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So a couple of years ago my spouse, finally, went in for psychological testing. He was diagnosed with ADHD, very low executive functioning, and OCD from these two diagnoses.
The psychologist he has been working with has discussed how cheating could be attributed to these diagnoses. My WH believes this is the case for a variety of reasons and for the sake of discussion let's assume this is true and accurate.

My WH has been focusing on our relationship since DD, discussing his feelings, and is very remorseful, doing the couple's work, etc. My concern however is he has not consistently done the individual work (journaling, attachment theory work, mindfulness practices, etc.). He is also refusing to take ADHD medication, the reason being he is worried about symptoms (his OCD is around health/aging/germs). Mind you he is perfectly okay that a couple of years ago I went on hormone replacement therapy and an antidepressant to try and feel better about my marriage and libido/hot flashes.

If his diagnoses are what caused cheating and he isn't working on himself to resolve this, nor willing to take medication I fear he will cheat again. Also, he is very stressful to live with due to these diagnoses. I've been thinking about reconsidering if I want to reconcile because of all of this. That brings guilt and a whole array of feelings.

Any advice, experience, suggestions, or thoughts are welcome!

He didn't cheat because he has ADHD.

Tell him if he wants to attempt reconciliation, a requirement is that he takes his meds.

Like you said, let's just assume that it's true and accurate that his cheating could be attributed to his diagnoses. The dealbreaker is that he's unwilling to take the necessary steps to help you feel safe in your relationship. He won't take the medication and he isn't doing the cognitive behavioral therapy either. You're already on the fence and leaning out. He knows this and that's still not enough of a spur in his side.

This is how it's going to be, it seems. You get to decide whether it's enough. Also, he could be the perfect R candidate, doing all the right things, and you could still opt for D. Hell, he could have been the perfect spouse who never cheated and you could still feel the need to be alone instead. Please don't feel guilty for leaning out. We get one life. We have to do right by ourselves.

Actually, I believe cheating is associated with ADHD, usually attributed to impulsiveness (one of ADHD's symptoms).

I certainly understand your fear, lessthinking. I would have the same fear. Perhaps more important, I'd have a hard time committing to a partner who would not at least test the results of the various treatments.

ADHD gives your WS some strengths that 'normal' people don't have but also gives your WS some weaknesses. I understand his fear, having gone through it myself. But I also know the benefits of effective treatment. As much as I hate taking my medicine, it's better than not taking it.

The most common treatment - stimulants or meds that mimic stimulants - work differently on true ADHDers. Aderall XR gave me much more control over my brain. It calmed me, lowered my blood pressure. When I took too much stimulant, I went to sleep. When I forgot a dose, I just got ravenously hungry. When I had to stop taking Adderall XR, I experienced no withdrawal, although I slept longer than had been usual for a few days.

Your post says to me that your WS is doing a lot of white knuckling, and I just don't trust that approach. Pressure builds, and it has to be let out. Sometimes the pressure results in trying out something new, but sometimes it's someone new.

*****

A lot of cheating is pretty clearly an attempt to get external validation. I would bet a lot that's true for ADHDers, too. But ADHDers have to deal with feeling something is wrong with them (and wanting the external validation of someone telling them they're OK) and a brain that works better with new things than with maintaining old ones.

My reco is to figure out what you want. Are you unwilling to stay unless your WS tries out using drugs to moderate hos ADHD? That's a perfectly good position to take. Do you get enough out of your WS as he is to risk future infidelity and other chaos? That could be a good choice, too. Or is he out of more chances now? That's OK, too.

The nasty part of this is that you have to decide for yourself. But that's the good part, too - you've got the strength you need to make the choice.

*****

I urge you to put guilt aside in making your choices.

There is - or should be - no shame in being ADHD.

There is - or should be - no shame in knowing that living intimately with an ADHDer - especially an ADHDer who refuses treatment - is not for you.

[This message edited by SI Staff at 9:43 PM, Tuesday, December 5th]

Sasson - SPOT ON about the external validation and the white knuckling is a perfect way to put what I'm worried about. That's not sustainable.

The psychologist he has been working with has discussed how cheating could be attributed to these diagnoses

ADHD-er here. I would shut down any suggestion about how ADHD CAUSED the A. I think it's probably fair to say that ADHD may have created a vulnerability in your husband, but a vulnerability is not a cause. As Sisoon pointed out, ADHD-ers tend to be prone to impulsivity. THat might explain being prone to making a bad choice one night while drinking but it does not explain making a millions different choices and telling a million lies that are part and parcel of having an A. One of the trademarks of ADHD is low levels of dopamine in the brain, which makes people chemically wired to seek out more. THis is the validation/attention/thrill seeking you are referencing. An ADHDer may therefore be more attracted to the rush of chemicals that affairs provide, just like they are more likely to the effects of drugs (ADHDers have highs incidence of substance abuse as compared to the general population). Obviously however, we can agree that ADHD doesn't CAUSE drug addiction though, just like it doesn't cause cheating.

As someone who has taken medication, I can confirm that one of the side effects of stimulants (especially on higher doses) can be exacerbation of OCD type symptoms, so his concern in this regard may be totally valid. I don't think it's at all reasonable to rule out treatment however without ever trying it. I know Concerta is a drug that is often considered when someone has comorbid OCD and ADHD. There is often a role for SSRIs too. Not all treatment programs are one sized fits all. While I can appreciate he has concerns, I think his refusal to address it at all is was is concerning. Now is a time for big drastic lifestyle changes.

I do not think you are unreasonable for requiring your spouse to be seeking treatment in some shape or form. If he tries it and the side effects are intolerable or his OCD symptoms worsen, I think it's fair for him to try alternatives. My guess is that the specific treatment he's undertaking matters less right now than the effort he's putting into it. Is that fair? I absolutely agree that a lack of effort is a bad sign right now.

[This message edited by emergent8 at 5:13 PM, Wednesday, December 6th]

I've long suspected my WH has undiagnosed ADD, not sure about the hyperactive part in his case but who knows. While I wouldn't blame the affair on it, I do consider it one of the factors that led to the deterioration of our marriage and left us vulnerable to the affair. His executive functioning was not the best and I became less and less tolerant/patient to the point I was annoyed all the time and he felt completely worthless in the partnership, and yeah, definitely seeking validation elsewhere. We are still very early on the process but for me, I will need to see him do the work on himself to address these things in order to know that reconcilation is going to work. If he's not able to be an active participant in our lives then that will be a problem.

I should also mention he did 2025 sessions of neurofeedback with some positive results. However, the 3rd cheating incident happened a few months after the neurofeedback had been completed. It was secretive flirting and sexual innuendos.

Thanks for all the support and feedback. I agree not the cause for sure but spot on with the vulnerability. I too have become increasingly frustrated with the low executive function and ADHD. 33 years together, it can be exhausting holding it all together but then finding out about the infidelities just makes it so much more unbearable. :(

Person with a lifetime of ADHD experience and knowledge of it from 1st grade on. I also have dysgraphia and dyslexia.
I was fortunate in 1976 to have a bee teacher fresh out of school identify my issues and recommend treatment and a pediatrician that also recommended a great team to treat me. The goal was meds long enough to learn coping skills to be able to function normally without meds. School was always an incredible challenge. However I am a doer and by any measure a successful professional and adult. Never once did I ever consider cheating. That is not an acceptable behavior. Period.

I believe your spouse is using his diagnoses to excuse his behavior. Second his unwillingness to try adjunct therapies that include meds with therapies shows he is not willing to "do whatever it takes" to heal and make it better and as a grown man hr has that option. But by no means should you feel obligated to stay and wait for it to happen again. Yes in sickness and in health...
But what about love and honor. Not trying to do what makes you feel safe , sorry thats not honoring.

I agree he is white knuckling and getting these diagnosis as an adult is probably a little more life altering but I also have to believe there had to be some inkling prior to this that he was ADHD. Yes all that stuff goes with it but he HAS to try all the methods to gain back control and get his life on track if he wants to stay M to you.

I appreciate your response and perspective. I've thought about an ultimatum for the medications. I know for a fact he would start meds if I did that. BUT, I'm tired of being the one to push and force. I need him to make this decision on his own for once. I pushed for testing, neurofeedback, and coping skills. I'm done pushing, it makes me not like myself very much.

That's OK, but what are you going to do about it? One option is to stay in your M while stifling yourself. Another it to D, because you've already given more than you want to give. There are plenty of other options, too.

Please don't stay unhappy in your M when you believe you'd be happy if your H governed his ADHD + OCD. I see a lot right with telling him you're about done, but he might be able to retrieve the sitch by getting effective treatment, if that's true.

There's nothing wrong with asking a partner to change, IMO. My W & I have asked each other to make a lot of changes over the years, and we've both said 'No' a lot, although my guess is we usually say 'Yes.'

[This message edited by SI Staff at 4:35 PM, Friday, December 8th]