Most people have heard of attention-deficit/hyperactivity disorder (ADHD), a condition that affects a person’s ability to focus, shift their focus, stay still, or control their impulses. Experts estimate that over seven percent of children and three percent of adults experience ADHD, although their symptoms vary widely case by case.
Until the 1990s, many people, including clinicians, believed that ADHD symptoms faded away as adolescents moved into adulthood. Although the research on and acknowledgement of adult ADHD has advanced substantially since then, it is still widely underdiagnosed—especially, according to a growing body of evidence, in Black and Latinx communities in the U.S. As such, until relatively recently, it was difficult to find information about how ADHD can affect adult life and relationships, and particularly about how ADHD can affect sex.
The effects of ADHD on sex can present themselves in many different ways, according to a person’s specific symptoms and life experiences. One person with ADHD might have a higher-than-average sex drive, desire for multiple or new sexual partners, or interest in exploring new sex acts. Another person might find it hard to focus on or make time for sex, struggle to remember their partner’s sexual wants or needs, or have a lower-than-average sex drive. Overall, people with ADHD seem to experience more sexual dysfunction and relationship issues and less sexual satisfaction than people without the condition, on average.
Though some people with ADHD have no sexual or relationship problems because of the condition, others, even with treatment, may struggle to navigate the idiosyncratic ways that their symptoms affect their sex lives. Given the diversity of ADHD experiences, it can be hard to figure out which issues in people’s sex lives stem from the condition, which stem from something else, and, thus, how to approach them.
Over the last decade, ADHD clinicians like Ari Tuckman and educators like Gina Pera have started to pay more attention to the ways ADHD can affect sex, and to build resources for people with the condition to navigate those issues. People with ADHD have also started sharing more stories about their experiences with sex and sexuality.
VICE spoke to Dani Donovan, an illustrator who makes comics about life with ADHD, and her husband, Josh Price, who also has ADHD, about their shared sex life.
This interview has been edited for length and clarity.
Dani: I’d gone to psychiatric professionals since I was in the eighth grade [for behavioral and mood issues], but none of them ever mentioned that I might have ADHD. My mom actually asked one of my teachers when I was in the fifth grade if I could have ADHD and she told my mom, point blank, “No, she’s too smart.” I could finish my work really quickly, before the rest of the class, then get bored, doodle, and be generally disruptive.
I got diagnosed as a freshman in college when I went to my school’s mental health services for depression. That psychologist had ADHD and, when I was telling her about my life, she recognized symptoms she’d seen in herself. Like, on my own in college, without my parents creating a supportive and structured environment for me, I was having trouble functioning in basic ways—like feeding myself regularly. She asked about my childhood and explained how sometimes ADHD symptoms in girls get read as something else—like, hyperactivity gets read as chattiness. I started on meds, which definitely helped—but mostly with getting my homework done and things like that. I wasn’t seeing anyone regularly about my ADHD and developing wider management strategies. Other parts of my life, like my relationships, were still pretty rough. I didn’t realize how ADHD was impacting those parts of my life until 2016, though, because I only thought of it as a condition that was relevant to school or work.
Josh: I didn’t get diagnosed until I was an adult, either, but my teachers thought I probably had ADHD. I was an OK student, not great. I always did OK in school at first, but then I’d get bored with what we were doing, or I wouldn’t like the teacher, and then it’d all go down from there. But I was quiet; I daydreamed a lot, and I wasn’t hyper, so I wasn’t disruptive.
Dani: The idea of you not being hyper as a child is strange to me, because when we met, you were the guy who’d suddenly just go, “Wanna watch me climb this?” and then run and climb it.
Josh: I was raised in the South, and my mom would always be like, “Just go outside and climb shit and play.” I probably channeled being hyper into that. But also, being raised Southern Baptist, with this culture of, You’ve gotta act this way, and if you don’t, you're gonna get in trouble and get a spanking, definitely led me to have a quiet childhood.
When I got older, I started voicing my daydreams more, which meant that I was constantly blurting things out and interrupting people. When I got to be an adult, with adult money—my family didn’t have a lot of money when I was growing up—my impulse control issues turned into, “Oh, I can buy whatever I want now.” I’d go on like two-week bender bar crawls and blow all my money. That hurt my ability to work in college, and later to find a job. When I did get into corporate America, it was like, Well, this sucks. There were just so many rules I had to follow, and I was struggling. That’s when I got a diagnosis.
It’s hard for me to recognize all of my ADHD symptoms, though, because both of my brothers had ADHD when I was growing up. I’m pretty sure my mom did, too. I wasn’t really around neurotypical people all that often until high school. This was just normal to me.
Dani: Josh is an adrenaline junkie. I chase adrenaline and dopamine, too, but in ways that feel safe to me. Starting in high school and into college, I’d get enamored with people and into relationships, because I wanted the dopamine hit of an early relationship and the feeling of being wanted. My relationships rarely lasted more than two and a half months until I got bored of them or got broken up with; I'd never made it to a one-year anniversary before I got together with Josh five years ago. When I got dumped, I’d get really hurt: Rejection sensitivity is an ADHD thing. I’d play that pain on a loop until I could find someone else to make myself feel wanted and better.
I only started having sex in college. I also started binge drinking a lot in college because of impulse control issues and dopamine-seeking—I was getting blackout drunk on a regular basis. (Even now, if we go out to drink, we blow hundreds of dollars on a bar tab and later think: Why did we do that? Since we both have ADHD, at times we enable each other’s behavior a bit, though we're calming down now in our 30s.) So, I’d be single and out drinking, trying to get that next dopamine hit, quite often. Eventually, I stepped back and realized I was drunk for all the sexual experiences early in my adult life—and I didn’t remember several of them—and I felt sad about that.
Josh: I’d started watching porn when I was really young. I was hyper-sexual. I had all these fantasies I wanted to try.
Dani: I started watching porn in fifth grade myself. I was curious about sex. I probably wouldn’t have watched so much porn if I’d been having sex earlier in life, but porn felt like the safer dopamine hit option for me when I was young. But I find that when you start watching porn, if you’re always looking for novelty, the threshold for what gets you excited can go ever upwards, until standard vanilla porn doesn’t do it for you anymore and you want to try these things.
Josh: I had a few brief relationships in high school. Then I met a woman and got into a super long-term relationship. We had sex and eventually got married. My first wife wasn’t interested in experimenting beyond vanilla sex, though. My frustration with not being able to do the things I wanted to try in sex, and with having to suppress a lot of myself in general in that relationship, turned into a lot of drinking and just going wild. I was seriously depressed. I’d sit in my truck after my job for hours because I didn’t want to go home.
Dani: A lot of people with ADHD wind up in relationships with someone who just doesn’t want them to have the condition. Because people with ADHD might be afraid of ending up alone, of conflict, or of people getting upset—of rejection—we’re more likely to blame ourselves and change ourselves to make our partners less mad at us.
Josh: I was a people pleaser, and I’d always go out of my way to make up for the problems my adrenaline-seeking adventures caused. Actually, I think I wanted out of that relationship before I even got married. But because of my cultural upbringing, I thought getting married to this woman, having kids, and just pushing through any problems I was having was the right thing to do. You don’t get divorced in my community. Eventually, I cracked, and I told myself, I don’t give a fuck. I’m not going to change for anyone. I’m going to find someone who doesn’t want me to change. Because I don’t want to be a different person.
Dani was the first person I could have sex with the way I wanted to. She was down to try new things. We said at first that we didn’t want to get into a big, exclusive relationship if we lived in different states, which we did at the time. But we were just vibing too well for me not to want to pursue that.
Dani: Josh eventually moved to my city, which changed how we were evaluating our relationship. When he did, I still definitely didn't want to move in together right away. But then my roommate was suddenly like, “I got engaged, so I’m moving out!” I sent Josh a 10-page, single-spaced document about pet peeves and chore splitting and everything I could think of, and we had the same answers on almost everything. He moved in and we got engaged after a year and a half. I think he looked at this as a relationship with someone who wouldn’t try to change him, and I looked at it as a relationship with someone who clearly knew what he wanted, and what he wanted was me, so it felt like a stable relationship. But it was still scary! It did feel nice to be able to be genuine, though, and not feel like we had to hide a part of who we were, like how ADHD people can often feel like they have to hide themselves. That’s a huge deal.
With sex especially, I’ve always wanted to talk about it constantly—to blurt out and overshare things that other people find inappropriate. That can be part of ADHD, too. I could never get why everyone was so buttoned up about it. Not being able to talk about all of the kink things I was exploring in earlier friendships and relationships just felt like confirmation that, yes, I was alone. We’re both good at making people uncomfortable with our level of oversharing.
Josh: We've heard a lot of, “TMI, TMI, TMI.”
Dani: We did eventually get past the horny bunny stage of our relationship, where we had sex like seven times a day. But we never let sex become routine and boring for us. In relationships I’ve been in with neurotypical people, they eventually want to have sex always in bed, at the same time of day, or even to schedule it for one day of the week. If we tried to schedule sex…
Josh: I would never have sex again. I don’t react well to being told when and how to do things.
Dani: I would check out, too. It’d just be boring. We have sex at different times of day, in different parts of the house, and we explore different kinks. Every time is a novel experience.
With our bipolar issues—with depression, and stuff—we can forget about sex for long periods of time. But, for us, that can actually be an advantage, because if we forget about it long enough and then rediscover sex again, that gives us a little kick of novelty, too.
Josh: We check in with each other before we initiate sex, too. If one of us is even remotely not into it, then we’re like, “Nah, I can wait.” If I need to, I can just masturbate.
Dani: We don’t hide that we masturbate, like some people do in relationships specifically because they feel guilty that they want to be sexual but their partner doesn’t. They don’t want to put pressure on the other person. Our relationship is based on not hiding our needs.
Josh: Often, when we do have sex again, we’ve found sex acts online that we want to try. We share similar kinks and we’re both always open to trying new things.
Dani: Or I’ll have ordered this toy online that I want to bring into sex. ADHD impulsiveness can lead to a lot of, “Oh, I saw this thing online and I just bought it.” Then we try it once… and maybe it doesn’t work for us. So we put it in this treasure chest of toys we’ve got in case we ever want to use it again. In other areas of our lives, impulsiveness can lead to feelings of, Aw, darn, I wasted money. But we can look through the chest for new sexual ideas any day.
Josh: And it is a legit treasure chest.
Dani: When one of us isn’t in the mood for sex, we still find ways to be close to each other, like kissing the other person and whispering in their ear while they touch themselves. We show each other that we still think of them sexually. We touch each other on a daily basis, tell each other, “You look hot,” so that we both know that we’re wanted.
Josh: One of the only issues ADHD creates in our sex life right now is the fact that I can actually hyper-focus on our sex—and when I do that, premature ejaculation comes into play.
Dani: You didn’t have that issue with premature ejaculation before me, did you?
Josh: No, but that’s because I wasn’t sexually compatible with partners in the past, so my mind wandered during sex because I got bored, and that led to me lasting longer.
Dani: I’ve never had issues with my mind wandering during sex, although I know that a lot of people with ADHD talk about that. I think it’s because I engage in a lot of enthusiastic behavior during sex that keeps my mind engaged. I pay attention to what feels good and give feedback, and by doing that, I stay focused. Some women I know with ADHD think we tend to be louder and more vocal during sex, than other people, which may be a tool for keeping ourselves present and engaged. Actually, the only times I’ve noticed myself zoning out during sex and getting distracted by other things are when I’m not making noise. Josh knows by now that if I’m quiet, I’m not all the way there. It doesn’t happen very often, though—making noise is just such a natural behavior for me now.
ADHD does make it difficult to do maintenance work in my life, including on my sexual health. Like, if I have a recurring yeast infection, I might be able to motivate myself to go to a doctor and get meds. But then I have to remember to go to the pharmacy and pick them up, and then to take them, and then if they don’t work all the way, I have to do the whole thing over again. That whole time, I’m not having sex. I’ve got a number of other medical issues that can affect sex. I’ve had a whole month or two where I’m just not taking care of those issues because of ADHD things. All of this sounds so simple for neurotypical people. They just don’t understand how hard these things can be for people with ADHD—being able to find the motivation for that.
There are indirect impacts, too. Like, if I’m having trouble with self-care that I don’t want to do, I might not shower for days, and then I just end up feeling gross and not wanting to have sex.
Josh: When we do end up going a long time without having sex because of issues like that, we just talk about it. Like, “Hey, this is what’s up,” and, “I get it, thanks, fine.”
Dani: I think people’s satisfaction with their sex lives is tied to their expectations. In our ADHD experiences, our wants constantly ebb and flow, so there is no constant expectation. We’re both very adaptable people. Overall, our communication and our actual sex is great.