Sanctum Healthcare • Jan 27 •
Does ADHD mean my brain works differently?
If you have ADHD or are wondering whether you have it, you may feel somehow different to others or that your brain must work differently because of the traits you possess. However, ADHD can be an extremely positive condition to have and adds to a wonderful mix of neurodivergent people we have around us, making our lives wonderfully diverse. It’s understandable to feel anxious, especially if your diagnosis is new, so let’s take a look at what it means to have ADHD and how an ADHD brain possibly works slightly differently from a non-ADHD brain.
Attention Deficit Hyperactivity Disorder (ADHD) is a very common neurodevelopmental disorder that affects around 1.8 million adults in the UK today. It commonly appears during childhood and if left undiagnosed, can continue into adulthood and affect day-to-day activities as well as working life, making it difficult for someone with ADHD to undergo certain tasks that, for someone without ADHD, would be easy.
There are 3 subtypes of ADHD: the first being hyperactivity and impulsivity, affecting a person’s behaviour and control of physical movements. The second is inattentiveness, which affects a person’s ability to concentrate and sustain attention and the third is combined, which is as it sounds, a combination of both subtypes. Easy tasks to a non-ADHD brain such as replying to important work emails and prioritising workload would be much harder for a person with ADHD to focus on and complete, leaving them feeling frustrated, tired, and worn out.
How a non-ADHD brain works compared to how an ADHD brain works
For someone who is “neurotypical,” your day may be split up into varying sectors with varying priorities. Like getting yourself and your children ready for the day, whether that be work or school, preparing breakfasts, lunches, and planning dinner. Keeping appointments such as doctors or dentists. Heading to work and completing the various tasks that come with it. Picking children up from school or childcare, preparing an evening meal, completing bath time and bedtime, tidying, cleaning, and resting at the end of the day. Even for someone with a non-ADHD brain, that all seems very busy and for most, they would go into autopilot and work through various priorities with relative ease, delegating where they need to and changing and adjusting as they go. For someone with ADHD however, this picture will look very different.
ADHD affects a person’s ability to regulate attention and emotions, resulting in hyperactivity and impulsivity as well as organisation problems. So, to start the day organised and knowing what needs to be done and at what times would be a challenge for someone with ADHD. Keeping on top of time management for school drop-offs and pick-ups and getting to work on time is a difficulty as well as staying focused on tasks at work and evening preparations.
Structure, function, and chemistry of an ADHD brain
For many years, countless research has been carried out on how the structure of an ADHD brain is different to that of a non-ADHD brain. Many people are quick to scrutinise the condition, questioning whether it is real or not, however, this research is vital in proving that ADHD is, in fact, a real condition and one that proves challenging for children and adults all over the world. This research has shown clear structural differences in the ADHD brain, mainly that of a smaller brain volume in five subcortical areas, including the amygdala and hippocampus. These areas are responsible for emotional processing and impulsivity and were greater in children than in adults.
Research has also been carried out to show alterations in the blood flow to various areas of the ADHD brain, including decreased blood flow to certain prefrontal areas. The prefrontal area of the brain is responsible for tasks such as planning, organising, paying attention, remembering and emotional reactions and evidence also suggests that ADHD may be related to dysfunctional brain connectivity.
The brain chemistry in a non-ADHD brain works as a message system being passed from one neuron to the next. There is a gap or synapse between these neurons which needs to be filled with neurotransmitters in order for different brain functions to work. It is thought an ADHD brain has a disregulated system when it comes to the 3 main neurotransmitters: dopamine, noradrenaline, and serotonin. For example, there is either too little dopamine, not enough receptors for it or the dopamine is not being used efficiently.
So, what are neurotransmitters and how do they regulate brain function?
As mentioned above, neurotransmitters are brain chemicals which allow signals to pass from one neuron to the next and onto your muscles and organs. An altered activity in these brain chemicals is what is linked to ADHD and what prohibits the ability to focus, control impulses and regulate activity. The three main neurotransmitters are dopamine, noradrenaline, and serotonin, let’s take a closer look at what these chemicals do…
Dopamine is the main brain chemical for feeling reward, like when we shop for bargains or go after a new job, it is scientifically refined as activities that we will work to acquire using time, energy, and effort. These also include simple everyday processes such as eating and drinking and non-essential activities such as gambling, substance abuse and other addictive behaviours. Memory also goes hand in hand with the feeling of reward. Remembering a past experience helps guide us toward a future experience and reinforces the ’pleasure’ element of undertaking the activity, for example, our brains tell us to eat tasty food or drink a sweet beverage. The main difference between dopamine in an ADHD brain is that its activity is disrupted by a change in how dopamine is transported. When dopamine is inside a nerve, it cannot pass signals between other nerves, so communication in the brain is affected. The receptor for dopamine can also not work properly in conjunction with this. Lastly, dopamine is also particularly active in the parts of the brain associated with attention, and the ability to prioritise longer-term rewards over short-term ones.
This chemical is also a neurotransmitter that regulates the behaviours of attention and alertness. An imbalance in noradrenalin, such as in an ADHD brain, prevents signals from travelling to parts of the brain, particularly the prefrontal cortex, which handle executive functions such as emotion regulation, impulse control, and the ability to focus.
It is not completely clear whether serotonin is reduced because of ADHD or that the effects of having ADHD can cause anxiety and depression, which is linked to a dip in the levels of serotonin found in the brain. However, serotonin is another neurotransmitter that regulates lots of mood and thought processes in the brain.
How ADHD medication works to modulate neurotransmitter
ADHD medication can be extremely helpful when it comes to getting on with daily life, as they help by regulating the chemicals in the brain and improving their functionality. All current ADHD medications modulate either or both, dopamine and norepinephrine levels in the brain and work to increase the mood neurotransmitter, serotonin. Neurotransmitter function is possibly the central most affected part of the brain in ADHD and medication can help in regulating its function.
How speaking to a specialist ADHD clinic can help
So, in short, yes, an ADHD brain does work differently to a non-ADHD brain, and it is a complex structure of neurons, neurotransmitters and how they effectively pass around your brain and body. However, ADHD is most definitely also your superpower. Enabling you to hyper-focus and bring an abundance of energy and enthusiasm to what you love.
Understandably though, this can be overwhelming to wrap your head around, but here at Sanctum, we can provide you with a professional, medical assessment and diagnosis along with the help and support needed to navigate this complex condition.
With a bespoke treatment plan from one of our ADHD psychiatrists, Sanctum could be the first step into gaining that all-important understanding of your condition and leading you to live a healthier and happier life. We offer a comprehensive and multi-professional assessment for adults and children who may have ADHD.
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