Could ADHD be harming your sex life?

We explore the implications of Attention-Deficit Hyperactivity Disorder in adult life, especially in people’s personal equations

Attention-Deficit Hyperactivity Disorder (ADHD) is a widely recognised term. However, the common association is often with children and adolescents and how this condition influences their experiences at home or in educational settings, primarily due to the prevalent diagnosis of ADHD in the pediatric population and the misconception that individuals naturally "outgrow" the disorder over time.

Contrary to this notion, a significant number of children with ADHD continue to grapple with the condition as adults. Furthermore, a considerable portion of adults are living with undiagnosed ADHD. Thus, it becomes imperative to explore the ramifications of ADHD on adult life, particularly its impact on personal relationships and sexual dynamics. How does it influence the way they navigate intimacy and connections?

Dr. Ari Tuckman, a United States-based certified sex therapist and psychologist who specialises in the diagnosis and treatment of ADHD, in his book on the subject, ADHD After Dark, explores the various ways that ADHD affects people’s sexual and romantic lives. We potentially know how ADHD affects adults in the workplace or in managing things like paying bills on time and getting to appointments. But according to Tuckman, its ultimate impact has been neglected: how people with ADHD see themselves and how they relate to others, particularly in intimate relationships. "For most of us, our relationships are one of the biggest drivers of life satisfaction and happiness. So, increasingly over the last 20 years of specialising in ADHD, I've become interested in the relationship part of it and even more specifically in the part that sexuality plays in, well, relationships in general, but specifically in these kinds of relationships," he says. 

In researching for his book, Tuckman surveyed over 3,000 individuals with ADHD in the United States and discovered that folx with ADHD, compared to their non-ADHD partners, were generally more sexually eager. "I compiled a set of 12 questions called the 'sexual eagerness cluster'. Interestingly, individuals with ADHD frequently scored 10 out of 12 on this scale, exhibiting a robust sexual interest. This discovery holds significant potential as a positive attribute within relationships. It could maintain a heightened focus on the couple's sexual life, preventing it from becoming a secondary concern. Thus, partners can sustain the advantages of a fulfilling sexual life together, ensuring its enduring significance," says Tuckman. 

However, this aspect can also have a dual nature, presenting potential challenges, believes Tuckman. For him, it might evolve into a source of conflicting desires or yet another area of disagreement within the partnership. There's a possibility that the heightened sexual interest could be adversely impacted by other ongoing relationship difficulties, leading to a decline in the couple's sexual intimacy. This observation alone is fascinating. 

A helping hand

Sukrit Koul, an advertising professional based in New Delhi, received an ADHD diagnosis in 2017. Her decision to move in with her girlfriend hasn't significantly impacted their relationship. Instead, any challenges that do affect their partnership aren't directly related to Koul's ADHD. What primarily influences their dynamic is Koul's struggle to engage in basic chores, as she finds them uninteresting. "I don't derive pleasure from tasks like dishwashing or laundry. To address this, we've divided these responsibilities between us. She manages the laundry, while I handle kitchen duties such as cooking and cleaning. Cleaning our living space is a shared effort. Additionally, the simpler aspects of life also affect our interactions. I'm grateful to have a partner who understands my challenges," Koul shares.

Empathy and understanding

Koul's girlfriend compassionately reminds her to stay on track with tasks. "Frequently, we practice something called 'body doubling,' which holds me accountable for my work, whether office-related tasks or household chores. She also has her challenges, so it balances out in a way. We recognise that various issues manifest differently, and that's perfectly fine. This understanding creates a safe environment for me to be authentic. While we certainly face challenges, I'm confident she won't use my ADHD against me, a stance some people have taken in the past, directly or indirectly."

Empathy plays a crucial role in assisting individuals with ADHD to establish a sense of security and inclusion, given that many are accustomed to rejection and feeling unwanted. The nature of ADHD presents a somewhat intermediary state. It's not a severe mental disability but distinct from neurotypical behaviour. You might be aware of your executive dysfunction, but attempting to explain this concept to someone convinced you're simply "lazy" proves ineffective. It's challenging for others to comprehend the concept of time blindness when they attribute it to an individual's alleged inability to manage time.

"Sadly, this lack of understanding often stems from those closest to us, including parents. The repeated experiences of seeking help only to be rejected or shamed due to our condition can lead many individuals with ADHD to develop apprehensions about forming deep bonds with others. These formative encounters are why therapy is integral to our ability to navigate romantic relationships," says Koul, who insists that cultivating a successful relationship requires substantial work and dedication. "If you find yourself wrestling with more challenges than you can handle, it's wise to refrain from pursuing serious dating until you've progressed. While you might not resolve everything completely, putting forth genuine effort for your personal growth and the betterment of the relationship demonstrates your commitment to your partner and the partnership itself," she says.

Sexual exploration

Mumbai-based licensed psychologist Vidya Sharmarecently engaged in an interesting conversation with a friend of a friend, who happens to be a sex therapist, about the challenges individuals with ADHD can encounter when achieving an orgasm. She was informed that the underlying issue revolves around their minds being easily distracted, which can hinder their ability to engage and shut off distractions fully. "Many of us may not have contemplated this aspect before, making this discussion particularly valuable. There could be unresolved matters that we haven't linked to ADHD," she says. 

Sharma was also told there are difficulties in maintaining focus during sex, which can hinder the path to orgasm. "This challenge is more common in females due to the intricate neural processes involved. For women, achieving an orgasm often requires heightened mental engagement and being 'in the zone.' The time it takes for women to reach an orgasm can be longer, as several physiological and psychological steps must align before the climax occurs. This intricate process is speculated to be linked to women's evolutionary role in childbearing and child-rearing," she says.

From an evolutionary standpoint, Sharma says, it's hypothesised that women's reproductive responsibilities—such as carrying a child for nine months and nurturing them for years after birth—have influenced how female bodies respond to sexual stimuli. "While men also possess a genetic predisposition to ensure the survival and reproduction of their offspring, they don't share the same immediate physiological burden of pregnancy and early childcare."

This leads to the concept that women are naturally more selective in their sexual encounters. Their bodies and minds are more attuned to optimal conditions for reproduction, which include a strong emotional connection with the partner and a safe environment for raising a child. This might translate into needing a reduced level of distraction and stress to engage in the sexual act and attain orgasm fully. 

Sharma also works closely with individuals with ADHD as part of her evolving practice. One of her male patients recently admitted that he's started to ponder whether his own experience of not fully enjoying sex unless there's a strong emotional connection or chemistry could somehow be related to having ADHD. "He told me when it's solely physical, he finds himself getting disinterested, resulting in an experience that's satisfactory but not profoundly fulfilling. He wonders if ADHD shapes his perspective on intimacy and pleasure, steering him towards seeking emotional resonance as a crucial element for a gratifying experience," she tells The Established. Sharma is currently working with this patient to arrive at a prognosis. 

Gender discrepancy

In his study, Tuckman interestingly came across a significant finding regarding ADHD's influence on sexual frequency based on gender. It appears that when the woman has ADHD, couples engage in sex 25 per cent more frequently than in cases where the man has ADHD. 

What seems to transpire is that when the woman has ADHD, and the man doesn't, their sexual preferences are more closely aligned due to the ADHD-related sexual eagerness. However, a noticeable divergence emerges in cases where the man has ADHD, and the woman does not. In such situations, there's a more pronounced difference in sexual interest, potentially leading to more challenges in the couple's sex life. This discrepancy in sexual interest might also extend to other aspects of the relationship, owing to varying gender expectations and how ADHD interacts with fulfilling these expectations for each partner.

The observations regarding sexual eagerness show some intriguing gender dynamics, adds Tuckman. In his study, typically, men scored higher than women on most variables related to sexual eagerness, except for the question about engaging in consensual non-monogamy. This anomaly might be attributed to the often-observed role of women as gatekeepers when initiating such activities. This finding, however, suggests that in same-sex couples—whether composed of two men or two women—there's potentially less disparity in terms of sexual interest. When partners are more similar in this aspect, it reduces the need for contentious discussions and fosters better mutual understanding.

For example, in a same-sex couple comprising two men, where one has ADHD, the difference in sexual interest might be less pronounced than in a scenario where a man with ADHD is in a relationship with a non-ADHD woman. This implies that same-sex couples, from a sexual standpoint, could potentially exhibit more compatibility due to this shared similarity. However, challenges persist even in same-sex couples when it comes to the overall dynamics of the relationship and the practical aspects of daily life. "Balancing workloads, managing responsibilities, and ensuring a fair distribution of tasks are common issues that transcend gender. The struggle arises when a non-ADHD partner takes on more responsibilities and becomes increasingly resentful, while the partner with ADHD becomes more avoidant or defensive. This dynamic can harm the relationship, especially when it extends to the bedroom, impacting intimacy," says Tuckman. 

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