Eli5: Why is the medical treatment for people with ADHD/ADD often a stimulant?

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So, being a young adult with a suspicion of having some sort of the aforementioned, I’ve read that the treatment involves medicine of the stimulant sort.

Wouldn’t that make the underlying anxiety and restlessness worse? Or is it some sort of “shove” to artificial motivation, like making an old engine start up? Thanks in advance.

In: Biology

That’s something that’s called a “paradoxal reaction”.

Stimulants make people calmer, depressants make you more stimulated. I don’t know excact mechanism.

But, something similar happens when you smoke lots of weed. After a long time, to acieve the same “high”, you can smoke less pot. (actually, it’s called reverse tolerance)…

The idea is that ADHD people actually have less activity in the part of the brain that you use to regulate yourself. Stimulants help get this part of your brain working so that people with ADHD can focus and self regulate the way most people can on a normal basis.

I have 4 kids, 3 of them are Attention Deficit. This is my understanding of how it works.

The ADD mind can’t easily focus on one thing. When the person tries to “think hard” about something, brain activity actually **drops**, to the point that some of my kids have complaineed about feeling sleepy when they try to do math. Some ADD people will even “self-medicate” by arguing pretty much constantly, because that stimulation electrifies the brain, and they can think clearly.

By providing a stimulant in a controlled, time-released dose, thinking clearly and remaining calm(er) is actually easier, because the stimulation from the meds allows them to focus on things like school work.

As far as i know, an ADD/ADHD brain is lacking signal transmission from neuron to neuron like a normal brain does.
The stimulant will compensate for this a bit, and since hyperactivity is a lack of regulating activity, the boosted brain does this better and induces calmness and tiredness.

First, it isn’t a PARADOXICAL effect. Those are *unintended* and *unexpected* when they are seen. You don’t purposefully prescribe anything for this effect, ever.

Second, Here’s a good write up about why stimulants are used for ADD/ADHD:

https://www.verywellmind.com/how-do-stimulants-for-adhd-work-20895

ADD/ADHD is [believed to be] caused by a *reduction* in activity in the part of the brain that regulates attention and focus. The problem is not that the brain is *too* active, it’s that a particular region is not active enough.

Stimulants don’t calm down the ADD/ADHD brain, they increase activity in the brain, including the focus/attention region of the brain. This helps give that person the ability to control their own focus. So although their whole brain is more active they can reign it in and direct that activity towards their desired goal, instead of bouncing between different stimuli.

Get all the education you can from reliable sources… not just asking strangers on Reddit.

Different parts of your brain communicate via a chemical called dopamine. Dopamine basically tells some parts of your brain that whatever you’re doing right now is very important. If you have ADHD, some parts of your brain receive too little dopamine and they can’t communicate with each other properly. Let’s say you want to do homework. The network that’s responsible for your consciousness is aware of how important this is, but the part of your brain that is actually used to focus on that doesn’t receive the signal. That means you consciously want to focus but you physically can’t.

Stimulants generally increase the concentration of dopamine. If you didn’t have enough dopamine before, now you have, and you can normally focus on the work you want to do. If you however do not have ADHD, stimulants make you have too much dopamine. With too much dopamine released in your brain, suddenly everything becomes extremely important. You are extremely awake, you don’t think about eating or sleeping anymore because other things are more important, and eventually you cannot focus anymore because everything around you becomes equally important.

That’s where the unexpected reaction comes from. Stimulants actually always work the same, it’s just that some people don’t really need them so they would take too much and automatically have non-lethal overdose side effects, if you will. Please note that this is a huge oversimplification, as dopamine does a lot more than that, and another chemical called norepinephrine or noradrenaline usually also plays a role in stimulants, but that would be way too much for an ELI5 🙂

ADHD is a deficiency of norepinephrine and dopamine, or it’s ability to be used correctly by the brain. By giving someone with ADHD a stimulant, it makes up for the deficiency. Norepinephrine stimulates the brain. ADHD is a disease of an understimulated brain.

I can tell you that when i was about 11-12 years old, they put me on every single ADHD drug on the market, from Adderal to Vyvanse. I immediately stopped interacting with classmates, started being even more withdrawn, not eating at all during the day, hardly sleeping at night. Never really was able to even identify what I was feeling as anxiety until nearly 11 years later. I’m 26 now and looking back, my mental health really started taking a nose dive around then. Could have been puberty tho who knows

Thank you for everyone who answered 😀

After reading through the comments I’ve pieced together the general idea of the workings, and damn I’ve got to get myself checked out. The drowsiness during homework, the focus only in things I enjoy even though I am consciously trying to do something else, describes my young and current self to a tee.

Bye everyone