Hi everyone, I have never posted about this problem online before, and in fact I generally avoid such online forums because it always seems like a lot of "misery loves company" without many sincere solutions on offer. That being said, obviously for me to be here I have reached a certain level of hopelessness and am hoping to hear from others who have genuinely improved their relationships, and find out what worked in those cases.
Here's our particular situation: my husband has variously been diagnosed with ADD, depression, and borderline personality disorder. He tried Ritalin for a bit as a kid, a short stint with Strattera as an adult, and is presently only on Lexapro, which he has used for a few years now. Hard to say if the Ritalin worked or not (or would work now, more importantly), but he does have a heart condition in the form of a mitral valve prolapse that makes me nervous for him to go on the typical stimulant drugs. The Strattera seemed to do nothing and was pricey, so he stopped that. The Lexapro seemed to make a mood difference at first, but as time went on he reports that it doesn't seem to help anymore (though the side effects persist).
For my own observations, the short and dirty version is he is basically a 13 year old child in a man's body.
To start with, my husband does the usual ADD stuff, i.e. runs late often, forgets to complete chores, gets agitated quickly if we are working on a chore together that lasts more than 40 seconds, lets clutter build up repeatedly, etc. When forgetfulness is not an option he often writes off chores by arguing that they don't "need" to get done. He cannot pay attention during most conversations, and plays on his phone instead. Sitting at the dinner table with family for a conversation is like torture to him - like a kid, he wants to down his meal as quickly as possible and go back to playing games.
Speaking of games, I feel he has an unhealthy obsession with video games (some people take issue with the term "video game addict"). He spends pretty much every waking moment playing games, texting other people about games, visiting internet forums in order to refine his gaming strategies, and plotting out his next purchases. He even brings his Nintendo DS to work on days he thinks he can get away with it. These days he is awful at conversation, usually giving only brief one-word responses, but if the topic is about video games he will talk your ear off. And I say this as someone who happens to like video games. Video games are one of the common interests that actually brought us together. There are even a few we play together to this day. But for him it is unhealthy, and in a rare moment of clarity he admitted he had a problem with them and tried to moderate himself, but that was long ago and now he maintains that they are just his "hobby." Sadly I feel like he gets all his feelings of engagement, success, and camaraderie from games, so gaming has become his substitute for life.
Money has historically been a huge issue for him, and he has wasted literally thousands of dollars heedlessly in the past and gone into debt. This was a known issue before our marriage, so we agreed - without conflict - that I would handle the finances and he would basically get an allowance. This arrangement has mostly worked, except sometimes it only exacerbates the mother/child dynamic of our relationship when he asks to buy more video games, ostensibly oblivious to our financial situation even though I keep him involved with that information. Sometimes when it comes to spending he has a "good boy" mentality, like our finances are based on how well-behaved he was (again, childlike). Whether the money is there or not, he feels like he should be able to make ludicrous purchases based on merit alone, even though we have come up with a budget so he should not have to "ask" if it is okay to buy a specific game or not - he need merely consult the budget (we even made a spreadsheet showing how much money he has left annually for games!). That being said, I would not characterize this as a primary source of stress in our relationship since for the most part, it works.
If my husband were merely an immature and disorganized, but good-natured, buffoon, I would not think our relationship so troubled. However, he also has mood problems as well. He gets irritable very easily and has a tendency to use me as his "stress ball." Somehow things that have nothing to do with me become my fault, or even if he doesn't accuse me as such, he still acts out towards me because I am a convenient outlet for his aggravation. For example, if I am the only one in the room when he fails in one of his video games, I'd better take cover!
When life throws its usual curveballs (getting lost while driving on vacation, backed up plumbing in the house, dog needing to be walked in sub-zero temperatures, etc.) instead of rising to the occasion he crumples into an angry ball of helplessness and rage, blaming me for the problem and/or requiring me to fix it.
He also has very immature arguing and conversation habits, and has a tendency towards trying to defend himself by bringing me down in the most irrelevant of ways. The epitome of this was, one time, he defended his laziness with the only character assassination he could come up with at the moment: "You WISH you could be as lazy as I am," he says to me, as though his presumption that I too desire laziness justifies his own poor behavior.
Without continuing to run down the gamut of problems here, I need to conclude by saying that my husband is aware of his issues (barring the video games at this point), knows that he needs help, and for years he has tried to get it. He attended anger management for a bit (though I would categorize him as more "petulant" than angry), and individually saw two-three different psychologists over the course of years. Things did not seem to get any better, which is probably why the latter psychologist gifted him the label of "borderline personality disorder" (codename for "helpless cause"?).
Part of the problem (as ever) is money. As we are not rich we cannot afford quality mental healthcare. My husband has received counseling from the local college as well as the local community health center. However, I feel like he really needs a specialist, not just whatever counseling is affordably available. About a year ago I suggested we try marriage counseling since I didn't know what else to try at this point. However, I feel like that was no good either, because all of the things the counselor suggested might work for "normal" people, but were not customized to our unique situation. Plus I feel like in traditional marriage counseling there is reluctance to diagnose and treat only one of the partners lest they feel ganged up on, but in our case my husband does need the special attention, which he freely admits.
So for my real question: what can we try now? What will work given our special circumstances? Money is definitely a barrier, and whatever kind of therapy we next pursue must be the wisest choice. I considered DBT marital counseling if we can find a DBT specialist that provides such counseling, but in the end I am thinking maybe he just needs a highly specialized counselor to see individually. We cannot afford three kinds of therapy (i.e. individual therapy for each of us AND marriage counseling), so we have to pick one. Have any of you had success in this kind of relationship, and if so what worked? Where is our money best invested? The goal here is a "real," peaceable, and equitable relationship. I am not trying to ascertain how to be a better "caretaker" for an ADD partner - we are both striving to do our best and be our best for each other in this relationship.
And before anyone gives us any money-saving tips: we don't smoke, we don't drink (not even coffee), don't have cable TV or a landline telephone, and don't go out much where $$$ is needed. We are willing to make some financial tradeoffs to get the help we need but realistically it comes down to our income being too small to try all kinds of different therapies. Which one type of therapy is likely to do the most good for us?
I think the best value for
Submitted by PoisonIvy on
I think the best value for you would be one therapist for your husband, who, I believe, must consent to you contacting the therapist directly to relay your concerns and observations.
Hi Rosered, thanking you for
Submitted by Light on
Hi Rosered, thank you for reading my post and for your reply. I am sure my husband would have no problem with me communicating with his therapist. Now the question is what is the "best" kind of therapist he should see?
Unfortunately, my experience
Submitted by HurtButHopeful on
Unfortunately, my experience with therapy is that it sometimes takes a while to find a good fit. That being said, I think it might be a good idea for you to try to find someone who has a lot of experience with ADULT ADHD. Not many do and like you said, if not, then you get strategies and techniques that would work for more traditional couples/individuals, but do no good whatsoever in addressing his specific needs.
I know money is an issue when it comes to therapy. It isn't cheap. Many places offer sliding scales based on income and also now with the Affordable Care Act, a lot more mental health things are covered now that weren't before, so that may be something to look into if you have insurance.
I don't know what kind of
Submitted by PoisonIvy on
I don't know what kind of therapist to suggest. Here is the description of the therapist my husband saw for a while: Dr. X "assists individuals with dysfunctional and disturbing emotional and behavioral patterns. He uses cognitive/behavioral and family systems orientations to develop strategies to overcome the negative consequences of genetic, neurological, and environmental influences that contribute to their difficulties. Dr. X works with a wide population including children, adolescents, and families, as well as individual adults. His therapeutic approaches are successful with many disorders including ADHD, Oppositional Defiant Disorder, anger management, eating disorders, and other impulsive behaviors. In addition, his use of cognitive/behavioral techniques is effective in treating depression and anxiety."
When I read this, I had hope. But it didn't help my husband, who went every few weeks, talked about his feelings, and didn't work on behavioral changes.
DBT
Submitted by Light on
Hi, thanks again for your reply. This is one of the reasons I was considering a DBT specialist specifically, since DBT seems more goal-oriented and tailored toward overcoming these kinds of disorders. But I know what you mean about not working on behavioral changes. During the few sessions I sat in on, the therapist and my husband mostly just discussed trivial things like movies they saw that weekend. Probably at this point the therapist was just collecting on her bill with nothing productive to try.
Hi there, your post was very
Submitted by smilingagain on
Hi there,
your post was very well-written, measured and insightful. I understand the issues you are talking about well. I have adult adhd and was diagnosed later (age 33). I had a borderline personality label thrust on me at one point... And I was so offended (you mean I'm just a bitch??), but the hallmark symptom of borderline personality disorder is a fear of abandonment and I don't have that... Sorry- I digress...
anyway- I have been on methylphenidate (both concerta and Ritalin) for the past few years, aside from during my pregnancy and while i was nursing and it has changed my life! So I would research the medication aspect and heart condition thing a little more so see if there is chance that he could take a stimulant.
As for the therapy. I agree it is most important for him to do individual therapy. If his symptoms are not managed, there is no point doing couples therapy. I personally have had a lot of success with cbt (not familiar with dbt). I LOVE it and want to share it like a Jehovah's Witness wants to share Jesus. :) moreover- my husband was also recently diagnosed with adhd (inattentive) and he has just started with the cbt a few months ago and I have noticed BIG improvements...
Best of luck to you and your husband. You sound like a very caring, pragmatic person and he is lucky to have you in his corner. Hang in there and hopefully you will find the right treatment for him.
Thanks so much!
Submitted by Light on
Hello there, and thank you so much for your reply! :) This is exactly the kind of shared experience I was looking for. I am happy to hear that CBT worked out so well for you, and perhaps it is another option we can explore. Also, you are one of the many folks I have seen lauding the effectiveness of the stimulant medications, so that has got me thinking that perhaps they're worth re-discussing with a professional. After all, it was not as though the doctor forbade them, but only my own concerns that led us to try other options first.
Thank you again for sharing your experience and also for the very kind words. Your positive experience helps me feel more optimistic that we can find the right treatment approach.
You are totally welcome.
Submitted by smilingagain on
You are totally welcome. Please let us know how it works out! :)
Another view
Submitted by sunlight on
Since we're dealing with neurochemistry when we're dealing with ADHD, and with the manifestations you're describing, it's my (very lowly) opinion that you won't get far until his meds are addressed and he finds one or a combination that he will consistently take. For that it will be best if you can find a psychiatrist who specializes in Adult ADHD (and specifically one who is not only primarily familiar with children with it) and start there. A psychiatrist should be able to, from his medical history, be able to lay out alternatives, which may or may not include stimulants as well as (if needed) meds to help his apparent mood disorder (impulsive anger outbursts which may not be under his conscious control). It's my personal opinion, which is worth what you're paying for it :), that these meds are best prescribed and monitored by a psychiatrist rather than a family doctor or similar, since psychiatrists have the best understanding of side-effects and interactions with other psych meds, and some of these drugs are powerful magic.
I really think that other types of therapy should ideally come after getting the meds sorted out. Put it this way, I think you are in for tough going if trying other therapy without addressing the physical neural processing which is at the root of the issues.
For context, I am the non-ADHD female, husband was diagnosed in his 50s, he takes Adderall and gabapentin and those have made a huge difference (really changed his life for the better in so many ways that he regrets not starting decades ago).
Medication
Submitted by Jclams on
One experience, one experience that made a remarkable difference in my life.
First and foremost, make a commitment to find the medication that will work.
Work through a therapist that works with a medical doctor for RX and you will save hundreds, but make sure the therapist is a good match and is experienced with adult adhd. Your primary care doctor should also be in the loop and take over as the doctor managing the medication.
My brain chemistry is mine, so here is mine. I started with Adderall 10 MG in am, 5mg in PM.That was 10 years ago. My life turned around. I was kicking and screaming coming in an, the DX took probably 10 mins for the therapist, but 3 months before I was ready to hear it.
Your husband is way ahead of the curve.
Last year I started up therapy again to handle new issues, and through the process I felt it would be interesting to try a higher dose. After working with the therapist and medical psychiatrist, I settled on 30 mg time release. There is no magic number here. Pure trial and error. And the cost of time release is staggering. I justify the cost to my productivlty at work and my ability to handle stressful situations without agitation, anger, frustration, disappointment, and short fusing. The same result can be achieved with little 5 mg doses during the day, except I will not remember them.
Get moving is essential to a well balanced adhd life. I am in front of computers eight hours a day, so I can relate to video game playing as far as how unhealthy the activity is. That said there is balance, and it is achievable with proper neurochemistry tuning, attention, healthy diet and exercise. It is much simpler than we initially think to make changes.
Thank you sunlight and Jclams
Submitted by Light on
Thank you sunlight and Jclams for your replies and your insight. This thread has definitely got me thinking we need to sort out the prescription side of things before moving on to the "heavy lifting" of therapy. I will discuss these new insights with my husband. We are both sort of disillusioned with the Rx side of things due to past medications that were less than impressive, but are also at a point where a) insurance might be more helpful than before, thereby making more options available to us, and b) would rather spend more money on something that works well than a little less money on something that doesn't.