Eli5: How do ADHD meds work in the ADHD brain in comparison to a normal brain?
In: 5
TL; DR
ADHD -> too little dopamine
Meds -> more dopamine
Too little dopamine -> dementia/adhd
Too much -> schizophrenia
Normal + meds = too much
One of the side-effects of uppers is tunnel-vision-like focus. An ADHD brain doesn’t filter information correctly. It just takes in everything. For example, the cocktail party effect. Where the whole room can be noisy with conversation, your brain filters all the other things being, said. Allowing you to hear the right one correctly. With ADHD you hear everything, at once. Stimulants like ritalin, aderall, even cocaine, focusses so that it is easier to do these things. And keeps you focused by forcing you to do that one thing over and over again. Because the hyperactivity is a result of continuous overstimulation, people with ADHD get calmer on drugs that will keep others awake for a week.
Edit;
You asked for how it works in the brain so here it goes
Prefrontal cortex does attention behaviour impulsiveness etc.
One of the hormones involved is dopamine, it inhibits the orefrontal cortex.
ADHD disregulates dopamine
Too little dopamine – prefrontal cortex goes haywire, party-time, All the time, like a rave in the head
Ritalin limits the re-uptake. So dopamine stays around longer, more inhibition. Normal functioning.
Normal brains don’t have a low dopamine circuit. So add ritalin, you get overstimulation, anxiety, stress, Increased risk-taking behaviors
Increased impulsivity
Mood swings
Excitability and energy
Disrupted sleep cycles or trouble sleeping
Extreme reduction in appetite
Problematic weight loss
Depressed moods and decreased anxiety
Basically, too much of a good thing.
Dopamine, (and norepinephrine), are also key in many forms of dementia and share many characteristics with adhd
Rewards you with large amounts of dopamine. This dopamine trains your brain pathways to be rewarded with those activities regardless of how they are are. This means if you pick your fingers you will train your brain to reward dopamine to the pain of picking your fingers. If you are doing homework your brain will be getting dopamine so it won’t want you to get up and move around in search of more dopamine. You get an endless supply of dopamine to endlessly reward yourself for doing much of nothing.
So, as best as I can without overcomplicating it.
The theory goes that ADHD brains lack the chemical dopamine/have a hard time making/absorbing it. This chemical is really important for a number of things. Yes, its a “reward” chemical, meaning that the little hit of it you get when you complete a task reenforces the neural pathways that formed from doing it. Thats why most people can do a boring/annoying task. It sucks but they can do it, because they have a lower threshold for this chemical.
ADHD brains lack the ability to produce enough dopamine/have a higher threshold of tolerance, meaning it takes more dopamine than normal to get the same effect. Thats why when people with ADHD find something that interests them, it REALLY interests them. It also explains why people with ADHD tend to be fairly impulsive or more prone to substance use disorders. Our brains are CRAVING dopamine. Thats why when I find a song I like, I can often listen to it on repeat for hours.
Stimulants essentially boost the available amounts of dopamine in the brain. This brings people with ADHD up to around the same level as those without ADHD, meaning what little dopamine they can produce/ absorb, goes a lot further than normal.
Think of it like trying to run a car on really low fuel. All ADHD stimulant meds do is top up the fuel to around the same level as people without.
Dopamine is also really important for other tasks, like filtering out excess stimuli. The amount of sensations that a human body encounters, if our brains didnt filter out the “noise” from the important stuff, we’d go insane! ADHD brains cant do this as well as people without ADHD, so are more sensitive to stimuli, hence distraction/lack of focus.
Generally when people without ADHD take these meds, they are increasing the level of dopamine past what they need, hence the feeling of being high.
I believe people without ADHD often hear or see the effects of these medications on people with ADHD and think it will do that for them. It doesn’t. I believe there is are a few studies that show using stimulants for study (when you dont have ADHD) doesnt improve your results. It lets you sit at a table longer to study, sure. But it doesn’t help you remember nor does it make you smarter.
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