ADHD & Intimacy: The Physical Intimacy Issues No One Talks About – Part 1

Summary

Podcast Summary: "ADHD & Intimacy: The Physical Intimacy Issues No One Talks About – Part 1"

Change Your Brain Every Day
Hosts: Dr. Daniel Amen & Tana Amen
Release Date: March 10, 2025

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Introduction

In the compelling first part of their series on ADHD and intimacy, New York Times bestselling authors Dr. Daniel Amen and Tana Amen delve deep into the nuanced challenges that ADHD presents in romantic and physical relationships. This episode, titled "ADHD & Intimacy: The Physical Intimacy Issues No One Talks About – Part 1," explores how ADHD affects focus, impulsivity, emotional regulation, and ultimately, intimacy between partners.

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Understanding ADHD vs. ADD

Dr. Daniel Amen begins by clarifying the often-confused terms ADHD (Attention Deficit Hyperactivity Disorder) and ADD (Attention Deficit Disorder).

"[00:36] A: ...ADD, ADHD, low dopamine. Medications we use specifically increase dopamine."

He traces the history of the diagnostic terminology, explaining that the shift from ADD to ADHD in the DSM (Diagnostic and Statistical Manual of Mental Disorders) in 1987 inadvertently excluded many individuals, particularly girls who predominantly exhibit the inattentive type.

"[02:02] A: ...they changed the name to adhd, highlighting the hyperactive component, which basically threw out half the people, right. Who had it."

Tana Amen adds personal insight into the gender disparities in diagnosis, sharing her own experience with ADHD:

"[10:22] B: ...I scanned my mom, you scanned my uncle, you scanned my dad, you scanned everybody in my family. And my mom had terrible add, like, really bad add. And it explains my childhood."

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Impact of ADHD on Relationships

The hosts discuss how ADHD is a brain-based condition that significantly impacts relationships. Dr. Amen shares an anecdote about a patient, Sandy, whose untreated ADHD led to marital conflicts and a suicide attempt.

"[04:44] A: ...how ADD and ADHD affects focus, impulsivity, emotions, and relationships, and that includes intimacy."

Tana emphasizes that many couples struggle with connection and communication, especially when ADHD is unmanaged:

"[01:26] B: ...so if you and your partner or one of you or both of you have ADHD, you're not alone. And there's good news."

They highlight that ADHD can lead to feelings of neglect, misunderstandings, and emotional outbursts, which strain the relationship.

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ADHD and Intimacy/Sex

A significant portion of the discussion centers on how ADHD specifically affects physical intimacy:

• Focus and Distractibility: ADHD individuals often struggle to maintain focus during intimate moments, which are crucial for achieving orgasm.

  "[00:00] A: ...you have to pay attention to the feeling long enough to make it happen. So they're often easily distracted..."

• Sensitivity to Touch: Misaligned touch can lead to discomfort, likened to "nails on a chalkboard."

  "[00:00] A: ...they're sensitive to touch. So if you touch them the wrong way, it can be sort of like nails on a chalkboard."

• Rejection Sensitivity Syndrome: ADHD can cause individuals to fear rejection, making vulnerable moments like sex particularly challenging.

  "[21:31] A: ...with ADD, there's also rejection sensitivity syndrome. And so because they've been in trouble a lot in their life, they're sort of looking to be rejected."

• Conflict Seeking: Some with ADHD may unintentionally seek conflict as a stimulant, which can disrupt intimacy.

  "[30:48] B: ...so add, it affects both partners in a relationship."

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Coping Strategies and Solutions

Dr. Amen and Tana offer actionable strategies to improve intimacy for couples where one or both partners have ADHD:

1. Assessment and Treatment:

   • Dr. Amen: Emphasizes the importance of getting assessed and treated properly to manage ADHD symptoms effectively.

     "[33:07] A: ...if you notice you have add, go get assessed. Because the treatment literally can change the trajectory of the rest of your life."

2. Medication and Natural Dopamine Boosters:

   • Medications like Ritalin can help increase dopamine levels, mitigating ADHD symptoms.

     "[23:36] B: ...the proper doses through a doctor are therapeutic. And doing illegal doses of methamphetamine will ruin your life."

   • Natural methods include exercise, a healthy diet, Omega-3 supplements, and mindfulness practices.

     "[27:50] B: There's a lot of natural things you can do... exercise, healthy diet, supplements like Omega 3s."

3. Communication Techniques:

   • Open and empathetic communication is crucial. Instead of blaming, partners should express their feelings and work on solutions together.

     "[37:25] A: ...don't blame it. Acknowledge ADHD's impact without making it personal."

4. Creating Rituals for Connection:

   • Setting aside regular times for intimacy can help ensure that ADHD partners remain engaged and present.

     "[33:07] A: ...create rituals for connections. Set times for intimacy so the ADHD partner doesn't get distracted or forget."

5. Managing Stress and Cortisol Levels:

   • Chronic stress associated with ADHD can deplete testosterone, affecting libido. Managing stress through mindfulness and organizational strategies is vital.

     "[36:34] B: ...it's cortisol on me... I'm making lists and constantly feeling behind."

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Personal Anecdotes and Insights

Throughout the episode, Dr. Amen and Tana interweave personal stories that illuminate the challenges and solutions related to ADHD and intimacy:

• Dr. Amen's First Patient Experience:

  "[04:44] A: ...my first scan which hooked me on imaging was with Sandy who is a 44 year old woman who the night before I met her tried to kill herself."

• Tana's Experience with Family ADHD:

  "[10:27] B: ...you scanned my mom, you scanned my uncle, you scanned my dad, you scanned everybody in my family."

• Relationship Dynamics:

  "[34:32] A: ...you have to be thoughtful... it's nothing personal."

These anecdotes underscore the pervasive impact of ADHD on various facets of life and relationships, emphasizing the need for understanding and tailored strategies.

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Key Takeaways and Conclusions

1. ADHD Significantly Impacts Intimacy: From focus issues during sex to heightened sensitivity and emotional regulation challenges, ADHD can create numerous barriers in intimate relationships.

2. Proper Diagnosis and Treatment are Crucial: Understanding whether one has ADD or ADHD and seeking appropriate treatment can transform personal lives and relationships.

3. Communication and Empathy are Essential: Open dialogue about needs, feelings, and challenges helps in navigating the complexities of ADHD in relationships.

4. Lifestyle Modifications Aid Management: Incorporating exercise, proper nutrition, mindfulness, and structured routines can mitigate ADHD symptoms and enhance intimacy.

5. Ongoing Support is Vital: Continuous effort from both partners, coupled with professional guidance, can foster a healthy and satisfying intimate relationship despite ADHD challenges.

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Notable Quotes with Timestamps

• Dr. Amen on ADD vs. ADHD:

  "[02:02] A: ...we made a mistake and a lot of people who have ADD are never hyperactive."

• Tana on Realizing ADHD in Her Family:

  "[10:30] A: ...can I scan you?"

  "[10:32] B: ...it explains my childhood."

• Dr. Amen on Changing Brain Health:

  "[00:36] A: Every day you are making your brain better or you are making it worse."

• Discussion on Dopamine and Intimacy:

  "[24:46] B: So low dopamine. Let's talk about that for a minute."

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Conclusion

Dr. Daniel Amen and Tana Amen provide an insightful exploration into the often-overlooked intersection of ADHD and intimacy. By blending clinical expertise with personal experiences, they offer a comprehensive guide for individuals and couples striving to enhance their relationships amidst the challenges of ADHD. This episode serves as both an educational resource and a beacon of hope, demonstrating that with understanding and the right strategies, it's possible to foster deep, meaningful, and satisfying intimate connections.

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Stay Tuned: This summary covers Part 1 of the series. For more in-depth discussions on ADHD and intimacy, continue listening to upcoming episodes of Change Your Brain Every Day.

Transcript

[A]

Short attention span, distractibility, which really becomes important with sex. If you're easily distracted, often, say, what does an orgasm require? Focus. You have to pay attention to the feeling long enough to make it happen. So they're often easily distracted and they're sensitive to touch. So if you touch them the wrong way, it can be sort of like nails on a chalkboard.

[B]

So what you might think of as intimacy, they may find annoying. So communication is really important.

[A]

Yeah. Every day you are making your brain better or you are making it worse. Stay with us to learn how you can change your brain for the better every day. So welcome back to the change your brain every day podcast. Today we're going to talk about my favorite topic with my favorite person. It's a topic that's not talked about enough. We're going to talk about ADD or ADHD and sex. Add, ADHD affects focus, impulsivity, emotions, and relationships, and that includes intimacy.

[B]

So many couples struggle with this, with their connection, their communication, intimacy, especially when they have unmanaged adhd. So it's hard enough normally, but then you have unmanaged adhd and it's 10 times worse. So if you and your partner or one of you or both of you have adhd, you're not alone. And there's good news. There are ways to improve intimacy, connection, and sexual. Sexual satisfaction. But it starts with understanding how ADHD works. But, you know, I think a lot of people have been curious why the interchangeable add, adhd. I have a tendency to say add. So explain that to people.

[A]

And I think actually most people do, because 1980, when the DSM 3, so the Diagnostic and Statistical Manual of Mental Disorder. So it's what they teach medical students and obviously psychiatrist how to diagnose things. It came out with add, Attention Deficit disorder, with or without hyperactivity. And then in 1987, for God knows what reason, researchers see, most of these diagnoses are sort of made up by researchers. The researchers decided to change the name to adhd, highlighting the hyperactive component, which basically threw out half the people, right. Who had it.

[B]

So does that mean that a lot of people won't get diagnosed then?

[A]

Especially girls.

[B]

Right?

[A]

Because girls often have the inattentive type. I was furious because I knew it was wrong. And in 1994, so 1980, the DSM3, 1987, DSM3, revised edition. So that's the culprit. 1994, they sort of figured out the error of their ways. But rather than, you know, most guys can't say, sorry, they changed it again. To AD slash hd. I'm like well what the hell does that mean? It means we made a mistake and a lot of people who have ADD are never hyperactive. And that was right at the time I was developing my typology of ADD and I wrote internationally best selling book Healing add, see and heal, the seven types. But, but that's why the difference. And on this podcast we'll talk a lot about ADD or now you know the difference adhd, it's just different term. But today I wanted to talk about sex. We're going to break down the common challenges, the strengths, best strategies for improving your relationship both in and out of the bedroom.

[B]

So let's start with the basics then. So how does ADHD impact relationships in general?

[A]

So many ways. It's a brain based condition that and I've studied 260,000 brain scans over the last 34 years. And my first scan which hooked me on imaging was with Sandy who is a 44 year old woman who the night before I met her tried to kill herself. So she was conflict seeking as we'll talk about. So she was always poking at her husband and he exploded, she cried, then she had a suicide attempt. She wasn't really suicidal but impulsively she was so angry and that's what landed her in the hospital. And I went to my first lecture on brain spect imaging. It was just grand rounds at my hospital and I walked out of the lecture into her room and as I'm sitting there now, I'm also a child psychiatrist and 50% of the patients child psychiatrist see the kids have ADD of one form or another. So I'm sensitive to it and I listen to her, I listen to the suicide attempt and then I learned she has an 8 year old son that has ADD. Always think if a kid has it it's coming from somewhere, unless it's a head injury or something like that, it's. And so she has an IQ of 144 but never finished college. And I asked her and I was sensitive to this one question. I asked her so just tell me how you studied. And she said well I never did except for the night before exams, I'd go on a date, I'd come home at 11:00 at night, realize I had a test the next day, I put on a pot of coffee, stay up all night. That's how I did school. And that's a classic ADD way of doing school. So really bright, underemployed, she's a lab tech but she's underemployed for her ability. And I'm going, have you ever thought that you might have add? And she goes, oh, adults can't have add. And I'm like, wait. Then I thought I was the doctor of, like, of course adults gonna have add. And we fuss. And I'm. And I'm like. Just went to the lecture on brain spectimation. I'm like, can I scan you? And we're gonna do it twice. Once at rest, once when you concentrate. Because I'd been doing some EEG work, quantitative EEG work, and we saw that ADD is not a disorder of a resting brain. It's a disorder of a working brain. And virtually everybody, when you go, can I scan you? They go, yes, because everybody wants more information. So she said, yes. And so scanned her the next day at rest, next day after that when she did a concentration task. And then the following day, I come in with the pictures and I put them on the table, and I said, very healthy brain at rest. But when you try to concentrate, sort of goes away. That she had decreased activity in her frontal lobes. And then she starts weeping. And she said, you mean it's not my fault?

[B]

How many times have you heard that?

[A]

So often. But that's what hooked me on imaging, because immediately it decreased shame. And. And I wear glasses to drive. And I took the glasses out of my pocket and put them on my face, and I said, you know, having EDD is sort of like people who need glasses. People need glasses. Aren't I'm crazy or stupid? Their eyeballs are shaped funny, and they wear glasses to focus having add. You're not dumb, crazy, or stupid. Your brain sort of turns off when it should turn on. And the medicine or whatever treatment we do is sort of like glasses for your brain. So helpful. She took the medicine. So I gave her. I think it was 10 milligrams of Ritalin twice a day. And finished college, stopped fighting with her husband, was a better mother. Um, ended up as a nurse practitioner and made, like, four times the amount of money, right? People go, oh, I can't afford to get help. It's like, can't afford not to get help. And just think about what that did to her intimacy. Because when your frontal lobes turn off when they should be turning on, you do things to turn them on. Whether it's poking, you know, what I've often seen.

[B]

I grew up around me. I didn't believe in it until. Till I really understood. And you explained that part to me, and I'm like, oh, that's why there was so much chaos in my family.

[A]

Well, in our first day, you asked me what I did and I talked about it. And then we started talking about add, I'm not sure why. And you went, you think I have add, doctor? Yeah.

[B]

I'm like, this is complete nonsense. Yeah.

[A]

And then what happened?

[B]

Well, you scanned me. You mean after you scanned me, you scanned my mom, you scanned my uncle, you scanned my dad, you scanned everybody in my family. And my mom had terrible add, like, really bad add. And it explains my childhood. Like, it really explains my childhood. So, you know, she made good decisions, bad decisions. Good decisions, bad decisions. But chaotic. Just very chaotic. And so I began to understand a bit more about it and it made more sense to me.

[A]

And you could actually see it in your family?

[B]

Oh, a lot.

[A]

Because it's a disorder.

[B]

Yeah. Both of my uncles have it.

[A]

It's genetic.

[B]

Yeah.

[A]

And I remember when I treated your uncle and your mother because at the time they worked together and they used.

[B]

To complain about each other constantly. They fought all the time. And then all of a sudden my uncle is saying, oh, your mom is so much better. And my mom is like, your uncle is so much better. He's not so annoying. And I'm like, it was so funny. But how does. Let's. So how does this, like, how does that translate to the bedroom? How does that translate to intimacy? I mean, besides the. Obviously, if you're annoyed with people.

[A]

Well, that's one. You know, our friend Earl Henslin always says if there's no forethought.

[B]

Right.

[A]

There's no foreplay.

[B]

And people with ADD or ADHD often don't have forethought. That's the whole problem. So.

[A]

So it's a brain based condition that affects your prefrontal cortex. So that's impulse control, attention. It's the break in your brain also involved in emotional regulation. That means it can create patterns and relationships. Like one partner feeling ignored, while the ADD person may feel misunderstood.

[B]

Right. And it's common for this to show up in communication struggles, obviously forgotten commitments, which doesn't work well for foreplay either. Emotional outbursts. And that all leads to problems with this connection.

[A]

But having flashbacks and it's public. We've talked about you having add, although you have the angst.

[B]

Yeah, I'm not.

[A]

So in many ways it's not typical.

[B]

But I'm almost ocd.

[A]

But having love. Several ADD women, one of them just didn't follow through. Like, I couldn't trust. If I said, could you please do this? That it would be Done.

[B]

Yeah, that's not.

[A]

And I was.

[B]

Let's be clear, that's not me.

[A]

And. And I was furious until I really understand it. Because if someone doesn't live up to their commitments.

[B]

Right.

[A]

If you're a conscientious person, it really sort of irritates. Yeah.

[B]

Well.

[A]

And living with stress, lack of trust, irritability, that begins to disconnect.

[B]

Yeah, that's a trust issue. And also, if you have got kids or you're like, that's a big issue.

[A]

Yeah. Now, on the other side, people with ADD can be passionate, spontaneous, funny, and intensely focused when interested, which can make for exciting, deep relationships for a time. Then they get born, and then it. And then the other stuff starts to wear things out.

[B]

So isn't it true, though, if they are intensely focused on something, that's when they're really good at it. But. But the novelty wears off. And if the novelty wears off, then all of a sudden there's a problem.

[A]

Right. Because love is a drug.

[B]

Right?

[A]

And new love, we often talk about this. New love is cocaine, dopamine on steroids. Lasting love is more like heroin. It's that warm, peaceful connection. And so new love, if you break up, it's not the end of the world. Right. And getting off.

[B]

So I think people like me, who haven't done any of these drugs, I think what you're saying is that one is like a high and one is like a warm blanket.

[A]

Right?

[B]

Okay.

[A]

And so breaking up with cocaine is really hard. Breaking up with heroin is a nightmare. Breaking up with a new love is hard, but generally a lot easier than breaking up with someone you're very connected with.

[B]

Right? So.

[A]

So let me just say this. I have seen this pattern in teenage girls so often, and this is the pattern. New love is a drug. People who have add, when they fall in love, they can pay attention until it becomes. The relationship begins to become more routine, more regular. But it's very important. Sidebar. If you have ADD, and a lot of people do, pick a job you love because your focus is going to be so much better.

[B]

Well, maybe that's why I picked a trauma unit. It's completely unpredictable.

[A]

Love it you. Right? It made you.

[B]

Oh, I was terrified.

[A]

Terrified for six months. But many people who have ADD are running toward fires.

[B]

Right? That's me.

[A]

Rather than away from fires. Like, if a dog comes to attack us, you're in front of me. Ready? Bring it on. Scratch. Scare the other dog a lot. And I'm like, how do I protect this situation? Every thought, every decision, every Success is created by your brain. And the one thing I've learned from looking at over 250,000 brain scans over the last 30 years is that you are not stuck with the brain you have. You can make it better and I can prove it. This is why I created brain fit life 5.0. To help you assess your brain and then help you optimize it by knowing your brain type and giving you access to the tools you need to have a better brain and a better life. It includes a 30 day happiness challenge, brain and mental health trackers, hypnosis, audios, brain enhancing music, and tools to conquer stress and anxiety. You can feel better, think sharper and live happier. Go to the app store and download brain fit life 5.0 today. What I see in teenage girls is they fall in love, new love, they get very excited, but after a couple of months begins to wear off and then they start picking on their partner and poke, poke, poke, poke. Excitement over the drama and then they break up. Excitement over the breaking up and they're so sad and then there's new love and then they start picking on them and then they break up and then there's new love and then they start picking up. So it's this.

[B]

So that could either be with someone who's constantly finding new people to fall in love with and break up with, or people who constantly break up and get back together for the makeup sex.

[A]

Right? Which means maybe both of them have addicted. And so if you just look back at your pattern, that might give you a sense of whether or not you have add. Now, the hallmark symptoms I think of as five short attention span, but not for everything. It's short attention span for regular routine, everyday things. Schoolwork, homework, paperwork, chores, the things that just make life work. On the other hand, for things that have dopamine, things that are new, novel, highly interesting, stimulating or frightening. People with ADD can pay attention just fine. So they love scary movies.

[B]

My mom loves scary movies. I hate them.

[A]

And you are how old?

[B]

9 years old when she took me to see the Hills have Eyes in Silent Scream. And I'm like, who does that? Who does that to a child? I'm still, I'm still like, I need therapy over it. Like, what? Who does that?

[A]

So they pay attention just fine. New, new relationship novel. So when it comes to sex can get weird. Highly interesting is why you have to be so careful with pornography.

[B]

Well, we should talk more about that as we go on because, I mean, there's a lot of things with sex where you can see this Taking a role.

[A]

Right. That with a dopamine deficit comes behaviors to increase it. Pornography. So risk taking behaviors and then risk taking behaviors and so on. So short attention. Spanish distractibility, which really becomes important with sex. If you're easily distracted off and say, what does an orgasm require? Focus. You have to pay attention to the feeling long enough to make it happen. But if you hear everything in the house, you know, I did a post recently on people with ADD often have white noise on at night, and that's so they don't hear everything else that distracts them. So they're often easily distract and they're sensitive to touch. So if you touch them the wrong way, it can be sort of like nails on a chalkboard.

[B]

So what you might think of as intimacy they may find annoying. So communication is really important.

[A]

Yeah, communication is so important when it comes to sex. You know, it's like, what do you like? And how can I do that better and be a good listener as opposed to with add, there's also rejection sensitivity syndrome. And so because they've been in trouble a lot in their life, they're sort of looking to be rejected. And when you're having sex, it's a very vulnerable time and someone really can get their feelings hurt. But communication is just so important. Disorganization, often for time and space. If you look at their rooms, their desks, their cars, their book bags, often a mess. And they tend to be late. Thank God you're not. But, well, I'm anxious. I used to lie all the time to one of my ADD partners in the past because it's always late and, and I'm like, I. I like to be at the airport early. And so I'd like, oh, we're going to leave at 11 when the flight was at 10. And because she was disorganized, she just never checked.

[B]

So I think you did that to me early on. And. But I'm the opposite. I like to be early. So you're like, I need to stop telling her we need to be early because then I'm on ner.

[A]

Okay, so distractibility, disorganizing, procrastination. Oh my goodness. They like, don't do something until someone else is mad at them because they haven't done it. So everything is last minute. I wrote a book with someone once who had terrible add. And of the 42 books I have written, everyone has been turned in on time, most of them early. But he, like, wasn't given me the chapter is resp. I'm like, I show up his house, 11 o'clock at night. And I told his wife, do not give him sex until I get that chapter.

[B]

So sex as a weapon is a whole. Another podcast.

[A]

So procrastinate and then impulse control, where you say things or do things that are not in your best interest.

[B]

Well, and when it comes to intimacy, that can be very hurtful. And people often don't get over those things for a long time.

[A]

Right. Because they. The female brain has a larger hippocampus than the male brain, and the hippocampus is the major memory structure in the brain. So if you say something that hurts her feelings, she may hold onto it for a long time. So short attention span, not for everything, easily distracted, disorganization, time and space, procrastination, impulse control. And if you have two or three of those things, it would be good to be assessed. Add, adhd, low dopamine. Medications we use specifically increase dopamine.

[B]

So low dopamine. Let's talk about that for a minute. For a minute. Because I've heard that low dopamine actually can. If you have low dopamine, it actually decreases your sex drive, and that can be a problem. So that's one of the hallmark signs of ADHD or ADD is low dopamine.

[A]

Yes. Although it's highly variable because some people who have ADD are hypersexual and some people. Their libido.

[B]

And is that because they're looking for the stimulation and the excitement sinking.

[A]

Yes, the hypersexuality.

[B]

Right.

[A]

So they can get. There's a higher incidence of all addictions in people.

[B]

So like pornography or strip clubs and.

[A]

Cheating and gambling, shopping, drugs, alcohol. They tend to not go for marijuana as much as they go more.

[B]

Oh, yeah, that just sounds terrible. I tried it twice in high school and absolutely hated it. Like, it slowed my brain down way too much.

[A]

I have this one just so sad story. I mean, it has a good ending, but this one guy was wildly successful as an attorney, great focus. But he was using a little bit of methamphetamine every day. He found that just a little bit of speed helped him tremendously. And then he got married. And he's. On the day he got married, he's like, I'm going to clean up my life.

[B]

Oh, no.

[A]

And he stopped, which was his treatment for add. Now, I'm not a fan of speed.

[B]

When I say, oh, no. My thought was, he should have seen a doctor.

[A]

He should have seen a doctor. And so he stopped. And all of a sudden he's impulsive, he's disorganized. He's distracted.

[B]

Was he cheating?

[A]

And he wasn't cheating, but his wife divorced because she said, you're different. And through it was through the divorce, he had read Healing add, my book. He's like, oh, my God, I was treating.

[B]

Yeah, he was.

[A]

And when we treated him, he did so much better. But having undiagnosed or untreated ADD is a major cause.

[B]

But we should be clear, like, the proper doses through a doctor are therapeutic. And doing illegal doses of methamphetamine will ruin your life. So be very careful. Like, not.

[A]

Yeah, no, absolutely. In fact, for most people, not him, but for most people, they start using a little bit and it really helps addicts, but then they use more and more.

[B]

Right.

[A]

And dosages that are not. That are higher than therapeutic, you lose your soul. Right, right. Of all the murder empathy you lose.

[B]

Right.

[A]

I've seen it can make you paranoid. And so we're a fan of seeing a doctor treatment and getting.

[B]

There's a lot of natural things you.

[A]

Can do and getting your brain assessed. Right. Like, some people respond really well to saffron. There are four studies now, five studies on ADHD and Saffron, that Saffron can be real helpful. L Tyrosine, which is the amino acid building block for dopamine, can be helpful as well, omega 3 fatty acids, especially EPA.

[B]

Exercise.

[A]

The low dopamine is why some partners crave newness and variety in the bedroom and out. Now, one thing that really messes up relationships is that their conflict seeking or negative seeking. And it's like, what does that mean? It's. And in my book Healing add, which is very. The introduction is very funny of that book because I write. I know you're not going to read this book. Just read the first five pages just to like go. I'm honoring your add. And I tell the story of Betty, who I saw one of my very first patients when I opened up our first clinic. And I loved her. And I was actually seeing her a couple of times a week because she's chronically suicidal. And when I started scanning, I scanned her and I'm like, every session she'd come into my office and tell me how she was going to kill herself. And I was always freaked out because I don't want that for them, and I for sure don't want it for me. And then when I saw the add, I'm like, oh, negative seeking. You're using that as a stimulant. And for those psychiatrist, therapists don't do this unless you really know Somebody. Well, I looked at her, I said, you're no more going to kill your yourself than I am. I said, you have five children. You know, if you kill yourself, you just gifted them a 500% increased risk of killing themselves. You do that to get me upset and to be upset yourself, you're using it as a stimulant. Right. Because that's like a really stimulating, horrible thought. And she stopped talking about and didn't kill herself. And then, you know, I more effectively treated her ADD because when I saw it on her scan, I'm like, okay, it's clear. Because it's harder to diagnose in females. And do you know how I often diagnose in females? They bring their boys to me. The boys getting in trouble in school, you know, he's like all over the place. And I'm like, where did this come from?

[B]

So you can see where this is a problem in the bedroom then. Because if you are constantly conflict seeking a negative. Yeah. It becomes really difficult.

[A]

It's not sexy.

[B]

No.

[A]

When you're mad at someone, disconnects you.

[B]

Yeah.

[A]

From them for sure.

[B]

So add, it affects both partners in a relationship. So let's talk about how you know, this is, this is not. I mean, obviously if you both have it, but even if only one of you has it, it's going to affect both of you in this relationship. So.

[A]

Well, many couples fall into a cycle where the non ADD partner feels like they have to remind, nag, or parent their partner, which sort of gets weird when you're thinking about sex, it's like, no, they feel emotionally neglected. They crave more consistency and follow through.

[B]

So you can see where people might feel criticized or controlled then. So if someone's always being nagged, they feel criticized and controlled all the time. And this becomes like a terrible thing.

[A]

I also feel overwhelmed and guilty for not meeting expectations. And shame is huge for people who have add.

[B]

Yeah. Because if you're constantly making bad decisions or you're constantly, you know, messing up, that's, you know, gonna create this feeling of shame for the things you've done.

[A]

Well, and guilt is feeling bad for something you've done. Shame is feeling bad for who you are.

[B]

So, like, I can't change this. I have no power over this.

[A]

It's, I'm a bad person.

[B]

Right.

[A]

And if you have untreated add, you know, I've often said if you have untreated ADD and it's not been treated before your age nine, you carry a lot of shame because you've been in Trouble a lot. And you go and you have this feeling that I'm bad. And these patterns carry into sex, where one partner feels disconnected and avoids intimacy while the other feels pressure or frustration.

[B]

So let's get practical then. What are some of the best strategies for improving intimacy with people who have ADD in a relationship?

[A]

Well, some of the things that are really game changing. If you notice you have add, go get assessed. Because the treatment literally can change the trajectory of the rest of your life. And it just, it doesn't mean go to the family doctor and get stimulants. Now, stimulants may be part of it, but you need more. A whole person approach, like we do here at Amen clinics. You can increase dopamine naturally, exercise, healthy diet, supplements like Omega 3s.

[B]

Well, that's a big part of our treatment here. We've often said if we can get your nutrition right, we reduce. You've often said you reduce how much medication people take.

[A]

Well. And you almost broke up with me because I was keeping you out late.

[B]

Yeah. When we were dating, I was just getting up at 4 o'clock in the morning every day to work out and I was like, I, I could tell I wasn't like, I didn't feel like myself and I didn't believe in ADD then I didn't have add, but until I met you, I didn't have addiction. But when I wasn't exercising, I could feel like my brain wasn't right. It's how I cleared the cobwebs every morning. And that's when you looked at me and you said, oh, but you don't have add. A coffee. And you need to exercise to clear the cobwebs. But it's very effective, is my point. Exercise, very effective.

[A]

I've actually had lawyers get through law school because they exercise two hours.

[B]

The most important things for my life.

[A]

Getting treated was so much better for their joints.

[B]

Yeah.

[A]

Because they didn't have to work out.

[B]

So it's something that a lot of people have used. I was never a person to use drugs because of the drugs in my family. I figured out exercise very early in my life. But I did beat my body up.

[A]

Yeah. And caffeine.

[B]

And caffeine. Yeah.

[A]

Yeah. And you picked a job that was a bit excitement seeking. So if we think of professions that have a higher incidence of ADD or adhd. Police officers, firefighters, trauma surgeons, emergency room doctors, trauma nurses.

[B]

Yeah. I had nightmares for a year, so.

[A]

Right. But you love the, the adrenaline.

[B]

Yeah. I actually got depressed when I stopped working there. I Remember I felt like some. Like, what? Oh, this is like, what do I do? This is normal life. Like, this is weird. Normal life is very slow.

[A]

Yes. But we're very grateful for the people that run toward fires or trauma surgeons. We are very grateful for them. So increase dopamine naturally. Create rituals for connections. Set times for intimacy so the ADHD partner doesn't get distracted or forget. And when you have add, it's chronically stressful. Right. Even though you have the same amount of time as everyone else, because there's always this flurry of things you're behind on. You feel chronically stressed and overwhelmed. So I know which steals cortisol, the stress hormone, steals testosterone. So you don't have the sort of energy of libido.

[B]

Yeah. And I think one of the signs, because I'm not usually behind in things, but I need to almost feel like I'm behind in things. So I constantly, like, that's just a feeling I have of, like, needing to make a lot of lists. And I'm like constantly saying, I'm gonna get behind. I'm gonna get behind if I don't. You know what I mean? So it's like I almost need to feel like I'm going to get behind. It's very strange. So that.

[A]

No, no, it's not strange. It's cortisol on me.

[B]

Yeah.

[A]

Because I'm like, make a list. Like, I've made lists and the list. Rituals for connection, mindfulness, which I think you find incredibly helpful.

[B]

And I think you finally believe me that I have to get up and meditate. Like, it's just. It's not a. It's not an if. It's a must.

[A]

I know, but you're so cute. I want to keep you behind.

[B]

I know, but I need to get up and meditate. It's for you. It's for your good.

[A]

Name it. Don't blame it. Acknowledge ADHD's impact without making it personal. Instead of saying, you never pay attention to me, try. I feel disconnected and I want to.

[B]

Connect on this same one. I think, you know, sometimes it's. It's a little like when women have pms. The worst thing a man can ever say. Let's just say it. Let's just bring it out right now. Don't ever say, oh, it's going to be okay. In a couple of days, you're going to get a shoe thrown at you. Probably the high heel end of it. So just, Just saying. So just sort of along those lines. When the person who has the ADD or The ADD ADHD feels like they're the ones being blamed as opposed to like, it's not. You don't need the label. We need to, we need to work on a solution together. If you love that person, don't do that. It's like, let's just work on this. We don't need to like, oh, it's your add, like, it's your pms. Like, that's not helpful.

[A]

It's not helpful.

[B]

You don't do that. And I'm grateful.

[A]

No, I don't do that.

[B]

It wouldn't go over well, just FYI.

[A]

No. Yeah. You have to be thoughtful.

[B]

Yeah.

[A]

Like, what's the goal? And my goal with you is always the same. Kind, caring, loving, supportive, passionate.

[B]

Right.

[A]

Relationship. I married my best friend. Right. I always joke saying this yesterday to somebody, I wanted to scan both presidential candidates that guys have fantasy women. I have fantasy brain mostly because I married my fantasy woman. Yeah. So kindness requires forethought. And that's why getting ADD treated can decrease the chance you get divorced. So important novelty in the bedroom. That can be very helpful. New experiences, locations, techniques, studying sex together.

[B]

I think, I think it's also important to. This is where communication comes in because someone might be going, okay, great, novelty. But they didn't run this by their partner. You guys have to, I think it's really important that you both are on the same page and have the same idea about what novelty looks like.

[A]

It's, it's so important. I wrote a book once. It's actually the first book I wrote after you and I met. It's called the Brain in Love. And there, there are some people you need to know your partner.

[B]

Right.

[A]

When it comes to sex, if your partner tends to be anxious, you're probably not having sex in an airplane.

[B]

Right.

[A]

They're not going to join the mile high club. If your partner's really impulsive, then that becomes a possibility. So.

[B]

Right. But we, you talked about, we talked earlier about the impulsiveness and the risk taking behaviors. So like, like I've known people who are into some crazy stuff and they talk about this crazy stuff they're into. And you talk to someone if they have a partner who's anxious, that's probably not going to fly. Right. So you have like choke parties are probably not going to fly for someone who's anxious. So I think it's really important to understand who you're with. And you know, don't just show up and go, oh, Dr. Amon said novelty is a good thing. Like that's not. Yeah.

[A]

I've never heard you talk about joke parties. Is there something I need to know?

[B]

Definitely not. Definitely not. So stay tuned. We're going to finish up ADHD and intimacy. More about sex coming up. In the meantime, subscribe, leave a comment, a question below and follow us. O.C. amen, Orana. Amen.