Jim Carrey...driven to distraction
I would drive Bron crazy, always losing things or forgetting what I'm talking about and she would constantly remind me to do things only to see them half done." This is how Dave, 53, describes his 20-year relationship with his partner, Bronwyn, 51, before he was diagnosed with attention deficit hyperactivity disorder (ADHD). Bronwyn puts it differently: "I thought he was a knucklehead."
A genetic condition that affects 3.4 times more males than females, ADHD is characterised by inattention, impulsivity and hyperactivity. While many children grow out of it, for 30 to 50 per cent of sufferers, ADHD follows them into adulthood. This can mean a string of broken relationships, lost jobs, addictions and financial difficulties.
"Those who have been struggling all through childhood and teenage years and don't know they have ADHD will particularly experience frustration and self-esteem issues," says Dr Steve Dawson, a Sydney-based clinical psychologist who specialises in the condition. "Those issues will, in turn, have an impact on their relationships, which is why it's so important to get an early diagnosis."
For Dave it came much later in life. While he was doing his master's degree, a lecturer tactfully suggested that the class do an online ADHD test. Up the back of the room, and never one to keep his thoughts to himself, Dave shot back, "Why would anyone want to know if they had that?" "That night I passed with flying colours," he says.
Eventually, Dave saw a psychologist who asked a series of questions, the first being, "How did you get here?" Dave told him, "I went around all the back streets to avoid the traffic; it drives me insane.""I think from that point we both knew where this was heading."
Frustration is a big part of ADHD. Watching the news, Dave will scream at the TV. His inability to "sit behind people" in traffic has resulted in numerous fines and accidents. Once, a passenger got out of Dave's car and literally kissed the ground.
It's frustrating for Bronwyn, too. "Dave has impulse buys, from door-to-door salespeople, late-night TV, even speakers out of the back of a van at traffic lights."
"I make snap decisions," agrees Dave, "buying things I know are a bad idea, knowing I will be upset with myself and Bron will be upset with me, but I can't stop myself."
This could easily be dismissed as a behavioural problem or a lack of will power, but new research reveals ADHD impairs the processing ability of the six "executive functions" of the brain. These are the areas responsible for activation (organising, prioritising and starting tasks), focus, effort (regulating alertness and processing speed), working memory (the ability to link intention with action), managing frustration and other emotions, and the self-regulation of behaviour.
In relationships, the partner with ADHD sees things in black and white and is often difficult to please, rigid, judgmental, uncompromising, negative or lacking empathy, according to author Gina Pera in her book Is It You, Me or Adult ADD?
Confirms Dawson, "Difficulties with executive functions will frustrate partners, who see the ADHD partner as unreliable and disorganised. The partner may expect that if they talk things through, the ADHD partner will improve, but this doesn't happen easily. The ADHD partner cannot easily change time- and task-management strategies, while poor memory means they might forget important discussions quite quickly. They might also forget other things, like picking up the kids or the shopping."
Another big frustration is the way ADHD affects communication as the sufferer changes topics, interrupts or drifts off. The problem is not that people with ADHD don't think, but that they think too much. "People with ADHD tend to have multiple, competing thoughts that can distract them from the topic at hand," says Dawson.
Dave agrees. "I have trouble staying engaged; my mind is running 10 different things at once. I also have less tolerance for things that are boring to me. My brain is constantly looking for stimulation or activity, and if things slow down, then I have to find something to be stimulated by. Someone could be talking and instead of concentrating on what they're saying I'm lining up the lines in the carpet to keep my mind occupied.
"Bron would say I wasn't listening because I didn't care," he continues. "I would turn that back on her and tell her to 'stop carrying on', but really it was my own inability to stay focused I was trying to cover up."
Add difficulty with managing frustration to this and anger can escalate. "I get worked up and then lose it pretty quickly, which would put Bron on the defensive and we'd fight," says Dave. According to Dawson, people with the more hyperactive type of ADHD will be "more reactive, inclined to respond impulsively or be hurtful without stopping and thinking, and this can be difficult for a partner".
Pera writes that the adrenalin stimulation from fighting can actually make people with ADHD feel calmer and they can unknowingly pick fights as a form of self-medication. This can leave the non-ADHD partner questioning their own sanity. These frustrations, if left unaddressed, can see a partner ready to walk.
Or get help. "Often clients present with relationship issues, or anxiety, or depression, and it's not until after exploring a whole range of contributing factors that ADHD comes out," says Dawson. After a child is diagnosed, for instance, when the parents are questioned a genetic link often becomes apparent.
After addressing the problems the patient has presented with, Dawson does an assessment, partly retrospective, to determine whether his client showed symptoms of ADHD as a child. School records are often telling, particularly teacher comments such as "always distracted", "fidgety" or "can't complete work". After that, results from a series of tests are preferably cross-checked with someone who knows the person well. One option for treatment is to see a GP for a referral to a psychiatrist, while another is a prescription for Ritalin, a stimulant that assists focus and sustained performance.
Receiving the diagnosis was a relief for Dave, who is able to "laugh at some things now", but it also presented a new challenge. "I have a really good understanding of it, but I'm also grieving the loss of being 'normal'. I have to work so hard to do things other people seem to do easily, it's upsetting."
A diagnosis of any kind can commonly cause a grief reaction: shock, denial, anger and depression all come before acceptance.
For Bronwyn, the diagnosis made a lot of sense and she says it was liberating "knowing the reasons why he did what he did. I'm more tolerant and patient now." She also needed support to come to terms with the diagnosis and its effect on Dave.
Says Dawson, "A sense of loss is common - sadness that for all those years it could have been different, especially if earlier treatment had enabled someone to function at a level closer to their potential." Continued support is vital. Dawson helps clients to understand ADHD, then to come to terms with the associated issues, and finally to develop practical strategies to deal with symptoms.
Dave and Bronwyn saw a relationship counsellor who helped them manage conflict. "We found the problem started when all Dave was hearing was 'blah blah blah' and not me," says Bronwyn. "Through counselling we both realised it wasn't because he didn't want to listen, but because he was genuinely struggling with it. This reduced the arguments because we both understood why we were having the problems and how to work with them. Now we can blame the condition instead of each other."
Dave also did his own research and took comfort from finding himself among impressive peers: Justin Timberlake, Richard Branson and Jim Carrey all have ADHD. He also repaired his dented self-esteem by reminding himself of all that he had managed to accomplish despite the condition. His family - the couple have four adult children - tops the list.
Dave now recognises there are advantages to having ADHD, including loyalty, creativity, a great sense of fun and the ability to be empathic once feelings are understood. "It's a different way of being, a different normal," he says. "It's who I am; I have strengths and weaknesses, but I'm still me."
Bronwyn has come to her own place of acceptance, too. When asked if there are any positives to Dave's ADHD she lists "good in a crisis, playful, adventurous and outgoing". Then she pauses. "I don't know if the positive qualities are Dave or the ADHD, but I guess it doesn't matter. There's a lot to love about him."
From Sunday Life
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