ADHD informed couples counseling

ADHD can have a dramatic effect on couple dynamics and it's important to work with a specialty trained couples therapist who also is specialty trained for ADHD.  Many adults may not have been diagnosed at an early age or maybe some still haven't been diagnosed.  Both situations can mean that habitual dynamics have been firmly established that can make it hard to work through built up resentments and can create roles between the partners that aren't satisfying for either.

Although ADHD has specific symptom requirements in the DSM (psychologists' "bible" for diagnosing), the clinical and behavioral ways it shows up, especially in adults, isn't fully captured there. For example, some people with ADHD experience something called rejection sensitive dysphoria which often looks like feeling rejected and hurt by seemingly innocuous things, sometimes even innocent questions.  This can happen because it's common for people with ADHD to have experienced so many comments that they are doing something wrong.  That hurt can sometimes lead to what look like random "blow ups" of anger that are confusing to the partner.

Couples with at least one ADHD partner can frequently fall into a dynamic of parent-child that nobody likes. Both partners have to make some changes to reduce these roles. The ADHD partner will need to develop successful strategies to compensate for the executive function challenges that are a typical part of ADHD. Further they also need to have empathy for how their ADHD impacts their partner. The other partner, assuming they are neurotypical, has to have a good understanding about ADHD and empathy for how challenging it can be for the partner with ADHD.