According to the Wall Street Journal, some 10 million American adults suffer from ADD/ADHD. Even worse, less than 25 percent of these individuals know they even have it (but their wives probably do!).
Typically, the symptoms of ADD/ADHD first show themselves in childhood. However, as we mentioned, many, if not most, never receive a diagnosis or the help they need. What happens when a hyperactive, distracted, or inattentive child manages to get through adolescence and into adulthood without a diagnosis?
Until recently—nothing.
Historically, the medical establishment has focused on ADD/ADHD as a childhood disease. It was not until the 1980s that psychologists even began to entertain the idea that the disorder could progress well into adulthood. Before this time, symptoms of ADD/ADHD may have been integrated into alternative diagnoses including OCD, anxiety disorders, or even bipolar disorder or schizophrenia. Such mislabeling could be highly problematic for the person affected and his family and friends.
As adults, those with ADD/ADHD may appear to be scattered, unfocused, unreliable, unpredictable, or simply annoying to co-workers, spouses, and pretty much anyone else who has to deal with them. They may have difficulty finding or holding down a job, their personal relationships may suffer, or they may just feel generally scattered and unhappy. These problems are compounded by years of underachievement, feelings of failure, depression, and low self-esteem.
Left untreated, men with ADD/ADHD are unlikely to do much of anything positive to reduce their symptoms on their own. Sure, they may self-medicate with alcohol or other substances, but this only magnifies the problem. The result of untreated ADD/ADHD can mean years of anger, frustration, and loneliness for their wives, who are often left to their own devices in terms of keeping their families from descending into chaos.
Lisa H., is an IT help-desk consultant with a major manufacturer in the Midwest. She described the conflicting emotions she wrestles with regarding her ADD/ADHD husband.
“Let me start off by saying that I love my husband. I really do,” she said. “Do I want to kill him sometimes? Oh my God, yes! Don’t get me wrong; he’s an incredibly loving, protective, and loyal husband and father. But, sometimes I feel like I have three children instead of two. It’s not that he isn’t a good provider, or that he’s an absentee parent—I mean he’s not physically absent, but mentally, sometimes I wonder.”
Does this mean that every insensitive, easily distracted husband suffers from ADD/ADHD? Of course not. It’s about the degree to which his issues negatively affect his life, career, and family. The greater the impairment in functioning, the higher the probability that he meets criteria for a diagnosis of ADD/ADHD.
Adult ADD/ADHD is a newly understood psychological disorder, which means it is not always easy to obtain an accurate diagnosis. As previously stated, some of the symptoms associated with ADD/ADHD are also seen in patients with anxiety or other psychological disorders. The challenge for psychologists and psychiatrists is to determine the primary disorder that needs to be treated. Are your husband’s challenges related to his anxiety, ADD/ADHD, depression, or all three?
If you are like most wives of men with ADD/ADHD, you may have asked yourself, “Is my husband annoying because he likes to drive me crazy or does he really suffer from an identifiable problem?” Until recently, therapists may have tried to treat the symptoms without recognizing that their adult patient also suffers from ADD/ADHD. If you can be married to someone for over 20 years and still miss it, then someone who has only had a few sessions with him may not notice it, either.
To top it off, some women prefer men with ADD/ADHD. They may not see it as a problem. Especially in the early stages of a relationship, men with ADD/ADHD are often quick, smart and creative. They possess great charisma, and can be brilliant in the areas that capture their interest. Some of these men achieve tremendous success, despite having to cope with the difficulties presented by ADD/ADHD. When an individual suffers from a particular problem for a long time, he often comes up with creative and functional ways to cope with it.
For example, according to a report in the Wall Street Journal, David Neeleman, the founder of JetBlue Airways, and Paul Orfalea, founder of Kinkos, have stated that their ADD/ADHD helped them come up with innovative ideas for their corporations, despite their poor academic history. When it comes down to it, there are two kinds of intelligence: book smarts and street smarts. Although men with ADD/ADHD may lack the skills to turn in perfect papers or perform on standardized tests, their fast-moving brains and creativity may have helped them develop into successful “out-of-the-box” thinkers who could transform whole industries.
Nevertheless, these types of success stories are rare exceptions. The vast majority of wives can testify to the fact that living with an ADD/ADHD man is a daily struggle, full of large and small frustrations that only add to an already stressful life. (But if you are reading this book, you already know this.)
So what do we know about ADD/ADHD in adults?
Let’s start with what ADD/ADHD is not. ADD/ADHD is not the result of bad parenting, childhood trauma, or any environmental factors. Instead it is a disorder in brain function. Genetics also play a large role in the development of ADD/ADHD. Eight out of ten people diagnosed with ADD/ADHD have at least one parent with the disorder. This is also important information if you are wondering if your child has ADD/ADHD. Chances are one of them might.
More specifically, ADD/ADHD stems from miscommunication between different parts of the brain. This disconnect seems to be exacerbated by an imbalance in neurotransmitters, the chemical messengers that relay signals within the brain. This is particularly evident in the frontal cortex, which controls planning, impulse control and other “executive functions.”
In young children, particularly boys, ADD/ADHD can manifest as constant motion. That’s the reason for the “H” in ADHD: it stands for “hyperactive.” The constant need for movement does not just mean that the motor never stops running. It makes many vital tasks—such as sitting still and learning in school (or, later in life, listening to one’s spouse)—much more difficult. Before anything seems to start, the train has already left the station.
Psychologists and parents also face the challenge of trying to determine the difference between ADD/ADHD symptoms and normal “kid stuff.” With boys, ADD/ADHD often goes undiagnosed for years, because parents assume the symptoms are just “boys will be boys,” a passing phase, or due to growth spurts. By the time it becomes clear that the problems are more pronounced, many years have already passed.
With adult men, the symptoms of ADD/ADHD manifest themselves in a different manner. The hyperactivity common to pediatric ADD/ADHD now appear as impulsivity, procrastination and organizational deficits. Certain struggles, like the ability to set priorities or focus on the task at hand, start to interfere with normal functioning in much more detrimental ways. Managing time and money also pose huge challenges for ADD/ADHD men—and their wives, who must swoop in to pick up the pieces. Nevertheless, pinning such life-skill challenges on ADD/ADHD is not always so easy. How does a wife know when she’s dealing with a full-blown case of ADD/ADHD?
Dr. Ivan K. Goldberg is a psychiatrist in New York City who co-developed a commonly used test to screen for ADD/ADHD. Assigning a diagnosis, he pointed out, depends on the “amount and intensity” of the dysfunction. As we have pointed out, Dr. Goldberg regards ADD/ADHD as “disturbance of the executive functions of the brain. It’s the inability to plan things, to initiate them at the appropriate time, not to skip any of the steps, and to terminate them at the appropriate time. An awful lot of these people are very bright, but they can’t keep it together, they keep screwing things up.”
Rob C., 38, works for a social service agency in New York City. As someone with ADD/ADHD, Rob identifies with Dr. Goldberg’s worlds. “There’s a huge incidence of depression, because you are continually failing in the eyes of others, not reaching your potential,” he said. “People recognize you are smart, and you can’t find your niche.” The sense of failure may kick in at a particular point in an ADD/ADHD man’s career, or it may follow them through a series of life transitions, adding a not-so-silent commentary to the soundtrack of their lives. Many times, men with ADD/ADHD have developed coping mechanisms that help them advance fairly far. They may find a good job, or get into law school, or get married — only to hit a wall when their coping mechanisms break down.
Dr. Peter Jaksa, who suffers from ADD/ADHD himself, works as a clinical psychologist in Chicago. He vividly remembers when his ADD/ADHD began to get the better of him, long after graduate school when he was already in practice, working with underachieving kids. “Once you know what it is, things make sense that didn’t make sense previously,” he said. As an example, he vividly recalled his pattern of writing every college paper the night before it was due, with a six-pack of Mountain Dew and a box of Red Bull at his side.
Ultimately, even when men with ADD/ADHD enjoy professional success—and many do not—it comes with a cost. Living life constantly behind the eight-ball takes a toll in terms of wasted time, choppy family life, and frayed nerves for everyone involved.
“If your husband has ADD/ADHD, his level of distraction and disorganization interferes with the basics of his life, causing a major impairment,” Dr. Jaksa said. “Impairment is the magic word. Everyone gets distracted. Who’s not late occasionally? But if you are chronically late, you lose your job and maybe your friends as well.”
John K., a writer currently living Miami, at first tried to confine his messy habits to his bedroom, figuring that he could laugh it off as one of the perks of being single. It was not long before the mess spread throughout his entire house. Bills went unpaid. Projects lay unfinished. Deadlines came and went. At one point, he found himself involved in a string of minor car accidents that he could never explain. At age 35, he could no longer pass off these occurrences as a case of extended adolescence. Certainly, the women in his life no longer felt like giving him a pass. Instead, he felt as if his life was spiraling out of control.
“It wasn’t that I didn’t want to get my life in order,” he said. “I just wasn’t capable of doing it. There’s a big difference between not doing something because you don’t want to and not doing something because, for some reason, you simply can’t.”
It’s not always just ADD/ADHD that affects relationships, but the concurrent disorders often associated with it. In his book, Driven to Distraction, Dr. Edward Hallowell calls attention to a number of disorders that may accompany ADD/ADHD. These include depression, anxiety, agitation or mania, substance abuse, Conduct Disorder, Oppositional Disorder, Borderline Personality features, Obsessive-Compulsive Disorder, and/or learning disorders.
ADD/ADHD has even been linked to criminal behavior. A study of prisoners in Norrtälje Prison in Sweden estimated that four out of ten of the inmates there had ADD/ADHD, with only 6.6 percent receiving an early childhood diagnosis of the disorder. All subjects reported substance abuse, and mood and anxiety disorders were present in half of the subjects.
In 2009, researchers at the Adult Attention Deficit Disorder Center of Maryland at Johns Hopkins University looked at studies done between 1998 and 2008 on the prevalence, persistence, and consequences of ADD/AHDH in adults. They also looked at the relationship between adult ADD/ADHD and mood disorders. Results showed that most children with ADD/ADHD had symptoms that persisted into adulthood. When left untreated, these behaviors adversely affect school and work achievements, diminish self-esteem, damage interpersonal relationships, and significantly reduce quality of life for adults.
Before we move on to a more detailed exploration of the various ways in which ADD/ADHD can affect your relationship and what you can do about it, let’s take a moment to review the top ten ways in which ADD/ADHD manifests itself in adult men. The following list of problems is described in more detail at WebMD.com. If you see five or more of these symptoms leading to impaired functioning, you may want to encourage your husband to obtain a full diagnosis from a competent professional.
- Difficulty Getting Organized
- Reckless Driving and/or Traffic Accidents
- Marital Trouble
- Extremely Distractible
- Poor Listening Skills
- Restlessness, Trouble Relaxing
- Inability to Start Tasks
- Chronic Lateness
- Frequent Angry Outbursts