18 Nov

ADHD Brain

ADHD (Attention Deficit Hyperactivity Disorder)

ADHD (Attention Deficit Hyperactivity Disorder) is easily the most fascinating, misunderstood, contested and over-diagnosed psychiatric condition.  Through ADHD, we will see how our brain affects our behavior.

There is a brain chemical (neurotransmitter) called Dopamine.  When you get something right, the dopamine levels in the brain go up.  Of course, getting something right is often closely linked to improving one’s chances of survival or reproduction.  Dopamine is the reward chemical.  It supplies the feel good when we solve a mathematical problem, find delicious food or a delectable mate.  Cocaine high is also supplied by drug induced dopamine.  Dopamine is also responsible for movement, motivation, impulse control, alertness and focus.

There is a neurotransmitter called Norepinephrine (NE).  NE increases secreted in your brain when your stress levels go up.  NE also increases the alertness and focus.  NE is a product of Dopamine.

A small set of the population seem to have a mutation that leaves them with sub-optimal levels of dopamine and/or NE.  Because of the sub-optimal levels of alertness/focus chemicals, unless something excites them (and increases the dopamine levels) or frightens them (and increases the NE levels), these people tend to remain distracted and under-motivated.  These people are thought of attention deficit.

There is also a difference in the way an ADHD brain in wired.  When a baby is born, the neurons inside the brain are cross wired in an almost random fashion.  As the baby grows up, surplus connections are pruned out.  This pruning is needed to build specialized modules inside the brain and make the brain more efficient.  Often, parts of an ADHD brain remains under differentiated.  As you will see later, this not always a bad thing.

It is interesting to see how these subtle changes inside the brain express as personality traits:

  • There is a portion of the brain called striatum, which is partly responsible for physical movement.  People with sub-optimal levels of dopamine in striatum can’t sit in one place.  These are the physically hyperactive types.  The physical movement seem to increase the dopamine levels in the striatum.
  • Striatum is also responsible for motivation.  Less dopamine here results in poor motivation.
  • There is a part of the brain called pre-frontal cortex (PFC) that sits just behind our forehead.  It is believed to be responsible for several functions, including acting as the breaking system of the brain.  When someone has less dopamine in the PFC area, they exert poor impulse control.  It makes them short tempered (bad) and/or spontaneous (good at times).
  • PFC also smothers the creative insights to some extent.  This is one reason why creative people often have poor impulse control.
  • PFC is responsible for forethought, planning, executing, etc.  People with less dopamine in PFC show deficiencies with these skills.
  • PFC is also thought of as the seat of working memory.  Poor dopamine levels in PFC impairs a person’s working memory and makes them poor with details.  On the other hand, they become good at dealing with the big picture (which amounts to consolidating several smaller details into one bigger package).
  • Because of poor level of dopamine in PFC, this brain type is typically disorganized.  On the other hand, some of these people who learn to organize are super-organized.
  • Poor dopamine levels in PFC also results in poor time sense.  Even estimation of time required to complete a task is difficult for them.
  • People with low level of dopamine in cerebellum become physically sluggish.  But all the action happens inside an overactive mind, encased in a still body.
  • Novelty increases dopamine levels.  People with this brain type are usually novelty seekers.
  • Routine task doesn’t generate dopamine.  While these people can handle a novel task of higher difficulty, handling even a simple routine task is such a drag for them.
  • Risk taking pumps up dopamine and norepinephrine.  So, this brain type actively goes looking for risk.  Several of soldiers, police men, stock brokers and other high risk professions are filled with this brain type.
  • Of course, verbal quarrels also increase NE.  Some people with this brain type are pugnacious, particularly when they also have a short temper.  Almost everyone with this brain type is a drama queen.
  • Dopamine is also responsible for salience.  People with sub-optimal dopamine levels forgive others easily.  Except if they also have deficient levels of serotonin in anterior cingulate gyrus, in which case they won’t easily forget a slight.
  • The sub-optimal level of serotonin is ACG is often seen in people with ADHD brain type.  ACG is like the gear shift of the brain and serotonin acts like the gear fluid.  With deficient serotonin, their brain tends to get stuck in the same state.  Combined with poor working memory, these people tend to forget the rest of the world when they lay their hands on a task that fascinates them.
  • Throughout the brain, dopamine and serotonin are in a balance.  As less serotonin is known to cause depression, ADHD brain type with less dopamine (and hence, more serotonin) is not easily susceptible to depression.  However, we live in a world that is designed for non-ADHD brain and living in this world often puts them into very high level of stress.  This high stress often makes them prone to depression and anxiety.
  • Because the wiring inside the brain is criss-crossed, this brain type often results in traffic congestion.  This traffic (data) congestion expresses itself in several ways, including dyslexia.
  • Because of the hyper-wiring, people with this brain type usually have sharper senses.  Some of them can hear very feeble sound and/or sound from wide frequency range.  Many of them wear soft and casual clothes as formal clothes (and wrist watches) are too rough on their skin.  Many of them have a nose that can overwhelm them.  As a matter of fact, any of the senses can overwhelm easily them.  Of course, more severe cases of under-differentiation results in complications which have their own jargon and we are not getting into them here.

There are two people inside every person with ADHD brain type.  One is the dull, distraction prone, absent minded, careless and low-motivation person they live most of their life as.  The second character is highly charged, super-motivated, quick, sharp, intelligent and daring person they turn into when they are in a dopamine or norepinephrine pumping situation.

In other words, the baseline of performance for these people shift from situation to situation.  This dynamically shifting baseline is not understood by most of the people, including the ones who have this brain type.  That leads them to falsely under or over estimate their self worth.

In the next post, we will see how our compulsion to generalize ruins the lives of millions of people with this brain type.

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