I understand the energy of stimulant medications may help *inattentive type* ADHD people to focus: but how would they help someone who is already *hyperactive*?
It sounds counter-intuitive : ELI5?
In: 8
I have two ELI5 analogies I like to use:
1) Imagine there is a gauge in your head that measures how bored or attentive you are; “maddeningly bored” at one end “overstimulated” at the other. Now, Imagine being stuck in a boring place. As you stay there longer, you start to get bored and your interest gage starts to go down. As this happens, you start to get antsy and you need something, *ANYTHING* to stop the boredom. If you find something interesting, you calm down and your gauge goes up. Now Imagine being at a big party. There’s so much going on that you might start to feel overwhelmed. This is what it means to be overstimulated.
How does this relate to ADHD? Simple, ADHD brains get to that bored and antsy state much easier than normal people. Their meter will be at “bored” when other people are at “neutral”. Giving them a stimulant will artificially push their interest meter to neutral. Meanwhile, a person without ADHD can take the same stimulant and it’ll push their meter from “neutral” toward “overstimulated”.
2) Imagine your brain is a corporation (there have been quite a few cartoons to use this, so I think you get the gist.) Different parts of your brain are all doing their own tasks as different branches of the corporation. The head of this company is the Chief Executive Officer, the prefrontal cortex.
As the CEO, it’s the PFC’s job to take in the info from other parts of Brain Co., decide what the company should do, tell the rest of the brain how to do it, and repeat. In short, the PFC’s “function” is decide what the body should “execute” (hence “executive functioning”).
Now, there is simply too much work for the PFC to review every little detail. So, the PFC allows different brain departments to work with varying degrees of oversight. The “keep the heart beating” department doesn’t hear from the PFC often, but the speech center is constantly in touch. Some parts of the brain might decide that the PFC takes too much time and things need to happen now! If you touch a hot pan, for example, your spinal cord will have already told your body to move before your brain gets the memo. Various parts of the brain that deal with emotions can also do this if you aren’t careful. If you’ve ever been so mad that you don’t realize what you are doing, it’s because your PFC has lost control.
A person with ADHD has a decreased blood flow to the PFC. In other words, their CEO’s office is understaffed, underfunded, and the other departments are more likely to ignore it. Their CEO can issue orders and the rest of the brain will generally follow, but other parts are able to much more easilly talk over the poor PFC at corporate meetings.
Stimulants increase blood flow. This gives the CEO gets more resources to get the rest of the brain under control.
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