I don’t want to make these posts long. I have realised I am going to need more time to break down ADHD and its medication.
This post is for teachers, parents, students and ADHDers. I have never taken any medication myself. I have never been diagnosed. In a therapy session a few years ago my therapist asked me if I had adhd, I said I had dyslexia but I never even considered myself having adhd.
Below I have linked my sources, so if you want to learn more, please go for it!
To start with we are going to answer some small questions and then bring it back.
What is the Prefrontal Cortex and its function?
The Prefrontal Cortex (PFC) is found just behind the forehead and is in charge of:
External reception:
-Internal narrative
-Attention to the environment noises/noises
-What have I forgotten?
-Working memory
Internal bodily state:
-Am I feeling hungry?
-Am I comfortable in this chair?
What is the role of Dopamine and Adrenaline in our body?
Dopamine: is a messenger in the body it relays information about:
Movement
Memory
Pleasurable reward and motivation
Behaviour and cognition
Attention
Sleep and arousal
Mood
Learning
Lactation
Adrenaline: is a hormone and a neurotransmitter. It is part of your sympathetic nervous system- fight or flight in other words. It helps the body with.
Metabolism
Attention
Focus
Panic
Excitement
How is your brain wired and messages sent?
Messages are sent through a complex network of neurons. There is a small space between each neuron where a chemical message is exchanged . Neurotransmitters are released and passed from the pre to the post cell.
At the presynaptic cell neuro-transporters suck back up some of the neurotransmitter that has been released. There are dopamine transporters and adrenaline transporters.
What is the PFC like in an ADHD brain?
The PFC has the ability to quieten down and turn up different areas of the brain. In a person with ADHD, it is the ability to coordinate the PFC with other parts of the brain NOT a deficit of the PFC. So in other words, it is the signalling process or the passing of messages that has an under or hyper-connectivity with other parts of the brain.
Example:
There is a part of the brain called the default brain network (DBN). And, it is in charge of imagination, daydreaming, internal thoughts and it is on all the time. When you want to focus on something the PFC dials this part down. However, children with ADHD the DBN is often very active even when the task is to concentrate on a particular activity.
How do ADHD drugs affect the signals from the PFC?
I am just going to start with an overview and later get into specific medication.
So we have to start with how dopamine and adrenaline collaborate.
When an event happens the PFC needs to decide how much focus and attention it needs. It coordinates with other areas of the brain. A message is sent to, for example, the DMN to quieten down. However in a person with ADHD the message is not received, why?
Because, in the synapse there has been an imbalance of neurotransmitters. If dopamine transporters are used they catch more dopamine neurotransmitters to reduce the amount of dopamine being passed from cell to cell. If adrenaline transports are recruited they catch more adrenaline neurotransmitters which reduces the amount of adrenaline being passed from cell to cell. The next time a signal is sent because the cell now has more neurotransmitters, it releases more dopamine and adrenaline all together.
Example:
If we have someone who can’t concentrate on anything and is always daydreaming. Their medication would promote more attention and focus. In the synapse their medication would catch more dopamine being sent to an area of the brain like the DMN and leave adrenaline to be sent to the area of the brain that is for concentration.
So the medication acts like a stimulant, that stimulates the neuro-transporters to catch more or less dopamine or adrenaline.
Stimulant vs Nonstimulant medication
Here I have spoken of stimulating medication as around 80% of people with ADHD take a form of stimulant medication.
The other 20% take non-stimulant medication which targets adrenaline in the body, not dopamine.
Take away points:
ADHD medication plays with the collaboration between dopamine and adrenaline.
An ADHD brain is under or hyper-connected and NOT a deficiency of the PFC.
The PFC has difficulty in talking to other areas of the brain clearly.
It is literally a game of catch. Medication promotes neuronal transporters to catch the neurotransmitters in the space of the synapse.
Next post we will look at specific medications on offer.
FUN FACT….(not)
80% of University students have used ADHD drugs to concentrate for exams and tests, even though they have not been diagnosed. Is this a good idea?
Reference
https://www.verywellhealth.com/prefrontal-cortex-5220699
https://kids.frontiersin.org/articles/10.3389/frym.2020.540970
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