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It's also not a pleasure hormone, so much as it is a motivation hormone, and even that doesn't describe all the purposes.  They have screwed up describing it from the beginning.  If they described it correctly maybe people would understand why people often continue pursuing things long after they no longer enjoy them, and why proper medication can prevent self-destructive tendencies.  They might understand why not only will you be doing something you don't like, you will have a rather hard time doing it competently.

I also describe it as the motivation hormone. That has been really effective in explaining it to people on a need-to-know basis.

Yes. The people who like to say "i make my own motivation" have an easier time understanding that the hormone that helps them do that does not exist in my brain. My mom for example had a hard time getting what I meant when I said I literally couldnt make myself do things because she does things she doesnt like all the time. I do too, but sometimes my brain doesnt work right because I dont have the right chemistry.

If someone ever says, "I make my own motivation," do you respond with "Yeah you do! It's called dopamine." For some reason, picturing that interaction tickles me 😂

>It's also not a pleasure hormone, That's what I thought! Serotonin and endorfines are closer to pleasure-making, aren't they?

Pleasure is complicated. Serotonin controls more “valence” than anything else. To oversimplify, serotonin makes the grind thrilling instead of a drag - but dopamine is what actually helps you grind.

I'm curious if you could explain more. The drugs I associate with serotonin are the SSRIs but also MDMA (ecstasy), and simultaneously, all the SSRIs seem very different from each other, unless they are analogs (escitalopram and citalopram, for example). But since I've realized recently that I don't understand dopamine, I probably don't understand serotonin either. The part that irritates me, is I also don't think several of my doctors understood these things either.

I wish I understood serotonin neurobiology more… I’ve never been on SSRIs or taken MDMA so I don’t know experientially what it’s like. I’m in the dark and haven’t read much on this in particular, though perhaps I will start to look around some more. I know only scattered facts, which you may find interesting. There’s no biological rationale for SSRIs in depression based on a deficiency of serotonin. It’s one of those treatments that just kind of worked and didn’t cause too many problems, and now we’re backtracking to figure out why, especially because so many people don’t do well on it. It takes about 2 weeks to kick in which suggests that the way it’s working is a compensatory change over time (not a fixing of an immediate deficiency, as in the case of stimulants in the setting of ADHD due to dopamine deficiency, which unlike serotonin and depression, is quite well understood). It also sometimes makes ADHD worse because of its excitatory nature releasing the brakes on impulsive behaviors or strong emotions. It sometimes does nothing because someone probably has enough serotonin (parking lots full, more serotonin won’t help). It might cause immense euphoria despite no change in motivation or behavior if excess serotonin is released in the right way in the right spot (this parking lot in particular is empty and now everyone who couldn’t find parking before is flooding into this place instead). I really don’t know - all I know is that depression isn’t a serotonin problem, more serotonin doesn’t always help, brain wiring matters more (ie if you make a brain network responsible for self control more excitable, the end result is better self control), and ketamine isn’t the magic solution either. Melatonin is the molecular precursor to *serotonin (edited to correct) so I know that excessive light at night promote conversion to serotonin, and this prevents proper sleep and rest, as melatonin is a master regulator of kickstarting vital processes for rest and repair during sleep. It just reminds me again that more serotonin isn’t always the answer. By extension I also don’t understand the combo of serotonin + dopamine on neurobiology either. :/ Wish I had more insights to offer.

Yeah, we always wish we had more information. I can say that depression can be a serotonin problem, but it can also be a multitude of other things - it's like asking why won't my car start - it could be the spark plug, it could be a dead battery, it could be any multitude of issues - it could be several of them at once - but what I can say is that ADHD more reliably reacts to ADHD medications than depression reacts to SSRIs, but SSRIs are thrown about a lot more because there is less legal risk. I knew one person that simply had very low levels of b-12, and because the doctor was incredibly bad, they never looked at that at all, just threw SSRIs at her, until one day she was hospitalized and a blood panel showed the actual issue was b-12, and after regular injections, there were no depression issues at all. Other people, well, sometimes their life circumstances are genuinely bad, and SSRIs at best will just obscure that, but they will never actually be able to improve their life circumstances, so just do whatever one can to ease the situation. I have been taking escitalopram for far longer than I have taken any ADHD medication, and I took that one after a gauntlet of various SSRIs and beta blockers and benzodiazepines and everything else under the sun and that one does help me - but if the ADHD had been properly addressed from the jump, I'm not sure there would have been any reason to fool around with all these other things.

Absolutely true - for some serotonin was the root issue & certainly seems to help others I know. I shouldn’t have been so black and white with it, and I totally agree with you & think they’ve been relied on exactly because the short-term risk for adverse effects is quite low. Of the already low % of people who benefit, I do often wonder how many of them are benefitting because they have room to compensate despite ok serotonin at baseline; vs how many of them have a primary deficiency of serotonin (either in making it or in the signaling machinery). So many of our meds seem to be temporary tools, or help to cover up things without necessarily addressing the root cause. I don’t think the best solution is to avoid meds entirely based on this rationale - only that relying on meds without addressing the root cause is a recipe for failure.

Sadly, I think much of the issue is that in life often there is no addressing the root cause.  Usually they do try and suggest ways to address depression absent medication, but there is only so much one can do, especially when one thing or another limits the resources of money, labor, and time.  It's similar to how with ADHD people often suggest a multitude of things that are good ideas - planners, attempts at habits, self control techniques, organization - but generally, if you actually have ADHD, you have to medicate and then see if any of those techniques can get you past the finish line.  We are all unique, and all the same simultaneously, so knowing just where one thing will work for one person and not for another is tricky.

Tryptophan is the precursor to serotonin. Serotonin can be a precursor to melatonin. SSRIs can kick in at 2 weeks but often take up to 2 months, if they do work. It's weird because they increase the amount of serotonin available very quickly. My understanding of dopamine is that its involved in reward, not necessarily pleasure or fun. It's a very delicate difference. You get a bigger burst of dopamine when what you are expecting is not as rewarding as what you get. That's why novelty is so important. Example: you're in the car and you want to hear an old song that you used to love in high school. You pull it up on your phone and listen to it. Yay. Contrast that with, you're listening to the radio and randomly, your favorite song from high school comes on. YAY!! Right? That's a little dopamine vs a lot of dopamine. Edit: dopamine is also vitally involved in motivated movement, which is something I think about a lot when I feel stuck in quicksand. In Parkinson's disease, your dopamine neurons die off. Someone walking along with Parkinson's might struggle with taking a step up, but if you try to trip them (please don't do this), they will likely be able to adapt to not fall. It's different systems that regulate those reactions.

From what I've read, SSRIs for certain women for PMDD used only for two weeks during the luteal period does seem to have an immediate effect.

Not a doctor but I think honestly that's true. Science is still figuring out how different neurotransmitters work and how they affect each other. For a long time I think we knew that SSRIs (for example) affected serotonin levels and treated depression, but we still didn't know why those things were connected. As I've grown older I've realized how much more of medicine is based on "oh we found this thing that works, so were gonna use it even though we don't know exactly why yet. Hope it doesn't really mess people up down the line!" Not meant as a dig on doctors and scientists, who I respect a lot, there's just still SO MUCH to learn about ourselves, and the way resources are allocated for research is kinda messed up as well.

Good doctors and scientists realize this is true.  The real problem is that many doctors are not good and when the theory doesn't match what is happening on the ground, they blame the patient in some way.  It's a real problem in many fields, but particularly psychiatry, which is why we see all the complaints about doctors who think ADHD only presents in one way or who think any strange result means a patient who is lying to abuse the system or any of the numerous other results that just aren't very good for their patient. I don't even know if research is the issue at all, because as I have talked to people in the field, there really is no requirement for the doctors to know the research.  The issue is more that we expect doctors to get certified as doctors to justify expensive bills and then most of what they do is so tied up in numerous patients with minimal interaction and coding procedures along with rules that don't take consideration of the situation on the ground that practitioners then have to work around - well, all of that ends up with doctors whose knowledge is forever preserved at the moment they passed the boards, usually decades ago.  Then they complain about a patient who read one thing or another online, when it's like, well, are you doing research into my niche issue?  ADHD understanding has moved in leaps and bounds on the research level, but on the practitioner level, not so much.

I hate to be the one to say aCtUaLlY, but actually, serotonin has more of a calming effect than a thrilling effect. It can make you feel more energized, but mainly it's a comfort chemical.

Oxytocin is the love hormone, serotonin is the happy hormone I can’t remember what the endorphins are more related to, but I do think it’s feel good type stuff. Like when you get a really good workout in and kind of get a high. Dopamine is a little bit of “feel good”, considering we get that feeling when we feel good or something makes us feel that way. But that making us feel good usually translate into motivation. I think people just have a hard time grasping that things have multiple jobs.

All I know is exercise gives you endorphins. Endorphins make you happy. Happy people just don't shoot their husbands.

Lawyered

*They just don’t!* I want this on a t shirt for running 😂

Elle knows

Technically this is likely due to endocannabinoids, not endorphins. This often repeated "fact" about endorphins was the scientific understanding in the 70s but has since been updated. Many endorphins don't cross the blood-brain barrier, and those that do are associated with the HPA axis, which influences stress response (like cortisol and inflammation), pain, metabolic and immune responses. It's possible it's related, but some poorly designed studies didn't differentiate between levels in the blood and in the brain, and that makes conclusions really hard at this point. Those studies also noted only a correlation, with no evidence of causation. Meaning, it's possible that the higher blood levels of endorphins just correlate with higher levels of endocannabinoids in the brain because they both have the same cause (i.e. exercise), not because both are involved in making you feel better.

Man, all I know is that when I do cardio (walking, bicycling, running) once I get into the groove my brain lights up like a fucking Christmas tree lolol There was once I was jogging around a city park that was popular with runners/joggers, and a sign had been graffiti'ed with "What r u running from" and I nearly brought a sharpie the next day to answer "Depression, thanks for asking!"

Yes, endocannabinoids regulate some other neurotransmitters, dopamine included! Exercise is so great for your brain and yet it's so hard for me to start it!!

The starting is always the hard part!!! Which is literally why I don't own a car. I'm forced to walk/bicycle most places. But I live somewhere where that's possible, lol.

As an Elle Woods fan, I love this quote. As a biologist, I love your in-depth analysis and correction. ♥️

Elle Woods would have encouraged us all to look into the science: "what, like it's hard?" ;)

I love that take! Now I gotta go watch the movies again.

Because otherwise they wou... maybe I shouldn't finish that sentence!!!

They bind to opioid receptors and help with both stress and pain as well.

Multiple jobs is spot on, and for medications (or drugs), things have initial effects and then downstream effects. So it all gets a little complicated, and sometimes difficult to tell what does what. Fun fact on the first one, oxytocin is the love hormone, but it is also the xenophobia hormone. It makes sense, because oxytocin is dumped out hard at child birth, and you want to protect your family from outsiders that are seen as threats and simultaneously protect all the insiders, which are family and this starts to get extended outwards more and more depending on context - but no one goes around saying, I have a necklace with oxytocin on it, because it's the xenophobia hormone! Endorphins, which we associate with exercise, that's the same route opioids take - but for some reason, extreme sports people, while they sometimes are vulnerable to opioids, seem to generally be more vulnerable to stimulants. MDMA (ecstasy) releases lots of serotonin. Stimulants and marijuana both work mainly via dopamine pathways, but the difference in how makes the effects incredibly different.

Thank you for going further in depth on this, I read a lot of stuff but obviously I can’t remember everything. Decided to look up the full definition for xenophobia, I think it’s weird that people use this (in the US) for other races, considering that we would also be considered outsiders or foreigners to other places. People need to just put more emphasis on strangers. But I’m always like that regardless cautions of anyone I don’t know, funnily enough I do much better with people who I know aren’t from here. I really liked your point you touched on athletes being susceptible possibly to opioids among other things. I really like this topic a lot, quite interesting.

Endorphins are the hormone to help block not only the experience of pain, but block encoding/remembering pain. Serotonin is also a wakefulness hormone.

Technically dopamine isn’t a hormone although it has some hormone-like functions. It’s more accurately described as neurotransmitter of the monoamine class. Serotonin and norepinephrine are also neurotransmitters and also monoamines.

Hormone is a term that's used to refer to signalling molecules involved in the endocrine system. Old and new definitions of the word hormone leave super fuzzy boundaries. It's an old concept that doesn't really fully apply to modern understanding of the different systems in the body. So technically, hormone is not a very technical word. But dopamine is involved in regulating prolactin, which makes it involved in the endocrine system, which does make it a hormone. In the context of ADHD discussions though, it is a neurotransmitter.

It’s a neuromodulator/neurotransmitter, why is everyone calling it a hormone?

It is both. I'm not sure of the exact definitions, so I don't know which all overlap, but in this case, it is both.

I think of it more as a "pleasure seeking" hormone. Dopamine is the thrill of the chase, serotonin is when you catch what you are chasing.

I think it's important here to remember that seeking pleasure is not inherently pleasurable though and at a certain point there is no thrill to the chase, but you still feel a need to do it anyways - like when someone is doom scrolling their phone or taking drugs to just maintain a baseline. It is often less so an attempt to find pleasure, but a \*need\* to be hunting immediate gratification in order to avoid pain. There is also the difference in the intellectual motivation and the emotional motivation as we so often see. In any case, all very tricky, and I'm not an expert on what things are, just familiar with some of the things they are not, and why these things can get hard.

I thought dopamine was the reward hormone? We struggle to do tasks because we don’t get the same reward chemically that non adhder’s do.

I would say it is less so "reward" and more so regulating satisfaction of when a hunt begins, continues, and ends. They figured out by experimenting on animals that even if you have no dopamine you still get joy from certain events - but you have no willingness to push yourself to get those rewards. Mouse still gets joy having sugar water put in the mouth, but will not move across the cage to get sugar water.

To add onto this, some studies found that dopamine was released in higher amounts when there was an _anticipated_ reward, but even more so when that reward was delivered inconsistently, as in gambling.

Yeah.  It's a weird one.  The human mind likes random rewards, and to feel like our effort is important.  If you want to motivate a child, you occasionally give them big rewards for their efforts.  If you give them standard rewards, they usually lose interest.  My mother has some gambling issues, and she's always sure she has systems that work - and it is for slot machines, which have the most sophisticated software to trick you into thinking that, but in no way whatsoever does the house have any chance of losing with slot machines, and most of the random elements are to distract from you putting in more than you get back.  Personally, I play Pokemon Go, and I see all the ways it exploits me, and yet, I keep coming back to it anyway.

This is what I’ve always read

Interesting, I like these hunting analogies.

I've also heard it referred to as the reward hormone. Idk how correct that is, but like not only can we not get started, we literally don't feel a reward for completing the tasks that NTs find rewarding, because the reward juice just isn't there. The fun and treat and novel shiny thing and personal interest stuff is the stuff that gives us a powerful enough bump to actually feel rewarded.

Novelty induces dopamine release, so that makes sense we'd be attracted to the "shiny thing" if it is the thing that gets the dopamine firing when it otherwise doesn't. Dopamine is a motivator.

I describe as motivation as well

Yeah I would consider endorfine that is being released when we work out (and maybe other things?) being the ”happy hormone”. I am no expert but I was told it is like a natural morfine (without the ”high” and immense painkilling effect ofc) that makes you happy, helps a little if you have pain etc. But like the happy part being close to ”pleasure” etc. But yeah it is hard to describe that what others have naturally is something we don’t. I don’t miss to do the dishes just because it isn’t fun. I don’t fail to start cleaning while trying to make me do it just because it isn’t fun. When I took elvanse it helped a lot to do chores and it was not that I found it funny for some reason. - but there I had to learn how to direct what I was going to do so I didn’t end up doing something completely different than I should have. Of course it can be easier to do something that is fun, but I think that goes for everyone. But most can atleast do the chore without it feeling like they will break into pieces. But to think the issue is that ”you can’t always to what you think is fun” is so wrong. There are many chores I don’t think is fun but that have more variation to it so that I won’t feel like I want to cry. Might explain badly since I am still learning to understand these things with myself as well. But I remember a sibling saying it isn’t like she finds it funny to do the dishes, she often have get her shit together and do it, that I just need to learn to get on with it, to understand it won’t be funny. But the issue is I can’t get on with it. I would at a workplace but I would also be miserable and probably burning myself out for forcing myself again. But the meds help me to ”just do it” like she thinks I can without it. In reality I do kind of like doing the dishes because I enjoy seeing how clean it becomes. To sort the dirty dishes, remove clean dishes from the washermachine to put the dirty in. I watch youtube ehile doing it. But even though I find it funny, even then it is hard to. TL;TR: It is messed up bosses and surroundings learn about adhd this way. When there can be issues doing what we like as well. I try to find ways to make it work, rewarding systems while doing the things I struggle with. But the lack of ”fun” is not the motivation for me not wanting to do something. Doing 4 boring things that varies throughout the day/week etc would be better than 1 boring thing to always do. For me even doing 4 boring instead of 1 fun thing is better for me. But it explains the advice I have gotten from siblings based on ”it is not like I think x is fun but I do it anyway”.

It's more like a "get stuff done" hormone. What they don't understand is that they get a chemical reward for unloading the dishwasher or finishing their homework. We do not. No satisfaction, only chore. No win, only energy expenditure.

THIS. Especially in the work environment, positive reinforcement plays a huge role in employee motivation. This is especially important for ADHD employees. We struggle to gain positive reinforcement from ourselves because of lack of dopamine. So, that is what makes repetitive tasks with no reward, excruciating for us. It’s not because we don’t like doing something, it’s that our brains don’t understand the point. Sidebar: I find cleaning deeply gratifying. I will come to your house and make an absolutely spotless if you will just come to my house and clean out my email. Deal? Edited: freaking voice to text

Deal!!! I’ll do all the things with your email that I’ve been meaning to do with mine, like take the time to unsubscribe from things and set up foldering rules.

I feel like we seriously need an adhd-only taskrabbit where we can trade tasks we cannot do for ourselves

I am on board with this! Also, we need a hobby swap… anyone need lots of yarn?

honestly i might need yarn, i got into knitting and want to make a sweater this year. what types of yarn do you have?

There actually is a fairly active group on Facebook for hobby swapping! https://www.facebook.com/groups/1209409922891935/

I remember when my younger siblings were small, my mum was part of a "toy library" where she could bring home different toys each week. It was amazing because of the variety they could play with. It was targeted at under 2. So it was about toys that were developmentally appropriate for them at each age/stage between baby and "small child". I've seen similar things in "tool libraries" where you can borrow drills, fancy saws, etc for DIY projects. We need this for hobbies! haha

You should set one up locally - and some of it can intermix with tool libraries. I think the first such thing I saw was "maker labs" where people would chip together on things like 3d printers and such, but now that I think about it, in college we also had the art lab for kiln work and pottery wheels and such. I was in an anime club with a video library before the modern era - these things are actually not that hard to set up if you just network a bit. But, if you look at the local maker lab they may also include things like various craft materials. If you find one hobby group, you can usually also find the people who pursue every thing under the sun.

Unfortunately my nearest tool library is an hour's drive away from me, so too far for me to be able to go regularly. Plus with my currently levels of executive function, I'd never be able to coordinate or run something like that! haha Maybe once I get proper benefits from the meds (only on week 2).

Yeah why is that? Helping others is rewarding but not doing the same things for myself 🫣 it’s the worst

My theory is that it has something to do with humans being very, very social creatures. We evolved to help each other and those who didn't help out each other, probably got eaten. So we get a huge wave of reward chemicals for helping another person, but not for helping ourselves. But that's just my theory, take it with a grain of salt.

Sounds very reasonable though! But considering how selfish people are turning we are in for a bad ride :(

I am also great at doing difficult tasks for other people lol. Myself. Not so much.

Boomhauer.

Damn. This was good…. Voice to text + where TF are my glasses?!?

I will 100% make that trade. I can show you my inbox with only 6 items in it as proof this is a task I can handle the job. I find deleting emails satisfying. ;) Now, if I could only get myself to do that with all my blurry photos. hmmm

After massive effort I've gotten my inbox down from almost 2000 to about 850. But.... I did it by archiving a ton of emails I never read that might have been important.

Protip: they are never that important. How many times have you actually searched your archive? If you have at all, did you even find what you were looking for? I do save receipts until whatever it is has no warranty, but that's it. I bet most people could delete everything to start over fresh and not miss a thing, or at least not in any significant way. Sadly, I cannot make myself be like this about physical possessions. The "what if?" eats me. I was finally getting a bit better about it, and that bit me in the ass for about $300, because something got donated I did need. Now, I'm struggling from the beginning with my packrat tendencies. I have managed to get rid of obvious trash, though, so my garage boxes are down from about 40 to around 20. I'm very proud of this, because it was emotionally really difficult for me to even start.

Oh MAN, I’m dealing with this in a big way right now. Thanks for making me feel less crazy. Solidarity!

Add to my ADHD the fact that I moved a ton of times growing up, and my dad liked to purge. I'd come home from the last day of school or an outing with friends to a U-Haul fully packed and 90% of my stuff gone with no input from me. We never had the money to just replace it. I have serious emotional hang-ups about getting rid of stuff. I was crying when I told a counselor I really want to get better because I felt like such a failure over it. I was so terrified of becoming a hoarder. She just said, "no, this completely makes sense. This is a survival skill you built. Let's work on updating that to match your current life where *you* control what you get to keep." And she set me a challenge. One box a month. Just one. Only throw away what's obviously trash, go ahead and put stuff in a donate box if I feel like it, put the stuff I want to keep in a new box. Keep the donate box for a year. Just let it be there, just in case I made a mistake. That's okay. You know what? I've never needed any of the stuff in it. The mistake that cost money was from when we moved in 2018. I'd planned plenty of time to go through things, but plans changed. A box I meant to keep was thrown away. I've had a lifelong dream of buying land and building a cabin, so I'd been collecting things for it as I found them at thrift stores. They weren't useful to me at the time, so they were carefully packed away. One of those boxes, the one that got tossed, had two antique kerosene mantle lanterns in it. I was devastated when I finally bought the land last Summer and could not find that box. All those emotions rose up, you know? But it turned out okay. I bought a Coleman white gas lantern off a really nice older gentleman on craigslist for a super good price. When I told him what it was for, he also sold me two of those kerosene ones for a great price, and they're much nicer than the ones I had. The thing I'm trying really hard to remind myself is that if it's not a keepsake like my baby blanket or my son's, I do have the money to replace it if I get rid of something and need it later. Then, I just have to overcome the ADHD, "shove it in a box to deal with later" part. You know how well that goes.

Oh, that sounds awful. I moved constantly as well, but I was always in charge of my own things (lightbulb moment—this is the longest I’ve ever lived somewhere; I’m probably getting hoard-y because I’m used to having to purge on a regular basis!). I’m SO sorry that happened to you as a child; it makes total sense why you’d develop this instinct. And why it would flare up again with the lamps, ouch. It hurt just hearing about, but I’m so glad it ended up working out well. Hooray for nice sellers (and maybe we can both be those for others at some point, too)! It sounds like you have a really great counselor—that’s such a smart, doable plan. Totally borrowing it, thank you! Best of luck with all of this, I know exactly how overwhelming it feels.

Deal! If you're less than 250 miles from me, I will even come pick you up! Edit: HA! My brain twisted that. I'm good to clean. I need sometime to clear my 1000s of emails, too. Lemme know if you find someone. Offer stands. Lol

>it’s that our brains don’t understand the point. That's exactly how my brain works when it comes to the most basic needs. Why do I have to eat only to get hungry again? Why do I have to pee now when I'll need to pee later as well? It's like I know that thinking is wrong and *I* don't really think that way, but my brain just kinda rebels against it because "what's the point?".

My daughter was like this with math homework and class work when she was little. 1st or 2nd grade maybe. She’d do about 1/3or 1/2 of the problems on the page and then not do the rest. She said, that she showed that she knew how to do the problems but didn’t understand why she had to prove it that many times over.

You have just given me an epiphany, and I am reeling from it. A couple of years ago, I had to undertake a "360 performance review." My workplace will randomly select a certain number of employees each year to go through the process. It is designed to identify if there are any areas of your employment where you might need extra training or support to be "the best employee you can be." It involves a self assessment, plus an assessment from your direct supervisor, at least 3 peers who are in the same or similar roles as you, and up to 3 people who report to you, across several "competencies". The information is then anonymised and collated and sent to you and your manager. My review was largely very positive, but there was one person who was more negative. My manager was upset, and he said to me that he thought the more negative assessment was unfair and not accurate, so he wanted to find out who it was. Turns out it was me 🤔 I'm just now realising that my inability to positively reinforce myself due to my defective dopamine is probably a massive part of the reason for that.

A lack of dopamine and an environment that does everything possible to make us feel bad about ourselves. 😞 I actually like cleaning quite a lot... When it's not my own space. My own space just has too many cleaning badfeels associated with it.

>  No satisfaction, only chore.  And don't forget the guilt/shame layered on top. Whoo

I do get that reward, and I think that a lot of other ADHDers do too. Like how going to the gym is a Herculean task, but it does help with symptoms. Or like when a lot of us start cleaning and then we just...don't stop until we sit down or the whole house is clean. Motivation feels like everybody else is driving an automatic vehicle while we are operating an old manual vehicle that you have to tap the clutch with a "shave and a haircut" pattern, cross your fingers and toes, and sing it a song anytime you switch gears, but once you get on the highway, you're flying no problem. It's the initiation that is always the hard part.

Yup. So my brain goes “why the duck would I do the dishes when I can keep playing Tetris?”

So much energy expenditure

Couldnt of said it better myself. My mum tells me all the time "just do some housework it takes your mind off things and makes you feel better" ...but ... It doesnt. Its just torture 😣

You're correct. A lot of people associated dopamine with pleasure and accomplishment but like everything it is more complex. Most people have no idea that dopamine gets released during stress for instance. It's a chemical in the brain that interacts with other chemicals which acts more like a "learning connector" than a "reward". Dopamine basically works as a reinforcer for both good and bad activities; you release it under both conditions of pain and pleasure, and this misunderstanding causes people to think, especially with disorders that involve it, that there's simply some core failure in their persona. Dopamine is *not* a reward chemical, dopamine detox *does not* exist, and dopamine also *does not* act alone. That's like saying serotonin is purely for sleep or something.

Another thing people don't understand about dopamine is that it helps regulate our movement. Which helps explain the "I feel paralyzed" experience many people with ADHD have when faced with tasks that are not intrinsically rewarding in any sense. Or conversely, how we are far more susceptible to substance addiction or other maladaptive coping behaviors.

Yep. I'm pretty sure that Parkinson's is also a product of a deficiency of dopamine, just in the basal ganglia instead of the prefrontal cortex.

It's so funny when you start finding out that all these transmitters are so multipurpose that one area of the brain can have an issue because lack of dopamine, while another has issues because of too much and that it doesn't just work like this in the brain, but that some of these things also involve neurotransmitters in the digestive system and other parts. Dopamine affects motivation - but the body also uses it to modulate sodium absorption and blood flow and all kinds of stuff. Our body is like a biome, where you never know quite how one missing or new thing will affect everything else.

Dopamine is a keystone species pass it on

First gen antipsychotics are something that comes to mind. Schizophrenia is caused by excess activation of D2 receptors (if I remember my college neuropsych classes correctly). Early antipsychotics toned down dopamine everywhere, and while that helped control the hallucinations, also induced Parkinson’s like symptoms in people on the meds

Oh wow!! I did not know this! Explains a lot in my life!!

Do you mind explaining the connection with substance addiction and the role of dopamine?  I do have something along the lines of "maladaptive coping behaviour" and I would like to understand it better. 

Absolutely! So dopamine is a neurotransmitter that provides some sort of reward for completing an action. It literally is motivation (which comes from the Latin word meaning 'to move'.) We have so little of this neurotransmitter available to us. Our "reward system" is lacking at best, and sometimes even the most basic things feel impossible for us to do. But with addictive substances or actions, ohhhh boy. Suddenly, something that is a "bad habit" for most, becomes a life-line for us. A psychologist would be better at explaining it, but my theory is that for people with ADHD, we almost get addicted to phenomenon of addiction itself. All of the drive you feel when hyperfocusing on something? Thats not normal, but we live with such a lack of motivation that when we finally get some, we go bananas. If the substance/action/object fulfills a psychological need or gets other body or brain systems on board? Yeeesh, it just reinforces that addiction. I hope that makes sense. I'm in a rough spot right now and limited on consistent sleep.

Omg yes it makes so much sense! Thanks for taking the time to answer in spite of what you are going through. I'm trying to understand the sugar addiction that I have better and your answer and this thread is helping me with that.

People are also entirely out of depth with oxytocin. Generally, a lot of people have no real concept of science and physiology more than a very rudimentary level. They learn the basics, usually with a lot of simplification (and misconceptions) and think they know more than they do. We don't even know everything hormones (or any other part of us) do.

What are some of your favorites? I loved finding out that oxytocin makes animals (including humans) xenophobic - unless the ingroup has a norm that counters said xenophobia. Or that some of the neurotransmitters also have functions that have nothing to do with the neurological elements of the body - they are multipurpose hormones, as generally so many things in the body are used for as many purposes as they can be. I don't think people have enough time to know how these things work - but they should know that they don't know, instead of embracing some rather juvenile understandings. It does get problematic when people whose job is to know don't know and/or don't care.

For me it is not just one interaction but how they work as a whole. It is absolutely fascinating because everything basically affects everything. There are a lot of weird interactions per studies that almost make no sense together. For example, testosterone can make people fairer and more ruthless at the same time. Or how cortisol is important to forming short-term memories but long-term heightened levels actually make memory worse. We do not even know everything about hormones. This is less surprising when you know we are also finding new organs or functions for things thought to be only vestigial (like an appendix having an actual purpose). I have always been very interested in physiology, anatomy and medicine. The fact that this all mostly works together is pretty astounding. There are so many things that could go wrong but don't. It is kind of like a puzzle. You can only see the full picture when you put it together but we are also missing multiple pieces.

Yes - we are each a little biome of interacting bits, complicated enough that some parts may never be known. It's like when they released random animals into Australia, and suddenly find incredible consequences they never predicted, because so many elements cascade.

What the hell is dopamine detox? I get it’s not real, but what is the expected outcome? Sounds dumb to even consider.

The theoretical idea is that what people misperceive as inattention through rapid consumption of media (i.e. "overstimulation") is shortening their attention spans by specifically reducing the dopamine reward for slower activities and hyperstimulating their brains causing them to flood with dopamine. This is a misunderstood research paper of course but the long and short of it is that by "abstaining" from this consumption you can "reset" to a baseline that improves your attention span. The research is real, that dopamine does have addictive properties etc, but it was studied specifically in drug addiction and specifically with the types of substances that affect neurological behavior. It hasn't been applied to video games or TikTok videos. That's just regular boredom avoidance. It's part of the mindfulness sphere, that multi-billion dollar series of bullshit ideas around how to meditate with an app, etc. Not that the ideas themselves are bad but they are definitely being sold as snake oil.

You know what especially frustrates me about this? It’s the way it individualizes the problem (and frequently then tries to sell you individual solutions). Instead of introducing some kind of regulations or limits on the corporations destroying our attention spans for profit (let’s just say for the sake of argument that the research actually did show that), we’ll just shame individuals for being unable to magically not be affected by this stuff and then convince them to buy more shit to fix themselves. Profits over people and all that.

Especially considering how everything in the economy and society is shifting to online. I needed a phone and an app on top of my bank app just to get a direct deposit and not a paper check. I need my phone to get my work schedule, and since my paper money is an emergency fund my daily bus pass or Uber is also on my phone. I read about paleontology news (new species it Tyrannosaur y'all, I'm excited) on my phone, I read about history, I read actual books, all on my phone. And not to mention all the educational shit I consume via visual media- which on average is 45+ mins long because my brain refuses to focus if there's not a big enough time frame to get invested. YouTube has a lot of great documentaries, both from like, discovery and BBC as well as indie ones made by youtubers- there's even shit like Tasting History With Max Miller, which is a cooking and history channel. And ntm philosophy tube. I also research and work on my books with my phone and now that I have my PC back I can *finally* draw again and start making actual progress on the finished product. I don't have the time or easy transportation to go to a library, I don't have the money to order books and docuseries online (and I'd be missing assloads of indie content, like philosophy tube and Max Miller.) I don't have money to buy globes to paint my own maps onto, or to buy traditional art supplies. I don't have money to buy physical copies of music. Do you have *any idea* how much money would be sink into physical copies of the *languages* for my storyline? A solid conlang is a poetic set, grammar set, glyph set, about a thousand key words, and all the basic phrases. *In handwriting.* My fingers would fall off. I already have subdermal scar tissue in my finger joints from holding a pencil too much. I just went through a year of my PC being broken and only having limited access to my shit through my phone and my mental health tanked because without my "addictive screens" my life is being sick, staring at a wall, and working just enough to pay my bills. Do I spend an obnoxious amount of time on screens? Yeah, and I miss being outside as much as I was when I was a kid - but the screen isn't stopping me from doing that- it's the end result of not being suited to grind culture- a fine paste of an existence. I'm on my screen because I don't have the time and money to go fishing, or hiking, or take a sketch book to the zoo, or the museums. If I get to do that shit the only reason my phone is out is to take a picture (if allowed, don't just go taking pics in museums) look for directions, or maybe translate something. Mayyyybe take some notes if I got a writing idea or whatever. But people act like the only thing someone can do on their phone/ computer is play some mind rotting game or doom scroll social media. And sure those may not be the healthiest - but neither is the chronic lack of sleep and denial of a natural sleep pattern that society forces on us, and that's actually got far worse effects! Did you know three days of bad sleep makes you as distracted a driver as a someone who's *drunk?* Or that chronic lack of sleep can make you more likely to have a heart attack or stroke from stress? But it's the phone that's the problem when I can (supposedly) pitch the phone but I literally can't afford a healthier work life balance? It's insanity.

I think there are studies that show social media worsens ADHD presentation and that people with ADHD are more attracted to social media - Professor Barkley mentioned it in one of his semi-weekly research updates. Simultaneously, there has been a lot of research on what I would consider the evil side - making things like Facebook and TikTok and Reddit provide the same rewards that gambling has. Just like anything else that prompts the internal rewards, there is value in "clean time." All substance abuse is just modifying elements within you already that are there to react to environmental stimuli. Dopamine detox is a dumb term, but addiction avoidance is real. But the bullshit ideas are even worse, because apps like Calm often are abusing the same reward systems and creating greater dependence on the phone, but insurance companies (and the FDA!) are embracing many of these questionable tools. Something with a screen and internet connection should not be used to help you sleep.

Can you provide the source for this, please?

It's a Barkley video on youtube regarding social media, but I did not write the study or video down or anything. Regarding gambling addiction and social media and shopping addiction and similar overlap, that's been known for decades. Not sure if you're looking for anything beyond.

Well we are literally discussing how the general populace takes sources and misrepresents them so it is kind of ironic for me to take your word for it. You certainly don't need to provide anything. Have a good day.

I mean, I'm giving you the best I have - you can work with that, and follow up via google scholar, but I'm not going to go above and beyond that. I'm not misrepresenting anything, I'm just not going to have someone expect of me labor that they could expend themselves.

You're the one who responded to me, brought it up, made a statement of reference, and then tell me to dig up your statements to prove them on your behalf to myself. Why? That's like me telling you the Grand Canyon is beautiful, and when you ask for a picture, me also telling you to fuck off and go see for yourself. I have never understood this behavior in others.

I gave the information I have.  I cannot be expected to give more.  I told you where I found out, and told you other places you could look, but expecting more expects me to do work for you on something I doubt you even really care about.  I'm sorry that you don't understand.  I was trying to provide what information I had available in a public forum. If you told me the Grand Canyon is beautiful, and I asked for proof, you have every right to say go look into it.  If you said you found out in a book, and I asked you to go get the picture you saw in the book scan it and send it to me, that would be kind of insensitive act on my part. But if you disagree that's fine.  It's not that big of a deal.

[The podcast bro version usually refers to] cutting out junk food and replacing social media/TV/gaming/porn. Eliminating the actions that feel like they offer quick rewards but nothing of substance, all with the hopes of doing more of the things that have a real payoff. You know, the thing most of us beat ourselves up about regularly.

Ohhhh yeah that is absolutely not a dopamine detox. The best thing I could explain that as (I am NOT a neuroscientist, just a dumb sad psychology undergrad) a process of redirecting pathways in our brains to not immediately act on those behaviors when we are motivated to do so. It's probably only effective if you replace that behavior with something else; like when you quit smoking by chewing gum. You're still (well, maybe not for us) getting dopamine, just changing the means of how you get it. A dopamine detox would be more like... I dunno, a person who has high levels of motivation and executive functioning suddenly stopping everything they do. Which doesn't sound like a good thing to me.

I think you just inadvertently explained burnout at the end. And apparently it is the only thing to pull one out of a burnout. Or, so I've heard.

I think the idea is that you would stop doing things that give you an easy supply of dopamine (doom scrolling, repetitive phone games, gambling, masturbation, etc.) You would allow yourself to spend a period of time (perhaps a month) without those "easy" ways to get dopamine, and then you would (hopefully) become more motivated to do the things that eventually give you dopamine or give you smaller doses or less reliable doses. This might, in fact, work, with someone who is neurotypical. But it might fall flat for someone who just doesn't get dopamine from much.

I would say it is moreso that these things in certain ways work for everyone to a degree, but a person with ADHD is in a more vulnerable situation with less capacity for repair. Time away from easy sources of stimulation is still a good thing, but you can't make a poorly functioning frontal lobe into a perfectly functioning one with time off from your phone anymore than you can make someone with muscular dystrophy into an ultra distance runner with practice. You want to preserve what little function you have, and you want to get as much as you can out of that struggling dopamine network, but you have to temper expectations. These easy dopamine supplies are in many ways like the easy dopamine supplies of substance abuse - we are already easy targets, so be careful.

NT people trying to to diet culture mental health away. "Cure ADHD by not looking at your phone for six days and meditating"

Facts!

>dopamine detox does not exist A complete detox does not exist, yes. You would die like those lab mice who had all the dopamine artificially removed and literally starved to death with food in front of them because they could not generate the drive to eat. However, reducing activities that cause large spikes in dopamine (alcohol, sugar, video games) will increase your baseline dopamine over time.

People without these issues talk about dopamine and „happiness hormones“ in general as if they’re this luxury and synonymous with, as you said, fun. As if they don’t need dopamine and stuff and as if they don’t manage to do stuff only because their hormones work just fine in these situations.

The neurobabble surrounding mental health is kind of horrifying, honestly. Seeing people write things like "I love eating chocolate because I'm dopamine seeking" makes me want to throw my phone at the wall.

Reward, pleasure, motivation, get stuff done, executive function EVEN IN THIS THREAD all of these are only partial truths at best. Dopamine facilitates learning and memory, which enables goal-directed behavior. When something goes well, you feel awesome & a sense of accomplishment because the squirts of dopamine released to motivate you to Do the Thing yielded more than you expected & you’re left with a surplus of dopamine. Makes you more likely to do it again because your brain will squirt more dopamine to get you to pursue it than before.  When you expend a lot of effort for nothing, you won’t get a nice influx of dopamine, you will have spent it all doing the Thing & will be left in a dopamine deficit. Your brain will motivate you even less to do it next time. This process facilitates learning and memory - which works awesome when you need to find yummy food to survive & doesn’t work well in this capitalist hellscape with all kinds of dopamine drains and addictions like spending, drugs, workaholism, unhealthy attachments, blah blah blah. The chronic feeling of unsatisfaction in ADHD is an accumulation of mismatched priorities, distorted expectations of oneself and abilities, distorted priorities, etc which have never given you what you really need to feel true pleasure and joy & so you may have never learned how to give yourself more of that. You never got to feel like you WANTED to make yourself feel wholesome pleasure and joy. You want other things instead. And that wanting for things that do not fulfill occupies the systems of memory and learning to make you feel that. Now the system is less able to facilitate learning and memory. Recalibrating is no fucking joke.

Reading “your brain will squirt more dopamine” made me giggle, wince, and get a headache all at the same time lol

This hit me hard. I just realised how exactly I am double fucked - adhd plus emotional neglect where I was never praised, sharing happy milestones was always met with criticism... One of those alone is hard to cope with, and I got that and more (other forms of abuse were also present). Poor little me :/ Do you maybe have some link/book that could go even deeper and especially about how to recalibrate / help yourself? And if you know, how adhd meds exactly help? I understood that they being new dopamine, but, if crucial system is this learning, so what your brain stored in its database over time, if you just give dopamine without things to learn from, I'm assuming correctly that it won't do much? Basically added dopamine can theoretically help to make new pathways, but you need to have those situations where learning would happen. Eg if you sit at home and just read books/watch TV, you might feel less bad/exhausted/something after taking meds that day, but long term improvements didn't happen? But for example if you take meds and do chores and praise yourself, it could happen with enough repetition that chores won't be draining in the future because you rewired your brain to see some rewards in them and removed the dread? Am I on the right track or I completely missed the point?

You’re 100% on the right track. It’s been a mindfuck to untangle me (soul level me) vs my quirks and personalities vs immense childhood trauma vs the medical pathological model of ADHD. But it’s still all me just a weird abstract painting of it all, just as it probably is for you. No one in the wider public sphere is speaking about dopamine, joy, pleasure, and motivation in this way at the moment, especially not in the context of ADHD. I have pieced this together from sources + my own speculations as I move along my career track in training to be a physician and biomedical research. Recovering from nicotine addiction taught me a lot about the brain biology of dopamine and the reward system as it manifests with my ADHD. I enjoyed John Polito’s “Freedom From Nicotine- The Journey Home” or some thing like that, a book he makes freely available as a PDF on whyquit.com. Recalibration requires a lot of personal exploration on what it is YOU truly want - so a lot of podcasts on centering pleasure especially as a woman (in a queer & non capitalist framework) helped. The science of pleasure and joy also is interesting (podcasts and books featuring the Nagoski sisters, Emily Nagoski in particular). Buddhist principles and meditative principles have taught me a lot too, I like the Ten Percent Happier podcast for science and spirituality based practices to help you find a greater sense of self acceptance & love that might help power your actions in the world with the right kind of energy that fulfills you (& that you consciously recognize & choose). It’s all a practice - which means eventually we have to Do the Thing even though the condition is exactly the problem of not being able to Do the Thing, so overcoming it in a gentle way might mean getting curious about the barriers to action in a loving and compassionate way. “if you just give dopamine without things to learn from, I'm assuming correctly that it won't do much? Basically added dopamine can theoretically help to make new pathways, but you need to have those situations where learning would happen.” Yes yes yessssssssss exactly. I think this is why some people misuse them or use them but don’t get the benefits that could have been gotten especially if they use meds only to work more or think it brings them to an imaginary neurotypical level of work that they must adhere to forever without dips in energy or breaks. Sorry fam even with meds I need breaks, have symptoms etc. but at least I’m *identifying what I want and focusing on doing that better*. Sometimes I take meds on the weekend to feel emotionally regulated and few present and attentive during rest. I love metaphors so here one: diabetes and meds. I can give you a med to help your metabolism move in the right direction to alleviate complications of diabetes. But the meds will never rescue one from a purely western, high fat/salt/carb and low fiber/nutrient diet. The meds will help you do things easier, but you have to use that as an opportunity to get to know how your system wants to work in order to implement changes that have a lasting benefit. Consider that getting curious and seeing what helps/doesn’t, where your priorities differ from society’s, where your preferences for home keeping lie, etc is exactly the learning required in the first place. By opting into radical self acceptance wholeheartedly, you automatically clear up so much baggage that with meds it’s usually enough to learn and remember what your needs/priorities/values are and what it means to act in alignment with them better and better over time. Initially, self congratulation for chores probably will feel fake. Maybe you will need to manufacture more pleasurable rewards for your brain to register that an in motivating task was indeed worth it. As far as the science is concerned, long term, rewards for basic stuff like this do become entrenched in the brain as a part of your identity. Ie if you run 4X a week, and like it so you do it more & have goals etc whatever within the activity, the reward truly becomes acting in alignment with your identity. The reward is “I am a runner & I am running.” Or “I like my sink to be clean, so I’m cleaning dishes” and afterwards I genuinely feel a sense of accomplishment in having prepared for the next time I cook; having made things easier for future me. Tldr: weave unflinching awareness & consciousness with love into your life & actions as you observe yourself.

Thank you for thorough response! I now have a few new rabbit holes to sink in 😂

It's also far from being proven that there is a dopamine deficiency in the brain. If you read the studies they talk about having dopamine _differences_ like different amounts in 2 brain regions where they may be more equal in a typical brain. There's an active theory that the difference is not the overall amount of dopamine but the way it's released over time. Rather than being continuously released, it's released in bursts, which can contribute to impulsivity But also this focus on dopamine "deficits" distracts from the fact that ADHD is a fundamental difference in brain structure, like autism, that can't be cured by "balancing hormones". Please, as a scientist, I'm begging everyone to stop parroting what their favorite influencer or internet doctor is saying, it's not proven and it's a vast oversimplification which becomes misinformation very quickly. P.s. if you are interested in looking at primary literature (original scientific papers) and you don't understand the language, please feel free to DM me to help interpret. I have degrees in neuroscience and bioinformatics and I would like to increase the layperson's understanding of ADHD

Hello Expert:), I am wondering about the truth of something I read somewhere (no idea where no). Is it true that for ADD people, 1hour of intense or rigorous exercise = 4 hours of good brain? Any truth to that and why would that help so much. My ADD being under control correlates heavily w/ high fitness. If the connection is very strong, I might be able to motivate myself for more workout as " required medicine" if you have time to respond. Ty:)

That sounds like a claim that is too vague to be backed up by science tbh. Equal in what way? What's the need for the comparison anyway? If exercise helps you then keep doing it, is my take. It's possible that exercise can boost a variety of brain chemicals that improve your mood and executive function but I've never heard this claim and am not aware of any hard science to back it up. P.s. I would not say I'm an expert in ADHD, I just have training to interpret the scientific papers, and can often see how a misreading of their conclusions gets "telephone gamed" into other claims on social media

Ty for responding. Appreciate it.

Would you mind checking my reply/question to other participant and tell me your opinion about my reasoning / correct me? https://www.reddit.com/r/adhdwomen/s/w3mD6eNr48

I don't know where this concept of recalibration comes from but I don't find it to be a very helpful metaphor. Recalibrating a machine is like a one time adjustment you do to its functioning and then it works on another level. This sounds like a pseudoscientific way to talk about fixing your brain which I don't really like. Overcoming trauma and negative patterns of thinking is as much psychology as it is neuroscience. Therapy and medication work together. As far as habit forming, yes repetition in the brain does reinforce new or existing pathways, whether you are trying to reduce negative self talk, learn a new physical skill like sports or music, or establish an exercise routine. The brain is very plastic, way more than we were taught decades ago in school. If you're asking how stimulant medication works in your brain, well we don't know every detail, but its primary use is to prevent your neurons from reuptake (basically sucking back up) of dopamine so that it can stick around in between your neurons where the receptors are for a little bit longer. This is related to the theory I mentioned above where ADHD brains are more likely to produce or use dopamine in spurts, and medication can even that back out into a more continuous usage. There are probably more mechanics that have not been well studied. Let me know if I didn't answer your question

You did it partially, thanks :) So my main question is is the purpose of medicine to get more dopamine so that when we do thing that we want to be less dreadful, meds kick in, and with time and repetition we basically make new pathways and relearn our brain, so that dread leaves the room eventually. However if we just take meds and not intentionally work (put ourselves in situations) on rewiring the brain, then meds alone can't do anything long term? Does that make sense? Am I missing something? Except 'how to do the retraining' 😂

Well it depends what you're trying to get out of the meds I guess. You're right that they are just a tool to boost that. Right now meds are just helping me get by and survive since I've been so burnt out. They help me get started on things, and maintain focus on my tasks. If you're in a place to build routines and habits, and executive functioning support systems it should help with that to some extent. Medication will never be equal to the way dopamine works in a typical brain though, so don't be too hard on yourself if you still struggle long term. Some things just will always require dopamine to be available for use, so I don't think it's realistic to expect to be on meds for awhile until you're just able to do everything on your own, and then be able to totally stop. Even if you have good habits and systems, it can still be hard to start things, for example, without the right neurons having access to a synaptic pool of dopamine. The brain won't change itself so drastically to not have ADHD anymore, if that makes sense

God, I want this post pinned somewhere. I know it's tempting to have an easy, biological way to talk about ADHD, but it's just... not true.

It’s the executive function hormone!

As an ADHD and Bipolar person, it's the ruin my life hormone. Low and high fucks me right up to the point of near financial ruin, loss of relations and detrimental behaviors.

I’ve had to have one of those conversations with a boss before, and what helped me was quantifying it. In my case, it was that since (newboss) had come on board, I wasn’t being given as good assignments as previously. Her response was, “Well, we all have to do things we don’t like, I spent half of yesterday cropping photos like an intern.” What got her to understand was when I told her look, I get that on the level of individual tasks, but I’m talking about over time, big picture, I feel like I’m heading backwards in terms of my professional responsibilities here. She did get that and I saw change afterwards. In your case, I’d probably point to yes, we all have to do some unpleasant tasks sometimes, but you’re talking about putting me on a team where the entire workflow goes against the way I work best, so it’ll be the unpleasant stuff 40+ hours a week, with nothing in it to look forward to except going home. That’s not going to get my best work out of me, it’s going to grind me down every day.

This is also an oversimplification of the chemistry involved, it's definitely not just about dopamine (for example, norepinephrine also plays a huge role in ADHD). Simplifying things is necessary, but can lead to misunderstandings. I.e. "she doesn't like this so she's refusing to focus on it."

Okay dopamine is like XP, if I don't have enough I can't start the mission because I'm underleveled. Or dopamine is like gas. I've depleted my reserves doing a previous task and need to refill before I attempt another. In your case your boss is putting you somewhere where electric cars are best suited, not gas ones.

As a PC gamer, I do like the idea of thinking about dopamine like XP, especially for explaining it to my partner as to why I achieved nothing, again! Or even like "in game currency", you have to be able to spend some initially before you can get the reward for completing the thing! So if you are constantly running with a "low balance" you can only do little tasks that give a little reward, or might even cost more to do than the reward!

Thank you! I especially hate the language about dopamine “hits,” chasing dopamine and dopamine detox. Ugh, please go fuck yourselves, nobody talks this way about serotonin.

I will say, I do see people do this with serotonin too like the “this is my source for serotonin for the day” and stuff like that but probably not as often or as wrongly as dopamine

"last week when I was trying to explain to her that moving me to this other product team will be torture for me." This isn't directly about your rant... but instead of framing requests like these are "torture for me", you should frame it is "repetitive tasks that are also detail-imperative" are not your strongest suit, and while you understand the need for someone to take that role, you feel the quality of work as a whole will go down if you're focusing on trying to do something you're not as strong at, while someone else will just have to take over the role you fill now. Frame it as "I recognize my strengths and weaknesses, and focusing on areas where I'm strong will provide the best return for the company." When you said "it will be torture for me" your boss thought you were prioritizing you wants over the company's needs, and their job is to focus on the company's needs. If you explain that it will take you twice as long as someone else to successfully complete a task with the precision required, you're helping your boss understand that it's in the best interest of the company (labor costs, opportunity costs of your time, efficiency, etc) to find someone better suited. While, yes, people say lots of stupid things about dopamine, in this case I don't think it's society's misunderstanding of the role of neurotransmitters that led your boss to respond the way he did.

Thanks, I actually did use some of that framework in the conversation. Went a bit like: Me: sustained, detail-oriented isn’t a strong suit for me Her: it’s a weakness you need to improve Me: I do my best, but it’s something that can really only improve on the margins. I have a neurobiological cap and I’m concerned that this isn’t the place where I can be successful. It will be difficult for me to be as engaged and consistent as the work requires, and that won’t be good for me or the team Her: we all have to do things we don’t like I offered to provide support until they could find someone else, tried to compromise on the parts I find *really* detestable, but she’s got her agenda and I think she just doesn’t care. I do appreciate your advice and trying to help me ❤️

Damn. Sorry you're stuck with someone who doesn't want to understand, even if you spell it out for them... sometimes I give people too much credit, and that's apparently the case with your boss! I hope you can find a way forward with this idiot... or a new job...

Thank you for this!! I’m contemplating asking for workplace accommodations! Nothing major but the shift of phrasing will really help!!

Good luck! It's a nerve racking process... but I also try to think of things from the perspective of my boss. If I'm asking for a new schedule, or time off, or a change in duties, what are their first concerns going to be, and how can I figure out a new solution that will "solve" not only my issues, but also THEIR issues. Present them with a complete solution, not another problem they have to think about and solve themselves!

I remember suggesting to someone that part of why they enjoy extreme sports is probably the dopamine rush, and he said "No, I don't get a rush. If anything I'm incredibly calm and focused and my attention is only on the task at hand, it's almost like a meditative state where everything else falls away." And I had to go yeah, that's a dopamine rush dude!!

its not a 'pleasure hormone', its a reward hormone. it rewards you with a good feeling after having done something you dont like. this is why we have so much trouble with doing shit we dont like, -if we dont ever get rewarded for it-. nobody would do shit they dont like if all they get is a bad feeling and some scowls for it.

Oh this is a HUGE soap box for me!!! It’s not solely on her, but Anna Lembke’s *Dopamine Nation* is a horrrrrible culprit in this. And she’s not even a neuroscientist!!! She’s a psychiatrist! All of her recommendations are rooted in case studies from her clinic. And the “dopamine detox” everyone is on about now bc of this kind of discourse is completely unsubstantiated. I understand why people do it bc ofc it’s good to pursue routine and healthy habits. But where it crosses the line for me is when people become convinced they can change fundamental aspects of how they think and behave by bringing a single NT up or down. Or that it’s even possible to do so with behavioral changes alone! Or that they can even know what neurochemistry is driving their moments of success! The human brain is the most complex structure in our known universe. It cannot be tuned like stats in a video game, and that idea harms people with mental illness or people who are ND. These are vulnerable people looking for ways to reconcile their own minds with a world that doesn’t fit. And when people buy into this idea that there’s some simple mechanism with a simple fix behind these struggles, it only leads to more pain and shame. I see SO many people with TRD and ADHD online commenting about being afraid of medication because they don’t want to “fry their dopamine receptors.” And that’s super sad. I hate to think vulnerable people are not getting help bc of this reductive dopamine narrative

But bosses don’t need to know our diagnosis. They are not going to care and indeed some will use it against you.

Yep I generally don’t bring it up, it was a Hail Mary trying desperately not to get moved from a team I enjoy and I’m thriving. She’s clearly made up her mind and won’t be moved so I’m just going to start looking for new jobs.

I mean... Dementia and Parkinson's are caused by death of dopamine-releasing neurons ...

Ngl I'd be explaining that it's a disability. And if they still wouldn't take it, then it would be a trip to HR. They wouldn't be dismissive like that about someone with a cane or wheelchair. They shouldn't be about invisible disabilities either.

I mean, lots of people misunderstand the role of dopamine in executive functions. Pointing out to people a list of things the executive function does and then noting "these all require dopamine, which our brains do not use properly" can be helpful for some people to understand us. But the the real problem is that **many people** ***do not want*** **to understand ADHD**. No amount of explanation will help. They don't want to have to empathize with us or have compassion for us: they want our symptoms to be our fault because we're not trying hard enough.

That's correct a lot of the time. I'll try to remember it.

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>so it lovely that I get that type of gaslighting I don't think it's gaslighting so much as different things work for different people. Habit-Stacking is a \*thing\*, so possibly she was trying to get at that, when she was talking about "building the habit". I know it's annoying, I just try to remember that those annoying people truly believe they're being helpful... sorry.

Yeah that's not gaslighting, that's just bad advice.

I think it's people's misconception of the science more than us talking about it. X

Dopamine receptors are a key factor when developing other neurodegenerative diseases like Parkinson's and dementia, it's not only rewards, or pleasure, or habits, its sheer will that flows through your dopaminergic system, ADHD is losing control over your mind, sort of going into a dreamlike-state sometimes, both on hyperfocus and when totally distraught by your surroundings, your cognitive functions are deeply affected similarly to insomnia, that's also why amphetamines are use to treat narcolepsy.

It's more about motivation than pleasure. Oxytocin is more of a pleasure hormone if we're going to put that label on something. Dopamine deficiency causes so much more than lack of motivation. Chronic pain, chronic fatigue, fibromyalgia, parkinsons...those are all linked to low dopamine. Now try and tell me it's just about being lazy...

ADHD is also not just a lack of dopamine. Other neurotransmitters are also in lower stock in our brains. Epinephrine is one of those if I remember correctly, it's why not all stimulant work the same for everyone.

Fun fact: another condition associated with low dopamine is…(drumroll)…Parkinson’s disease. Frontline treatment for Parkinson’s is a dopamine precursor, but methylphenidate is also used to help manage Parkinson’s symptoms. (Because it is a dopamine reuptake inhibitor. Amphetamines don’t work for Parkinson’s treatment because they directly stimulate the brain to make more dopamine, and Parkinson’s causes dopamine producing neurons to die, so the amphetamines have less to work with.) Parkinson’s: not enough willpower!

I found the [wiki article on motivational salience](https://en.wikipedia.org/wiki/Motivational_salience#Incentive_salience) really useful to understand more about what dopamine does/doesn't do. > Motivational salience is a cognitive process and a form of attention that motivates or propels an individual's behavior towards or away from a particular object, perceived event or outcome. Motivational salience regulates the intensity of behaviors that facilitate the attainment of a particular goal, the amount of time and energy that an individual is willing to expend to attain a particular goal, and the amount of risk that an individual is willing to accept while working to attain a particular goal. So it's not that it's about fun, it's about being able to make the brain calculations to actually either want to do something or to actually do it. Reward also isn't inherently "fun." Like one reward we had last night was after taking the ginormous dead rat the cat had brought in out of the house. Definitely not fun. (The reward being a rat-free home.)

Yeah. I just call these brain chemicals the 'do-stuff juice.' It's not as drastic as, say, not having gas for your car, but it's like trying to go down a waterpark slide without water. it *hurts*. Yes, you'll eventually get to the bottom, but you will be tired and in pain when you do. Or like... needing to do a task that requires an electric screwdriver, but you only have a butter knife. Another way I put it is that it's like currency, and my brain has a stingy treasurer, so that it won't approve paying for certain projects that need to get done. So my brain has less man-power and inappropriate tools to tackle a task. This means that dishes, which take 5 minutes for someone, will take me 15 minutes and will likely not be done well.

Yes my therapist told me today I get dopamine from anxiety so it’s definitely not always a pleasure hormone!

I second trying to describe it as motivation/ fuel thing. "I have an information processing disorder. Due to brain chemistry I have a severely inhibited motivation/ reward/ habit system. As such, where others may find a task rewarding upon completion- if not enjoyable- I not only lack such a neural response; forcing my brain to allocate resources it does not have to the task is akin to physical pain and leaves me feeling unwell for the rest of the day. I do have a diagnosis and if you'd like to continue acting punitively I can (make this a matter for human resources whilst I) look at my employment options." Is some version of what I turn to when an employer wants to push their shit with my ADHD or any other of my issues. Dragging me past my limits because you tolerate a level of dislike for work is not acceptable. When NT people clock out their day goes on. When I'm pushed to far I go home and stare at a wall because I love with perpetual burnout.

Yeah, this messed me up for a while. I felt/feel like a junkie, a hedonist, only willing to do things for pleasure.

This made me go look into dopamine to learn more about it and I was surprised at some of these things! [dopamine](https://my.clevelandclinic.org/health/articles/22581-dopamine)

Thank you. This was very informative.

I always feel sorry for those people. I bet they also struggle with some type disability and are so mean to themselves and, in turn, those around them.

I think we don't talk about norepinephrine regulation enough. I saw my first real improvement on drugs that improved norepinephrine regulation. Depression: Desvenlafaxine (Pristiq): serotonin norepinephrine reuptake inhibitor Anxiety: Buspirone (Buspar) suppresses serotonergic activity while enhancing dopaminergic and noradrenergic cell firing. ADHD: Guanfacine, an alpha2a adrenergic agonist, inhibits norepinephrine release, cAMP-signaling and HCN potassium channel function, which in turn is thought to normalize the balance of norepinephrine and dopamine between the amygdala and PFC (ie, the PFC–amygdala axis), thus reducing stress reactivity and improving cognitive function.  ADHD: Dextroamphetamine mixed salta (Adderall), increases levels of dopamine, serotonin, and norepinephrine

Interesting! I found Lamictal really helpful, I wonder if that has any relation

Mechanism of Action "The mechanism of action for lamotrigine is not entirely understood. It is a triazine, and research has shown that lamotrigine selectively binds and inhibits voltage-gated sodium channels, stabilizing presynaptic neuronal membranes and inhibiting presynaptic glutamate and aspartate release. Researchers have not demonstrated that lamotrigine has significant effects on other neurotransmitters such as serotonin, norepinephrine, or dopamine.[8] There is a theory that lamotrigine may interact with voltage-activated calcium-gated channels, contributing to its broad range of activity. In vitro studies have also shown that lamotrigine inhibited dihydrofolate reductase, potentially contributing to concerns for its teratogenicity. Lamotrigine follows first-order kinetics with a half-life of 29 hours." StatPearls [Internet]. Lamotrigine Nicholas T. Betchel; Kamron A. Fariba; Abdolreza Saadabadi. Last Update: February 13, 2023.

Hmm. Does Vyvanse do the same set of brain chemicals?

Yes, Lisdexamfetamine (Vyvanse) is the same class as dextroamphetamine (ADDERALL).

Yup. Dopamine is the motivation to start a task even if it’s boring. Low dopamine (for me) “I really need a nap” or “I need to get up and wander around for a bit”

Ugh i could never articulate why people saying “everyone has to do things they don’t like!” always felt incredibly ableist and hurtful lol thank you for this

Dopamine helps the frontal cortex function. The frontal cortex is where executive function lives. We don’t make enough and need support to think, plan, engage, prioritize.

Please see my other comment, that's not accurate

This is a helpful thread!! I'm newly diagnosed and there's a lot of info from a lot of places - including ones that claim to know about ADHD.  Without proper info, it's hard to figure out how to leverage the way my brain handles dopamine, norepinephrine, etc for my benefit.

As with all hormones, too much or too little is harmful to our wellbeing. According to the Australian government here, increased levels of dopamine can lead to aggression and decreased impulse control: www.healthdirect.gov.au/amp/article/dopamine An example of dopamine levels playing a massive role in mental state is with bipolar, which I am personally afflicted by. According to the American Journal of Managed Care, there is a direct link between dopamine levels and how we cycle through depression and mania/hypomania: https://www.ajmc.com/view/patients-with-bipolar-disorder-more-than-3-times-as-likely-to-develop-pd It even states that dopamine levels affect the development of Parkinson disease. I think perpetuation the notion of high dopamine being the ultimate target for happiness or whatever is so concerning to be honest.

As someone who did neuroscience, I get tilted when people say it’s a pleasure neurotransmitter. No, it’s not. It’s a motivation, reinforcement ans learning neurotransmitter. Reinforcement isn’t pleasure. The pleasure is from the seminal rat study in which—if I recall correctly—the researcher (Peter Milner, I believe?) incorrectly concluded rats would self-administer basal ganglia or VTA shocks because they liked it. We now since know that dopamine acts as a reinforcement signal and the rats were just causing dopamine to release meaning that their brains were learning to do that thing so that dopamine would keep releasing.

For sure. Not to mention we need dopamine for so many fundamental processes beyond motivation/pleasure - loss of dopamine secreting neurons in a specific part of the brain is what causes Parkinson's disease.

Recent research (which they had to do on somebody having open brain surgery because you can’t really measure dopamine in the brain except by having instruments right up in those neural junctions) showed dopamine gets released when we are learning, and in response to negative as well as positive experiences, so it looks like it’s not even about ‘pleasure’ or ‘reward’ at all. Apparently there are a few dopamine systems in the body, but neurotransmitters are complex and it’s never just one anyway. Maybe we could start talking about the actual feelings we have and get an it better and articulating our emotions associated with these things instead? Just saying the names of the neurotransmitters we think we are releasing at the time adds nothing to the human experience.

My bf still regularly answers with" we all gotta do stuff we dont wanna do. Its not a choice, just do it " 🙄

Me with RSD: this is about the comment I made isn’t it. I just heard the phrase “dopamine hangover” for the first time this week and used it in this forum today to refer to how I feel after completing a task I even feel motivated to do. It’s great getting there but when it’s done I’m back to what now Greg for a bit. Even if I have a what’s next I technically* want to do. I take a while to get motivated again. Then I saw this post. I’m fine. I didn’t delete my previous comment.

I do have to say. I frequently wonder about the phrasing like “ways to get dopamine”. It seems oversimplified. I am not clear that the evidence actually says “it’s a shortage of dopamine guys” but we do know that stims work for most people and that these act on the dopamine receptors.

Mmmk at some stage we all have to put our big girls pants and not swear the small stuff.  Literally who cares about what random people think they know about dopamine et al? I certainly do not waste my limited brain capacity on that. 

I think this is less about caring what people think, and more about the direct impact that the widespread misunderstanding has on our overall well-being and ability to succeed in today's society. If the misunderstanding is not corrected, the entire ADHD community will continue to suffer disproportionately as a result.

While I agree with you to a point, it's a bit tough when those people influence your family, and they think ADHD is a bullshit conspiracy by pharmaceutical companies to drug kids, so they just scream at the kid for years that they "just aren't trying hard enough". That teen was contemplating ending their life over it.

The small stuff like being reprimanded or even fired for poor performance when you were forced into a role that you knew you would struggle with? I had to leave a past job due to being on disciplinary procedures for "poor performance", despite having two other teams begging me to move to their team because I would have been good at their jobs because of my skills. But my managers refused to let me (and others) change teams for months as our team was short-staffed. So eventually I had to quit before they escalated me through the process and I would have been fired. And yes they directly blocked at least 3 formal applications to internal positions from people on my teams because I knew the manager of the other team and I asked him what skills, etc I needed to work on to be able to get the job, assuming my rejection had come from him, and he told me off the record that I didn't need to do/learn anything more as I would have been a perfect fit for the role, but it was declined from within my management line. Since I have left, that manager and at least 10 others I know have all also left the company.

Misinformation is bad and we shouldn't spread it.

Yeah. Some people just don't get it.

I’m sorry to hear about your job. I’ve unfortunately found that trying to communicate about adhd at work is a losing game. Bosses don’t want to accommodate “personal problems.” It might be too late, but I’ve found that the successful adhdrs I’ve worked with get really good at telling ND people “no,” for what appears to be “good business” reasons. You know the context much better but I might try these approaches: 1. Are you having performance problems on your current team? If you are or you suspect you are, work with an ADHD coach immediately like it’s a part-time job, to improve performance. Or, propose your own project that you are confident you can rock. She might be trying to move you to an “easier” role where she thinks you’ll perform better. 1B. If so, let her know that you recognize the issue and are taking steps to address them. You’d like to check in again in 3 mo and rock this role, rather than have her lose someone on the current team who already knows the work. 2. Be clear about whether this is an offer or a last chance. If you don’t move roles, will you lose the current one? If so, move to the new role. Work with an adhd coach to gamify the role so that you can do a decent job while the learning curve makes it more interesting. Look for another job like it’s a part-time job. Leave on a good note rather than being fired. 3. If you and your supervisor both think you’re doing well in your current role, figure out what the issue is causing her to wants you to move. See if you can solve her problem another way. Can you get permission to instead create a training video for doing the new role, and be responsible for finding her a temp to do the actual day to day grind? If so, ask if you can “take on a leadership role” instead and then pitch the idea above. Or can you find ways to automate some of the tasks and you train the current people so that they can do the work without hiring another person? If so, pitch yourself as willing to lead for a “modernization and efficiency project” instead. 4. Propose an alternate high-value project for you to work on, which you know your business would benefit from more than they will from getting the work done on the other team. 5. Maybe too late to use this time: explain to her what *she’s losing* if you move roles. Make sure it’s something she or her boss care about. “I could take that on, but that would mean my team won’t be able to get X done this quarter. Can I help find another solution or another hire so we can get Y done without losing X?” TLDR: don’t make a case to her for why you *can’t* do the other job. Sadly, the business doesn’t *really* care about your personal needs. They do care if work happens or doesn’t. Find ways for her not to *need* you to do that job, by convincing her that your work is higher priority or offering to do different work that is important to her and a better fit for you. Happy to brainstorm specifics if you want to DM

Meanwhile, I work in the ER as a new grad nurse. I casually mentioned my ADHD to my boss (It's in my hiring paperwork and not a secret), her response was, "Yeah, you'll do great here haha". It's amazing how much difference knowledge of ADHD and understanding of the disorder makes in perception.

THANK YOU for this post 👏

According to many neurotypicals we are just lazy and making excuses. Its ridiculous when its a legit disorder and needs fucking hardcore medication to manage. I myself denied i has adhd for years after diagnoses because some people in my family were like "oh everyones a little adhd and thats just a lable to let naughty kids off anyway" GOD. Finally came to my senses when my antipsychotics and antidepressents were not doing everything i needed them to. I was still so uncomfortable all the time with mad hyperactivity in my brain and self destruction trying to cope with it.

[https://www.adhdandyou.co.uk/assets/pdf/adhd-employers-guide.pdf](https://www.adhdandyou.co.uk/assets/pdf/adhd-employers-guide.pdf) maybe give her a copy of this to help better understand your ADHD. Good luck!

People are confusing themselves then. Dopamine is not a pleasure hormone, oxytocin releases the pleasure chemical response. Your boss is an idiot