For some ADHD brains,
optimal functioning involves augmenting the
seeking louder, faster,
bigger, funnier, and riskier—the more intense,
the better. Boredom is a
common complaint for
the owners of these
brains. For them, it is
physiologically uncomfortable when their
struggle to engage with
their environment. In
fact, in mundane, low-stimulation situations,
these restless brains may
compel their owners to
increase the intensity level with fidgeting, noise, laughter, or
conflict, if there is no other route to high stimulation available.
These more impulsive ADHD brains have their own logic: If
some stimulation is good, more is better. This is the signature
short-sighted philosophy of brains compelled to choose
immediate rewards over long-term gratification.
Too Much Stimulation
In their hunger for greater stimulation, ADHD brains can suddenly find themselves in a state of over-arousal. Egged on by
their need, most are unable to modulate their responses, and
can’t anticipate an impending “crash.” The fun suddenly gets
out of control, the laughter takes on a tinge of hysteria, sights
and sounds bombard them until they are overwhelmed.
Ambushed by physiological overload, and depleted of
psychic energy, they become irritable, tearful, restless, or aggressive. Their brains abruptly demand
respite from the commotion, so that they can
regroup with negligible stimulation. Their sudden
and total withdrawal is a source of confusion and
consternation to those who know only the spirited
At the other end of the continuum, there are ADHD
brains that can barely tolerate existing levels of stimulation.
These brains teeter on the brink of sensory overload, and seek
every opportunity to escape from the bombardment. Unexpected or novel stimulation is experienced as an ambush,
evoking discomfort, frustration, and irritation.
Owners of hypersensitive brains reduce stimulation by
avoiding group activities, tuning out of conversations, and
reward from ordinary activities. These dopamine-deficient
brains experience a surge of motivation after a high-stimula-
tion behavior triggers a release of dopamine. But in the after-
math of that surge and reward, they return to baseline levels
with an immediate drop in motivation.
One of the many consequences of reduced dopamine in the
synapses is that the significance of tasks is decreased. If most
stimuli appear equally compelling, it’s difficult to attend to
the most important task. As a result, stimuli need greater personal relevance—larger, more immediate, or repeated rewards—to be attractive to ADHD brains. Reward Deficiency
Syndrome (RDS) has been proposed to explain why ADHD
brains need stronger incentives. Deficits in the reward pathway, including decreased availability of dopamine receptors,
decrease motivation. Indeed, ADHD brains struggle to sustain
motivation when rewards are mild or are linked to long-term
gratification. As a result, ADHD brains search for stimulation
that can increase dopamine more quickly and intensely.
Ultimately, the pursuit of pleasurable rewards may become a
potent form of self-medication. In fact, addicted brains exhibit
similar dysregulation of the dopamine reward system.
Every behavioral reward that has been studied has been
shown to amplify dopamine production, including food, sex,
exercise, competition, and music. High-risk activities—driving
fast, motorcycle riding, and waterskiing—motivate ADHD
brains to focus. Some extreme activities, like daring ski jumps,
sky-diving, or taking fast-acting street drugs, elicit a dopamine
spike, the brain’s most intense reward. Some ADHD brains
have benefited from the greater dopamine involvement that
is intrinsic to high-intensity, high-risk careers, like those of
emergency medical technicians, firemen, and ER doctors.
However, nicotine, caffeine, alcohol, opiates, risky sex, pornography, gambling, physical risk-taking, reckless driving, and
compulsive buying increase dopamine even more. In fact,
all substances or behaviors that can ultimately result in
dependencies have the ability to increase the release
of impulse-reinforcing dopamine, and reduce the
impulse-inhibiting effects of serotonin.
The Search for Stimulation
So ADHD brains are highly motivated—to find that
unique balance of stimulation that enables optimal
functioning. Whether ADHD brains overreact or under-react to the stimuli at hand, they rarely engage with moderate
stimulation that falls “in the gray area.” ADHD brains tend to
respond at one end of the continuum in most but not all areas
of functioning. These opposite routes to the same goal explain
how a high-energy, outgoing, talkative, over-subscribed
individual and a shy, low-energy, passive, and withdrawn
individual can each have an ADHD brain.
with ADHD act the
way they do:
Wants (and Why)