Science Explains How ADHD Impacts Romantic Relationships (And What You Can Do About It)
ADHD is often an unwelcome guest in romantic relationships. Science explains how you can fight back.
Here’s a helpful way to think about ADHD:
Picture two cups, one with water and the other is empty. This is a brain cell (neuron). You take a third cup and start filling the cup with water to the brim. When the cup is full, it overflows and pours into the empty cup. Each time the cup overflows and spills into the next cup, you have a thought.
The water is dopamine.
Since you’re constantly thinking, the cup is constantly overflowing and pouring into the next cup.
But people with ADHD have a difficult time filling up the cup with water. Their brains lack the amount of water needed to fill the cup up every time. Every so often, the cup doesn’t overflow when it’s supposed to. The thought that should’ve happened doesn’t happen.
Their brain gets distracted and wanders, thinking about something else.
This is why stimulants are so effective. They boost dopamine to help make up for the lack of production in the ADHD brain. It’s not perfect, but it was a helpful way to help me envision it.
And though we don’t yet understand all the inner workings of ADHD, we know that dopaminergic drugs, like stimulants, are incredible tools to help people mitigate their symptoms.
That’s how a psychiatrist friend of mine explained it to me once.
The Distracting Details of Attention Deficits
ADHD is weird. Take it from me, I know. Within the last few years, I took an ADHD test. I literally scored 100%.
Since then, I’ve been seeing a professional and, I’m pleased to report, my symptoms are in complete remission.
For those who aren’t ADHD, having it is like constantly hopping from one topic to another with no rest.
You feed your cat and forget your cell phone by the cat bowl. Then you spend 15 minutes looking for your phone. When you find it, you forgot what you were doing before you fed the cat. When you finally remember, you realize you’re late for work. So, you get yourself together and run out the door, only to realize you forgot your phone again…and on it goes, endlessly.
ADHD stands for Attention Deficit Hyperactivity Disorder, a neurodevelopmental disorder affecting millions of people.
It’s characterized by symptoms such as inattention, hyperactivity, and impulsivity. While ADHD can have a significant impact on an individual’s personal and professional life, it can also impact their romantic relationships.
Contrary to popular belief, ADHD has numerous genetic components. Some people seem to think it’s “not a real disease” or they subscribe to a conspiracy theory about how ADHD is really just a symptom of modern living.
To the contrary, ADHD is a full-blown biological disorder.
ADHD is highly heritable. Recent research has found that ADHD is 74% heritable, meaning that in a population, 74% of the disease is related to genetic causes.
ADHD & Medications
Another common myth about ADHD is the use of stimulants to treat it has been somehow excessive. This is one of the most rampant conspiracy theories, and it doesn’t end with stimulants.
People might say, “I think meds are overprescribed.”
I’ve never met a single person who says this who has idea how many prescriptions are dispensed for any given drug each year, they’ve done nothing that remotely resembles a thorough study, crunching numbers and applying statistics.
They just heard someone else say it, and it feels good to look down on people with invisible illnesses.
One of the most egregious examples happened during the pandemic-related Adderall shortages of 2022. Meltem Demirorsviral tweet suggested that ADHD was pharmaceutical companies “re-branding meth” to get America hooked on illicit drugs:
This is the kid of disinformation I eat for breakfast.
Lifetime ADHD rates were 8.8% at the time, meaning 8.8% of the adult population suffers from ADHD at some point (now it’s up to 9.8%). The U.S. population is 332.28 million people. 8.8% of 332.28 million is 28,908,360. So, roughly 28,908,360 people in the U.S. have ADHD.
While these numbers are far from perfect, they suggest that roughly 1 in 8 people with ADHD are diagnosed and being treated with Adderall.
This doesn’t account for narcolepsy, which Adderall is extremely effective at treating. About 200,000 people in the U.S. have narcolepsy, or, 0.3% of the U.S. population.
So, if everyone with ADHD and narcolepsy were diagnosed and treated with Adderall, it would be 108 million prescriptions per year. That’s far more than the 41 million Meltem Demirors was complaining about.
The Subtypes of ADHD
There are three subtypes of ADHD:
Inattentive ADHD, also known as ADHD-PI (ADHD predominantly inattentive), is a subtype of ADHD characterized by difficulty paying attention, following instructions, and staying organized.
Hyperactive-impulsive ADHD, also known as ADHD-HI (ADHD predominantly hyperactive-impulsive), is a subtype of ADHD characterized by excessive physical activity, fidgeting, restlessness, difficulty sitting still, interrupting others, and impulsive behavior.
The combination type of ADHD, also known as ADHD-C (ADHD combined), is a subtype of ADHD characterized by symptoms of both inattentive and hyperactive-impulsive types. Individuals with ADHD-C may struggle with attention, organization, impulsivity, and hyperactivity.
ADHD-Related Relationship Challenges
Despite the growing body of research on ADHD, studies examining the romantic relationships of adults with ADHD are scant. ADHD is mostly framed in terms of productivity at work or school — not in love and romance. This says a lot about our culture.
A 2020 study sought to summarize the existing research on ADHD in romantic relationships, and provide recommendations for researchers and clinicians interested in finding ways to help couples dealing with the adverse effects of ADHD, a topic worth discussing.
Individuals with ADHD face several common challenges in romantic relationships, including poor communication skills, difficulty managing emotions, forgetfulness, impulsivity, and distractibility. These challenges can lead to misunderstandings, conflicts, and feelings of frustration or resentment between partners.
People with ADHD may struggle with maintaining a consistent routine or following through on commitments, which can further strain the relationship. However, by understanding these challenges and working together as a couple to manage symptoms and improve communication skills, couples can overcome these obstacles and build a stronger relationship.
The struggles aren’t distributed evenly, either. Men with ADHD partners who are women report their partner's ADHD behaviors more negatively impact the relationship. And ADHD women in relationships with men are more dissatisfied, while men are less dissatisfied.
The exception is men with an inattentive ADHD presentation. They tended to have later relationship milestones (first date, first kiss, etc.) than other ADHD men.
The study authors said:
Adults with ADHD are found to be less satisfied in their marriages and self-report lower marital adjustment than non-diagnosed control groups. Although two studies found that spouses of adults with ADHD report somewhat higher relationship satisfaction than their partner with ADHD, another study found that spouses of partners with ADHD reported lower intimacy in their relationships.
ADHD can severely hamper a relationship.
They go on to explain:
Acknowledging how common dis- satisfaction and partner strain is in relationships with adults with ADHD, it is logical that most, but not all studies, have found that extramarital affairs as well as separation, divorce, and remarriage occur more frequently in these couples than in relationships of couples without ADHD. Delving deeper into the divorce findings, preliminary evidence indicates that women with ADHD may be more likely to have divorced than men with ADHD. In sum, marriages including adults with ADHD are more likely to be unsatisfying, a burden for partners, and to end in divorce.
How People Can Manage ADHD in Their Relationships
Thankfully, science has provided us with some tools to work with to mitigate the deleterious effects of ADHD on our relationships. If we put in the time and effort, we can keep our ADHD at bay and live healthy, happy lives.
People can employ the following strategies to manage ADHD symptoms and strengthen their relationships:
Improving communication skills: Couples can work on strengthening their communication skills by actively listening to each other, expressing their thoughts and feelings clearly, and avoiding negative communication patterns such as criticism or defensiveness. Talking about it out in the open is the first step to dealing with most mental health issues as a couple, as it equips us with language to describe our experiences and understand one another.
Setting realistic expectations: Couples can set realistic expectations for each other based on their individual strengths and limitations. This can involve dividing household tasks based on each partner’s abilities, or setting achievable goals for personal or professional projects. It’s important to understand, we can’t snap our fingers and make a disorder like ADHD go away.
Creating structure and routine: Establishing a consistent routine can help individuals with ADHD manage their symptoms more effectively. Couples can work together to create a structured daily routine that includes regular meal times, exercise, and sleep schedules. Staying up late to watch Netflix can easily throw your whole world off. Keeping things like this in mind, couples can work together to break these bad habits.
Practicing mindfulness techniques: Mindfulness techniques such as meditation or deep breathing exercises can help ADHDers manage stress and improve focus. Couples can practice these techniques together to reduce tension in the relationship.
Seeking professional help when needed: Couples may benefit from seeking professional help from a therapist who specializes in working with individuals with ADHD. Therapy interventions like Cognitive Behavioral Therapy (CBT) or Emotionally Focused Therapy (EFT) have been found to be effective in improving relationship quality among couples dealing with ADHD.
What Treatments Are Available for Couples Dealing With ADHD?
Yes, there are specific therapy approaches that have been found to be effective for couples dealing with ADHD. The study concludes with clinical recommendations, including:
Cognitive Behavioral Therapy (CBT): CBT is your typical talk therapy. Thanks to its wide array of applications, it’s a very common approach to treat countless health issues. It’s a specific type of talk therapy that focuses on consciously changing thought patterns and behaviors. It has been found to be effective in improving communication skills, reducing conflict, and increasing relationship satisfaction among couples dealing with ADHD. However, it’s not without problems. Notice I said “consciously” thought patterns and behaviors. That’s hard to do when your focus is hampered by ADHD.
When it comes to medication treatment for ADHD, stimulants are the most commonly prescribed. These medications work by increasing dopamine and norepinephrine levels in the brain, which can help improve focus, attention, and impulse control. Different types of stimulants are available, including methylphenidate (Ritalin) and amphetamine (Adderall). Non-stimulant medications, such as atomoxetine (Strattera) and guanfacine (Intuniv), are also available and may be prescribed if stimulants are not effective or if there are concerns about potential abuse or side effects. It’s important to work closely with a healthcare provider to find the right medication and dosage for each individual. Additionally, medication may be used in combination with other therapies, such as CBT, to help manage symptoms of ADHD.