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In Consultation - Page 2

Bart's AD/HD diagnosis, revealed when their child was diagnosed, comes as a relief to both of them, providing an explanation for many of the challenges they've had to confront. That doesn't mean, however, that Jeanine can easily let go of the resentment she feels for having been blamed for the family's problems all these years and for now having to dig their family out of debt.

For his part, Bart struggles with a lifetime's worth of baggage, always feeling unfairly beaten down, criticized, and frustrated with (and by) the people around him. Even though he's willing to accept the diagnosis, he lacks the fortitude to withstand Jeanine's anger, especially when he, like many adults with late-diagnosis AD/HD, holds out little hope for change. Nothing he's tried in the past has worked.

This couple needs a walloping dose of optimism. They need to start feeling that they can turn their relationship around, with the right help. Their therapist might feel like the little Dutch boy at the dike, but not knowing which holes to plug first: the emotional, the medical, or the practical. In fact, effective treatment covers all those issues and more. Fortunately, though AD/HD is considered the most impairing outpatient condition, it's also the most treatable.

Flying Beneath the Radar

One reason therapists often overlook AD/HD is that the challenges with communication, cooperation, discordant parenting styles, sexual intimacy, domestic chores, and money management that arise from it resemble those brought into therapy by many other distressed couples; however, with AD/HD, these issues have a greater severity.

When novelty and stimulation are higher—at the beginning of a relationship or a job, for instance—many people with AD/HD function at a high level. Frequently, their mates fail to recognize certain behaviors as red flags for long-term AD/HD. These are both reasons AD/HD can fly under the radar. With previously high-functioning AD/HD adults, it's sometimes the gradual addition of new responsibilities that can ultimately overwhelm their brains' capacities, diminishing competencies over time and exposing counterproductive coping strategies.

For instance, until their first child arrived, Bart had always coped with his disorganization and poor time sense by strictly structuring his day. It wasn't easy, but Jeanine managed to accommodate him—until they had a family. Judging solely by appearances, one might think that his newfound difficulty lay in adapting to fatherhood, but more accurately, fatherhood exposed the real issue: unrecognized AD/HD, compounded by counterproductive coping strategies.

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