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Building social capital is critical for strong relationships. ADHD can get in the way.

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An earlier version of this story misspelled Sasha Hamdani's last name. This version has been corrected.

A group of medical school friends nominated Sasha Hamdani to create a memory book for their pregnant classmate. Hamdani worked hard on the task for several weeks. She printed pictures, gathered mementos and listened to stories about their friend. The book — meant to be a group gift for their classmate’s baby shower — was more than 100 pages long, with items such as anatomy class doodles and fabric from a white medical coat.

On the flight to the baby shower from Kansas, Hamdani realized when she was searching in her bag for her headphones that she had left the memory book behind. She felt awful. “I’m sure that half of the people here thought I never even made anything,” she recalled thinking.

Hamdani, now 35, was diagnosed with attention-deficit/hyperactivity disorder at age 9. She frequently misplaces important items, runs late or struggles with a disorganized purse — all symptoms of ADHD. She has been labeled a “flake” because she forgets social engagements or to reply to texts. People have often told her, “If it was important to you, you’d remember.”

The repercussions of such missteps are an important yet underdiscussed issue for children and adults diagnosed with ADHD. While most people think of this disorder as causing difficulties with completing assignments in school or the workplace, it can also lead to a deficit in what experts call “social capital.”

“Social capital is the network and goodwill that you have with other people that help you not only accomplish tasks, but also [maintain] important social connections,” said Caroline Maguire, a family coach in Massachusetts and the author of “Why Will No One Play With Me?” Once you amass social capital, you can then draw on it by asking for help when needed.

Here are some reasons people with ADHD might not have much social capital to draw on, how a lack of such capital can affect them and what can be done to build social capital.

Why children and adults with ADHD sometimes lack social capital

Poorly managed ADHD. Failure to treat symptoms — such as not paying attention or being disorganized — with medication or counseling, can lead to relationship problems. For example, a person with ADHD may forget to put away their clothes or leave dirty dishes on the table, annoying their partner. Over time, this can leave their partner feeling unsupported and resentful.

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Even those who are being treated might skip their medication during the weekend, believing it’s unnecessary if they’re not at work or school. But weekends are when people socialize with friends or family. Ari Tuckman, a psychologist in Pennsylvania and the author of “ADHD After Dark: Better Sex Life, Better Relationship,” said that when people with ADHD don’t take their medication on weekends, they may experience problems in their relationships. One of Tuckman’s clients told her husband, who has ADHD, “Your co-workers get ‘Medicated Joe,’ and I get ‘Unmedicated Joe.’ ”

Trouble with social cues. Even with the proper medication, people who have ADHD may still struggle with paying attention to social cues. “If you don’t read social cues, which a lot of ADHD kids don’t, then they might not even realize the social ramifications” of their actions, Maguire said.

In social situations, people with ADHD may impulsively interrupt conversations or have trouble waiting their turn during a game. For example, if a group of children at a birthday party are all waiting patiently to hit a piñata, the child with ADHD might run up, jump to the head of the line and hit it. This might cause the other children to feel angry.

Ryan Wexelblatt, a clinical social worker in New Jersey who specializes in ADHD said that people with the disorder have trouble understanding other people’s thoughts and feelings. The partner of a person who has ADHD might consider their relationship one-sided and think, “They’re asking me for something but not really giving anything in return,” he said. This inability to invest in social relationships also leads to a lack of social capital.

Lack of face-to-face peer interactions. Children who have ADHD might avoid in-person interactions because their difficulties with social cues lead to shallow connections. They’re often drawn to video games because of the stimulation they receive from them, Wexelblatt said. But when kids play video games or engage in other solitary activities, they aren’t spending time with peers or building relationships; instead, they’re retreating into an artificial world with superficial relationships.

Difficulty with executive-functioning skills. Organization, planning and memory are helpful not only in school or the workplace, but also in relationships. If a person with ADHD is always late to meet a friend for lunch, then that friend could eventually feel they can’t rely on that person or they don’t value their time.

“One social expectation is that you be on time. If you text me, you respond to my text,” said Maguire. If people with ADHD don’t adhere to these social norms, relationships can suffer.

People with ADHD sometimes struggle with what experts call “time blindness” — when you are unaware of the passage of time. This behavior can also disrupt relationships.

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“If they’re chronically late and they don’t have a real excuse and say, ‘Oh, I was on TikTok, and I just spaced,’ ” their friends will feel upset, said Anita Robertson, a clinical social worker in Texas and the author of, “ADHD & Us: A Couple’s Guide to Loving and Living With Adult ADHD.”

Other people’s misunderstanding of ADHD. “ADHD is not taken seriously, and it’s looked at as a character flaw,” Wexelblatt said. That can mean that people with ADHD aren’t given the benefit of the doubt in social situations or assumed to be “flakes,” as Hamdani has been labeled. For example, if a person tells their friend with ADHD about an upcoming job interview that they are nervous about, but that friend later forgets to ask how it went, it could be misinterpreted as not caring.

How a lack of social capital affects children and adults with ADHD

A lack of social capital may translate to a lack of friends. A 2021 study done at the Peres Academic Center in Israel found that parents of children with ADHD perceived their kids as lonelier than those without the diagnosis. “These kids [with ADHD] may not get the same number of invitations to hang out,” Tuckman said.

A 2019 study conducted at the University at Buffalo showed that adults with ADHD experienced more interpersonal problems compared to those without the diagnosis. They may try to make up for their lack of social capital by being people-pleasers. “They tend to get involved in romantic relationships with people who take advantage of them,” Wexelblatt said. Alternatively, they may overpromise to make up for past mistakes. But that sets people up for failure, said J. Russell Ramsay, a clinical psychologist and the author of five books related to adult ADHD. “They think that there’s no way I can keep up with this.”

Whether a child or adult, Maguire said, “if you don’t feel like your social connections are successful, then you start to lack confidence, and it spirals.”

How to build social capital

Manage ADHD symptoms. One way to build social capital is by managing ADHD symptoms through medication and counseling. When symptoms like inattention, disorganization and impulsivity are managed, then the person with ADHD will be able to interact with others in socially acceptable ways.

Another way to help people with ADHD be successful in relationships is to create routines and structure. If the expectation is specific, like taking out the garbage every Wednesday night at 6, then it becomes a habit that is easier to remember.

Set up positive social environments. Ramsay said that often children don’t have a social-skills deficit; rather, they have trouble understanding when to appropriately use the skills. People with ADHD can improve their social skills through an exercise Maguire created called “Social Spy.” Go to a location where people like to gather and watch them (discreetly), paying attention to social norms like turn-taking. Then challenge yourself to detect social cues.

Robertson suggested turning tasks into games for both kids and adults, to make them more interesting and enjoyable. “ADHD brains are at their best when they’re having fun,” the clinical social worker wrote in her book. For example, you could say, “I’m going to time you and see how fast you can put the laundry away.” You could ask them to guess how fast they can do the task or see if they could beat their record from the last time.

Educating others about ADHD. Parents may need to educate teachers or their child’s friends about ways their child with ADHD might struggle with relationships. Kids and adults with ADHD may also need to help other people understand their disorder.

“Often it’s psychoeducation for the non-ADHD partner about what ADHD is and is not, and what will be the frustrating points in relationships,” Ramsay said. He cautioned that people with ADHD are still responsible for their share of expectations, like household chores. But sometimes the non-ADHD person may incorrectly infer meaning to behaviors — for instance, if my partner forgets to mow the lawn, that means that they don’t care about the relationship.

Tuckman also discussed the importance of talking openly instead of making assumptions. “Try to create a relationship where both people can be honest and direct.”

Resources like Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) and the website “ADDitude” can help people with ADHD and their families or friends.

Maguire is a writer based in Massachusetts. Find her on Twitter: @CherylMaguire05.

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