When the Patient Says No And The Partner Says Yes

It’s quite common for a patient to deny symptoms, only to have the partner come to the next visit, tell a different story, with examples, and the patient then looks a bit sheepish and agrees that yes, the partner is right.

What if on hearing the partner’s concerns the patient says it isn’t true, or there are reasons, special circumstances, or it doesn’t reflect the norm for them?

Several things can be done to clarify the situation.

  1. is the partner the only person who sees these symptoms, not friends or bosses or employees, co workers or other family members? We’ve had five year olds give helpful feedback on a parent’s behaviour. There are questionnaires that can be completed by parents and family members.
  2. the patient needs to do a bit of reading up on ADHD – the classic book being “Taking Charge Of Adult ADHD” by Russell Barkley.
  3. A FULL psychoeducation assessment is very expensive but a consult with a psychologist skilled in all things ADHD could be well worth while.
  4. the partner should read the book “Is It You, Me Or Adult ADHD” by Cera. This book is aimed at couples who are debating whether to do something about ADHD. There are strategies for the partner to encourage the patient getting help, there are lots of examples of real families struggling with ADHD that can help you determine whether you are being too critical – these people are a lot worse than your partner; or on the other hand, the book is absolutely describing your marriage.
  5. Simply reflecting on what you have been told and setting yourself a deadline to do better with the behaviours your partner finds most frustrating is reasonable. Not only if you fail to improve, simply over time you can come to recognize the truth of what your partner is saying, despite absolutely rejecting the idea initially. Interestingly, I’ve had this experience when learning something new in medicine – it’s so radically different from what I believe and have been taught that I reject it out of hand, only to come round through further experiences – seeing examples of what was being taught, of finding the concept helpful in managing patients. Perhaps the same will happen to you.
  6. consider another opinion. Perhaps you feel I’ve bought in to your partners viewpoint too much, or maybe you just didn’t find me a good fit for you. Unfortunately there are only a few of us working with Adult ADHD in the city who do this on a daily basis.
  7. If you partner reports enough symptoms to make a diagnosis of ADHD, and you think they are from something else, there could be a valid argument for a trial of medication. While a modest response could be coincidence, a dramatic turnaround in symptoms could be enlightening. Remember that in the end we are treating you the patient, not your partner. Medication has to work for you. Mind you, having your partner pissed off with you all the time isn’t pleasant and not a great environment for your kids, and sometimes we just aren’t very good at seeing ADHD symptoms in ourselves.

SO how often does it turn out the partner is wrong and you really don’t have ADHD? Well, sometimes there’s another diagnosis, from anxiety to depression to marital breakdown, to pathology in the partner. The number of times there is nothing else going on is very seldom.

Look to your childhood, and don’t be fooled by thinking isn’t everyone like this some of the time – its about how often – is the problem daily or occasional. ADHD shows up by age 12 at the latest.

Remember too that many people are great at their jobs and only show symptoms when things aren’t of critical importance to them. Can you remember to take out the recycling in the right night? Can you quickly lay your hands on the things you need when paying bills? Can you remember conversations when they are important to others?