Episode 65. ADHD & Relationships with Melissa Orlov

All relationships have their hurdles, but couples in ADHD-impacted relationships? Like most things in life, it tends to be more complicated for us. ADHD divides our attention, which makes managing and maintaining relationships way more challenging. 

Today’s conversation with Melissa Orlov is all about how ADHD can show up in our relationships. Motivated to start ADHDmarriage.com in 2007 while sharing stories from her own ADHD-impacted relationship, Melissa has helped so many couples by sharing her expertise with the neurodivergent community over the last 16 years. 

Tune in now to learn more about ADHD and relationships from Melissa Orlov!

Join the conversation by reaching Lindsay via po[email protected] or on social media at @lindseyguentzel now!


  • Melissa’s journey in helping couples with ADHD
  • Melissa’s career with ADHD and couples’ counseling 
  • Defining Adult ADHD and the emergence of the culture 
  • Adult ADHD’s pointers and symptoms 
  • How ADHD is managed in different interpersonal relationships
  • ADHD in the digital age 
  • Awareness, misinformation, and stigma of ADHD
  • Patterns of ADHD in couple dynamics

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Lindsay Guentzel (00:00):

Happy February you guys and welcome back to Refocused. My name is Lindsay Guentzel, and today kicks off the first of four episodes with the incredible Melissa Orlov, who was so generous in sharing her time and expertise with me last month when we were able to connect in person for a marathon session talking all things ADHD and relationships. We are going to cover so much over the next four weeks. Hyper-focused courtship, biological clocks, ADHD and same sex couples, what happens when ADHD mixes with anger, shame, and love bombing, how impulsivity can wreak havoc, and Melissa even shines some light on the age old adage the grass is always greener. But to get started, I wanted to go back to the beginning and get the origin story, so to speak, on how Melissa Orlov became one of the most respected voices in the ADHD community. Support for Refocused comes from the team at ADHD Online, a telemedicine mental healthcare company based in Grand Rapids, Michigan that provides affordable and accessible ADHD assessments and treatment plans, including medication management and teletherapy.


Available right now over on adhdonline.com, “How to Make Love Work When You Have ADHD”. Read real life stories from ADHDers who have found love, whether in an inter enabled relationship or on the second time around. They share what has helped them throughout the years, a nice easy read that I’ve linked for you in the show notes. And while I have your attention, if it’s been on your to-do list but you need that extra push, it would mean so much to the entire Refocused team. If you would take some time and leave us some love online, whether that means giving us the good old rate, review, subscribe wherever you’re listening right now, or by sharing us with your social networks. Maybe it’s a favorite episode or a story you really connected with from our first Refocused, Together back in October. You can also just follow us on social media @refocusedpod and my personal account for all the cat videos in the world @lindsayguentzel. Oh, and we have a new way for you to get in touch with us that we’ll share with you after we wrap episode one of our four-parter with Melissa Orlov.


Welcome to Refocused. I’m your host, Lindsay Guentzel, and to say I’m excited about this month’s episodes is quite an understatement. Whether you like the holiday or not, February 14th, Valentine’s Day makes a lot of us think about relationships, whether you’re married, dating, wanting to date, starting over after a breakup, learning to embrace your own independence, or maybe you’re focusing on the other important relationships in life with your friends and your family, blood or chosen, the people you work with, and I’ll just say it because we all need a good reminder. Maybe you’re focusing on the most important relationship, the one you have with yourself. That’s the one that seems to affect everything. There are boatloads of studies out there that suggest people with ADHD have higher levels of interpersonal problems than their peers do. And over the next four weeks, we’re going to dive into different relationships you might be managing in your life right now.


I’m going to go out in a limb and guess that you all know today’s guest. After I was diagnosed with ADHD two years ago, it was one of the first names I learned when I started down my rabbit hole of ADHD research. And today I am so excited to get to share a studio with the incredibly talented and kind, Melissa Orlov.

Melissa Orlov (03:29):

Thank you. I’m so happy to be here and sharing it with you.

Lindsay Guentzel (03:32):

Well, in case you didn’t know, Melissa Orlov is the founder of adhdmarriage.com, a marriage consultant, and the author of two award-winning books on how ADHD impacts couples. Her first, “The ADHD Effect on Marriage,” was published in 2010 and helps couples understand what’s going on in their relationship and how they can respond to find the love they feel they’ve lost. Her second book, “The Couples Guide to Thriving with ADHD,” delves into particularly difficult interactions that couples may need extra help addressing. Melissa also blogs about ADHD and marriage, provides insight and resources for both couples and for therapists over on her website, adhdmarriage.com. She also teaches therapists how to help couples navigate challenges associated with ADHD, and her expertise has been highlighted in the New York Times, U.S. News & World Report, and many, many more. So I thought we could get started by talking about how you got here today.


And I have to say, while doing some research for this conversation I was over on your website and I saw your resume, and I know that this is not the only thing you’ve done in your career so I’m curious where the career change came from. Get us to this point in 2023.

Melissa Orlov (04:47):

Well, so the background on me, I started out actually, as you say, in a completely different career, and I happened to follow my then husband out to the Bay Area and had to take a break for a few years from what I had been doing, which was marketing and marketing research and consulting, et cetera. And when I came back, moved back to Boston, I found that I really wanted to talk about what had been going on in my own life, because my ex had ADHD. And I hate to say it, but we were completely average. I mean, completely. Everything that happens in relationships impacted by ADHD happened to us. And I thought to myself, “Well, maybe I’ll blog about this. Just maybe a few people will learn from it and learn from what we did,” because there really wasn’t much available at the time, and that was back in 2007. So I started blogging and the blog took off. I mean, I was astounded. And it got to, I don’t know, a thousand pages or something like that of comments and forum entries and et cetera.


And I thought to myself, “Well, okay, people want information about this, but now it’s such a mess. I need to do something to organize it, because this is who I am.” And so I wrote a book, and the New York Times picked it up, and then that took off, and then I was on TV, and that took off. I mean, it went crazy. So I changed careers. I just started helping couples, and it’s grown organically. As too many people wanted to work with me, I said, “Hm. How do I handle that?” So then I started a seminar so I could do more people at once. And my major goal has been to spread awareness about this and help people learn, because when people find out what is going on in their relationship and how ADHD and also responses to ADHD impact them, they can make huge changes in their relationships. And it’s so thrilling to be part of that just to even just giving the information that people need.


So that’s how I got into it. I’ve written a couple books, the ones you mentioned, plus I’ve been in a few others. I give seminars. I give support groups. I am working now on creating a professional training program. I’ve just really made it my mission to get as many people aware of this as possible.

Lindsay Guentzel (07:09):

Going back to the first time you put yourself out there, because it is personal and you’re talking about your marriage and then your divorce and what led to that, was that hard? Was it hard to accept having to go back and look at some of the stuff? It’s probably not stuff you want to go back and dive into.

Melissa Orlov (07:28):

Some of it is incredibly embarrassing, actually. I mean, there are many things that I did that I’m not proud of either. And again, completely average. This is just what happens in these relationships. You’ve got these symptoms and then they lead to patterns that are almost inevitable, if you don’t know the ADHD is there. I mean, I think the thing that motivated me was that we had been able to make such changes based upon being able to piece together this information. So I happened to be working in my other capacity, my marketing capacity, with Ned Hallowell, which is how I got to know him, and doing some seminars with him online before these were ubiquitous. And he and John Ratey, two of the top ADHD experts, were giving professional training seminars. And so, as the person who was helping him and the moderator of these seminars, I ended up taking all of these professional training seminars. So I thought, “Well, not only do I have my life story, but actually I’ve got the latest information on what ADHD is all about.”


I mean, this was literally soup to nuts everything that was known about ADHD back in 2005 when they were doing this. So I felt okay to share things in that I wasn’t going to be giving misinformation. And I’m a open person. Most of my friends laugh about this, but I am so it was okay. I did ask my then husband, “Okay, what can I share? What can I not share?” And he was very gracious and said, “Yeah, you should help people. Just stay away from this area and that area,” and I’m like, “Okay, I can do that.”

Lindsay Guentzel (09:03):

Yeah, setting those boundaries is very hard. I learned that very quickly with my own family and my partner who is neurotypical. And I noticed very quickly after I was diagnosed, when I understood how my brain works, which was so important. You go almost 35 years of going through life without a playbook. You think you’re like everyone else around you and you can’t figure out why things are so difficult, and then the diagnosis came. And I am very lucky. He’s very patient and he’s very understanding. And the second that my flight mechanism starts, I’m not a fighter. I am very much a flight. I’m like, “Hey, this was a great eight years.” The next morning he’s like, “That was just a fight. We’re having an argument. That’s what people do.” And I’m like, “Oh, we’re not breaking up? I can go unpack my boxes?” But it’s unreal, I think, once what you know what you’re prone to do, how quickly it can snowball.


And so I’m curious, from your own perspective, you mentioned in 2007 making this change and taking what you had learned from your own experience, but now you have all of these other things. You’re got 15 plus years working in this field, so when do you look back and see it start to change from your own experience to now what you’re learning from all the people that you’ve been working with?

Melissa Orlov (10:23):

That started pretty early on, because there was so much interest in this. And in order to follow through on the, “Hey, I want to share information,” I started working with couples pretty early. And now it’s just a matter of I have so many examples of all of the nuances of how this all works for people that I just pull… People say, “Well, can you do this presentation?” I’m like, “Yep, no problem.” It just comes very easily just because I have so much background in it now. And speaking of background, you talked about Valentine’s Day. Valentine’s Day is a horrible holiday for many, many couples with ADHD.

Lindsay Guentzel (11:01):

I’m starting to think that more people dislike Valentine’s Day, ADHD or not, than actually do Valentine’s Day. I think we were very misled as kids that this was going to be a great holiday in our lives.

Melissa Orlov (11:12):

Yeah. This is like all the Hallmark cards. But I cannot tell you the number of partners who say, “I had great hopes for Valentine’s Day and my partner forgot.” And it’s an ADHD, I don’t know, black hole or something. It’s just a horrible time for many couples with ADHD.

Lindsay Guentzel (11:33):

You’ve been focusing on ADHD, as I mentioned, for more than 15 years, and I’m curious what you’ve noticed throughout your career as far as changes. Now, we can look back at the last couple of years with the pandemic. And for me, the silver lining of losing my job and getting state health insurance was that when the hyper-focus moment came of going, “I think I might have ADHD.” I could call and make an appointment and not think anything else of it, and that was literally two years ago and I feel like it’s the best thing that’s ever happened to me. And so from the pandemic, I look at that silver lining as I would not have had that. I would’ve not had all of those things come together in that moment and had that happen. But I’m curious, over the last 16 years, we’ve got the pandemic, but what else can you point out throughout that time, and it can be good and it can be bad, about how we look at ADHD as a culture?

Melissa Orlov (12:22):

Well, there’ve been huge changes in that time. So back in the mid-2000’s, people were not even thinking about adult ADHD. That’s when Hallowell and Ratey came out with, “Delivered from Distraction”, which was really the first big public book on adult ADHD. So that was the beginning of thinking about it. And since then, there’s been a ton of growing interest in adult ADHD and understanding of some of the elements. The most recent part actually is understanding just how much emotional dysregulation is a part of ADHD and the huge impact it has on whether or not you keep your job, on whether or not your relationship is successful, et cetera. But unfortunately, we’re still in the beginning phases because about 80% of adults who have ADHD don’t know they have it. And so until you know have it, like the moment that you had, until you know you had it, you’re just wandering around going, “Why am I so different? I don’t get this. Why is it so easy for everybody else?: And once you know about it, things can change dramatically.

Lindsay Guentzel (13:28):

So let’s say you have a couple that comes to you and one of them has ADHD and they’re trying to figure out this new life together. What are some of the first things that you either point out or ask them about?

Melissa Orlov (13:42):

Those are two different things, but I think the first thing that I want to communicate to couples is that… Well, a bunch of them. First of all, it’s about ADHD and responses to ADHD, and it’s the interactions between them. So it’s not just about, quote, unquote, “fixing” the ADHD partner, it’s also about looking at what those interactions are and what the responses are. So couples need to be much more nuanced in terms of understanding what’s ADHD and what’s not, and how to respond when ADHD is present. So there’s a huge educational component to it. I think the other thing is that there’s a desire to want to deny either that ADHD is important or that the responses to the ADHD are important. So the very first part of my task with almost any couple is demonstrating to them that it’s not personal. It’s not actually that your partner is a jerk or whatever that is. This is actually about symptoms and expressions of symptoms, and then how you can respond in a healthy way and grow your relationship. So that’s the starting place.


And then there’s a lot of work in terms of figuring out specifically the questions you ask any given couple about, okay, so what are the issues specifically for you, and what are the strategies known to help people who have those particular issues?

Lindsay Guentzel (15:04):

I’m curious, do we know anything about how a couple can do if the person with ADHD is medicated or not?

Melissa Orlov (15:12):

Well, so it’s a bigger question than that, which is the ADHD managed? Not everybody can use medication. So 70 to 80% of folks can find a medication that works for them pretty well or very well without meaningful side effects. That means 20 to 30% can’t, but it’s not just about medication, right? It’s about a bunch of different ways. In fact, medication alone, isn’t particularly effective in relationships. But it’s about learning how to optimize that management of the ADHD so that the partner feels they have agency, that they can get things done that they want to get done, that they’re more reliable, that they’re addressing shame or reasons to cover things up or whatever. All of those impact their relationship. So it’s not just about medication, but medication can certainly help.

Lindsay Guentzel (16:03):

I have obviously a ton that I want to get to, but I want to change this conversation. And I asked you when you look back at everything you’ve done over the last 16 years and where do you see changes and where do you see moments that stand out. And I’ve been very curious. I was born in ’86, so I feel like I’ve lived this double life of paper distraction and clutter and then technology distraction and clutter. And I’m wondering how you view the addition of technological advances, like our cell phones and being able to stream whatever we want on our TV, and how that affects couples who might be dealing with an ADHD diagnosis. Because I know from my own experience, and I’m throwing myself under the bus, my phone is my best friend and my worst enemy, and a lot of times it’s my worst enemy with my partner.

Melissa Orlov (16:50):

Yeah. So if you think of a barbell there are two extremes. There are apps and reminders and alarms, and the phone is very handy, or even now when you have an Alexa or something like that where you can say, “Add X to the grocery list,” and you don’t have to move or do anything. There are a lot of very positive benefits to the electronics that we have these days, but it is also created, those apps and the online universe, is created to grasp your attention and hold it. And one of the issues in relationships is about how much attention you can in fact give to your partner, and so when you have that created environment that’s meant to pull you away from your life and into the apps, that’s really hard.


The ADHD brain is a reward focused brain because of the neurochemistry of that brain, and so you go for the thing that feels most interesting in the moment, which is often what’s online. And I hear a lot of other partners, the partners of people with ADHD, saying, “My partner pays so much more attention to his or her phone than they do to me, and that’s really hurtful.” In those situations, you really do have to figure out is the dining room a no phone zone, are there ways to turn it off at a certain time of day so you can pay attention to each other, how do you manage that, do you put filters on or what?

Lindsay Guentzel (18:13):

One thing that I have been talking about with people in my life who have ADHD and who don’t have ADHD is this idea that where we are right now doesn’t mean that at one point in time we didn’t want something else, and that we as humans need to also accept that we can grieve these lives that we thought we were going to have or these paths we were going to go down. And obviously, it’s like choose your own adventure, you have to pick a path, and it doesn’t mean that you don’t miss out or think about what that path would be. And I wonder sometimes with the ADHD brain and always looking for the shiny object and seeing all of these things on social media, like the comparison game, you’re always inundated with what if and what not and what could be, and I wonder sometimes if that is something that can affect relationships.

Melissa Orlov (18:59):

I think so. I mean, I’m not sure it’s just ADHD, because if you think about the levels of anxiety and teenagers these days, a lot of that has to do with how we clean things up and only present our best side on social media and there’s this very unrealistic look. There’s also a growing number of vignettes out there about what it’s like to live with ADHD, this laugh along with me, this is crazy kind of stuff. And so there’s a tribe that’s gaining some stuff there. But I think it can be really, really hard for anybody, and also for people with ADHD, for sure.

Lindsay Guentzel (19:35):

Is there a moment you look back in your career where you knew that this was what you were supposed to be doing?

Melissa Orlov (19:41):

Yes, and I think it was a while ago. When I wrote my first book, which I wrote in 2010 and actually revised again in 2020 to update it, and the response that I got to that book really made me realize that there was this huge need for this. Which I had wondered, because I myself, I would’ve loved to had somebody figure this out and give it to me. And so I think at that point I was like, “Wow, this is just a lot more interesting and fulfilling.” My job, I don’t think of my job as going out and coaching people or counseling people or whatever. I think of my job as helping people save their families, and it’s so amazing to have the privilege of being able to do that. So that came pretty early on when I realized, oh wait, people are really thirsty for this.

Lindsay Guentzel (20:31):

And those updates, what were some of the biggest changes that you saw in those 10 years?

Melissa Orlov (20:38):

Again, my business has grown organically. There’s this growing need, like the website being too many pages and too disorganized and I say, “Okay, how do I address that,” and that’s just how it’s gone the whole time. People say, “We want more in-depth information.” “Okay, I’ll create a seminar.” People say, “Well, we need more after that.” “Okay, I do support groups or ADHD programming.” Because I’m moving towards the end of my career, I’m not exactly sure when that’ll be, now I’m saying, how do I take this actually very important body of work and distribute it out into the world so that it continues? Because people really need these resources, and at the moment, there aren’t very many professionals who are ADHD savvy, sadly. It’s not really taught in the schools, and certainly not the couples work, and so now I’m moving into that. How do I make sure that this continues to be available to more and more people? So I’ve just followed along. And that doesn’t reflect changes, specifically. It just reflects growing interest and awareness in my trying to address what people are just giving to me, “Would you please give this?”


I mean, I also do these weekly marriage tips that I send out. People love them. I have fun doing them. I think they’re great. It’s just a fun way to keep in touch with people, and it’s sort of a tribe. I mean, one of the things that people say is, “I have felt so alone, and now I know I’m not alone, that there are a lot of other people who go through the exact same things. That’s so reassuring and helpful for me, mentally, to know that I’m not just out there by myself, isolated.”

Lindsay Guentzel (22:17):

Well, and one of the things that’s so important with anything when you’re trying to raise awareness is talking about it, because you can go back and look at anything. We can talk about breast cancer awareness and what they’ve been able to do with October and wearing pink, and you get professional sports teams involved and people talk about their experience, and then women know what to look for. There wasn’t that for ADHD. For a very long time, there was a very outdated idea of what ADHD was, and now we’re in this new era where everyone can go to that tricky little smartphone or their computer and find someone to connect to and, you mentioned, not feeling alone. And it’s so important to keep growing that.

Melissa Orlov (23:01):

Yeah, and also keep growing it in a way that’s actually factual. One of the issues is that there’s a lot of misinformation out there as well, so I try really hard to make the information that I make available be research based and actionable, right? It’s okay to read a research study, but then you go now what? And I actually see now what. I get lots of opportunities to work with my couples, and I actually see what works and what doesn’t work. And so I try very hard to provide tools and suggestions for, “Okay, try this. Experiment with this.” If you fail, that’s good because it means you’re working on it and you can learn from the failure and see what’s going to work specifically for you. Because even though the couples have patterns that are very much the same… I can almost predict after two sentences or three from a couple the top two or three things that they’re working on are that they need to address, just because these patterns are so consistent, and we can talk about that if you want, but each couple still has their unique qualities.


Maybe one medication will work or it won’t. Maybe you don’t need medications. Maybe you need interactive strategies. Maybe you actually are talking about executive function issues. It’s all sorts of different options.

Lindsay Guentzel (24:11):

I would love to talk about that. I mean, I don’t know that you have a running list of what’s the most talked about thing when couples come to you, but I have to imagine… You said within two to three sentences you can guess where things are going. And so what does end up at the top of the list, typically?

Melissa Orlov (24:27):

Well, so if you have ADHD you have a set list of symptoms, and how your ADHD expresses depends upon the weighting of those symptoms, but they’re the same symptoms. Otherwise you’re not diagnosed with ADHD, right? So there are ways that those symptoms show up, like distractability is the most common symptom of adult ADHD. It shows up in a certain way in certain behaviors. There are also very human ways that a partner responds to those particular symptoms. So if you’re really distracted, it means you’re not paying much attention to your partner usually, and your partner’s going to feel put out by that, right? They’re going to be like, “What happened here? Wait. You used to be all over me, and now you’re just like I’m chopped liver.” And then emotions build, like anger or whatever. So these patterns that develop are quite predictable because they’re based in the symptoms and the responses to the symptoms.


So the things that I’m most likely to see, the most common patterns, the top one is really what I call parent-child dynamics, where you have a non-ADHD or perhaps more organized ADHD, if you have two ADHD people in the couple, who is the manager of stuff that’s happening, and then they become the manager of the relationship, and then they become the manager of the other person, like, “Remember to do this,” and nagging about that, and they’re over functioning in the relationship, essentially. The other person with the ADHD, or the less organized person, is an underfunctioner in the relationship. They’re having trouble completing things because of the ADHD symptoms. They’re having trouble following through. They’re having trouble with time management. They make a lot of promises that they don’t keep, not because they don’t want to, but because the symptoms get in the way. And they lose status in the relationship. So if somebody says, “I feel like I’m married to another child,” boom, that’s parent-child dynamics. So there are phrases. That’s one of them.


Another is what I call like the chore wars, which is intertwined with this, having trouble getting things organized in the house and resentment around chores and stuff. And then there are a lot of usually anger issues or emotional dysregulation issues that you see. So those are the top ones.

Lindsay Guentzel (26:45):

I feel like that’s a great place for us to wrap up this first episode, because, as I mentioned, we are going to be talking to you throughout the entire month of February, so there’s going to be four episodes, three more after today’s, with Melissa Orlov. And you can catch all of them wherever you listen to podcasts. You can subscribe to Refocused and get it delivered right into your inbox. And I just want to make sure that if you haven’t checked out Melissa’s website yet, it is adhdmarriage.com. Make sure you go over there, because it’s an unbelievable resource for couples who are traversing the complexities of ADHD and relationships. And here’s the one thing that I want to make sure that you know about is her couples seminar. It happens live via Zoom two to three times a year, and it has helped so many couples improve their ADHD impacted relationships. It’s truly a lifeline for couples. And the great news is there is a self-study version that’s available on her website, so make sure you add that to your to-do list. Maybe set a little reminder that you head over there ASAP.


Refocused is a collaboration between me, Lindsay Guentzel, and ADHD Online, a telemedicine mental healthcare company that provides affordable and accessible ADHD assessments and treatment plans, including medication management and teletherapy. Now it’s time to thank the incredible team that makes Refocused happen week after week. The talented folks behind today’s episode include coordinating producer Phil Rodemann, Sarah Platanitis. Our writer, Sarah Gelbard, lead research for today’s convo. Social media production from assistant producer Al Chaplin. As always, shout out to Keith Boswell, Claudia Gatti, Melanie Meyrl, and Susanne Spruit, and the entire team at ADHD Online for all of their ongoing support. Bear Beat Productions is the team behind today’s edit. And a big shout out to the team at PS Creative in Phoenix for handling all of our production needs onsite. Our show art is created by Sissy Yee of Berlin Grey, and our music was created by Louis Inglis, a singer-songwriter from Perth, Australia, who was diagnosed with a ADHD in 2020 at the age of 39. Links to all of our partners we work with are available in the show notes.


To connect with the show or with me, you can find us online @refocusedpod, as well as @lindseyguentzel. And drum roll, please. Our new email is up and ready and waiting for you to send us emails, [email protected]. Again, that’s [email protected]. We hope to hear from you guys soon. And of course, stay tuned for the next installment of our conversation surrounding ADHD and relationships where we’ll dive into dating and divorce with Melissa Orlov. That’s coming up next week on episode 66.


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