Adult ADHD, Emotions & Relationships

Joined
Feb 19, 2019
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Relationships where one or both partners have ADHD can be troubled by misunderstandings, frustrations, unexpected breakups and resentments. Many adults who have attention deficit disorder (ADHD or ADD) also struggle with anxiety, depression, obsessive compulsive disorder, self regulation of emotions & even borderline personality disorder.

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Sometimes these co-morbid conditions arise independently of ADHD. In women with ADHD, sadness, anxiousness, emotional instability, feelings of worthlessness, insecurity, depressive feelings as well as ADHD symptoms tend to increase during the pre-menstrual phase. Symptoms also tend to flare up in the years leading up to and during menopause.

While the distractability, disorganization, and impulsivity of attention deficit hyperactivity disorder (ADHD or ADD) can cause problems in many areas of adult life, these symptoms can be particularly damaging when it comes to your closest relationships.

If you’re the person with ADHD, you may feel like you’re constantly being criticized, nagged, and micromanaged. No matter what you do, nothing seems to please your spouse or partner. You don’t feel respected as an adult, so you find yourself avoiding your partner or saying whatever you have to in order to get them off your back. You wish your significant other could relax even a little bit and stop trying to control every aspect of your life. You wonder what happened to the person you fell in love with.

If you’re in a relationship with someone who has ADHD, you may feel lonely, ignored, and unappreciated. You’re tired of taking care of everything on your own and being the only responsible party in the relationship. You don’t feel like you can rely on your partner. They never seem to follow through on promises, and you’re forced to constantly issue reminders and demands or else just do things yourself. Sometimes it feels as if your significant other just doesn’t care.

It’s easy to see how the feelings on both sides can contribute to a destructive cycle in the relationship. The non-ADHD partner complains, nags, and becomes increasingly resentful while the ADHD partner, feeling judged and misunderstood, gets defensive and pulls away. In the end, nobody is happy. But it doesn’t have to be this way. You can find new ways to face the challenges of ADHD and improve how you communicate, adding greater understanding to your relationship and bringing you closer together.

Understanding the role of ADHD in adult relationships

Transforming your relationship starts with understanding the role that ADHD plays. Once you are able to identify how the symptoms are ADHD are influencing your interactions as a couple, you can learn better ways of responding. For the partner with ADHD, this means learning how to manage your symptoms. For the non-ADHD partner, this means learning how to react to frustrations in ways that encourage and motivate your partner.

Trouble paying attention. If you have ADHD, you may zone out during conversations, which can make your partner feel ignored and devalued. You may also miss important details or mindlessly agree to something you don’t remember later, which can be frustrating to your loved one.

Forgetfulness. Even when someone with ADHD is paying attention, they may later forget what was promised or discussed. When it’s your spouse’s birthday or the formula you said you’d pick up, your partner may start to feel like you don’t care or that you’re unreliable.

Poor organizational skills. This can lead to difficulty finishing tasks as well as general household chaos. Partners may feel like they’re always cleaning up after the person with ADHD and shouldering a disproportionate amount of the family duties.

Impulsivity. If you have ADHD, you may blurt things out without thinking, which can cause hurt feelings. This impulsivity can also lead to irresponsible and even reckless behavior (for example, making a big purchase that isn’t in the budget, leading to fights over finances).

Emotional outbursts. Many people with ADHD have trouble moderating their emotions. You may lose your temper easily and have trouble discussing issues calmly. Your partner may feel like they have to walk on eggshells to avoid blowups.


How the partner with ADHD often feels:

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Different. The brain is often racing, and people with ADHD experience the world in a way that others don’t easily understand or relate to.

Overwhelmed, secretly or overtly, by the constant stress caused by ADHD symptoms. Keeping daily life under control takes much more work than others realize. Even if it’s not always apparent, ADHD can make someone feel like they’re struggling to keep their head above water.

Subordinate to their spouses. Their partners spend a good deal of time correcting them or running the show. The corrections make them feel incompetent, and often contribute to a parent-child dynamic. Men can describe these interactions as making them feel emasculated.

Shamed. They often hide a large amount of shame, sometimes compensating with bluster or retreat.

Unloved and unwanted. Constant reminders from spouses, bosses, and others that they should “change,” reinforce that they are unloved as they are.

Afraid to fail again. As their relationships worsen, the potential of punishment for failure increases. But their inconsistencies resulting from ADHD mean that this partner will fail at some point. Anticipating failure results in reluctance to try.

Longing to be accepted. One of the strongest emotional desires of those with ADHD is to be loved as they are, in spite of imperfections.


How the non-ADHD partner often feels:

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Unwanted or unloved. The lack of attention is interpreted as lack of interest rather than distraction. One of the most common dreams is to be “cherished,” and to receive the attention from one’s spouse that this implies.

Angry and emotionally blocked. Anger and resentment permeate many interactions with the ADHD spouse. Sometimes this anger is expressed as disconnection. In an effort to control angry interactions, some non-ADHD spouses try to block their feelings by bottling them up inside.

Incredibly stressed out. Non-ADHD spouses often carry the vast proportion of the family responsibilities and can never let their guard down. Life could fall apart at any time because of the ADHD spouse’s inconsistency.

Ignored and offended. To a non-ADHD spouse, it doesn’t make sense that the ADHD spouse doesn’t act on the non-ADHD partner’s experience and advice more often when it’s “clear” what needs to be done.

Exhausted and depleted. The non-ADHD spouse carries too many responsibilities and no amount of effort seems to fix the relationship.

Frustrated. A non-ADHD spouse might feel as if the same issues keep coming back over and over again (a sort of boomerang effect).
 
Joined
Feb 19, 2019
Messages
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The potential consequences of untreated ADHD have been shown in many recent studies, some examining the long-term outcome of childhood ADHD and others exclusively examining adult ADHD. They include:

(1) impaired quality of life
(2) impaired relationships
(3) reduced employment
(4) vulnerability to addiction
(5) vulnerability to depression and anxiety
(6) impaired driving safety
(7) premature death from accidents
(8) suicide and suicidal ideation
(9) bipolar and social withdrawal


I advocate for combined pharmacotherapy and psycho-social treatment as no one treatment is any more moral than another. Improving cognition pharmacologically enhances the engagement with psycho-social interventions in both ADHD and comorbid disorders.

Stimulants are first-line pharmacologic agents for adult ADHD with a long history and moderate to large effect. Like all treatments, side-effects occur (reduced appetite and initial insomnia during initiation especially), but tolerability and overall safety are good, especially when compared to most psychiatric medicines. Underlying cardiac vulnerability and a small increase in blood pressure (around 2 mm Hg once stable) need to be considered.

Long-acting formulations allow once daily simple treatment regimens so in the real world they are more effective than short-acting preparations and less prone to abuse/diversion & addication. Their pharmacokinetic profiles reduce profound onset and offset effects that can either disturb patients or occasionally foster misuse. They lack flexibility, but reliable, stable patients can augment these by ‘topping up’ their dose with a small amount of short-acting formulation if they are required to do evening driving, study or work.

Conclusion:

Adult ADHD is a chronic, costly and debilitating disorder which ruins lives when untreated & un-diagnosed where it is over looked and misunderstood. Despite the known efficacy of treatment and the substantial costs of untreated attention-deficit/hyperactivity disorder (access to healthcare and treatment is not a given for many patients in South Africa.

In terms of treatment, stimulants are by far the best studied and most effective treatment for Adult ADHD with an average response rate of 70%.

Methylphenidate (Neucon®, Ritalin® IR & LA, Concerta®, HCL Douglas-methylphenidate®)

Lisdexamphetamine (Vyvanse®)

Atomoxetine (Strattera®) For adults who do not respond to stimulants or have a history of drug abuse.

Clonidine (Dixarit®) has demonstrated efficacy in childhood ADHD, especially for cases marked by severe hyperactivity and aggression. However, there is an absence of literature on efficacy and tolerability in adults with ADHD.

Tricyclic antidepressants such as (Ethipramine®, Tofranil®)

Modafanil (Provigil®)

Selective serotonergic and noradrenergic reuptake inhibitors: Venlafaxine (e.g. Effexor®, Venlor®) appears to be mildly efficacious in moderating adult ADHD symptoms.

Noradrenergic dopaminergic reuptake inhibitors Bupropion hydrochloride (Wellbutrin®)

Monoamine oxidase inhibitors such as pargyline, deprenyl and selegiline in the treatment of adult ADHD, but their potential to cause hypertensive crisis and the dietary restrictions pertaining to tyramine-containing foods, seriously limit their use.

As a 26 year old male that has tried many different on label and off label prescription medication, and participating in clinical trails of newly available ADHD medications i found that Methylphenidate Neucon® 54mg extended release tablets once daily with a combination of Bio-Atenolol® 50 mg daily turned my life around.

Bio-Atenolol belongs to a class of medications called beta-blockers. It is used to lower high blood pressure and to prevent the symptoms of angina (chest pain). It works by reducing the demands put on the heart.

The reason i was prescribed Bio-Atenolol in addition to Neucon 54mg is as follows:
(1) My heart would beat really fast and i would religiously place my hand on my chest to feel if my heart beat was irregular.
(2) I have always had sweaty hands but using Neucon 54mg would literately make the sweat drip off my hands and having to shake someones hand was embarrassing as i would always have to wipe my hands before as if they were filthy.
(3) Using Neucon 54mg increased my blood pressure.
(4) Neucon 54mg gave me a sensational response of fight or flight, almost like your body floods with adrenaline when something bad is about to happen. Bio-Atenolol has a slight sedation effect which took that away.



References:
American Psychiatric Association. Diagnostic and statistical manual of mental disorder 4th edition text revision (DSM-IV-TR) Washington, DC: American Psychiatric Association.
Arnsten AF. Stimulants: Therapeutic actions in ADHD. Neuropsychopharmacology.
Arnsten AF, Dudley AG. Methylphenidate improves prefrontal cortical cognitive function through alpha2 adrenoceptor and dopamine D1 receptor actions.
Weiss M, Hechtman Trokenberg L, Weiss G. ADHD in adulthood: a guide to current theory, diagnosis, and treatment. Baltimore: John Hopkins University.
Wilens TE, Haight BR, Horrigan JP, et al. Bupropion XL in adults with attention-deficit/hyperactivity disorder: A randomized, placebo-controlled study.
Weiss M, Shingler T, Capone NM. Medication satisfaction among adults with ADHD: long term results from the Quality of Life, Effectiveness, Safety, and Tolerability (Qu .S.T.)
 
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ArtyLoop

Executive Member
Joined
Dec 18, 2017
Messages
6,843
The mistake you are making here dear OP, is posting this stuff to MyBroadband. I presume you are a sufferer of ADHD?
 
Joined
Feb 19, 2019
Messages
9
Where are you getting this from?
American Psychiatric Association. Diagnostic and statistical manual of mental disorder 4th edition text revision (DSM-IV-TR) Washington, DC: American Psychiatric Association.

Arnsten AF. Stimulants: Therapeutic actions in ADHD. Neuropsychopharmacology.

Arnsten AF, Dudley AG. Methylphenidate improves prefrontal cortical cognitive function through alpha2 adrenoceptor and dopamine D1 receptor actions.

Weiss M, Hechtman Trokenberg L, Weiss G. ADHD in adulthood: a guide to current theory, diagnosis, and treatment. Baltimore: John Hopkins University.

Wilens TE, Haight BR, Horrigan JP, et al. Bupropion XL in adults with attention-deficit/hyperactivity disorder: A randomized, placebo-controlled study.

Weiss M, Shingler T, Capone NM. Medication satisfaction among adults with ADHD: long term results from the Quality of Life, Effectiveness, Safety, and Tolerability (Qu .S.T.)

Safren SA. Cognitive-behavioral approaches to ADHD treatment in adulthood. J Clin Psychiatry.

And of course my own experience of taking medication and receiving treatment for ADHD over 11 years.
 

RedViking

Nord of the South
Joined
Feb 23, 2012
Messages
21,325
Why not just post links instead of copy paste an entire website. You look like spammer. Would you rather read your personal opinion than a copy pasted website. That's why there are things like links.
 

RedViking

Nord of the South
Joined
Feb 23, 2012
Messages
21,325
This not like the motoring section where stuff get copy and pasted. Please don't turn it into one. Post personal views and opinions for debate. :D
 
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