eli5: what is the neurobiology of ADHD and how does it lead to behavior/symptoms?
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Our brains are complex machines that use chemicals to function and operate. Neurobiology theories come and go, but about 75 years ago we were just beginning to accept scientifically that we didn’t have full power to control our consciousnesses, that a person couldn’t just stop being depressed “if they really wanted to” or that lacking a deep focus and attention span wasn’t a *personal flaw* but maybe, just maybe, it was determined chemically.
So in the mid-20th century there was sudden excitement to find chemical causes to our various “disorders”, that depression, or mood swings, or attention issues were all caused by “chemical problems”. The counterside to the argument was the assumption that there was a “normal” out there and that people with mental challenges “were different from normal”, so we can use chemicals to “fix that”. So in terms of treatment, pills and drugs came before things like talk therapy and counseling.
Specific to ADHD, it was “determined” that a handful of chemicals, dopamine specifically, were responsible for “abnormal” behavior, just give people pills that alter dopamine (and other stuff) and you’re good to go. More specifically, it was determined that having “abnormal” levels of dopamine (etc) during development could trigger structural changes to the brain that lead to issues with trouble focusing mentally, erratic behavior, and a lack of impulse control. Since this state was considered “abnormal” it was defined as mental condition which required treatment to restore the individual to “normalcy”.
I’m clearly using a lot of scare quotes here because our views have progressively changed with time and we are now viewing mental health a spectrum, there is no “normal”, we are all different and a variation in chemistry is part of a natural human development we call “neurodiversity”. Even the original promoters of ADHD have since recanting their beliefs and view it as an invented condition and treatment regimen underlying a problem that doesn’t really, necessarily exist.
I’m not pooping on ADHD and pharmaceutical treatment entirely, I’m just arguing that it’s less that we should consider ADHD as an actual ‘sickness’ that can to be treated and cured, and more of a natural state of a person. Perhaps it’s a society that has decided that sitting and staring a computer for 10 hours a day is “normal” that is the aberration.
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