eli5 Why do stimulants calm and bring focus to people with ADHD?
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People with ADHD have deficient levels of dopamine and noradrenaline, which are nueromodulators of various systems in the brain. If the brain doesn’t have enough, it can’t properly regulate those systems.
The brain is trying to send signals to conduct and orchestrate things in an organized manner but lacks the substance it needs to do it, so those systems get all out of sync.
All the classic hyperactive behaviors are the brains attempt at trying to self medicate by seeking out hits of dopamine. What’s this? what’s that? Jump, run, do something exciting! Give me those sweet drugs!
This is an excellent long form podcast about ADHD and common stimulants.
Stimulants increase the amount of dopamine available in the brain. Dopamine is a molecule that helps direct focus and attention. It’s the “reward” chemical in the brain, and your brain doles out little doses of it to keep you on task and motivated, even if a task is boring. Dopamine is also released when the brain encounters something novel and interesting, or in anticipation of something the brain wants.
People with ADHD have lower baselines levels of dopamine, and/or are less able to release additional dopamine as needed to direct attention. Part of the reason why the ADHD brain is so scattered is because it’s being drawn to stimuli in the outside environment (or sometimes drawn to passing thoughts that neurotypical people are able to ignore) because paying attention to these outside stimuli releases more dopamine in the brain than the boring task it was supposed to be working on does. Stimulants increase the release of dopamine in the brain such that there’s more available for your brain to use to keep you on task, and distractions are less compelling because the medicated ADHD brain is not as starved for dopamine.
This is why people with ADHD are actually quite capable of intense focus, but only on things that truly interest them. Interesting activities release a steady stream of dopamine in the brain, and the ADHD brain doesn’t really release much dopamine to reward itself for routine tasks. That’s why you’ll see someone with ADHD stay up for 20 hours doing something that interests them without making time to eat or attend to their other basic needs.
TLDR: Stimulants help the ADHD brain reward itself with dopamine for staying on task, reducing the propensity of the ADHD brain to bounce around to whatever thought or distraction is able to elicit a dopamine release in the brain.
I explain it like this. Before medication, I felt like I was taking one step in 10 different directions. After medication, I am now able to take 10 steps in one direction.
My life motto had always been “if you wait ’till the last minute, it only takes a minute!” That started off as a running joke in middle school, but ended up being how I was able to get through college.
Basically, I was only able to focus on whatever was immediately in front of me and my brain is, admittedly, easily distracted. Being distracted is a symptom of not having enough of the “hey this is interesting” chemicals in the brain, so my mind wanders easily in search of something more interesting or pressing.
Medication isn’t a stimulant to me in the same way coffee is. Personally, my ADHD stimulant medication doesn’t increase my heart rate at all, and frankly I don’t “feel” the medication. It just gives me just enough of the “hey this is interesting” chemicals to keep me focused on whatever task is at hand. This has subsequently reduced my anxiety and depression, which were a result of not being able to function as a productive member of society.
The thing is, even when I want to do something, my brain still continues to search for new even more interesting things to do or think about. So in the middle of doing something I really enjoy my brain may decide without my consent to wander off and have some shower thoughts which prevent me from doing even the things I enjoy or want to do.
It impacts every minute of my life and has had significant consequences where I have been left to pick up the pieces. Stimulant medications aren’t designed to give a leg up and help someone do something they don’t want to do. They specifically increase the “hey this is interesting” chemicals in the brain for those of us whose brains don’t produce enough of those chemicals naturally. It increases mine just enough to be a functioning human being.
If a person wasn’t diagnosed, but suspected of having ADD/ADHD and could access Ritalin, would it be self evident once taking a dose, that they did have the disorder?
What does Ritalin do to normal brains? Is it like a triple shot espresso for a non coffee drinker?
ADHD brains cannot produce normal levels of self-stimulating chemicals, so the ADHD brain finds or creates ADDITIONAL stimulation in other ways.
Some ADHD people are easily distracted by things. Others, like me, can focus but constantly have many many thoughts rapid-firing in our heads (I usually bounce between 4-6 thoughts, one past conversation, 2-4 work projects, and play a constant barrage of songs in my head – all involuntarily.)
Stimulants, like Adderall, force the brain to have more self-stimulation, so it has no need for these other sources of stimulation and the need for those external sources slows down, quiets, or stops entirely.
Having ADHD is like trying to ride a bicycle really slow. You may be able to keep your balance, but you’ll have to make lots of sudden corrections with the handle bars, and won’t go in a straight line. However, if you speed up a little bit, keeping your balance and going in a straight line becomes much easier.
Because ADHD is actually a disorder where you’re under stimulated. The brain tries to focus on many things to combat this. Stimulants re-stimulate the brain so it can stop searching for a stimulus.
I think they’re able to chase all the thoughts, when you can’t chase all the thoughts you jump back in forth like your able to catch 50 balls at once
Because ADHD brains are chronically understimulated for one reason or another.
You wouldn’t think a starving man would have energy until they start desperately looking for food. Same idea: starving brain wants norepinephrine & dopamine, and everything else becomes secondary.
Basically people with ADHD don’t have enough mental energy to stay focused. The right dose of stimulants gives them just enough of a boost to focus.
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