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
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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