Husband with ADHD with thoughts of shame and maybe even depression- advice for a loved one

[adhdwife-ML]

My husband has ADHD and really struggles with shame, anxiety and depression. There are a lot of times he says things like I am just not happy and I dont understand why. Its not depression, because he can get up and do things its just more directly related to shame. Or maybe a new job, it seems like shame weighs heavy on him with jobs. He has the hardest time keeping a job because of this. Entrepreneurial type endeavors have always been better for him but they dont always pay the bills up front... help!

Any advice on what I can do as a wife to help him, especially when he says things like he is not happy (with himself)?

[HadEnuf]

ADHD and the conflict it brings to life do promote depressive episodes: this is particularly true with regard to perceived rejection (real or imagined—look up rejection sensitive dysphoria). I suffer this continually, myself, though a correct titration of my stimulant medication has blunted it.

This is so prevalent that suspicions have been emerging, in the clinical community, that much of the “atypical depression” improved by bupropion (Wellbutrin) but not by other antidepressants may well have been a symptom of undiagnosed ADHD (for which earlier editions of the DSM first excluded adult diagnosis, then excluded adult emergence, until sufficient evidence of a lifelong condition was amassed).

Shame, in particular, is continually reinforced by neurotypical assumptions that the one with ADHD “just needs to try harder” (despite already trying harder than everyone else) or “organize better” (never mind most organizational techniques play directly into the weaknesses of ADHD by requiring deliberate addition of distractions to a routine by people who have extreme difficulty with habituation).

Breaking the shame cycle requires not only a steadfast refusal to compare one's “insides” with others' “outsides”, but also refusal to allow others to impose such comparisons without being informed (albeit gently and privately) that they are mistaken.

Having to overcome adversity that others can't see it experience is draining, but prevailing despite setbacks and recognizing the accomplishment can be a source of strength to keep going.

P.S.: Being not happy with oneself is normal: “pobody's nerfect”. We with ADHD simply feel it more deeply and may have more occasion to experience it. Sometimes, it's worth “getting a good mad on” (seething determination, not rage) to overcome the sadness and overwhelm and to drive finding improvements actually work—which usually won't be what works for “everyone else”.

[glitterpidgeon in reply to HadEnuf]

This is such a good reply. I have a lot of trouble with rejection sensitive dysphoria (call it the RSDemons lol) and it really amplifies those feelings of shame and messages of “not good enough”. My stimulant meds mellow it out a little, and guanfacine seems to be helping a decent amount, but it’s no joke

[HadEnuf]

I'll second the recommendation, and add “A Guide To Rational Living” (Albert Ellis and Robert Harper): while both are targeted more to “mood disorders”, they present useful tools for dealing with emotional overload due to the “broken filters” of ADHD.

[Lovinit]

He should see a a therapist and psychiatrist to talk to and the goal is they will help him figure out what’s going on with him. I never thought of myself as depressed but then the doctor listened to me talk and he explained what he observed had me try a low dose of anti anxiety/depression medication and my add medication, the anxiety/depression medicine take a few months to build up in you system before if fully begins working, I’m glad now I Reyes it becomes it’s helping me so much. I feel good, normal. Sometimes the first medication may not work so with that it can be trial and error.