Sex, Relationships and ADHD with Rachael Rose

Rachael and I both have the combined type of ADHD, which includes traits of the other two subtypes, known as hyperactive and inattentive. She was diagnosed in her early teens and it was sort of an afterthought. She told me that her brother presented more of the stereotypical “hyperactive boy” symptoms many people associate with ADHD. After he was tested, her parents thought maybe Rachael should be, too. Even after her diagnosis, Rachael wasn’t as convinced.

Rachael:

I didn’t actually think I had it. And actually, that went all the way through my 20s up until maybe like four or five years ago, when I realized I might be the poster child for it when I had a better understanding of what ADHD was. And it’s funny because I used to just think Oh, no, I’m just a head-in-the-clouds kind of person. I’m just artsy and creative and my classes boring. Why would I want to pay attention? I’d much rather just live in my head or doodle on my notebook. 

I did well in school, and so I think I was like, I don’t think I have this. I was medicated and I found the Adderall that I’ve been on for many, many years to be helpful with waking up and getting other things in my life done. And so I was like, Well, if they want to give this to me because they think I have this thing, sure. This works for me, only to later in my 20s have a therapist who also had ADHD and had done a bunch of their dissertation in that field and would point out different things to me that I was saying. And she would be like, “Oh, that’s an ADHD trait,” or “that’s really common in this,” and it was in such a relatable way that I was like, Oh, damn. I think I might be the poster child. 

So I started digging into myself and learned all this stuff about it. There are so many characteristics I thought were just quirky personality traits that really are part of ADHD. But they’re actually things I like about myself. They’re things that I identify with. And I think there’s a lot more to it than is presented in literature, perhaps, or when you see a news report or something.

August:

Yeah, absolutely. And that’s so great that you had a therapist who knew it so well, because many therapists, if they don’t specialize—I’ve heard that they might have a class on it—they might know a little bit. But it’s very easy for people who don’t really understand it fully to misinterpret things like “Oh, that’s a trauma response that you can’t sit still” or “Oh, that’s x, y and z.” Why don’t you just make a list and follow your calendar? And you’re like, what?

Rachael:

Just try harder. Cool! I hadn’t thought of that one.

August:

Right, easy. Sounds great. I’ll start right now. 

So for anyone who’s not really familiar with ADHD—maybe they’ve heard, “Oh, look, asquirrel!”—it’s just about being distracted all the time and hyper. What is that “more to it” that you described?

Rachael:

There’s a lot of stuff that scientists are figuring out and the research definitely hasn’t caught up with the fact that it impacts people of all genders and ages. So, there’s a lot that’s still being researched. But they believe it is actually more of a dopamine dysregulation disorder. So what that means is people with ADHD don’t have enough dopamine to get them to do the thing, whatever that thing is. And so where a neurotypical person would be, oh, cool, I have five things to do. I’ve got to pay this bill. I need to walk the dog. I need to do the dishes…. 

People with ADHD don’t have the dopamine that actually gets them to get up and go do that thing. And so they’re often really seeking dopamine. So things that bring us that are definitely going to catch our attention far more than things that do not, and boring, menial tasks don’t bring joy to anybody. But sometimes we can get ourselves to do it. And I think a lot of people find these little life hacks for it. 

So, if you have a bill you need to pay and let’s say your partner goes on a trip for a few days and you’re like, I’ll pay it before you get back. And then, of course, you don’t pay it at all. And they’re getting home in like 12 minutes, and they’ve given you a call and they’re like “I’m in the neighborhood.” Suddenly, because there’s all that extra buildup and stress behind it, you have all this dopamine to get you to do the thing, and it takes you five minutes when it took you a week of thinking about it to even get to that point. 

It’s something that impacts so many elements in our lives. And it’s not necessarily a bad thing. I kind of tend to think of it as more of a brain style than a disorder but it is one that doesn’t always align with the way we live in our society. And so that can be really problematic.

August:

Yeah, completely. And also, if you don’t know that you have it, you can experience all kinds of complications. At least for me, I was diagnosed at 30…I had an eating disorder that I’m pretty sure would not have happened had I known better—like all these things. So, I remember once I started medication, I was like, I love my brain. I’m fine. I like these parts of me. When it’s not managed, that’s when it feels like a disorder. Has it ever felt like a disorder to you? Because I totally embrace that we’re neurodivergent and it’s the world that makes it hard for us. And then at the same time, I need medication.

Rachael:

So growing up, I felt like my medication was really helpful. And that helped me get through school without a ton of trouble. School was also something I enjoyed. I really loved learning and that gives me a ton of dopamine—especially if it’s something I’m interested in. Really, only if it’s something I’m interested in. 

But I’m also chronically ill and disabled. It’s a long story but it’s a rare disease called mastocytosis. It’s a rare mast cell disease and very long story short, my body interprets normal, everyday things as if they’re attacking me and responds by releasing all the chemicals in this particular type of cell, a mast cell, which is part of the immune system, and that causes me to have allergic reactions. 

And I had this huge flareup a few years ago, in 2017. And it feels like at that point in time someone handed me a new brain and was like, figure out how to use it. And in the last three years, I have really, really understood why some people feel so negatively about their ADHD because before that, although I focus more on sex ed these days, my background is in graphic design and art. Those are all positive things. I’m very artsy and creative. I see solutions to problems that not everybody else can see and look at things differently. And I think that all comes from being neurodivergent. 

But also, in the last few years, I sit down to do a thing and the next thing I know, I’m on Facebook for 12 hours and I don’t even realize I’ve switched tasks. That’s an exaggeration; it probably hasn’t been 12 hours. But I find it hard to focus these days. I find it really challenging to keep focused to get things done on time and in a timely fashion. I feel like everything takes me too long. And I can’t tell if it’s a perception thing or reality thing. I don’t even have a sense of time. That’s one I’ve never had. So, I have to learn to life hack that a little bit.

August:

Many people call that inability to sense time or to feel time differently “time blindness,” a term Rachael and others are actively seeking a new title for. Disability advocates have pointed out that it’s not ideal and possibly harmful to name one disability with another. 

For ADHD folks, memories tend to be a lot more emotional than linear. You’ll remember how you felt and events that hold a lot of emotional significance but recognizing how much time has passed or placing things in chronological order can be tough. I think of my own memory as more kaleidoscope-y. 

All of these factors can impact sex and intimacy, as Rachael knows well. 

Rachael:

For me specifically, I’ve noticed it a lot more in the last few years, partially because of this flareup… I feel very confident that something in the structure of my brain or the way that it functions has changed, which makes some sense because the condition I have causes a ton of neuroinflammation. So that’s very plausible.

But, also, I’m polyamorous, meaning that I have multiple relationships in my life. Prior to that, I was in a long term, monogamous relationship, and my partner and I decided in 2016 or 2017 to open up our marriage and to start seeing other people as well. And it’s been really great but I can definitely see very clearly how ADHD plays a role in things when it’s new…. But also, new things are like ADHD candy, and you want to chase after them a little bit. 

And seeing how things like NRE (new relationship energy), that happy buzz you get when you start dating somebody new and you’re really into them, how that can be perhaps problematic, if you feel that for every new person you date but you have long term partners you care about deeply, trying to balance their needs versus your desire to just spend all the time feeling happy and full of dopamine in that kind of happy buzz. That’s a big one. 

I think there’s a lot of ways—I’ve seen it play out—where being in a long-term relationship, how time management and my lack of ability to manage my time, can play a role. I do a workshop:  Get Your Head in the Game: How to Have Great Sex with a Noisy Brain, that’s particularly about ADHD and anxiety, as two of the main ways people are distracted, or the epitome of those examples of being distracted or nervous. And one of the things I talk about is when you live with somebody and they’re around all the time, even if you super want to have sex with them, and it’s fun, suddenly, it’s always available, in a way. 

You find it hard to prioritize that over the other things that you may need to get done that may have a strict timeline or are causing you more stress or whatever. And so the next thing you know you’re like, “Yeah, yeah, well, give me 15 more minutes, give me 20 more minutes, I just need to finish this up.” And the next thing you know, it’s like two in the morning and your partner’s fallen asleep three hours ago. As a night person, I end up in that one more often than I probably should.

I’ve talked to other friends who have issues with not prioritizing housework the same way. I have a good friend who… she’s neurotypical and her partner is neurodivergent with ADHD, and she likes when her house is cleaned a certain way. And for maybe reasons of socialization or whatever else, personality, it’s not as much of a priority for him. And I know that because of the ADHD he finds it extra hard to do those things. And I know that that for them is a big issue. It varies wildly based on the individuals involved. But I think that there are so many ways that can play a role.

August:

Some of the strengths of having ADHD in terms of sex and intimacy involve using that hyper focus and fantasy for good. When I spoke with our resident sex and relationship therapist, Dr. Megan Fleming, about this topic she brought up great points about both of these things.

Dr. Megan:

When it’s a focus on something that’s of interest, it’s kind of hyper-interest and hyperfocus for those with ADHD. So, honestly, for many, sex is the one place that their mind can kind of quiet down, so to speak, because they’re super focused either on the sensation and or fantasy. Fantasy can be a huge piece of their turn on. And so if they know how to use that with their partner and be sort of talking out loud and sharing that fantasy with their partner, it’s a real sense, the ability to truly feel your partner with you, instead of the distractibility. Like I said, sex is the place where you truly can feel your partner there. And I think that can bring a lot of intimacy to a couple.

And then I think it depends on the dynamics of the relationship. But if fantasy is an important piece of it, sex is actually a really great place for them to be truly training themselves. Because if your partner isn’t present in sex—honestly, I hear this a lot—most people would really prefer to masturbate. It, to be honest, just doesn’t really feel good to be in the presence of somebody who is just sort of in their head or going through the motions. 

August:

Rejection sensitivity, also known as rejection sensitivity dysphoria or RSD, can also impact relationships when you or a partner has ADHD. This is an aspect I wish I had learned about a lot sooner. I only realized it was a legitimate thing a couple of years ago and having a name for it can really bring heightened understanding and compassion. 

Rejection sensitivity is basically what it sounds like, being a lot more prone to feelings of rejection and experiencing those emotions really deeply. It can manifest in all sorts of ways: from deep, sudden sadness and physical fatigue that lingers on for hours or days to chronic, low self-esteem, social anxiety, and bursts of anger. Someone might snap at you, a bit, out of frustration and then move on with their day like it wasn’t an ideal thing, it wasn’t something they are glad that they said, but it wasn’t this huge issue.  Yet you as someone with ADHD end up with these ruminating thoughts, tanked energy and just a lot of emotional angst.

These feelings can come on suddenly after what might seem like a no-big-deal conversation on the surface. So in addition to feeling hurt and rejected, it can be easy to feel foolish or silly for feeling those ways. In reality, there is nothing foolish about it. And RSD is very, very common. It’s been part of Rachael’s experience with ADHD as well.

Rachael:

Just an example of cognitive function, I often forget things. I remember having a conversation but sometimes the specifics often get blurry for me. And so I had been dating somebody, and I’d ask them a question. And they’d be like, “Oh, we’re doing this. Don’t you remember?” The cognitive function’s been a new thing for me. It’s something I feel very sensitive about. It’s not something I would choose, obviously, and it’s difficult to manage. 

So, you know, after that happened a couple of times, and I know that she just meant something totally harmless by it, but the way that I was reading was I feel stupid. I feel bad about myself. Why don’t I remember these things? And so eventually, I just said something to her. And I was like, “Hey, listen. I know, it’s really annoying to have to answer the same questions. And I don’t know that you meant it that way. But if I already remembered, I wouldn’t have asked. This is a thing for me. And it’s hitting on, you know, my rejection sensitivity dysphoria, and it’s making it feel like a bigger thing than I think it was intended from either of us. Would you mind not saying that in the future.” And that was like a really easy way to navigate that, and it never came up again. She was just like, “Oh, yeah, sure, cool.” 

Having the language behind it can just make it so much simpler to navigate and to explain to somebody why that’s a problem. And what they can do for you to frame it differently. We get to the same point without having to have her say that specific phrase or make me feel that way. And so being able to use those words, to describe it to her and explain the situation made it much easier to navigate and come to a conclusion that worked for both of us and got to the same point.

August:

As that experience illustrates, it helps to have people in your life who want to understand and who care about and respect things that make you unique or pose challenges in your life. I think that is especially true when one of you is neurodivergent. Those same attributes, I hope, we all find in partners and friends are often pretty pronounced in folks with ADHD.

Rachael:

When you understand what it feels like not to be understood or not to have somebody understand what you mean or to misinterpret what you’re saying or to be frustrated with those things or to feel bad because of your rejection sensitivity dysphoria, I think that’s built a ton of empathy for me. I feel like I’m great at creative problem solving. And I don’t know if it’s part of it or not, or if it comes from being fascinated by art, growing up and having that be a huge part of my life. But I think it all ties together. I think that my creativity and my ability to problem solve definitely come from being neurodivergent. 

I think it’s a pro and a con that people who don’t fit into our societal norm—if you’re chronically ill, if you’re neurodivergent, if you’re mentally ill— you suddenly become this spokesperson for whatever you’re dealing with, because in order to be treated the way that you want to be treated, you have to be able to explain to people what that looks like or why you need that, or how they can do that for you. And I think those are all really important things. 

And personally, I think that makes me a better educator, because I think that in learning to navigate my personal life, I’ve already come up with great ways to explain to people who may not have otherwise understood it in other contexts. And also, educating other people has also made me better navigating those things in my personal life. So, it kind of goes hand in hand, I think.

August:

Through Rachael’s work as an educator and speaking and teaching about ADHD, she’s heard about many other ways this type of neurodivergence can impact sex. 

We’ve both heard from folks who are so overwhelmed by distractions, such as certain aromas or sounds or sensations or thoughts, that sex isn’t very appealing at all. And even though, as Dr. Megan pointed out earlier, sex is present-bringing for some people with ADHD, it goes the opposite way for others.

Rachael:

I’ve heard both sides of it…. If you think about it, realistically, there’s no other point in life where we’re expected to just think about one thing. In fact, we’re both socialized and trained to think about as many things as possible at the same time. And then we are rewarded because got to feed into that hustle culture and multitask all the time. Yay, capitalism! And I think it’s that but on the other flip side, there are some people who that’s the only time their brain shuts off. And boy, do I envy those people because I’m not one of them. 

For some people, that trying to shut everything else out can become a source of anxiety, too. And that can be like a deterrent from wanting to have sex in the future. There’s the whole idea of the dual control model of sexuality; basically you have a gas pedal and a brake pedal. Stuff like that can totally feel like it’s extra weight on the on the brake pedal, and after a while that can change your interest in sex in a larger way, even when it was a small thing to begin with, because it can be a hard thing to navigate.

 In doing research for my workshop about it, there’s not a lot of first-hand accounts. Dr. Liz Powell and I are in the process of developing a survey because we want to write a book about this. Everything that’s been written about ADHD and and sex at this point, as far as I know, none of them have been written by people who have ADHD. And they definitely have not been written with a LGBTQ inclusive or looking at a spectrum of gender and not just “a” or “b” as options. We both really want to make it something that’s real because I think it’ll help a lot of people.

There are so many people who feel if they can’t focus during sex, they’re doing something wrong. They’re bad. Their partners will maybe accuse them of not being as into it and it builds up all this shame. That breaks my heart a little bit because it’s just how your brain is wired. And there’s not anything wrong with it. It’s just different. If you can explain that, then it doesn’t seem like such a bad thing. But if you don’t even know, if you haven’t received a diagnosis, and for a lot of people that’s the case, because there’s so many barriers to access that kind of health[care] and even more to get the medication, if that’s something that you choose to go for. And even people who do know don’t always have language to explain what’s happening. And so that can create so many problems, just the lack of being able to communicate around it.

August:

It’s so true. And I think knowing that we can experience pleasure, while our brains are bouncing all over the place. Just giving ourselves that permission, I think, can be really important. Because you’re so right. I mean, how many times do we hear, what’s your top sex tip? Slow down, be mindful, focus on the present. And I’m like, now I want to do jumping jacks and run around in circles. That makes me feel broken. 

Rachael:

And people will be like, “Oh, you should just meditate and it’ll help you be more mindful.” To be honest, meditation makes me anxious. It stresses me out. I’m like, okay, now I’ve got to find somewhere to meditate. I gotta block off a whole chunk of time for this. So now I’m just lying here listening to some person with a relatively soothing voice speak speak at me while honestly, I’m just making grocery lists and to-do lists in my head.

I once fell asleep during yoga. If I’m relaxed enough, I’ll just fall asleep, which doesn’t happen often. I’ve tried different things. And either I make lists of things I need to get done or I lean toward being less conscious and fall asleep. Those are the only two modes I really have. And so I think trying to do that during sex just feels like patting your head and rubbing your belly at the same time and it honestly feels more overwhelming than it does pleasurable, rather than just being yourself in the moment. You know?

August:

100%, yeah.

I feel like myths around ADHD, because they’re so prevalent, can interfere with intimacy and relationships and dating. If you’re on a date with someone, online or off, and you mentioned you have ADHD and immediately the person jumps into, “Oh, that means, you know, squirrel!” or whatever. “Why don’t you just try yoga?”  What are some of the most common myths that you would like to debunk?

Rachael:

The idea that people with ADHD just need to try harder is a big one. Because that’s not it at all. I don’t think I’ve ever met an ADHD person who doesn’t work their ass off at whatever the thing is. Largely, ADHD folks are an extremely passionate bunch of people who are really into whatever it is that they’re doing, because that’s really the only thing they can get themselves to focus on…the things they feel passionate about. So that’s where we tend to gravitate, and we are already doing our best.

It’s honestly not our fault that society isn’t designed for us. That doesn’t mean that we don’t figure how to live in it. It just means that we shouldn’t be shamed for it. And it also means that the people who love us need to understand that we’re doing the best we can in, a context that it wasn’t designed for us. It’s the same way that I think a lot of other people who are marginalized in other ways need to figure out ways to make stuff work for them, too.

August:

She’s so right about that. The challenges around all of that can be really tough. In hindsight, some can also be a mix of cringe-worthy, painstaking, ugh and funny—at least if you’re someone who likes to see the humor in these things, which Rachael and I do. 

For example, in my own life, I once got so bored during a date that I called my dad to come and pick me up. That probably sounds a little mean or selfish. It’s not like I’m proud of it . It also wasn’t this Oh, I’m a little bored, this is a little dull type of situation. It was I am in pain from boredom and I might explode.

I also got engaged on a first date once. Not as a joke, but actually engaged. 

I asked Rachael to share some similar memories.

Rachael:

The ones that come to mind are like not big, funny stories. They’re just things that happen a lot actually, especially with my very long-term partner.  I’ll remember something I wanted to tell him earlier in the day, or worse, a really bad dad joke or something I feel I need to tell him immediately but we’re in the middle of having sex, and I know that it’s wildly inappropriate. Here’s a specific example.

There was a TV show on E! several years ago called The Soup. I think they might have brought it back. There was this one segment called “Chat Stew” and the opening sound was some graphic and a woman’s voice going, “Mmm, so meaty.” It became this running joke with my partner because we would watch it. At one point we realized we’d been joking about it (a couple days earlier) and I was going down on him. I couldn’t stop myself. I was like ”Mmm, so meaty.” We burst out laughing. 

I could never have sex with somebody who couldn’t laugh at that kind of thing. Clearly a very mature human. Other times, if there is music playing in the background when having sex, I feel like I need to have sex to the rhythm and it throws me off if we’re not on beat, and then I’m trying to reach over and change the song on my phone, because I want to have an orgasm, and we’re not going fast enough. 

I never really gravitated toward this idea where people are super serious, it’s passionate and intense. Sex like that would never work for me because that’s not how my brain works. And I just find people who appreciate it the way that I do and that works.

August:

Learn more about Rachael Rose at her work at hedonism.com. 

Take a survey she put together with Dr. Liz Powell for a book they’re co-writing about various ways neurodiversity can impact sex, love and relationships here. 

The survey has sections for people with ADHD, people without ADHD and people who have partnered someone with ADHD. I’m excited to take it myself.

If you’re struggling with sex or relationships because you and a partner have different brain styles, or maybe you’re both neuro-atypical, Dr. Megan had this to say:

Dr. Megan:

Educate yourselves. I really love Dr. Hallowell’s Driven to Distraction and Freedom from Distraction. As I always say, we know what we know and we don’t know what we don’t know. Getting books is a great way to learn about how you’re feeling or your partner thinks. It’s kind of like a therapist, in a sense. It’s a third-party perspective. If you hear things that your partner is doing, or not doing, and see somebody writing about it, it’s like a common theme. And I think it helps you hold more curiosity and less judgment, and hopefully, gives you a little bit more acceptance. 

It’s not that your partner’s symptoms of ADHD can’t get better or change. But it is going to take energy and effort. It doesn’t necessarily come easily or readily. But I think that’s also true of relationship skills, in general. 

I think the biggest takeaway for somebody with ADHD is if you’re having problems in your sex life, or in your relationship, is to realize it’s often not going to get better on its own. First pass absolutely try self-help and get some books. But if that’s not working, definitely seek therapy and take the stigma out of that. If your car broke down, you certainly wouldn’t go try to fix it on yourself. You would get a mechanic, right. I think people have to realize at the end of the day, you only have so much of a skill set. And it makes complete sense to work with somebody else who’s got the expertise that you don’t have.

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