What is ADHD?
A Very Brief Overview.
When you hear the term ADHD, what comes to mind? Do you picture a young boy bouncing around in a classroom? There are many misconceptions about what ADHD is and what it isn’t. Typically, we think of ADHD as difficulty paying attention and being hyperactive or disorganized. While these traits can sometimes be true, they are really only a small part of how ADHD symptoms can (but don’t always) present themselves.
ADHD & Neurotransmitters:
The primary neurotransmitters that are thought to influence ADHD are serotonin, norepinephrine, and dopamine. In the spirit of brevity, we will focus on dopamine. To understand ADHD more clearly, we first need to talk about attention. Have you ever wondered why some things catch your eye while others don’t? I know I would love to trade my knowledge of '90s pop music for stronger math skills, but unfortunately, that's not how it works. Why? Because, for me, music is rewarding, while math can feel torturous.
According to the Attention Deficit Disorder Association (ADDA, n.d.), attention is driven by dopamine, the neurotransmitter responsible for regulating attention. Most activities that promote survival trigger a release of dopamine (Cleveland Clinic, n.d.). It makes sense that our brains want us to notice things that might harm us and enjoy basic functions like eating and sleeping, so those behaviors are rewarded by releasing dopamine.
In individuals with ADHD, dopamine levels are typically lower (ADDA, n.d.). Some studies suggest that higher levels of dopamine transporters may contribute to ADHD, because when dopamine is caught on a transporter rather than flowing freely, there is less available to interact with dopamine receptors. To illustrate, imagine you have an ice cream cart on the sidewalk, and the people walking by are dopamine molecules. The pedestrians who stop and buy ice cream are engaging with you. However, anyone passing by on a bus can't get off in time to buy from you, and they miss out on the opportunity to engage. The dopamine transporters work a lot like a bus going past a perfectly good ice cream stand.
Without a consistent flow of dopamine, attention becomes erratic. This inconsistency leads to dysregulation. When we’re dysregulated, we seek ways to return to baseline. Ready for another metaphor? Picture a racehorse wearing blinders. These blinders block out distractions and help the horse focus on one goal at a time. For someone with ADHD, their blinders might be like an old, loose pair that flaps in the wind, with one side starting to tear. There is still a main visual focus, but the loose blinders make it difficult to control visual input, increasing the likelihood of being distracted by placing attention on something other than the racetrack.
ADHD Reframed:
So, ADHD isn’t just a disorder of inattention; it’s a disorder of attending to too much at once. When we are dysregulated, we seek regulation. When dopamine levels are low, we search for rewarding activities to boost those levels. This explains why someone with ADHD can hyperfocus on a task they enjoy for hours, but struggle with tasks that don’t capture their interest.
Yes, everyone gets distracted, but someone with ADHD experiences a higher frequency of distractions and requires more redirection. The tricky part? Sometimes the distractions come from the mind itself. I’m not a young, hyperactive boy, but I have ADHD. I can attest that there is always a song or jingle playing in my head. Sometimes, I’m lucky and it’s just a niceportion of a song, but more often than not, it’s just one line or part of a tune. For six months in 7th grade, I had the “What would you do with a dollop?” jingle stuck in my head — I even wrote an essay about it on a state exam. It’s sometimes fun, and I’d miss it if it ever went away, but there are costs to it as well.
Have you ever been walking around and suddenly remembered that you need to run an errand or do a chore — without anyone reminding you? That internal narrator is constantly active in an ADHD brain. Picture this: you go to empty the dishwasher, and while you’re putting things away, you notice the Tupperware cabinet is a mess. So, you begin organizing it, but then you remember that there are leftovers in the fridge that need to be thrown away in order to put those containers in the cabinet too. Well, you might as well take out the trash while you're at it. As you go outside to toss the trash, you realize that you have completely forgotten about finishing the dishes.
When making decisions, someone with ADHD isn’t simply bouncing between a few options; they’re considering and weighing the pros and cons of every possible choice. Something as simple as being hungry can lead to decision fatigue, as they mentally scroll through every possible food option until one sparks enough dopamine to become actionable.
Summary
Despite the challenges, there are some perks. Many famous individuals throughout history are thought to have had ADHD, including Leonardo da Vinci, Albert Einstein, and John F. Kennedy. This makes sense — when you have a broader perspective on things, you see the world differently than those who can zero in more readily.
In my experience, I think that my ADHD makes me a better therapist. I am able to attend to my clients while cross referencing their stories through textbook tangents about neuroscience, combing through my own similar emotional memories to empathize, and sifting through training summaries to determine the best next approach. This makes it easier for me to reframe what my clients are experiencing in a way that makes a lot more sense.
There is so much more to the ADHD experience. If you are interested in learning more, let me know!
References:
Attention Deficit Disorder Association. (n.d.). ADHD and the brain. Attention Deficit Disorder Association. https://add.org/adhd-brain/
Cleveland Clinic. (n.d.). Dopamine. Cleveland Clinic.https://my.clevelandclinic.org/health/articles/22581-dopamine
