Tips for Couples

Follow these expert guidelines to ensure a happy, fulfilling relationship.

by Edward Hallowell, M.D. , John Ratey, M.D.

The following guidelines might be helpful in dealing with issues of concern to couples in which one partner has ADD.

The best way to use them is to read them out loud, together. Pause over each suggestion and discuss whether it might help you.

As you do this, you can begin to set up your own way of dealing with ADD in your relationship. The keys to it all, as is the case with most problems in couples, are improving communication and resolving the power struggle.

• Make sure you have an accurate diagnosis. There are many conditions that look like ADD, from too much coffee to anxiety states to dissociative disorders to hyperthyroidism. Before embarking on a treatment for ADD, consult with your physician to make sure what you have is really ADD and not something else.

Once you are sure of the diagnosis, learn as much as you can about ADD. There is an increasing body of literature on the topic. The more you and your mate know, the better you will be able to help each other. The first step in the treatment of ADD - whether it be your partner's or someone else's - is education.

• Keep a sense of humor! If you let it be, ADD can be really funny at times. Don't miss out on the chance to laugh when the laugh is there. At that psychological branch point we all know so well, when the split-second options are to get mad, cry, or laugh, go for the laughter. Humor is a key to a happy life with ADD.

• Declare a truce. After you have the diagnosis and have done some reading, take a deep breath and wave the white flag. You both need some breathing space to begin to get your relationship on a new footing. You may need to ventilate a lot of stored-up bad feeling. Do that, so you won't lug it with you everywhere.

• Set up a time for talking. You will need some time to talk to each other about ADD - what it is, how it affects your relationship, what each of you wants to do about it, what feelings you have about it. Don't do this on the run, i.e., during TV commercials, while drying the dishes, in between telephone calls, etc. Set up some time. Reserve it for yourselves.

• Spill the beans. Tell each other what is on your mind. The effects of ADD show up in different ways for different couples. Tell each other how it is showing up between you. Tell each other just how you are being driven crazy, what you like, what you want to change, what you want to preserve. Get it all out on the table. Try to say it all before you both start reacting. People with ADD have a tendency to bring premature closure to discussions, to go for the bottom line. In this case, the bottom line is the discussion itself.

• Write down you complaints and your recommendations. It is good to have in writing what you want to change and what you want to preserve. Otherwise you'll forget.

• Make a treatment plan. Brainstorm with each other as to how to reach your goals. You may want some professional help with this phase, but it is a good idea to try starting it on your own.

• Follow through on the plan. Remember, one of the hallmarks of ADD is insufficient follow-through, so you'll have to work to stick with your plan.

• Make lists. Over time, lists will become a habit.

• Use bulletin boards. Messages in writing are less likely to be forgotten. Of course, you have to get in the habit of looking at the bulletin board!

• Put notepads in strategic places like by your bed, in your car, in the bathroom and kitchen.

• Consider writing down what you want the other person to do and give it to him or her in the form of a list every day. This must be done in a spirit of assistance, not of dictatorship. Keep a master appointment book for both of you. Make sure each of you checks it every day.

• Take stock of you sex lives in light of ADD. ADD can affect sexual interest and performance. It is good to know the problems are due to ADD, and not something else.

Tips for Couples

• Avoid the pattern of mess maker and cleaner-upper. You don't want the non-ADD partner to "enable" the ADD partner by cleaning up all the time, in the manner that the nonalcoholic spouse may "enable" the alcoholic spouse by covering up all the time. Rather, set up strategies to break this pattern.

• Avoid the pattern of pesterer and tuner-outer. You don't want the non-ADD partner to be forever nagging and kvetching at the ADD partner to pay attention, get his or her act together, come out from behind the newspaper, etc. People with ADD frequently need a certain amount of "down time" every day to recharge their batteries. It is better that this time be negotiated and set aside in advance rather than struggled over each time it comes up.

• Avoid the pattern of victim and victimizer. You don't want the ADD partner to present himself or herself as a helpless victim left at the merciless hand of the all-controlling non-ADD mate. This dynamic can evolve easily if you aren't careful. The ADD person needs support and structure; the non-ADD mate tries to provide these. Unless there is open and clear communication about what is going on, the support and structure can feel like control and nagging.

• Avoid the pattern of master and slave. In a funny way, it can often be the non-ADD partner who feels like the slave to her or his mate's ADD. The non-ADD partner can feel that the symptoms of ADD are ruining the relationship, wrapping around it like tentacles, daily disrupting what could be, and once was, an affectionate bond.

• Avoid the pattern of a sadomasochistic struggle as a routine way of interacting. Prior to diagnosis and intervention, many couples dealing with ADD spend most of their time attacking and counterattacking each other. One hopes to get past that and into the realm of problem-solving. What you have to beware of is the covert pleasure that can be found in the struggle. ADD is exasperating; therefore, you can enjoy punishing your mate by fighting with him or her. Try, rather, to vent your anger at the disorder, not at the person. Say "I hate ADD" instead of "I hate you," or say "ADD drives me crazy," instead of "You drive me crazy."

• In general, watch out for the dynamics of control, dominance, and submission that lurk in the background of most relationships, let alone relationships where ADD is involved. Try to get as clear on this as possible, so that you can work toward cooperation rather than competitive struggle.

• Break the tapes of negativity. Many people who have ADD have long ago taken on a resigned attitude of "There's no hope for me." The same can happen to both partners in the couple. Negative thinking is a most corrosive force in the treatment of ADD. What I call the "tapes of negativity" can play relentlessly, unforgivingly, endlessly in the mind of the person with ADD. It is as if they click on as the sun rises and click off only when the unconsciousness of sleep shuts them down. They play, over and over, grinding noises of "You can't"; "You're bad"; "You're dumb"; "It won't work"; "Look how far behind you are"; "You're just a born loser." The tapes can be playing in the midst of a business deal, in the reverie of a car ride home, of they can take the place of making love. It is hard to be romantic when you are full of negative thoughts. The thoughts seduce you, like a satanic mistress, into "loving" them instead. These tapes are very difficult to break, but with conscious and sustained effort, they can be erased.

• Use praise freely. Encouragement, too. Begin to play positive tapes. Find something positive to say about your mate or about yourself every day. Build each other up consciously, deliberately. Even if it feels hokey at first, over time it will feel good and have a sustaining effect.

• Learn about mood management. Anticipation is a great way to help anyone deal with the highs and lows that come along. This is especially true in ADD. If you know in advance that when you say "Good morning, honey!" the response you get might be "Get off my back, will you!" then it is easier to deal with that response without getting a divorce. And if the other member of the couple has learned something about his or her moods, the response to "Good morning, honey!" might be "I'm in one of my ADD funks," or something like that, instead of an attack on the other person.

• Let the one who is the better organizer take on the job of organization. There's no point in flogging yourself with a job you can't do. If you can't do the checkbook, don't do the checkbook. If you can't do the kids' clothes shopping, then don't do the kids' clothes shopping. That's one of the advantages of being a couple. You have another person to help out. However, the job the other person does instead of you must then be adequately appreciated, noticed, and reciprocated.

• Make time for each other. If the only way you can do this is by scheduling it, then schedule it. This is imperative. Many people with ADD slip away like quicksilver; now you have them, now you don't. Clear communication, the expression of affection, the taking up of problems, playing together and having fun - all these ingredients of a good relationship cannot occur unless you spend time together.

• Don't use ADD as an excuse. Each member of the couple has to take responsibility for his or her actions. On the other hand, while one mustn't use ADD as an excuse, knowledge of the syndrome can add immeasurably to the understanding one brings to the relationship.