In response to you JJ – ADHD people cannot be lazy?
The thing is Hope, ‘knowing’ something on an intellectual level or being able to quote verbatim from your ADHD text books is entirely different from actually accepting and respecting the pragmatic reality of the condition, especially when it inconveniences you directly.
Your emphatic assertions of how informed and enlightened you are, to the point of ‘being the first to stand up to doubters', are incongruent with the language and tone you employ to state them. You say you understand and then you illustrate your 'insight' with non sequiturs. You use pejorative words like lazy, deride your partner’s achievements with sarcasm and speak about the way he is disrespectfully with undertones of scorn.
You are wrong to call your partner lazy because he doesn't do as much housework as you - both factually and morally.
Our executive functions enable us to carry out voluntary actions, such as housework. All of us require motivation to elicit goal-orientated behaviour and that motivation is provided by the reward. Rewards are intrinsically linked to dopamine, as is novelty and salience.
Doing the washing up or ironing isn't fun or enjoyable in anyone's book and most definitely not for ADHDers. There is no immediate or contemporaneous reward. The 'rewards' for these tasks are in the future - so having clean utensils or ironed clothes means being able to cook again or go outside looking presentable and there's a reward in having a tidy or organised environment. Similarly, the consequences of not doing these tasks immediately are in the future.
Some of the core skills required for delayed gratification, motivation and goal-orientated behaviour are impulse control, a fundamental sense of time, an ability to fully conceive the future and to place and maintain adequate salience or priority on a reward that is separated from the immediate by time. These are all skills of the executive functions, and are all specifically impaired in ADHD.
I can’t give you all the neurobiological reasons for this, but, I can give you some examples you might identify with, which illustrate motivation difficulties and might help you to understand why calling your partner, or anyone with ADHD lazy, with its connotations of being an act of volition, is deeply offensive and entirely inaccurate.
Have you ever been a few pounds overweight and wished you could lose them? Did you go on a diet, lose some weight, get into those fab jeans and feel wonderful? Did it last or did your weight creep back up, take away that good feeling and leave you wishing again? If losing a few pounds makes you feel so much better, why did you put the weight back on, why didn’t that good feeling motivate you to keep on your diet?
You’re aware of all the evidence based guidelines for substantially cutting your risk of heart attack, stroke, cancer, early and/or painful death - 5 portions of fruit and veg per day, alcohol, exercise, salt, saturated fat etc etc.. Do you always do everything to the letter according to the guidelines, without fail? Do you want to have a heart attack, early painful death etc? If you answered no and no, why don’t you do all the things you should all the time– what is more important than your life? How can that not motivate you?
If you’re like the majority of people, you’ll identify with these examples. Even though intellectually you know what you should do, you know you'd feel good if you did, even though your appearance, health and certainly your life are really important to you, you don’t always do them. And why? Because all of those benefits, all of those motivating factors, aren’t always big enough or salient enough to overcome the immediate reward of not doing them and doing something else instead. They’re too abstract, except they’re not, they’re very real, but they don’t seem as salient, especially when you’re staring into a bag of doritos or looking at the driving rain and deciding whether to walk instead of taking the car because that’s better for you. You can’t really explain it, you just can’t make yourself do everything you know intellectually you should do, all the time.
While on a diet, have you ever given in to temptation, have you ever been resolute, yet found yourself confronted with something yummy, given in and wished you hadn’t afterwards? That’s your impulse control not working at maximum. Why did you give in? You didn’t want to? Yet the urge was really strong, so you did.
These examples of lack of motivation to carry out actions you really would like to do and being unable to resist a temptation that provides an immediate reward are all normal behaviours that occur even with a fully functional prefrontal cortex, a bucket full of dopamine and executive functions to die for.
But our executive functions are impaired and we don't have enough dopamine and so we experience these conflicts between what we know we should do and what we actually do - all the time - profoundly - and about everything – but especially mundane, boring, repetitive, familiar things that aren’t life or death. We can’t explain why we can’t make ourselves do things, just like you can’t tell me why you can’t always do things you know you should, but we just can’t. And sometimes, when we do get a burst of organisation and motivation, we don’t know why that is either, we don’t have control over it.
It’s not lazy, it’s impaired executive functions. And the addition of a little tablet of methylphenidate, that ups my dopamine and my norepinephrine, takes it away for a few hours – it still requires a little effort to motivate myself to do something dull like housework, just like it does you, but that effort does produce results - and when I'm doing it, I don't get distracted by something else. So which is the real me – which is my ‘individual, warts and all’ me – the one with the abnormal levels of these neurotransmitters and 'lazy', or the one where they're raised, artificially so, to your levels - and I'm not 'lazy'? Does it matter?
Yes, we’re all individuals and I might have better executive functions than your partner, or vice versa. But, in the case of the diagnosed, these executive function deficits have been objectively professionally evaluated to be life impairing to such an extent that we have been deemed to have a disorder. So, however 'individual' your partner is, ‘warts and all’, he has met the criteria for illustrating that he has a severe neurological disability - you said 87% in his tests. To continue to insist he could just try a bit harder if he wanted to, or making a distinction between the level of impairment between diagnosed individuals, who are already therefore in the lowest 2-4% of the population, is a pointless debate – it’s neither here nor there whether I fall into the lowest 1% or 3% - it’s bad regardless. Would you be arguing the toss over how high to turn up the lighting for 2 people registered blind, because one might have a bit more vision than the other? These are core deficits, they form part part of the diagnostic criteria, so yes, necessarily we are all "tarred with the same ADHD brush".
So you need to stop getting him to 'admit to that lazy gene' - he has the genes for ADHD and this is a highly heritable condition (80% heritability in monozygotic twins - so more heritable than height). You need to stop referring to a manifestation of this disability in this pejorative way altogether - would you call a wheelchair user lazy for not standing up? No? Well you're being just as offensive to us. And don't link our lack of ability to easily carry out actions to our desire to perform them - for example, having a clean, tidy, organised environment is just as important to us as it is to you, but achieving it isn't just as easy. You need get down from your ivory tower and unclench. Maybe there's a reason you're the only non ADHDer in the group - it is, after all, a group for ADHDers - where they can be themselves, without non ADHDers with superiority complexes tutting at them... Have you ever thought about letting him go on his own sometimes, for some space?
I really hope you actually take the time to open your mind. I suggest you do just accept what the text books say, they were, after all, written by specialists and leading academics in the field - or put another way, people who know far more than you. You don't even have to understand, just accept - after all, this being such a heritable condition, if you ever have children with your partner, there's a good chance you could be reading some woman talking about your own son's disability in this way some day - you need to be able to stick up for him and help keep his self-esteem in tact.
I fully appreciate that living with an ADHDer presents difficulties and challenges, I know it's not easy, I'm not sure I could cope with the practical implications of the condition.... But your ability to manage and your happiness, as well as his, must start with proper acceptance of ADHD. If you want a discussion that's based on a genuine desire to understand, or support for the issues you face as a partner, then you are most welcome and there will be many here only too willing to help as much as they can. But please come here with an open mind.