Grant has been a science teacher in the public schools for 14 years. He currently resides in Washington state and enjoys outdoor sports.
Neurobiological Causes of AD/HD
The diagnosis of Attention-Deficit/Hyperactivity Disorder (AD/HD) is often controversial. There are all too many individuals who are willing to dismiss the symptoms of AD/HD as poor self-control that can be cured with better discipline. However, knowing that there are neurobiological differences in individuals with an AD/HD diagnosis can help others understand that not all individuals have the same resources to draw upon when given a certain set of societal expectations.
Thanks to scientific developments like neuroimaging, the AD/HD brain is able to be observed directly and compared with the brains of neurotypical individuals. Most research on AD/HD indicates that it is a genetic disorder affecting the brain's ability to regulate dopamine and norepinephrine levels (Arnsten, 2005, Faraone, 2008; Kieling, Goncalves, Tannock, & Castellanos, 2008; Pliszka, 2005). Dopamine and norepinephrine are critical neurotransmitters that impact how well a person is able to maintain attention, focus on relevant stimuli, and filter out irrelevant stimuli. Many studies also indicate that individuals with AD/HD have reduced volume in the areas of the brain that are responsible for planning, organizing, developing strategies, monitoring performance, and changing behavior in response to feedback (Castellanos et al., 2002; Durston, 2003; Rubia et al., 1999; Valera et al., 2007; Vaidya et al., 1998). Not only do AD/HD individuals have different levels of neurotransmitters, the actual structures of their brain are smaller in critical areas that are responsible for organized, goal-directed behavior and motivation.
It makes sense; if you look into it. When comparing the symptoms of norepinephrine and dopamine deficiencies to symptoms of AD/HD, you will find many similar trends. While norepinephrine has been shown to be found in abundance in AD/HD - Predominantly Hyperactive/Impulsive, it is more than likely that AD/HD - Predominantly Inattentive (AD/HD-PI) individuals have a deficiency in this neurotransmitter. This may mean that the hallmark symptom of all types of AD/HD is the dysregulation of the critical neurological functions of attention, arousal, and inhibitory control, rather than a deficiency of attention or an overabundance of activity.
Norepinephrine is responsible for maintaining alertness and arousal, which would mimic the symptoms of inattention, lethargy, and distractability found in AD/HD-PI. Dopamine is also another critical neurotransmitter for the brain's functioning. Dopamine provides motivation and is responsible for the body's "pleasure-reward" system. Ultimately, individuals who are low on dopamine may act like a "couch potato," have difficulty getting started on tasks, and struggle to complete difficult, long-term projects. All of these effects of dopamine are also key indicators of AD/HD-PI.
Impact of Neurobiological Dysregulation
While there is some controversy around whether AD/HD is an actual disability, the decision to medicate is often more controversial than the diagnosis itself. The most common method of intervention for an individual with AD/HD is through some form of stimulant medication, such as Adderall or Ritalin. There are many other medications being tried, but methylphenidate or amphetamine salts, along with behavioral strategies, are the two most common forms of treatment.
It makes sense. If the root cause of a person's symptoms is in neurobiology, then medication, which seeks to compensate for the natural chemical imbalances in the brain, would be an ideal solution. The reason that drugs like Adderall and Ritalin are so effective is that they stimulate the production of dopamine or norepinephrine. However, many people are against medication due to the possibilities of harmful side effects, or they resist the idea of being dependent on medication.
All this aside, many are unaware that there are natural ways to address these neurological deficiencies. While the brain is a self-regulating mechanism, you can't just say "brain, give me more norepinephrine." However, there are natural ways to enhance production of this chemical without having to use prescription stimulants. One of the most common ways AD/HD - PI individuals tend to do this, behaviorally speaking, is in the form of procrastination. Have you ever heard of the person who says, "I need to procrastinate because I don't usually get motivated unless I'm under a lot of pressure and stress"? In fact, AD/HD-PI individuals are usually those "crunch-time" players on the team who make frequent mistakes when things are calm and stable, only to become calm and hyper-focused in an emergency. The fact is, the AD/HD-PI brain is wired to have a higher threshold for stress, making the fight-or-flight response more difficult to activate.
This is also the reason behind many of the social difficulties that AD/HD-PI individuals experience. If an AD/HD-PI person needs a higher amount of stress to thrive, they will undoubtedly have a difficult time in situations that require harmonious interactions. No one enjoys going to the office Christmas party, because it's stressful. Social interactions, by nature, require the ability to be mentally alert during social interactions that are geared towards building harmony and avoiding conflict. While avoiding conflict is good for social interactions, it takes the stress out of the situation, and causes the AD/HD-PI individual to disengage.
Exercise is Medicine
There are many factors that come into play with AD/HD-PI. However, individuals who wish to treat the disorder naturally have some options available.
- Exercise: Since exercise produces a number of beneficial chemicals like dopamine and endorphins, exercise should be a regular part of anyone's life, especially if they have an AD/HD-PI diagnosis. While the bare minimum is 20 minutes, I would personally recommend at least an hour a day. This may sound like an intimidating number to some, however, those who are unconvinced might want to listen to the TED talk posted above. The speaker argues that an hour of exercise a day improves mood better than any medication or antidepressant. By exercising an hour a day, you maximize your body's resources in producing the necessary chemical compounds that promote good mood, emotional regulation, and mental alertness - thus lowering your need to be dependent on chemicals.
- Nutrition: A person with AD/HD-PI will benefit from incorporating more protein and eating less simple carbohydrates. Protein from animal sources can aid in the natural production of necessary catecholamines (dopamine, norepinephrine, and epinephrine). A lack of catecholamines can also be caused by overuse of tobacco, alcohol, or marijuana. If you've ever noticed, most people react differently to alcohol as they get older, probably due to the body's decreased ability to regulate catecholamine production effectively. However, a true AD/HD-PI person may have difficulty sleeping after drinking a couple of beers as early as their 20s. As a result, it is best to abstain from these substances if you have AD/HD-PI.
- Supplements: There are many supplements available at vitamin stores that help increase mental acuity and alertness. While behavioral strategies are great, the most difficult AD/HD-PI symptom to live with is the constant mental fog. Here are some natural supplements that help. Please be sure to consult with your physician or a medical professional before incorporating a new supplement into your daily regimen.
- Fish Oil: Contains fatty acids that can raise your catecholamines by 40%. Contains DHA and EPA, which are brain activating agents.
- DLPA (D-Phenylalanine): An over-the-counter supplement that boosts endorphins. 5,000 mg a day of Phenylalanine is potentially toxic so dose responsibly.
- L-Tyrosine: This amino is naturally found in foods like beef, fish, and eggs. It is also available as a supplement and can aid in the production of catecholamines. N-Acetyl L-Tyrosine is an easier-to-absorb version of this amino.
- B-Vitamins: These nutrients can be found in foods or through supplements. They also support the brain's production of catecholamines.
- Magnesium: This is not only important for bone health but also impacts the functioning of neurotransmitters. Many symptoms of magnesium deficiency, like sleep difficulties and hyperactivity, overlap with AD/HD symptoms.
There is no one-size-fits-all approach for individuals with AD/HD-PI. The key is to start slowly with any supplement at the minimum dosage, and monitor the effects before increasing the dosage. Starting with changes in exercise and nutrition will provide a good starting point for supplements, if necessary. For those of you who wish to continue learning more about the neurobiological causes of AD/HD-PI, you can try some of the books below. These are also the main sources that I used in writing this article.
Miller, Daniel C., ed. Best Practices in School Psychology: Guidelines for Effective, Practice, Assessment, and Evidence-Based Intervention. Hoboken: John Wiley & Sons, Inc. 2010.
Ross, Julia. The Mood Cure. New York: Penguin Group Inc. 2002.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.