HealthyGamerGG - Why ADHD Brains Don't Have Space For Relationships

Episode Date: January 10, 2026

In this episode, Dr. K breaks down why ADHD can quietly erode relationships—and why it’s still fixable once you can see the pattern. He opens with bleak data (most partners report ADHD significantly harms the relationship and that they feel forced to “compensate”), then reframes those stats as useful: patterns are predictable, and predictable means preventable. The core issue he names is symptomatic misperception—a neurotypical partner interprets ADHD behaviors (forgetting, distractibility, missed plans) as “you don’t care,” creating an emotional injury on top of the practical problem. From there, he explains how many people with ADHD develop dysfunctional adaptations (like masking, shutting down emotionally, or avoiding commitments) to avoid conflict, but those coping strategies create new damage. He offers a repair approach: map the recurring behavior → identify what emotion you’re trying to avoid in your partner (often disappointment) → build a shared plan to tolerate and address that emotion without avoidance. He closes by highlighting pragmatic communication (turn-taking, not interrupting, tracking topics, nonverbal cues) as a common ADHD struggle that affects “connectedness,” and points toward couples-based ADHD therapy and skills training as evidence-based ways to improve. Topics covered include: Symptomatic misperception: ADHD symptoms being misread as a lack of care The “two injuries” problem: the practical miss (cake) + the meaning attached to it Dysfunctional adaptations: masking, avoidance, indecision, emotional shutdown A repair map: behavior → what you’re preventing → the core emotion → alternative plan Pragmatic communication skills and why ADHD disrupts conversational “flow” HG Coaching : https://bit.ly/46bIkdo Dr. K's Guide to Mental Health: https://bit.ly/44z3Szt HG Memberships : https://bit.ly/3TNoMVf Products & Services : https://bit.ly/44kz7x0 HealthyGamer.GG: https://bit.ly/3ZOopgQ Learn more about your ad choices. Visit megaphone.fm/adchoices

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That's why you rack. Hey, chat. Welcome to the Healthy Gamer Gigi podcast. I'm Dr. Alokinoja, but you can call me Dr. K. I'm a psychiatrist, gamer, and co-founder of Healthy Gamer. On this podcast, we explore mental health and life in the digital age, breaking down big ideas to help you better understand yourself and the world around you. So let's dive right in.

So let's start with some statistics. So the first thing is this is super scary. So 96% of people who date partners with ADHD, say that their ADHD negatively impacts the relationship in some significant way. Even scarier, about 92% of people feel like they have to compensate for their partner with ADHD, which ends up making their partner feel like a burden. So I'm sort of lifting because you can't get your shit together. And so if we look at people who live their whole life with ADHD,

people between the ages of 60 and 94, they're three times as likely to have never been married because they can't sustain a relationship in the first place, or for that marriage to end in divorce. Now, just because these statistics are bleak doesn't mean you're screwed. And this is something that I've been focusing on a lot where I'll say like, okay, things are really bad, things are really bad, because this is literally what the data shows. But here's the key thing to remember. If there are statistics, that means that there's a pattern.

If there is a pattern, that means it's predictable. If it's predictable, that means it's preventable. So once we understand what is going on in these relationships, it will equip us with a roadmap to prevent these problems or fix these problems. And if you look at people with ADHD who actually seek treatment, one of the top reasons why they seek help is because of problems in their relationships. They can manage the work stuff. They can manage the school stuff, but there's something about their relationship where their partner is absolutely fed up with them. So in a regular relationship, if I forget your birthday, that is sort of like a callous thing to do. That

makes me sort of an asshole. But if I have ADHD, the reason I forgot your birthday isn't because I don't care. It's because I'm inattentive, I'm distractible, I'm highly forgetful. So one of the biggest challenges in relationships with ADHD is that you will end up engaging in a lot of behaviors that are incredibly hurtful to your partner. But they don't really understand that that's because of the ADHD, which creates another problem, which makes things super hard, which is that if you tell your partner, hey, the reason that I forgot your birthday is not because I don't care, but because forgetfulness is a symptom of ADHD. This can seem like an excuse. It can seem like dodging responsibility and sort of makes you feel pretty bad and doesn't really

satisfy your partner. So we're going to offer y'all a fair number of solutions today. If you all feel like the solutions are not sufficient, we have a whole workshop where we're going to go into specific skills around ADHD and relationships run by Dr. Michaela. So if y'all are interested, please check out the link in the description below. And the first problem that we're going to talk about, is symptomatic misperception. So let's say that I'm a neurotypical person in a neurotypical relationship. And there are certain behaviors.

Let's say I tell you, hey, my birthday is coming up, I really want chocolate cake. So if you're my partner and my birthday rolls around and there's no chocolate cake, how do I interpret this? I look at this and I say,

hey, I asked for chocolate cake. You did not get me chocolate cake. This means you do not care. So from a neurotypical perspective, there is a certain behavior in the relationship getting chocolate cake. And that behavior is associated with a certain meaning or interpretation. If you love me and if you care about me and if you want to make me happy and I ask you for something for my birthday, you should get that thing on my birthday.

Therefore, if you did not get that thing, that means you do not care. Here's the big problem with ADHD. So if you're a neurotypical person dating someone with a, ADHD, chances are you don't realize that there are other reasons why this person may not have gotten you chocolate cake. It is not that they don't care. It's that they forget. It's that they get distractable. It's that they weren't paying attention when you mentioned to them, hey, by the way, I'd like to get chocolate cake and your partner with ADHD was in the middle of playing Silk Song because it just got released. So this is something that we call symptomatic misperception.

So here's a great paper that looks at qualitative research on ADHD. A lot of things they held against me have to do with my ADHD symptoms, always forgetting everything and that I didn't care or that I'd lose things or all types of stuff that all come back to my ADHD. So that's hard to maintain relationships over time. He gave me a verbal list of things the other day. And I was like, I can't keep everything straight. Let me just see what you're reading. And he got so mad at me because he thought I wasn't paying attention. And I was like, I'm listening to you. It's not that I don't care. I just can't keep all of these options straight in my head. I have to see it. I feel. I feel. I feel. like that that's where the disconnect is. People on the outside think you don't care. And on the inside,

you're going, no, I do. But I need to learn tools or you need to learn tools to help us both succeed. This is exactly what symptomatic misperception is. It is not connecting around why there are problems in the relationship. So from your perspective, you're inattentive, you're distractible, you're forgetful. These are all clinical features of ADHD. It's just the way that your brain is wired. But from their perspective, they're not a priority. You don't care. If you cared more, you would not be as forgetful as you are. If you cared more, you'd pay attention.

So they take distractibility and they interpret it as a lack of caring. So how do we resolve this? This is where a lot of people with ADHD fall into a really, really, really scary solution, which really puss everybody off and doesn't fix the problem. They say exactly what I said. I watched a video. Dr. Kay said, I'm distractible, I'm forgetful, I'm impulsive, I have difficulty with inattention. That's why I didn't get you the birthday cake. Therefore, it is not my fault. Now, this doesn't help anybody because you're using your ADHD as an excuse. The reason we want

to dig into symptomatic misperception is because we have to understand what the injury truly is. There's two injuries here. One is that I didn't get a cake on my birthday. That is a very real, injury, whether it's due to ADHD or not caring or whatever, I wanted something for my birthday. This is important to me to have for my birthday. I did not get that thing. That hurt is there, whether it's ADHD or not. There is a second kind of hurt, which is why isn't the cake there? The cake isn't there because you don't care.

So there's a psychological and emotional injury that comes from an incorrect, neurotypical interpretation of the cake not being there. So this is why we want to focus on symptomatic misperception. because we need to fix these two things. Once we understand that, okay, the cake isn't there because you're inattentive, because you tend to be distractible, because you're forgetful,

that's part of the ADHD. I don't have to be personally hurt. I don't have to interpret this as a lack of caring, a lack of being a priority. So once we understand things from a neuro-a-typical lens, that is the first step to actually solving these problems. And this is where there are five principles of evidence-based couple therapy

that are adapted to ADHD. And the first one is altered views of the relationship. So what does that mean? So when I have a patient come into my office who has ADHD and struggles in their relationships, this is literally the first part of therapy. The first part of therapy is getting both people into the room and helping them understand that your interpretation of being not a priority for your partner is actually incorrect.

They do really care. They are really trying, but they have certain difficulties. Which then brings us to the second point because that's not enough. You can't just say, oh, yeah, they have ADHD. Sorry, you're never going to get cake again. We actually need to solve that problem too. So how do we solve that problem? This is where we get to the second point, which is dysfunctional adaptations.

Once we've addressed the emotional injury by hopefully helping people understand this is a consequence of ADHD, it doesn't mean I don't care. Then we can go on fixing the physical injury or the lack of cake. Chances are you've developed all kinds of adaptations to protect your. from the symptoms of ADHD. The problem is those adaptations create more problems. So if we go back to our five principles of evidence-based couple therapy, we need to modify dysfunctional interactional behavior and decrease emotional avoidance. And we're going to do that by addressing these dysfunctional adaptations. So if you grew up with ADHD, the ADHD caused you problems.

In order to solve those problems, you developed adaptations. Here are a couple of examples. My whole life, I was being told that I didn't think things through and that I would make really dumb decisions. And over time, hearing that again and again kind of manifested into taking really long time to make a decision. Over time, that kind of impulsive decision making has resulted into not making decisions at all. Another really great example of this is masking. Masking is something that people with ADHD do to prevent their ADHD symptoms from interfering with the rest of the world. Several participants reported masking their symptoms to the point of inversing how their symptoms presented. This overcompensation reportedly resulting in changing

one's presentation from impulsivity into difficulty with decision making or changing from being overly emotional into aloofness. Participants reported going from struggling with one extreme of their symptoms in childhood to having to manage the opposite extreme in adulthood. So a great example that I've seen time and again with my patients is people with ADHD have what I call jittery amygdalus. So that means that the negative emotional circuits of their brain are really quick to react. So whereas a neurotypical person may have an anxious moment, they'll feel some anxiety, but that anxiety will kind of go away, whereas someone with ADHD will have a gigantic

uprush of anxiety, and that anxiety can persist for the whole day. There are so many people who are worried about, let's say, I have a job interview at 4 p.m. That anxiety about the job interview at 4 p.m. makes me unable to act all morning and all afternoon. My mind literally cannot focus. So what tends to happen in relationships is when I feel a lot of emotional reactivity to situations, I end up compensating. I end up compensating by becoming aloof.

I end up compensating by shutting down. And then what happens is my partner complains. I'm not emotionally there. I don't feel connected to you. And I may think, oh, the reason I don't feel connected is because I'm not paying attention. Maybe it's some degree of inattention. There is this emotional suppression that I have to use as an adaptation. So how do we fix these dysfunctional adaptations?

So the way to start is by looking at what behaviors do you engage in that are designed to prevent your partner getting pissed at you? Once you understand, okay, I'm never making a decision because this person gets mad, then we want to have a conversation about that. The moment that you notice, oh, wait, I'm doing that thing where I'm avoiding making a commitment. Why am I doing this? Because I'm afraid of your fear. I'm afraid of your anger. I'm afraid of disappointing you. You say I'm disappointing you all the time.

You say, I don't care. I'm tired of disappointing you. So, easy. I figured it out. Since I'm tired of disappointing you and you hate me disappointing you, I'm never going to make a commitment. I'm never going to say I'm going to do something. Because if I never create an expectation, you're never going to be disappointed. So how do you discover these dysfunctional adaptations and fix them?

The first thing we do is you ask your partner, what is something that I do that pisses you off? What is the behavior? So once they select a behavior, let's say that you never make a commitment. Then the next thing that you need to do is ask yourself, when I engage in this behavior, what am I trying to fix? What is the solution? What is the problem that I'm trying to solve? What am I trying to prevent in my partner?

I'm trying to prevent the disappointment in my partner. So that's the chain that we want to follow. At the top, this is the behavior that annoys your partner. This is what you're trying to solve or trying to prevent in your partner. This is the key emotion. I'm trying to prevent disappointment. So when your partner is feeling disappointed, this is sort of the last important step, is to sit down and ask both y'all to work together.

What can we do to prevent this disappointment? How can we alter our view of the situation? when you're feeling disappointed, how can you communicate that to me so that I can tolerate that degree of disappointment? And we can both sit down and sort of figure out, now that you're feeling disappointed, how can we solve this? And this is where we go to the third part, the third principle of couples-based ADHD therapy,

which is decrease that emotional avoidance. So how do you fix these dysfunctional behaviors? So it starts by asking your partner, what is the behavior that you dislike? So my partner will say, you never make a commitment. Now, the next thing that you need to do is over here, you need to take this behavior and ask yourself,

what am I trying to solve by never making the commitment? What is the problem, right? Because you're avoiding the commitment because you're trying to fix something, you're trying to prevent something. So then what you realize is the reason I never make a commitment, I've had, if I never make a commitment,

I can never disappoint with you. Right? So what I'm trying to avoid, and usually what we'll find is there's going to be an emotion in your partner. that you're trying to prevent because here you are and you notice they're getting more and more disappointed more and more frustrated you know they're on their last legs they're about to break up with you

if i if you ever disappoint me again you let me down all the time if you if you let me down a single more time i'm done i can't handle it anymore and so you're like oh shit they're about to break up with me i better never disappoint them again in order to never disappoint them again never make a commitment so i'm trying to prevent this disappointment this is where we get to the third principle of evidence based ADHD couples therapy, which is decrease emotional avoidance. Once you've mapped this out, now what we need to be able to do is I need to be able to disappoint you. I need to know, okay, I'm okay disappointing you. And here's the key thing. That's so scary. We need another way to deal with that disappointment, right? So now that I'm, hey, now that you're feeling disappointed,

what can we do? How can we solve this problem? So instead of never making a commitment, let's understand that I may need to make a commitment. Here are the struggles that I have. Here's why it's hard for me to make a commitment. I always forget. And once you have an altered view of the relationship, you realize it's not just that I don't care. It's that there's ADHD things that are impacting our relationship negatively.

This is why I always forget. What are alternatives that we can come up with? Once you ask me to make a commitment, please understand that it's not, I want to try. Help me succeed. How can we come up with an alternative for this sequence of things? Okay, you're disappointed. Why are you disappointed?

What else can I do? When you ask me for chocolate cake, I struggle to remember. Can you help me figure out how I can remember? And that's where you have to do your work and your partner has to do the work. This is the other really important thing. If I start to struggle, when you feel emotional, here are the things that you do that really cause me to shut down. Once I detect that disappointment, I start spiraling.

So if you feel disappointed, can you come and tell me, hey, I'm starting to get worried that you're going to forget the chocolate cake? Can you come and vocalize this emotion to me? Can you raise it to the surface? Because if you can raise the potential disappointment, if you can raise that frustration, and you and I can sit down and talk about it, now we have an alternate plan. If we have an alternate plan, then we don't need to do this and we don't need to do this. It'll fix the problem. So this is how you fix the dysfunctional adaptations. Okay?

You want to decrease your emotional avoidance. You want to map out the pattern and you want to come up with alternatives. The last thing that we got to talk about is something called pragmatic communication. This is something that people with ADHD really struggle with. And here's what pragmatic communication is. Initiating interactions, communicating using speech or gestures, regulating one emotions and behavior and maintaining interactions by replying or asking questions. Other specific skills associated with pragmatic language include maintaining conversation topics, avoiding excessive talking, engaging in turn-taking during conversation, interpreting other people's nonverbal cues, not interrupting, controlling the intensity, the tone and volume of speech, displaying appropriate facial expressions, and maintaining appropriate eye contact and physical proximity.

So if you all want to know what pragmatic communication is, it is all of the things that are hard to do if you have ADHD. Now, fixing pragmatic communication involves, as y'all can see here, this is from the Occupational Therapy Association. There's a whole program of like occupational therapy where we can train people in these things. This really goes beyond the scope of today's video, but just to let you all know from a sense of completeness that this is a huge problem. If we look at the problems in ADHD and relationships, a huge part of it is that the way that you communicate don't involve these things. You interrupt when you're not supposed to. It's hard for you to pay attention. It's hard for you to take turns in the conversation.

So your partner feels like you're not there. You're not paying attention. Your partner feels like you're over here and I'm over here. The sense of connectedness is so difficult with ADHD. And the reason is because connectedness requires. I'm going to hit the ball across the net and you're going to hit it back. I'm going to hit it back and you're going to hit it back. There's a flow to communication.

This is what's difficult with ADHD. So unfortunately, if you're someone who's got ADHD and you're struggling with your relationships, you are not alone. The statistics are super scary, but if you understand how ADHD affects your relationships through symptomatic misperception and dysfunctional adaptations, as well as things like pragmatic communication, those are the things that you can improve on. And the good news is as you improve on these things, we have evidence-based programs of couples therapy for ADHD. And as we implement these things, people's relationships get better.

Thanks for joining us today. We're here to help you understand your mind and live a better life. If you enjoy the conversation, be sure to subscribe. Until next time, take care of yourselves and each other. This episode is brought to you by CarMax. Want to buy a car the easy way? Start at CarMax. Want to browse with confidence?

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