Stuart Bradford

Does your husband or wife constantly forget chores and lose track of the calendar? Do you sometimes feel that instead of living with a spouse, you’re raising another child?

Your marriage may be suffering from attention deficit hyperactivity disorder.

An A.D.H.D. marriage? It may sound like a punch line, but the idea that attention problems can take a toll on adult relationships is getting more attention from mental health experts. In a marriage, the common symptoms of the disorder — distraction, disorganization, forgetfulness — can easily be misinterpreted as laziness, selfishness, and a lack of love and concern.

Experts suggest that at least 4 percent of adults have the disorder, that as many as half of all children with A.D.H.D. do not fully outgrow it and continue to struggle with symptoms as adults, and that many adults with the disorder never received the diagnosis as children.

Adults with attention disorders often learn coping skills to help them stay organized and focused at work, but experts say many of them struggle at home, where their tendency to become distracted is a constant source of conflict. Some research suggests that these adults are twice as likely to be divorced; another study found high levels of distress in 60 percent of marriages where one spouse had the disorder.

“Typically people don’t realize the A.D.H.D. is impacting their marriage because there’s been no talk about this at all,” said Melissa Orlov, author of the book “The A.D.H.D. Effect on Marriage,” to be published in September.

Ms. Orlov says she began studying attention deficit’s toll on relationships after her husband received the diagnosis about five years ago. Although she had been working for years with Dr. Ned Hallowell, a leading researcher on the subject, Ms. Orlov had not realized that the disorder was also ruining her marriage.

“I felt like he was consistently inconsistent,” she said in an interview. “I could never count on him. It goes from feeling responsible for everything to just chronic anger. I didn’t like the person I’d become either.” (They are now happily married, she added.)

Of course, complaints that a husband or wife is inconsiderate and inattentive, or doesn’t help enough around the house, are hardly limited to marriages in which one or both partners have attention problems. But A.D.H.D. can make matters much worse.

It can leave one spouse with 100 percent of the family responsibility, because the other spouse forgets to pick children up from school or pay bills on time. Partners without attention problems may feel ignored or unloved when their husband or wife becomes distracted — or, in another symptom of the disorder, hyperfocused on a work project or a computer game. They may feel they have no choice but to constantly nag to make sure things get done.

Spouses with attention deficit, meanwhile, are often unaware of their latest mistake, confused by their partner’s simmering anger. A lengthy to-do list or a messy house feels overwhelming to the A.D.H.D. brain, causing the person to retreat to a computer or a video game — further infuriating their spouse.

“It’s not because they’re lazy or they don’t love their spouse, but because they are distracted,” Ms. Orlov said. “But if you don’t know that distraction is the issue, you start to think the person doesn’t care about you, and anger and resentment build up.”

Although treatment often starts with medication, it typically doesn’t solve a couple’s problems. Talk therapy may be needed to unpack years of accumulated resentments. Behavioral therapy and coping strategies — for both partners — are essential; for instance, Ms. Orlov would banish long to-do lists in favor of recipe cards that each contain a single task, sorted in order of priority. It’s a subtle switch, she says, but surprisingly effective.

One of the biggest challenges is for both spouses to accept the very real toll an attention disorder can take. Often the partner without A.D.H.D. worries that the diagnosis will give the other partner an excuse for not helping; meanwhile, that partner typically has a hard time understanding how his or her behavior affects others.

“Initially I think I was a bit of a skeptic about A.D.D. in general,” said a 52-year-old man from Cleveland whose wife of 26 years recently received a diagnosis. He asked that his name not be used to protect the family’s privacy.

He described a life of “crushing responsibility,” of working full time, caring for his children and his wife, and maintaining the household and finances. “After years of this, I felt I didn’t have two children, I had three children and no one to help,” he said. “I was always the one who said, ‘No, we can’t do that,’ or ‘Get this done.’ I had to be sort of a nag.”

His wife’s distractedness was particularly challenging when the children were young. “She could be in the room but paying no attention to what was going on,” he said. Traditional counseling didn’t help. On the brink of the divorce, the wife found Ms. Orlov and Dr. Hallowell’s Web site, adhdmarriage.com, and began consulting with Ms. Orlov. Although the couple have only just started therapy, they are finally hopeful about their future together.

“It’s been a revelation,” the wife said. “I didn’t realize what a critical piece the A.D.H.D. has been in my marriage.”

A version of this article appeared in print on July 20, 2010, on page D5 of the New York edition of The Times.