unhealthy dynamic. Sure, get into therapy and find an ADD coach. But I can’t believe that you are the sole cause of every problem in your marriage because of your ADD. ADD parents can be fun and spontaneous and loving and joyful. Talk to your therapist about all of this, including self esteem. Figure out what you want.

Also listen to Fierce Intimacy by Terry Deal and read Too Good to Leave Too Bad to Stay to get some insight into your marriage and this dynamic. Take care, friend.
posted by bluedaisy at 11:10 AM on January 1, 2020 [5 favorites]

It’s very strange to me that your partner won’t consider couples counseling. It does sound like you have a lot of practical skills to develop, but at the same time your marriage dynamic isn’t making either of you happy and the ADD diagnosis represents a significant change in circumstances that calls for some renegotiation in the relationship. I don’t want to downplay the changes you may need to make but I would encourage you to revisit the topic of couples counseling with her. She is probably going to have to make some accommodations and a neutral third party can help with that. Best of luck to you.
posted by praemunire at 3:42 PM on January 1, 2020 [2 favorites]

I second the recommendation for a ADHD coach. Meds were very helpful for me, but the net effect was to take the edge off of energy issues and to make it easier to access activation etc. The coach was substantially more helpful in addressing some of my other issues and setting up larger lifestyle changes. I can recommend mine; please memail me if you are interested, or have the mods post a throwaway email.

Relationship challenges with one ADHD partner and one non are recognized and there are lots of pepole who have done work in this area. And if you are a man, the most studied or talked about dynamic in the ADHD world is the male ADHD partner and the non-ADHD partner so you could be in luck there, in terms of resources. Other resources: ADDitude, CHADD, & Attention Deficit Disorder Association. I would also find a community of people--online, offline, whatever--that you can talk to about your ADHD. Even joining an ADHD meme page on facebook has been helpful for me -- I can normalize some of my stuff as "ADHD stuff" which helps with acceptance and getting over shame.

I have found that the non-ADHD partner needs a fair bit of education about what ADHD is and how it manifests specifically in relationships. But also there is individual work that needs to be done in terms of self-awareness and figuring out routines, tools, and strategies that work for you. I am the ADHD partner in my relationship. Although my spouse is not resistant to couples therapy, it has been most useful when we each work on own stuff and get to a place where the other can see the effort that has been put in. (barring a crisis situation, of course). I'm surprised that your wife won't do couples therapy since she's a therapist so that's a bit puzzling. I wonder if she would if she could see some work that you have put in.
posted by emkelley at 7:37 AM on January 3, 2020