People who have difficulty with concentration or sitting still often receive a diagnosis of ADHD (attention deficit hyperactivity disorder). Although children and young people with ADHD symptoms typically get this type of diagnosis, many adults also have the condition. In many cases, they were never diagnosed when they were young. The most typical way of managing the condition is through ADHD medication. However, ADHD medication does not work for everyone with the condition. A new study from the University of Cambridge points towards why. It has to do with dopamine receptors in the brain.
Defining ADHD
In its simplest terms, ADHD is a disorder that affects brain function. If you have ADHD, your brain works differently from what we consider the norm. Symptoms usually start before the age of 12 and may continue into adulthood.
A chronic disorder, ADHD can affect all areas of your life. People with the disorder may find it difficult to function properly throughout the day. They may also have interpersonal relationship difficulties and suffer from poor self-esteem. Many people with the disorder may also never reach their full academic potential because they find it difficult to concentrate.
Interestingly, diagnosing ADHD in boys is much easier than it is in girls. This is largely due to how the condition presents itself differently in the two sexes (2). Girls, it seems, tend to have less severe external symptoms of impulsiveness, hyperactivity, and inattention than boys. Instead, they tend to have greater intellectual impairment and more internalizing problems.
ADHD can be divided into three main groups: the predominantly inattentive type, the predominantly hyperactive or impulsive type, and the combined type. A fourth, less common type is the unspecified type.
Inattentive ADHD Type
Here, you may find it difficult to stay focused on a task. You may also find it difficult to finish it and have difficulty staying organized. People with this type of ADHD usually do not have hyperactivity symptoms.
Hyperactive/Impulsive ADHD Type
This type of ADHD is characterized by excessive energy. Sitting still for prolonged periods is just about impossible. People with this type of ADHD may also present themselves as extremely talkative, often interrupting other people or acting without first thinking things through. Paying attention, however, does not usually pose a serious problem.
The Combined ADHD Type
The most common type of ADHD, it is associated with both inattentiveness, hyperactivity, and impulsiveness.
Unspecified ADHD
Healthcare providers may diagnose someone with unspecified ADHD when they have symptoms that affect their daily activities but do not meet the criteria that put them into one of the three recognized ADHD types mentioned.
What Causes ADHD?
Research has not yet pinpointed the exact cause of ADHD. ADHD, however, tends to run in families. This suggests a genetic factor. But other factors can also contribute (5). These include:
- Environmental factors such as in-vitro exposure to certain toxins like lead and maternal tobacco and alcohol use during pregnancy.
- Premature birth is a possible risk factor.
- Differences in brain structure in those areas that deal with attention, executive functions, and impulse control.
- An impaired prefrontal cortex.
- Head injuries.
- A negative family environment that includes, amongst others, negative parenting and bullying.
- Gut Microbiome Dysbiosis causing imbalances in neurotransmitter production like serotonin and leaky gut.
ADHD and the Neuroaffect Circuit
The brain, autonomic nervous system, and microbiome make up the Neuroaffect Circuit. This triad makes use of neurotransmitters to communicate. Issues with any of these systems impact the others.
Stress is one of the major causes of issues with brain health. This is because when you experience stress, it causes your body’s NeuroEndoMetabolic (NEM) stress response to kick in. This response affects all body processes and could cause hormone changes, resulting from an increase in stress hormone production and a decrease in the production of other hormones not deemed essential to your immediate survival.
Role of Dopamine
Long-term stress means a continued imbalance in hormones, with the production skewed to higher stress hormone production. This could unbalance all organ systems, including the brain. You may see a decrease in dopamine production, for example.
Dopamine acts as a neurotransmitter, i.e., chemical messenger in the brain. It plays a key role in your motivation, movement, reward, and pleasure. It also influences concentration, learning, sleep, and mood.
Gut Issues
Stress can also affect your gut health. It can change the makeup of your gut flora composition, for example, and contribute to leaky gut syndrome. This could trigger your immune response, resulting in inflammation. Many mental health disorders have been linked to gut dysbiosis. Examples commonly acknowledged include depression, anxiety, and autism spectrum disorder. Interestingly, a 2023 study suggests compromised gut health as one of the contributing factors of ADHD.
The Brain Mechanics of ADHD That ADHD Medication Cannot Influence
Standard practice in most ADHD cases is the use of ADHD medications designed to increase the brain’s dopamine levels. This is because people with the condition have low dopamine levels according to neuroimaging studies (3). Ritalin is an example of one such ADHD medication. This does not, however, account for those on an ADHD medication where the medication does not seem to be effective. A new Cambridge study may explain the reason for this (4).
The study suggests that ADHD medication effectiveness depends on your dopamine receptor availability. Dopamine receptors are found in the central and peripheral nervous systems. Their role depends on their location. We need them because their functions include movement, reward, cognition, and motivation, amongst various others.
Although there are five main types of dopamine receptors: D1, D2, D3, D4, and D5, we can subcategorize them into two subcategories: D1-like, and D1 and D5; and D2-like, and D2, D3, and D4.
According to the study, which used PET brain scans, people with ADHD and autism spectrum disorder had a lower D2 and D3 dopamine receptor availability. This could explain why the ADHD medications did not work for certain people.
The study also shows that people with a higher D1 to D2 ratio did better on tasks relying on memory.
The study suggests that we should take a more personalized approach when dealing with ADHD and how we identify and address all neurodevelopmental conditions, especially those that have common symptoms.
ADHD Medication
The most common way of addressing ADHD symptoms is with some form of ADHD medication. The main aim of these medications is to increase the levels of certain neurotransmitters in your brain, like dopamine and norepinephrine. Doing so may help address ADHD symptoms relating to attention span, impulsive behavior, executive function, and hyperactivity.
Unfortunately, ADHD medications affect people differently. You may need to try different medications before you find one that addresses ADHD symptoms. In many cases, no ADHD medication seems to work.
Different Types of ADHD Medication
ADHD medication typically falls into one of three types: stimulants, non-stimulants, and antidepressants.
Stimulants
Contrary to the name, stimulants do not stimulate. Instead, they increase neurotransmitter levels in the brain, particularly dopamine and norepinephrine. We find two types of stimulants: immediate-release and extended-release.
An immediate-release ADHD medication is short-acting. You would take this medication when needed. Its effect usually lasts about four hours. The downside of this type of ADHD medication is that once it wears off, you may experience a crash. This is associated with a decrease in energy levels. Severe hunger, mood changes, and depression may also follow.
In contrast, you usually only take extended-release ADHD medication once daily. It has a longer effect that lasts six to eight hours. Some may last as long as sixteen hours. These medications tend not to have the same negative effects as found with an immediate-release ADHD medication.
In many cases, people use both types of ADHD medication. They would typically take the extended-release medication in the morning, followed by an immediate-release dosage in the afternoon. This may help stabilize things as the extended-release medication’s effects start to wear off.
Non-Stimulants
A non-stimulant ADHD medication takes longer to work than a stimulant. The effects may only present themselves after you take the medication for three or four weeks. Their action may last for 24 hours.
Typically, non-stimulant ADHD medication is only considered if stimulants do not work, you experience side effects, or it is paired with a stimulant to increase its effectiveness.
Antidepressants
A healthcare provider may often advise the use of an antidepressant along with a stimulant. This is because these antidepressants work on your brain’s dopamine and norepinephrine levels. They may also advise the use of antidepressants that solely work on your brain’s serotonin levels. This is especially the case where someone has depression or anxiety as well as ADHD.
Taking antidepressants can result in side effects like:
- Gut issues like constipation, nausea, and diarrhea
- Issues with your libido
- Weight gain or weight loss
- Sleep issues
- Fatigue
- Dizziness
- Headaches
- Increased sweating
- Tremors
Other Factors to Consider About ADHD Medication
ADHD medication cannot cure ADHD. It can only help you manage the symptoms associated with the condition. Furthermore, while your ADHD symptoms may lessen or even, in many instances, stop as you age, the condition can carry over into adulthood. In adults with the condition, taking an ADHD medication may help them manage their symptoms.
How to Address ADHD Naturally
A natural approach to addressing ADHD is a holistic one that takes all factors of your personal health and well-being into account. It involves not only managing the various symptoms associated with ADHD but also making the necessary lifestyle changes that support your body in a holistic manner.
Diet
The first step is to follow a balanced diet that will help stabilize your blood sugar levels. Your blood sugar levels can impact your mood and focus. A balanced diet should contain plenty of fresh organic fruits and vegetables, healthy fats like omega-3, and lean protein. You should also limit or cut out high-sugar foods and drinks and processed foods.
Exercise
Someone with ADHD can greatly benefit from exercise. This is because exercise naturally releases neurotransmitters like dopamine and norepinephrine. However, if you have other health issues and suffer from Adrenal Fatigue, you should avoid intensive exercise. Rather, focus on moderate exercise like dancing, brisk walking, Pilates, or yoga. Weight training may also prove beneficial.
Manage Stressors
The best way to manage your stressors is to remove yourself from stressful situations. This is not always possible, unfortunately. Instead, you could consider certain techniques that have a calming effect. These include deep breathing exercises, meditating, or even spending time in a relaxing outdoor environment.
Establish Routines
You can improve your focus and reduce your susceptibility to distractions by creating a structured, organized environment. This may mean creating a dedicated working space and establishing consistent routines for chores and homework. Breaking tasks up into smaller, manageable steps may also help, as would reducing clutter and using checklists.
Get Enough Quality Sleep
Your body and mind go through a healing process when you sleep. It is crucial for proper cognitive function and for managing your ADHD symptoms. This means:
- Having a bedtime routine and sticking to it.
- Making your bedroom calm, dark, and quiet.
- Going to bed and waking up at the same time each day.
- Limiting screentime before bed.
Herbal Remedies and Supplements
Explore the use of herbal remedies and supplements. Examples of herbal remedies that help address hyperactivity include ginseng, passionflower, and ginkgo. A supplement like Adrenal Quiet may also prove effective. It contains L-theanine and inositol.
L-theanine has a beneficial effect on brain waves and improves your ability to focus and concentrate by being a precursor amino acid to making Dopamine. It also tends to reduce anxiety and hyperactive behavior. Inositol has a balancing effect on your brain’s dopamine and serotonin levels.
However, herbal remedies and certain supplements may not work for everyone. It is best to consult your healthcare provider before embarking on any sort of self-medication.
Other Tips on Addressing ADHD Naturally
Cultivating appropriate social skills may help manage certain ADHD symptoms like impulsivity. Engaging in creative activities, especially those that interest you, may also help. So does providing encouragement and praise where it is due.
Exposing a child with ADHD to cognitive therapy may also help. This form of therapy may help them identify their triggers and develop coping strategies while helping them learn how to manage their impulsivity.
In Closing
You do not necessarily have to rely only on ADHD medication to manage the diverse symptoms associated with the condition. By considering a more integrated approach, you may help to manage these symptoms without having to consider the possible side effects of the different forms of ADHD medication.
If you would like to know more about ADHD, ADHD medication, and alternative solutions in dealing with the symptoms of the condition, please call our office. Our number is +1 (626) 571-1234. A dedicated team member is standing by to receive your call.
