Attention Deficit Hyperactivity Disorder is a genetic neurodevelopmental disorder, which means people with ADHD are born with brain differences that they inherit from their parents.
The differences in structures, network connections, metabolism, electrical activity, and neurotransmitter levels in the brains of people with ADHD create a complex host of cognitive traits which are not related to intelligence.
Some of these traits include:
People with ADHD struggle to focus on, maintain alertness for, and find the motivation to do things that are important over things that are interesting. This is especially true for boring, mundane, repetitive tasks such as dishes, laundry, filling out forms, and so forth. Dopamine is the chemical signal of motivation. Without dopamine, the body cannot take action. In ADHD things that are interesting trigger dopamine, not things that are important.
People with ADHD can go into hyperfocus modes where they may become so engrossed in something interesting that all other important things (including going to the bathroom, eating, picking up children from school, etc.) are completely forgotten until their focus is redirected. This is often followed by regret.
Working memory is the ability to hold something in mind while thinking about other things. Having a poor working memory is a very frustrating symptom of ADHD. “Out of sight, out of mind” applies to everything from what is on the calendar for the day, to the rotting vegetables in the back of the fridge, upcoming expenses, even friends and family, and beyond.
When someone has ADHD, they have a different perception of time, the way time passes, how much time things take, and they have great difficulty thinking about and conceptualizing the future and future consequences of current actions. This is often referred to as, “a nearsightedness to the future,” a phrase coined by Russell Barkley, PhD.
Someone with ADHD will have received 6 times more negative feedback from the adults in their life by the time they are 12. Frequently disappointing people, failing to finish things, and experiencing a perplexing struggle to do things that seem so easy to other people (dishes, laundry, remembering appointments, keeping track of things, adulting …) can create an exquisite sensitivity to criticism … or even perceived criticism. In addition, the neurotransmitter imbalances in the ADHD brain can create a baseline mental state that is something between boredom and frank depression. It is a sense of languishing that is relieved by whatever triggers the release of dopamine for that person. It may be a new hyper-fixation, it may be food, drugs, alcohol, sex, video games, scrolling social media, etc … People with ADHD also have a harder time recognizing and suppressing the expression of strong emotions. Their emotions are typically appropriate to the circumstances but are much more intense than what is socially acceptable.
As described, dopamine is the chemical signal for motivation. Humans are motivated to do things that we think will be rewarding. In ADHD, there is a decreased ability to predict rewards and experience the pleasure associated with rewards. This is especially true for any rewards that are too far in the future. This applies to consequences as well. So, saving for retirement may provide no reward and therefore no motivation for the person with ADHD even though they know they should and they want to.
ADHD is a very complex cognitive disorder that has nothing to do with intelligence. It is the inability to put one’s knowledge to use to do the right things at the right time to benefit one’s own future interests. It is not a disorder of knowing, it is a disorder of doing what you know. ADHD is a deficit in the level of global self-control that would normally be expected for a person of their age. ADHD is a serious disorder that when left untreated, can have a negative impact across all the domains of a person’s life: educational, occupational, social/relationships, finances, legal issues, and personal health.
The good news is it is also one of THE MOST TREATABLE mental/neurological conditions known. It is no exaggeration to say that appropriate treatment for ADHD can be life-changing.