The Link Between Dopamine And ADHD: How Does It Work?

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder involving symptoms of inattention, hyperactivity, and impulsivity. Dopamine is a chemical messenger in the brain that may play a role in the development of attention-deficit/hyperactivity disorder. ADHD dopamine refers to the relationship between ADHD and the neurotransmitter dopamine, which is responsible for regulating attention, motivation, and reward processes in the brain. 

Some experts posit that people with ADHD experience either low levels of dopamine or a dysfunction in dopamine transmission that keeps the signals controlling motivation, reward, and focus from getting through. This irregularity may cause behavioral and motivational problems that interfere with an individual's ability to achieve goals or manage everyday tasks. Research about ADHD, including that regarding the link between ADHD and dopamine, is ongoing. However, browsing up-to-date research on this topic may be helpful when looking to manage your life as an adult with ADHD.

What are neurotransmitters? An overview 

Neurotransmitters are chemicals inside the brain controlled by natural electric impulses. They travel across gaps between neurons, called synapses, inside brain cells, and signal the brain to perform specific tasks. Each type of neurotransmitter has its own function and its synapses on which they have effects. Essentially, they act as messengers.

Neurotransmitters include serotonin, norepinephrine, GABA, and dopamine, among others. These neurochemical messengers are responsible for controlling many functions throughout the brain and body, including mood, emotions, and focus.

The minds of those with mood, personality, or developmental disorders, including ADHD, may have a unique relationship with some neurochemicals. Some medications designed to treat these conditions' symptoms act on these neurochemicals—or the synapses they act upon—to promote changes in the activity or number of neurochemicals present.

What is dopamine?

Dopamine is an essential neurotransmitter involved in pleasure, attention, and information processing. Dopamine causes the brain to seek out rewards and experience satisfaction and a sense of accomplishment if those rewards are obtained. The human dopamine transporter (DAT) is a protein that moves dopamine around. Abnormalities in the dopamine transporter gene or its function are linked to several conditions, including bipolar disorder, attention-deficit/hyperactivity disorder, and Parkinson's disease. Dysfunction in dopamine transporters may account for ADHD symptoms in some people.

There are at least five types of identified dopamine receptors in the human brain, each with a unique function. Dopamine receptors that control sleep quality and motor functions, like balance and coordination, can be targeted with pharmaceuticals called dopamine agonists. Dopamine agonists bind to receptors to mimic the effects of dopamine. They’re intended to combat the effects of dopamine dysfunction or low dopamine levels.

Factors that determine dopamine effects include not only overall dopamine levels but also the number of dopamine receptors. Having too many or too few dopamine receptors or when receptors are damaged can cause difficulty in maintaining attention, problems concentrating, poor sleep, and mood instability, among other challenges that negatively impact overall well-being.

The brain’s reward system

Dopamine is responsible for the sense of accomplishment you might get when you finish a big project or the pleasant sensation you might experience after biting into a chocolate bar. This neurotransmitter is released when your brain interprets stimuli or a situation as rewarding. 

For example, when you eat a dessert, its sugar content may incite a surge of dopamine. This surge reinforces the behavior, so you're more likely to repeat it in the future, which you may experience as cravings for sugary foods. 

From an evolutionary standpoint, these bursts of dopamine are a way to communicate with the environment and seek out what benefits survival. Often called the "pleasure chemical," dopamine can also be described as the “desire chemical.” Dopamine causes the desire to seek out what has previously caused dopamine releases. This function may be beneficial if you seek a reward or a goal that has value to you. For example, stimuli like food, sex, and physical activity can cause a release of dopamine in varying amounts.

The reward system and ADHD

Dopamine-related dysfunction can make those with ADHD to have a physiologically wired higher threshold for reward. They may require more stimulation to experience the same amount of reward as they would if they didn’t have ADHD. This difference can make someone particularly reinforced by whatever is perceived as rewarding and may explain part of why conditions like substance use disorders are more common in those with ADHD.

Modern tactics designed to hijack the dopamine reward system can be especially problematic and self-reinforcing. In this way, engaging with them can make you want to engage more, often at the expense of other activities. Those with ADHD and other neurodivergent conditions may be particularly vulnerable to these rewarding effects on their brains, which in turn, may affect their cognitive and psychological symptoms.

What happens when dopamine is low?

Low dopamine levels can contribute to a loss of pleasure in previously enjoyed activities, difficulty achieving motivation, and insomnia. While the standard treatment strategy for otherwise healthy adults with depression is therapy and medication, which may work by increasing serotonin transmission, some people with ADHD respond better to medications that can prevent the reuptake of dopamine in the synapse. 

Conversely, high concentrations of dopamine in the wrong area can contribute to symptoms of other mental health disorders or symptoms, including psychosis and schizophrenia. In this case, a healthy level is all about balance.

Dopamine in attention-deficit/hyperactivity disorder

Brain imaging performed on children and adults with ADHD has shown differences in the dopamine transport system. 

Dopamine transporter imaging is a diagnostic tool that uses radioligands—isotopes that bind to receptors and can be seen via scan—to visualize and quantify dopamine transporter density in the brain. This imaging tool helps doctors investigate the role of the dopamine transporter gene in various neurological disorders. 

In ADHD, neurotransmitters like dopamine and norepinephrine (which is made from dopamine) may be deficient. The area most affected by ADHD is the prefrontal cortex, which is responsible for controlling behavior, directing attention, and inhibiting impulses. Dysfunction in the prefrontal cortex can cause the brain to fail to filter incoming stimuli effectively and process the information that gets in. It's believed that, in brains affected by ADHD, there are also naturally fewer dopamine receptors in the prefrontal cortex.

Risky behaviors

Dopamine is the chemical that tells the brain to pay attention to what's going on. Without a sufficient amount, attention, memory, and motivation may slip. A person with ADHD may, therefore, be chronically dissatisfied, bored, or unhappy if the condition is not managed correctly.

People with ADHD may compulsively seek high-dopamine activities and stimuli to achieve a dopamine rush. As a result, people with ADHD may be more likely to engage in impulsive and risky behaviors. An individual may seek out riskier situations that incite a stronger burst of dopamine.

Many people with ADHD may describe themselves as “adrenaline junkies,” never satisfied or always seeking what is out of reach. Individuals with ADHD may also describe experiencing difficulty separating themselves from interesting stimuli, such as TV shows, multiple tabs in a browser, or passion projects. They may also experience substantial difficulty getting started with activities they find less interesting. Young children living with ADHD may have outsized emotional responses when denied their desired stimuli. 

Increasing dopamine may help people with ADHD

Pharmaceuticals can be an effective management strategy for the symptoms of ADHD for some people. In particular, stimulant medications are sometimes prescribed to increase dopamine in the prefrontal cortex. Stimulant medication can be invaluable for some people, but its use may cause side effects and must be continuously monitored by a doctor. Non-stimulant medications may be prescribed as an alternative class of ADHD medication to stimulants and may be better tolerated by some individuals.

If you do start a medication to treat ADHD, seek medical advice before starting, changing, or stopping. Discontinuing ADHD medications can have negative side effects called discontinuation syndrome. Always consult a medical professional like your primary care physician or a psychiatrist beforehand.

The BetterHelp platform is not intended to provide any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action (including starting, stopping, or changing medication) without consulting a qualified medical professional.

What can help besides medication?

Treating ADHD can involve implementing healthy, everyday strategies to increase dopamine in the brain. Changes in eating that benefit mood may also benefit those with ADHD, such as prioritizing foods your doctor or nutritionist recommends for your unique body type and health status. 

Studies have relatedly found that people with ADHD are more likely to develop type 2 diabetes and heart disease later in life, making nutritious eating all the more crucial.

Whether you have hyperactive, inattentive, or combined ADHD, movement is also often an essential part of ADHD treatment. Exercise has been shown to increase both dopamine and serotonin production in the brain, as well as increase dopamine receptor density. You don’t need to complete long, vigorous workouts to achieve this effect—Going outside for a 30-minute walk several times a week can also make a difference.

Mindfulness meditation, once considered an alternative treatment, is now also recognized for its effect on the ADHD brain. Mindfulness practices involve focusing on the present moment using conscious breathing and other deliberate focus techniques. These activities may increase one's awareness of one's thoughts and emotions and can be pleasant or relaxing enough to incite a dopamine release.

Managing ADHD symptoms with therapy

Like medications and lifestyle changes, therapy can be a superb addition to one’s treatment plan. A therapist can work with you to help you set treatment goals, monitor your progress, and create behavioral strategies to work with your unique brain instead of constantly fighting its limitations. 

However, some people with ADHD may experience barriers to receiving support from an in-person therapist due to transportation limitations, a lack of financial resources, an especially heavy schedule, or being a large distance from the nearest office. Working with an online mental health specialist through an online platform like BetterHelp may be more convenient. In addition, online therapy is often more cost-effective, which may be helpful for people with limited income. 

Some people with ADHD can benefit from the structured environment that therapy creates, and research supports the effectiveness of online modalities. For example, a 2022 study on treating ADHD found that online therapy could improve symptoms of ADHD in adults and children as effectively as in-person therapy. 

Takeaway

Experts are still learning how dopamine dysfunction and deficiency play a role in attention-deficit/hyperactivity disorder (ADHD). Being aware of your symptoms and taking steps to minimize challenges related to these brain differences may help you better manage the condition. In addition, lifestyle changes, medication, and therapy can also be beneficial. A licensed mental health professional, in particular, may be able to provide you with tangible solutions to your obstacles. Consider reaching out to a qualified medical provider to get advice, receive a diagnosis, and review the best treatment options for you.