My husband has full blown ADHD, he takes ritalin, lexapro, librium and wellbutrin and is fighting with depression, also.  Was diagnosed about 2 years ago, he is 52.  He also tries to mask his lack of joy with a loud, annoying, know it all personality.  My husband used to scream and yell at me when our daughter was a baby and she would cry, by saying hurtful things like "can't you shut that kid up".  I remember it so vividly and wondering what was wrong with him and after many outbursts like that, I knew I would be caring for my child alone.  It turned out exactly like that and now he has a very strained relationship with our daughter.  My husband never complained about anything in our marriage either.  Of course, because I was pretty much taking care of everything.  But then one day he hit me with the same stuff "unhappy, doesn't think he has ever loved me, etc".  My husband suffered from abandonment in his childhood, too.  His father died when he was very young and his mother, who had issues of her own, kicked him to the curb when he was still a teenager.  He never says anything but I think my husband has the same dark, deep, blackened hole in his soul also, from a lack of love from parents early on, through no fault of his own.  He is in therapy but I can see it is going to be a long, hard journey.  Good Luck to you in your situation.     

Hi, Dr. Ned Hallowell here.  ---  I was reading some of these posts, and I wanted to comment on the issue of the personality disorders that have been mentioned, borderline personality disorder (BPD) and narcissistic personality disorder (NPD).  Not knowing the individuals who are being described, I'll keep my comments general. 

          BPD is a severe condition, and it cannot be caused by ADD.  ADD may of course co-exist, but treating the ADD will NOT cure the BPD (as treating the ADD so often does cure co-existing depression or anxiety disorders).  The symptoms of BPD include rage, devaluing of loved others, substance abuse, self-injurious behaviors like cutting or making suicidal gestures, flipping from idealizing a person (such as spouse or therapist) to demonizing the same person, manipulation of others, feelings of inner emptiness, a desire to be "filled up" somehow, often extremely intelligent and creative as well as dramatic, usually a history of childhood abuse or abandonment.  These individuals often require psychiatric hospitalization.  They require intensive, ongoing psychotherapy by a person skilled in handling this highly volatile condition.  Dialectical behavioral therapy, or DBT, is often the best therapy, sometimes in conjunction with medication.  If you are married to a person with BPD, you MUST get the proper skilled professional help, for your spouse, for you, and for your family.  Do not stop until you have found the full supports and professional help that you need.

          Narcissistic personality disorder, or NPD, is also a highly difficult condition to live with. They are unable to love others.  They see others as an extension of themselves and are unable to empathize with or give to others.  The person with NPD feels an inner worthlessness.  He deals with this by getting others to praise him all the time.  He requires constant adulation.  He can never get enough.  He may get this praise through high achievement (many of our top achievers are narcissists) or through manipulation of others.  He is fundamentally unable to love, either himself or anyone else (I use the male pronoun, but women can also be narcissists).  He is a drain to be around, as his need for attention and ego-boosting is insatiable.  If he senses that he is being in any way devalued or dissed, he becomes rageful, even dangerous.  If you are married to a narcissist, you probably feel lonely in the marriage, worn out by how much emotional support you have to give and how little, if any, you get, and you probably feel afraid of the rage attacks that can come out of nowhere.  Psychotherapy is indicated for the narcissist and for the spouse as well.  There is help, but you absolutely cannot do it alone.  You, the spouse, must find a good therapist.  Often the narcissist refuses to get help, but you, the spouse must get help for yourself.