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In Consultation

Hidden in Plain Sight: Adult AD/HD is Too Often Unrecognized

By Gina Pera

Q: A couple has asked me to help them deal with the husband's new AD/HD diagnosis and their past 20 years of discord. Financial problems loom large, and both seem exhausted.
Where do I begin?

A: You describe an all-too-familiar scenario. By the time couples finally realize that adult AD/HD is the common thread running through their long-term woes, they're often hanging onto their last, frayed nerve—and maybe their last dollar, too. It often takes a decisive event—discovery of secret debts, a job loss, an affair, an eye-opening article about AD/HD—to focus attention after years of missed red flags.

It's not solely the symptoms that afflict relationships, though adults with untreated AD/HD have roughly double the divorce rate. It's also the years of misattributing the symptoms to lack of caring, selfishness, passive-aggressiveness, and immaturity. Undiagnosed adults often lug around a lifetime of poor coping strategies and cognitive distortions; over time, the same becomes true for their mates. With both people reacting blindly to the effects of AD/HD, which counseling frequently doesn't identify, their life together can feel like a wild roller-coaster ride.

Jeanine complains she's been riding the roller coaster throughout her 20-year marriage to Bart, trying to hang on and "manage the unmanageable" of his chronic forgetfulness, perpetual tardiness, disorganization, and erratic sleep schedule. She repeats a common refrain: "I feel like I've been parenting another child!"

In response, Bart has long chided her for being too uptight and controlling. "She's always at me about every little thing." His lack of perspective makes sense, when you consider he knows no other way to be in the world (his dad had AD/HD, too) and that the symptoms themselves can inhibit insight and objectivity. Without a better understanding of their discord, Jeanine has often accepted her husband's viewpoint and tried to back off. The more she's done this, though, the more their household has spiraled into a dysfunctional mess of mislaid bills, huge credit-card debt, missed appointments and social events, lost keys and wallets, and uncompleted domestic tasks.

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