The ADHD-Dopamine Connection
When it comes to understanding ADHD, many of us come into our diagnoses having heard only what we’re told about it - which is mainly a lot of stigma, with symptoms being described through a lens of what’s inconvenient to others rather than what’s needed for us.
If you’re new to learning about ADHD, you might think of it as a hyperactivity disorder - it’s in the name, after all. So the first idea of someone with ADHD might be someone (probably a boy, who is probably about 12) who can’t sit still, is impulsive, who can’t listen, who struggles to be on time, who can’t get small things done. If you have ADHD, those things are maybe even true - or, they’re not true because we have so much anxiety about them being true that we overcompensate and exhaust ourselves to seem convenient because we’re told it’s disrespectful not to be. But those things are only the tip of the iceberg, and honestly the least important things to know about the ADHD brain. To be very clear, you are absolutely worth more than your convenience to others, and that’s worth reminding you before I talk about what I came here to talk about.
One thing those perceptions above have in common, and that relate to all the rest of our differences (some of which can definitely feel like symptoms, like our inability to concentrate or having a poor memory), is dopamine. Dopamine is a neurotransmitter that every brain makes, and every brain needs for several big aspects of our functioning: interest and decision making, focus, and memory. Generally speaking, neurotypical brains make enough dopamine and use it efficiently enough that they can keep enough of their brains online and function as expected in order to get through their day without encountering challenges with memory consolidation (they’ll remember why they walked into a room or where they put down their phone), decision making (they can think something through instead of being halfway through dyeing their hair pink before they realize their job won’t allow them to), focus (yes they did listen to everything you just said without having their own internal conversation about how they needed to be listening), or interest (they can get their job done even when it’s boring, like some weird superpower). They can plan their day, plan it to be on time and productive, and execute that plan.
There’s a major connection between ADHD and dopamine, because ADHD brains don’t make enough, and the brain might not absorb and transport existing dopamine as efficiently to where it needs to be. So now, that sets up a system that is dopamine-directed. If dopamine is what determines our sense of reward and pleasure (it is), and we don’t have enough, we become very interest driven. Doing things that don’t come with some type of “feel good” and more production of dopamine can become impossible. We run into impulsivity and executive dysfunction (which we talked about here if you’re interested). We can’t get things done, and we struggle to prioritize; everything seems equally urgent and can be overwhelming. We can’t direct our focus and become hyperfocused on one thing giving us dopamine (the utter depths of an internet rabbit hole in the middle of the work day, anyone?) and forget everything else, including our own needs like eating or even going to the bathroom. We become time blind (and late). Our minds and bodies aren’t satisfied with the stimulation of a typical day - we need to move more, see more, feel more, learn more, find more, than expected. Or, the normal amount of stimulation we can encounter is too much and may become uncomfortable, irritating or physically painful.
On the enjoyable side, it can also mean we’re really good at learning something quickly when we think it’s interesting. We might be really great at improvising or pivoting. We’re creative problem solvers, adventurous, fun, and are contagious about it. We can watch a show for the third time like new, because we didn’t remember it the first two times. The connection between dopamine and ADHD is important to understand, because it’s our key to regulating so that we can mitigate the things that bother us, and capitalize on our strengths.