Q: My husband and I have been married for 30 years. When we first lived together he was attending a prestigious college on a full ride scholarship. He was taking a double major that his mother thought he could handle. At the time his parents’ marriage was in a mess and family life was bad. Once we started sharing an apartment he would constantly watch “Looney Tunes” and put off any studies. I was concerned but he assured me that everything was fine until he flunked out of school. Surprising because his IQ is quite high but not shocking as he didn’t have “mom’s” constant enforcement.

He then got a position in a lucrative industry and for the past 28 years has traveled up the management ladder as far as he is able to go without a degree. I believe he is well liked however at one point a boss asked him if he was on drugs which he wasn’t. Just exhausted and in the “twilight zone.” He is often frustrated with his cognitive abilities and communication skills. About 5 years ago I insisted that he get tested for ADHD. He has ADHD, sleep apnea, and depression and is being treated with meds. His psychiatrist believes that he may have narcolepsy as he can’t stay awake quite a bit of the time even though he uses a c-pap at night. Testing for this is forthcoming.

My concerns are: Because of his inability to complete or focus on ANYTHING we are about ready to file a totally avoidable bankruptcy. He hasn’t filed 2 years of taxes, is paying fines for traffic violations that are huge as he put them off, has had electricity, water, etc. turned off even when he can afford to pay, can’t communicate well enough with his doctors to get a accurate diagnosis, and is piling weight on. His problems only get worse as he ages. His mother had schizophrenic symptoms (seizures, seeing things, and hearing voices) years ago and I’m wondering if this could be genetic. She also has ADHD and is a poor communicator as are 3 of his siblings. I’m at a loss… Should he be seeing a neurologist, psychiatrist, or who? I’m at wits’ end and both he and I can’t go on like this! Thank you.

A: It sounds like he is already seeing a psychiatrist so I would recommend sticking with this or finding a new one if you both are not satisfied with the care he is receiving. A neurologist wouldn’t be a bad idea either as well as a sleep disorder specialist. The best you can do is get a good team of doctors and make sure they communicate with each other.

If he is not in therapy, I highly recommend that he find a good therapist or coach as well. Some of this is behavioral and he needs to work on this with someone who can educate and guide him in this area.

There are several good books on ADHD and disorganization. One that comes to mind is Driven to Distraction. There are many workbooks as well that may help identify and change behaviors. In the meantime, I would suggest that you take over the finances and the monetary aspects of running the home. If his disorganization and procrastination are affecting you then maybe you need to be much more involved. Your livelihood is obviously at stake here too. If he does not get better soon you may want to talk to his doctors about filing for disability.

There are certainly genetic/hereditary components to mental illness. If one person in the family, especially immediate family, has a mental illness it increases the likelihood for others. So his mother having problems does increase his chances. I hope he stays connected to his treatment team and that things improve soon for both of you. Good luck.