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ADD and Relationships

Individuals who have attention deficit hyperactivity disorder (ADHD) both impact their relational environment and are impacted by it. Of course, many factors influence relationships, such as family background, financial or legal stressors, and health conditions. However, there are a number of problems that individuals who have ADHD commonly experience in relationships that are caused by the neurological effects of the disorder.

Adolescents and adults who have ADHD often experience social skills deficits and have poorly developed communication skills. Accurately reading and interpreting social cues (body language, facial expression), a crucial component of developing good social skills, are often challenging to individuals who have ADHD. Their distractibility, impulsivity, sensitivity, tendency to over react, self-focus, and poor self-regulation can interfere with learning these important skills. Children who have ADHD often miss the important details involved in mastering social skills through observing, copying, practicing, and receiving feedback. Adults may have learned some of these skills but have often missed important pieces and may not even know they are missing them.

As children, many tend to be socially neglected, living on the periphery of the peer group (those who are primarily inattentive) or actively teased and rejected (those who are hyperactive). Females tend to be more negatively impacted by poor social interactions, as they typically have a greater need for peer affiliation than do males.

The roles of spouse and parent add new dimensions of complexity to the daily life of an adult with AD/HD. Because in our society, women often bear more of the responsibility for maintaining the household and raising the children, women with ADD might struggle with these roles. We expect the homemaker to provide organization and structure for the rest of the family members. Office jobs often have specific schedules and clear job descriptions. The home is much less structured. Tasks may not have a clear beginning or end.

Some women with AD/HD may feel overwhelmed at the sheer number of tasks in the home. It may be difficult to break down and prioritize tasks. A woman with difficulty maintaining divided attention may blow up when her children make demands while focused on another task.  She may have difficulty providing the structure her children need to help contain their own AD/HD. A woman prone to impulsive temper outbursts may have difficulty disciplining her children.

Many individuals who have ADHD have suffered from social isolation or rejection because their ADHD behaviors were misattributed to selfishness, lack of caring, thoughtlessness, laziness or stupidity. For example, when an individual who has ADHD is late, others tend to attribute this to a lack of caring or selfishness, rather than understanding that time management is a chronic problem for many who have attention deficit disorder.

Low self-esteem is a contributing factor to the development of relationship deficits in individuals who have ADHD. Many have experienced a life replete with broken relationships. They have often felt disliked by parents, teachers, and peers. Many of their problematic behaviors, such as tantrums, arguments, and poor anger management, are indicators of relationship problems that continue into adulthood in the form of loud, angry arguments with family, friends, and even bosses.

When growing up, children who have ADHD were frequently bombarded with countless criticisms of behaviors that bother adults, with little or no focus on what the child needs. Others typically do not understand how an individual who has ADHD experiences the world, and thus they often do not feel heard or understood. A parent’s understanding of the difficulty adolescents have in doing their chores, starting their homework, turning off the television or video game, going to bed, and getting out of bed in the morning may make it more likely that parents and their children will engage in problem solving, rather than blaming, criticizing, and arguing.

Parents who have ADHD typically compound the problem through their own difficulties: tuning in to social cues, being distracted, and generally being busy, hurried, and disorganized. This cycle of frustration, blame, criticism, and lack of understanding forms the core experience of many individuals who have ADD in relationships with others, beginning in childhood and continuing though adulthood.

Other environmental and family impacts can contribute to the relationship problems an individual has. One example is that some individuals who have ADHD must maintain an orderly and clutter-free home environment in order to function effectively. Without it, they experience significant anxiety about losing control—not seeing important bills and papers among the piles of clutter, forgetting critical events, or losing key items. A boisterous family’s typical noise and chaos can be over-stimulating for many who have ADHD. Likewise, stressful home environments in which there are high levels of conflict, tension, or depression can exacerbate already challenged executive functioning and overload highly sensitized receptors. Another common family stressor is the tendency to take on too many activities, with resulting stressful over-scheduling. These over-commitments can intensify ADHD difficulties with time management, lateness, and forgetfulness, as well as leave no down time to recuperate from life’s daily stresses.

The development of poor communication skills probably results from a combination of social skills deficits and other typical ADHD-related behaviors, which interfere with healthy communication in relationships. Many individuals who have ADHD feel under-stimulated and may attempt to self-stimulate by seeking conflict and provoking others. Some seem always to need to have the last word, to create arguments, and to be unable to refrain from arguing once they have begun. Their inattentiveness can result in divided attention while listening to significant others, hearing only parts of what is being communicated. The tendency to have difficulty holding onto thoughts, combined with impulsivity, may result in interruptions, speaking over others, and failing to communicate.

Other common challenges of ADHD are emotional sensitivity and the tendency to over react and be prone to outbursts and moodiness. They are easily irritated, offended, and hurt because they instinctively respond to the smallest changes in the environment, both physical and emotional. This hypersensitivity and subsequent hyper-reactivity can be off-putting to spouses, family members, and others in the community. Others may respond by downplaying or negating what appear to be excessive reactions; by criticizing the individual as too thin-skinned, defensive, or sensitive; or by retreating from the intensity of the emotional response. This intense reactivity prevents people who have ADHD from being fully emotionally available to hear others, a trait that often leads to further exacerbation of the conflict or power struggle.

Impulsive behavior can also significantly impact relationships. Behaviors can take many forms, such as crossing the street or changing lanes without looking, taking on too many activities, making plans or purchases without consulting spouse or family, and making poor decisions. Impulsive spending can be a huge problem in many families affected by ADD, potentially leading to bankruptcy and/or divorce. The combination of poor self-control, stimulation seeking, and self-medication can lead to compulsive or addictive behaviors as well.

Executive dysfunction creates yet another set of interpersonal behavior difficulties. Organizational and memory problems contribute to relationship conflicts, both within couples and between adolescents and parents. Disorganization and forgetfulness lead to piles of unfinished laundry, clutter, chronic lateness, lost keys, missed events, and unpaid bills. These behaviors decay trust over time; the individual who has ADHD cannot be depended on to “execute.” Disappointment sets in and often causes the spouse to feel unimportant.

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