Ned Hallowell likes to talk about the "moral diagnosis" of ADHD - the idea that those with ADHD are lazy or ill-willed.  The 'moral diagnosis' was what people used to turn to when they didn't know as much about ADHD as we do now.  Yet the idea that an ADHD spouse is 'lazy' is amazingly persistent.  How to get at that?  I've often said that in general, people with ADHD are some of the hardest working folks I know - its just that you can't always see the work because much of it is going on inside them.  Their minds are working away, really hard, even as they might come across as "lazy" because they have trouble completing (and sometimes even starting!) tasks.  Now researchers confirm that extra effort going on inside the ADHD person's head.  MRI studies show that the area of the brain that orchestrate mental activity is more active for adults with ADHD than for those without.

This is important to understand for both partners.  The ADHD spouse "knows" they are really struggling to get mentally organized, yet gets consistent feedback from important people (teachers, parents, spouse, friends) that they aren't doing well enough.  This can lead to a sense of helplessness - a sort of "I'm dancing as fast as I can so please don't ask more of me" feeling.  Sometimes that feeling is voiced (and met with 'then why aren't you doing better if you're trying so hard?' from an angry spouse.)  Sometimes that "dancing as fast as I can" feeling is not voiced but, when coupled with continued inconsistency, leads to overwhelm.

The idea that the brain is working really hard already is also one reason why 'trying harder' doesn't work with ADHD, but 'trying differently', that is in ways that work for those with ADHD brains, is better.

It's important for non-ADHD partners to understand the effort that ADHD folks are putting in, as well.  Among other things, it can lead to better empathy.  In the best cases, this understanding helps a non-ADHD partner move into the role of "understanding advocate" and away from "chief critic."  It's also good to remember that the extra effort it takes to organize the ADHD brain needs to be taken into account when you set your expectations, particularly around organizational tasks.  Put into plain English, most folks with ADHD won't do the same things as quickly as their non-ADHD counterparts because it takes some extra steps inside the head.  You don't see them, but they are there.

Of course, 'my brain is already working really hard' isn't a reason for a person with ADHD to not seek to reach difficult goals or make changes.  In other words, it should not become an excuse for inaction.  Rather, it simply supports the "don't try harder, try differently" concept.  The ADHD brain spends lots of energy struggling to get better organized.  Creating external organizational structures helps relieve some of the pressure in this area (if you want to think of it this way).  Medication, exercise and fish oil, all of which can improve focus, also can play a role in using your brain energy more efficiently.  Get these treatments in place and you will spend less "brain time" thinking about how to struggle to stay organized, and more time making use of better focus to enact organizational strategies that turn "thinking" into "action."  And that's where you really do begin to become more consistent and effective.

If you want more information on the research, go to this Wall Street Journal article.