Traversing the territory of helping a partner with ADHD find the best treatment for ADHD can be like walking across a minefield. There is a great deal of danger, and you’re never quite sure where it will come from. Here are some tips that can help make the process easier:
(For purposes of this article I will write about an imaginary couple in which he has ADHD and she does not. But ignore the genders if you wish…)
TIP #1 - It’s his body, not yours: Non-ADHD partners often keenly feel the need for their ADHD partner to get a good evaluation and great treatment – after all, the survival of their relationship and families often seems to depend upon getting relief from unrelenting ADHD symptoms. Those feelings of need, however, shouldn’t obscure the fact that health decisions for any adult are the responsibility of that adult. You can’t force your partner to take ADHD medication, for example, and my experience is that the harder you try, the more he’ll resist. So step number one is to internalize the fact that you have limited power to change the status quo.
TIP #2 - Calm conversation is better than threats, anger, bullying and anxiety: When it comes to getting an evaluation and treatment, the old saying that the carrot works better than the stick definitely holds true. Staying with ADHD treatment takes a lot of effort – and that work will only be expended if the ADHD partner is seeking treatment because he genuinely believes he needs it. The more your threaten, bully, or cry, the more likely it is that your partner is going to tell you that the problem isn’t the ADHD – the problem is you. Don’t set yourself up for this fight – it’s unwinnable. Instead, remain calm and rational when talking about your experiences in your relationship.
TIP #3 - Focus on you, not your ADHD partner: One of the best reasons to get an evaluation for ADHD is that your partner is suffering and needs help. Think about what happens if you say, “I love you and I know you are trying hard to help me out, but I’m still feeling overwhelmed by the sheer volume of responsibility on my shoulders. While I understand that how you manage your ADHD is your choice, it would really help me out if you would pursue how to be better organized. The chores aren’t that much fun, but together we could make light work of it…” Now think about how your partner might respond to “You never carry your load around here and I’m fed up with it! Get your act together and start taking those meds!” One approach assumes partnership. The other is adversarial and controlling. It also won’t get you far, at least not in the long-term.
TIP #4 - Offer to help with the initial contacts: Many with undiagnosed or unmanaged ADHD are too scattered to effectively find an ADHD doctor and get to that first appointment. They want to, but feel overwhelmed by the process or simply don’t get around to it. This makes sense, since having trouble following through is a hallmark trait of ADHD. To get the ball rolling, you might gently offer to find a few doctors from which your partner can choose, and set up the first appointment. Over time, your partner can (and should) completely take over the scheduling tasks.
TIP #5 - Be a partner in the evaluation stage, and with monitoring medication successes: a recent research review suggests that getting input from other adults about possible ADHD symptoms can improve the accuracy of diagnosis of ADHD.* In addition, my observation of many couples with ADHD is that the best measure of the effectiveness of various treatments that an adult with ADHD tries, is taken with both partners observation. This is for a number of reasons. First is ‘self-report bias’ and the second is that not all changes are immediately obvious to the ADHD adult. As one excellent example of this, when my husband started taking the anti-depressant, Wellbutrin, he couldn’t ‘feel’ it and, therefore, assumed it wasn’t working. But my experience was quite different: I noticed he was doing a better job of thinking before acting and, most importantly, that the surprise ‘spurts of anger’ that he had lobbed my direction (and which had been so destructive to our relationship) had virtually stopped. After we talked about it, we realized that the medication was helping. He had a calmer mind, an ability to stop and think, and less expression of anger…all while not ‘feeling’ the medication at all!
At the evaluation stage, let your partner choose how (or whether) you will be involved. Some prefer that their partner submit a written statement about what they have noticed that makes them suspect ADHD, others prefer to have the partner go with them to the evaluation (which has the added benefit of an extra set of ears for any follow up instructions) and some prefer no input at all. Which it will be is the ADHD partner's choice (remember, it's his body...)
TIP #6 - Do NOT nag your partner to take the meds: There is little that bugs an adult with ADHD more than having a partner ask suspiciously, “Did you take your meds today?” after the ADHD partner has done something surprising or 'wrong.' Setting up an ADHD medication routine and sticking to it is the responsibility of the ADHD partner. If he’s having trouble doing it, he should hire a coach to figure out a good system. If your partner doesn't wish to take meds at all, that's his choice. Focus on your needs (such as "I'm feeling overwhelmed and need more help at home") and let him figure out how he is going to address meeting your needs rather than dictating what path he should take.
TIP #7 - Do participate in non-medicinal treatments that make sense: Exercise with your partner regularly – have fun being active together! Get to bed at a reasonable hour, and make it enticing for your partner to join you. Support his efforts to hire a coach or delegate to others (rather than telling him he should be able to do all that stuff himself!) Give him a break when he’s exhausted or overwhelmed. Eat well together, having a little protein at every meal and lots of vegetables and fruits. Make love to cement your connections. Make it a priority to set aside time to just focus on each other with dates or the like (‘attend time.’) There is a lot of ‘together’ stuff you can do that will help your partner manage ADHD symptoms and help your relationship stay (or become) healthy and strong.
TIP #8 - Get informed: Read up on ADHD treatment options. While it's not your ADHD, knowing that exercise helps manage ADHD symptoms (for example) will help you respond more positively when your partner says he's going to the gym instead of cleaning the bathrooms. A good resource is my online treatment guide - make sure to download the free chapter on treatment you will find there.
The bottom line is this – even if it seems imperative that ADHD issues be addressed immediately, it’s best to remain respectful of the fact that the ADHD belongs to your partner, not you. The most effective ‘position’ for a non-ADHD partner to take is that of ‘gentle lobbyist’ – a concerned, supportive and helpful partner with calmly expressed needs. In my experience counseling many couples, this type of open and respectful stance is the most likely to result in your partner seeking an ADHD evaluation and treatment.
*Molina & Sibley, The case for including informant reports in the assessment of adulthood ADHD; The ADHD Report Vol. 22, No 8