It blows my mind how productive I’m able to be, being properly medicated after a diagnosis. I don’t understand why I cannot do these simple tasks normally. Why does adderall make me “go” and actually accomplish tasks?
In: Biology
I assume you have been diagnosed with ADD/ADHD. This is a developmental disorder where the area of the brain involved in executive function (impulse control, attention, emotional regulation, etc) doesn’t work properly. Your brain’s connections in that region aren’t as robust as they are for other people, and the molecules used to transmit signals between brain cells in that region (known as “neurotransmitters”) aren’t as efficient as they would be for others.
With this disorder, your brain is constantly looking for the next interesting thing and it reacts to stimuli without checking in before hand.
Adderall (amphetamine) and Ritalin (methylphenidate) work by stimulating this region of the brain and improving the effectiveness of those neurotransmitters.
This means you have a greatly improved ability to focus on a task, to control your impulses to do things, and to keep your emotions in check.
In EIL5 terms, our brains like to have a certain amount of stimulation. In ADHD, normal life does not provide enough stimulation often leading people to seek more stimulating input. So doing “life tasks” like working, studying, or housework leave the brain feeling unstimulated so the brain starts wandering and getting distracted looking for stimulation. This often pushes people to do non-productive but stimulating things like watching TV or playing games.
Stimulant medications help the brain feel more normal, like it has the appropriate amount of stimulation and therefore it doesn’t need to constantly be distracted looking for more stimulation.
The best analogy about “executive function” I’ve heard was from my physician when I asked her how can a stimulant possibly make the brain more calm? She said imagine a grade-school classroom with a teacher who is hungover and groggy. She loses control of the students and they run wild. But then she has a strong cup of coffee. When it wakes her up she yells at the kids to sit down and get to work, and the room becomes orderly.
Pretend there’s a worker living in your prefrontal cortex and his job is to keep the prefrontal cortex running well. This part of the brain is responsible for controlling a lot of the things that we struggle with if we have adhd like emotional regulation, impulse control, ability to focus, consequential thinking, and so on. Because the man in your brain is so tired, he can’t do his job right so all of the adhd symptoms begin to present themselves. Adderall, a stimulant, stimulates the nervous system and wakes the man up; almost like giving him a cup of coffee. Because he can now do his work better, those symptoms become more regulated allowing you, his boss, to do whatever job you have for the day.
The way I’ve described it before is your attention is like the Z-targeting system in Zelda OoT. When you have ADD or ADHD, the system is a little broken, either it’s not working at all so you have to try to do everything without locking onto anything which the game was not designed to be played that way making it excessively difficult, or you automatically lock onto something, but the as soon as another target pops up you switch to that even if you dont want to.
When you take Adderall or a similar medication at the proper dosage, the system gets a little closer to the intended system, you’re better able to select your target and won’t as easily change targets unintentionally.
Think of it this way…
ADHD brains have slow brakes and overly sensitive steering. Adderall speeds up the brakes (less impulsive) and tightens up the steering so your focus isn’t swerving all over the place.
The more complicated explanation….
Adderall is a dopamine and norepinephrine reuptake inhibitor, meaning it increases those two neurotransmitters. We don’t know if ADHD brains need more than others or if they are low in production. We know these two neurotransmitters are extremely important in regulating executive function.
A way to understand why ….
Hunter brains & farmer brains. The world started out with hunter-gatherers as the most successful humans, so those genetics became dominant. Eventually, farmers became the most successful, leading those brains to be dominant.
A hunter NEEDS to have their attention constantly scanning (avoid being prey while finding prey). They need to be “distracted” by every little noise. Hunting is energy intensive and requires fight/flight on high. It is a very heavy dopamine and norepinephrine process. The body is flooded with adrenaline (nature’s Adderall) when the kill is near (the moment where you need all of your focus, aka hyper-focusing).
You have an ancient body in a modern world where farmers rule. But …. nature needs those ADHD brains. In a crisis, when flooded with adrenaline (speed), your brain isn’t going to be scattered and drown in panic. It will hyper-focus, and you will get calmer (again, adrenaline is like a mainline of Adderall). And if the farming isn’t feeding, hunters will be necessary. You are nature’s survival plan.
The reason ADHD brains struggle is that the world is mostly built for farmer brains. If you sat down and tried to come up with a way to F with the ADHD brain, you couldn’t do much better than the American school system or repetitive work. You’re not broken; the world just doesn’t make room for your difference right now.
Farmer brains are nature’s best fit for this current world. They aren’t “better.” They’re just perfectly suited to fit and succeed.
Hope this helps.
Adhd brain has a lot going on in it, but not enough of the transmitters to deal with all the shit going on.
Adderall/stimulants increase the amount of these transmitters, which is why adhd people generally feel calmer despite being on a stimulant. Brain can now keep up better and organize the thoughts. The desire to do things because of this primarily comes from the extra dopamine you get, but serotonin and norepinephrine are affected as well.
It doesn’t actually calm anything down. It increases neural activity primarily in the frontal left cortex if I remember right.
Best analogy is adhd brain is a car with a faulty steering wheel and gas pedal with a mind of its own. Stimulants fix these to a degree so adhd brain can now steer where it wants to go better and hit the gas or break to start and stop tasks better.
As a person with ADHD, you are constantly seeking gratification, you are constantly seeking something to be “stimulating”. You read a page of a book and after the page you realize you only mechanically read it. You are more prone to taking risks and being impulsive because maybe that will stimulate your poor dopamine deprived brain.
You get a prescription for a stimulant and take it and suddenly, you’re not actively seeking this gratification from everything, all the time. Simple tasks that may have been difficult for you to see through to completion now are able to hold your attention.
That’s one part of it, severely simplified.
Think of a cross guard in your brain, he directs traffic or thoughts. But he didn’t have his morning coffee. That’s the ADHD brain.
We give the entire brain coffee and the entire brain gets busier with thoughts but the crossing guard now how the energy to direct those thoughts.
Like you’re five, I’ll try:
Your brain has little gaps between thinking cells (neurons), we call them synapses. All your neurons talk to eachother via these connections. The charge between cells, chemicals released, what kind of cell is sending the charge, what kind of cell is recieving, where the cells are in the brain are all important factors in telling what the signal is doing.
The signal can have many effects. Make you happy, make you sad, make you less sad, make you see a monster. Etc. Changes brain states.
Two ways ADHD can manifest is as hyperactivity or inattentiveness. Let’s use hyperactivity as an example.
In this case, let’s focus on some dopamine producing neurons projecting to the part of brain associated with decision making. These cells are producing **slightly** too much dopamine (a chemical frequently associated with happiness and excitation, but also arousal: how awake and attentive you are).
The recieving cell is getting activated more than it ought to be. If the sending cell produced way too much, the recieving cell would die, and there wouldn’t be much issue, cells not working right get pruned, that’s how’s its meant to work.
The result is a child who can’t seem to sit still in school. At least the model I learned in neuropsychopharm many moons ago.
Let’s introduce Adderall, a complete/full dopamine agonist (agonist means it causes the release of that chemical.), which is pretty fancy. Adderall stimulates dopamine release, and functions like dopamine at the receptor site (the recieving cell thats getting activated too much) as well.
We now release dopamine into those brain gaps. The result is the the recieving cell is now getting activated way more often. To a person just taking it for the first time, side effects are: euphoria, excitement, arousal (being awake, not horny). Over time, those recieving cells will discover that they are getting activated way too often.
So they will do one of two things: die, or reduce the incoming excitation down to the desired level. So that recieving cell will stop producing a cell component called a “receptor,” it’s the protein that sits in those gaps waiting to be bound to a dopamine molecule to send the activation signal down the recieving cell. If the cell does not do this, it shall die. With that reduction of receptor production (or “down regulation”), the cell will actually be performing in the manner it was meant to.
This occurs over two weeks or so.
So tl;dr time:
We start with a malfunctioning cell, it gets too excited when prompted. We introduce an excitatory chemical, Adderall. The cell will reduce receptor proteins in an effort to survive the near toxic level of Adderall. After two weeks, the malfunctioning cell ought to be only getting excited at a level it was designed to be.
Malfunctioning cell 🙁
Adderall for two weeks.
Normal functioning cell.
Here’s a few takeaways. Nearly every adult ive known taking Adderall is abusing it in some manner. The euphoria that one feels on taking it is a **side effect**, not a therapeutic effect.
People often think of that sudden euphoria and excitation is what you are meant to be feeling. It isnt. Or that the elevated sense of productiveness is what people without ADHD feel like all the time. It isn’t.
The euphoria is a side effect that your body becomes tolerant to, such that you don’t feel it anymore. What the drug is designed to do comes two weeks later, and is very boring.
You will be somewhat more attentive or less physically fidgety if you have ADHD. That’s it. No more, no less.
I’ve seen middle aged adults chase that euphoria into a complete manic episode lasting weeks. One lost their job due to poor performance. Recently.
In those without ADHD taking Adderall, you’ll have likely have a small bit of usually reparable brain damage, and likely an addiction to Adderall.
Disclaimer: this was the model as I was taught it, it’s vastly shortened and I’m leaving out a lot.
Lemme know if you have questions. I have visual aids if needed.
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