Typical ADHD Behaviors

Never Enough? Why ADHD Brains Crave Stimulation

At times, it feels the ADHD brain is never sated — particularly when it comes to common sources of stimulation like video games, sex, and substances. Here’s why your brain craves these things — and how it affects your day-to-day behavior.

Advances in technology are offering us an increasingly bigger window into the neurological bases of ADHD. We now know that differences in structure, functionality, activation, and connectivity all come into play. The key to understanding your behaviors — why you act the way you do — is to understand the needs and wants of your unique brain. If friends and family can’t make sense of your actions, and sometimes you can’t either, learning how your brain works will explain your behaviors.

Rules of ADHD Engagement

The brain regulates our responses to stimulation, and needs to be engaged in order to function well. Optimal arousal enables brains to be alert, receptive, and ready to attend and learn. Well-choreographed executive functions cue the skills necessary for effective response selection. Goal-directed behaviors can be fine-tuned without the distractions of emotions or sensations. Generally, non-ADHD brains are adequately aroused by the shifting internal and external stimulation of daily life. Regardless of fluctuations in stimulation, those brains can operate with reasonably sustained focus, fueled by the dependable coordination of neurotransmitters. They can self-regulate with relative confidence, and exercise an adequate amount of control over their behavior.

ADHD brains do not adapt as easily; they have their own rules of engagement. They are motivated by their search for optimal stimulation, rather than by what others label as important. Their degree of arousal differs based on whether the request for attention comes from an internal desire or an external demand. The owners of these brains are not making conscious choices to ignore external demands, although it often appears that way. Instead, internal motivations are intrinsically more meaningful to their brains and, as a result, more dopamine becomes available. Concerns about time or consequences are dwarfed by the pursuit of pleasurable reinforcement. Whether through sensation or hyperactivity, ADHD brains compel their owners to scan the environment for engaging stimulation. When mundane tasks can’t be avoided, ADHD brains may be compromised in their ability to choose goal-oriented responses.

More Dopamine, Please

Learning from experience is the basis for sound decision-making, and the motivation to learn is modulated by the promise of reward. The current Incentive Salience Model describes a dopamine reward system that is responsible for motivation, positive reinforcement, and pleasure for all brains. However, dopamine-increasing behaviors are even more gratifying to ADHD brains.

Key aspects of the reward system are underactive in ADHD brains, making it difficult to derive reward from ordinary activities. These dopamine-deficient brains experience a surge of motivation after a high-stimulation behavior triggers a release of dopamine. But in the aftermath of that surge and reward, they return to baseline levels with an immediate drop in motivation.

[Get This Free Resource: Secrets of Your ADHD Brain]

One of the many consequences of reduced dopamine in the synapses is that the significance of tasks is decreased. If most stimuli appear equally compelling, it’s difficult to attend to the most important task. As a result, stimuli need greater personal relevance — larger, more immediate, or repeated rewards — to be attractive to ADHD brains. Reward Deficiency Syndrome (RDS) has been proposed to explain why ADHD brains need stronger incentives. Deficits in the reward pathway, including decreased availability of dopamine receptors, decrease motivation. Indeed, ADHD brains struggle to sustain motivation when rewards are mild or are linked to long-term gratification. As a result, ADHD brains search for stimulation that can increase dopamine more quickly and intensely. Ultimately, the pursuit of pleasurable rewards may become a potent form of self-medication. In fact, dependent brains exhibit similar dysregulation of the dopamine reward system.

Every behavioral reward that has been studied has been shown to amplify dopamine production, including food, sex, exercise, competition, and music. High-risk activities — driving fast, motorcycle riding, and waterskiing — motivate ADHD brains to focus. Some extreme activities, like daring ski jumps, sky-diving, or taking fast-acting street drugs, elicit a dopamine spike, the brain’s most intense reward. Some ADHD brains have benefited from the greater dopamine involvement that is intrinsic to high-intensity, high-risk careers, like those of emergency medical technicians, firefighters, and ER doctors.

However, nicotine, caffeine, alcohol, opiates, risky sex, pornography, gambling, physical risk-taking, reckless driving, and compulsive buying increase dopamine even more. In fact, all substances or behaviors that can ultimately result in dependencies have the ability to increase the release of impulse-reinforcing dopamine, and reduce the impulse-inhibiting effects of serotonin.

The Search for Stimulation

So ADHD brains are highly motivated — to find that unique balance of stimulation that enables optimal functioning. Whether ADHD brains overreact or underreact to the stimuli at hand, they rarely engage with moderate stimulation that falls “in the gray area.” ADHD brains tend to respond at one end of the continuum in most but not all areas of functioning. These opposite routes to the same goal explain how a high-energy, outgoing, talkative, over-subscribed individual and a shy, low-energy, passive, and withdrawn individual can each have an ADHD brain.

[Click to Read: ADHD Neuroscience 101]

For some ADHD brains, optimal functioning involves augmenting the existing stimulation — seeking louder, faster, bigger, funnier, and riskier — the more intense, the better. Boredom is a common complaint for the owners of these brains. For them, it is physiologically uncomfortable when their under-aroused brains struggle to engage with their environment. In fact, in mundane, low-stimulation situations, these restless brains may compel their owners to increase the intensity level with fidgeting, noise, laughter, or conflict, if there is no other route to high stimulation available. These more impulsive ADHD brains have their own logic: If some stimulation is good, more is better. This is the signature short-sighted philosophy of brains compelled to choose immediate rewards over long-term gratification.

Too Much Stimulation

In their hunger for greater stimulation, ADHD brains can suddenly find themselves in a state of over-arousal. Egged on by their need, most are unable to modulate their responses, and can’t anticipate an impending “crash.” The fun suddenly gets out of control, the laughter takes on a tinge of hysteria, sights and sounds bombard them until they are overwhelmed. Ambushed by physiological overload, and depleted of psychic energy, they become irritable, tearful, restless, or aggressive. Their brains abruptly demand respite from the commotion, so that they can regroup with negligible stimulation. Their sudden and total withdrawal is a source of confusion and consternation to those who know only the spirited stimulation-seeker.

At the other end of the continuum, there are ADHD brains that can barely tolerate existing levels of stimulation. These brains teeter on the brink of sensory overload, and seek every opportunity to escape from the bombardment. Unexpected or novel stimulation is experienced as an ambush, evoking discomfort, frustration, and irritation.

Owners of hypersensitive brains reduce stimulation by avoiding group activities, tuning out of conversations, and isolating themselves. They shun busy department stores, loud concerts, big parties, and prefer to stay where they can control the level of stimulation. These brains find comfort in the self-contained world of video games. With an internal structure that offers complete control over the kind and amount of stimulation, they select games with rewards that are strongly reinforcing to their brains. These rewards offer pleasure within a cocoon, shielding them from the unpredictable minefield of personal interaction. As a result, video games have incredible habit-forming potential for the inattentive ADHD brain.

Carbs, Chocolate, and the Brain’s Glucose Metabolism

Food activates the dopamine reward center in all brains. However, especially for the more impulsive ADHD brain, it leads to a torturous daily self-regulation challenge. The low levels of dopamine interfere with focused self-regulation, increasing the likelihood that ADHD brains will be inattentive to the factors that modulate eating behaviors. In addition, ADHD brains exhibit decreased glucose metabolism compared to non-ADHD brains, resulting in less energy available to the attention center in the prefrontal cortex. As a result, ADHD brains send out distress messages demanding more glucose, and the owners of those brains suddenly crave sugary foods and carbohydrates, which can be quickly converted into glucose. Glucose increases dopamine and serotonin, so brains experience pleasure and greater calm. Many people with ADHD chide themselves for indulging in pasta and cookies, when their brains are actually demanding those foods instead of salad. Chocolate is appealing to ADHD brains because it increases glucose and has the added stimulation of caffeine.

It is no wonder that those with ADHD struggle with diet and nutrition. When they self-medicate with food, their brains enjoy a surge of dopamine, an increase in glucose-based energy that improves attention, and a serotonin-based calming of restlessness. Particularly for the impulsive ADHD brain, this perfect storm of rewards increases the likelihood of overeating.

Sleep and the Reticular Activating System

The Reticular Activating System (RAS) in the brainstem is responsible for regulating arousal and the sleep/wake cycle. In ADHD brains, the RAS is dysregulated; circadian cycles skew toward higher activity levels in the evening, resulting in later bedtimes and waking times. In fact, many individuals with ADHD celebrate when they finally have time to themselves late at night. This is when they are attracted to internally driven activities, like watching TV, engaging with social media, looking at porn, or playing computer games. With their greater arousal, which is often experienced as a second wind, these brain-pleasing behaviors are reinforcing. Studies show that the blue LED light from screens further increases alertness while suppressing the normal elevation of melatonin. With delayed melatonin production, ADHD brains are flooded with both internal and external stimulation into the early morning, delaying sleep and making it difficult to be an early riser.

Neurology Explains a Lot

Understanding what ADHD brains want makes it clear that the struggle for self-regulation is neurological, and has nothing to do with character deficiencies. For example, it would be easy to misinterpret the following scenario as a standoff between two partners: Imagine that your partner asks you to pay the electric bill, and you say to yourself, “OK, I have time to do that today.” But when you sit down to do it, you keep getting distracted. The ADHD brain needs higher stimulation in order to complete this rote task with minimal payoff. Your ADHD brain says, “That task is way too boring, and I can’t focus on it. Find something that interests me more, which offers me a bigger dopamine reward, and I’ll work with you.” It doesn’t matter that you know you should pay the bill as promised; if your brain won’t engage, it’s an ugly standoff. Perhaps, after a day of procrastination — when your partner will be home in 20 minutes and the bill is still unpaid — there may be enough of an adrenaline rush from a sense of crisis that your brain will engage and you pay the bill.

The ADHD brain and its owner are at odds with one another. It’s difficult to compel a disengaged brain to engage by force of will. In fact, much of the treatment for ADHD involves learning to psych out the brain, so that it will attend to necessary, low-stimulation tasks.

Appreciating the tug-of-war within that pits intellect against neurobiology increases compassion and acceptance for one’s hidden struggle. ADHD behaviors are frequently mislabeled and misjudged by society, and there is some comfort in knowing that there are neurological explanations for seemingly incomprehensible behaviors.

[Read This Next: Everything You Never Knew About the ADHD Brain]

Ellen Littman, Ph.D., is a member of ADDitude’s ADHD Medical Review Panel.

26 Comments & Reviews

  1. The bit about Carbs, Chocolate etc… Can anyone help? All my life I’ve automatically craved these foods and find it so stressful and difficult to say no to the point where I break and binge. They give dopamine yes, and it feels good…I’m stimulated! but they put on weight and then I feel guilty which then effects self-esteem and so on… I’m not obese but I am overweight and it’s the lack of self control (EFD???) that worries me the most. Anyone any ideas I haven’t tried?

    1. This article was fantastic and I identified with so many of the (incredibly specific) behavior patterns that there were times I almost started to well up. So thank you for writing it. But my frustration with this article is one I’ve had with other excellent articles as well – they describe symptoms and reasons behind them but don’t offer solutions or alternatives. When it says force of will or intellect will have a difficult time challenging neurochemistry…what then?

      I am all about understanding and compassion and empathy as being core values of any good society and I try to practice them as much as I can…but at the same time I’ve gotta pay my electric bill on time, yknow? And not just the part where I forget to pay it (though I certainly do) but the part where I can keep a job that has low stimulation and long-term rewards (like paying my electric bill)

      Can someone link to or expand upon any resources for what to do next? I’m seeing a behaviorist and currently taking vyvanse and wellbutrin but 3 months later they really don’t seem to be helping at all. I guess I’m just having one of those days a lot of you can probably relate to.

    2. Hi Mo-Town 🙂

      Not sure if 1 or 2 of these might help you, but I had some neurofeedback (which helped) and as I just had an op to repair my ACL, I decided it was time to stick to a keto diet again – to avoid gaining weight as I’m mostly forced to be sedentary atm unfortunately. I’m finding it quite easy to stick to this time (thank the Lord! Lol) and shortly after you start it you find your cravings start to really diminish quite quickly – it’s AWESOME! The other things I do to trick my body/mind (I live in Australia) is I’ll regularly drink say some flaxseed and almond meal mixed with CocoQuench (It’s coconut milk, not the canned stuff – you can use regular full fat milk instead) that’s my substitute for cereal, and I’ll also have some Atkins bars on hand too (the yummiest I find are the mint choc & coconut choc – there’s other nut ones that are nice too) and so the fibre halts your sugar from spikes/dips & cravings and the Atkins bars are higher in protein and LOW sugar. Beware though, they’re not low in fat (fat keeps you satisfied) so don’t have more than 2 per day. Try nibbling them slowly 😉

      I hope this helps, I understand your plight!

      Louise x

      1. Agree re: the Keto diet. althought I still watch calories, I watch carbs even more closely and it’s the only diet I lose any weight on. But it is soooo difficult to do in this food world. Wondering how many carbs a day do you stay under?

        also agree about an article that describes the symptoms, and reasons for them (thank you)… mentions the psych tricks that are required to overcome them, yet doesn’t even link to any. That was disappointing to a huge degree.

      2. It seems easier to find keto stuff now, but it is hella expensive, at least for those of us who don’t have the time or interest to make this stuff from scratch in our own kitchens.

    3. I would go to a natural path and have blood drawn to check for nutritional defincies and food sensitivities. Add in probiotics, krill oil, magnesium glycinate, and Gabba. Gabba and magnesium glycinate need to be taken at bedtime. We follow a Keto lifestyle, but there are other food lifestyles that work. Whole Foods would be a great start. Clean out the house of all processed foods and start researching. It is not easy to change lifestyles, but you get used to it.

  2. Dr. Ellen Littman, I LOVE YOU!!! Thank you so much for this article, it articulates what I’ve been searching for, for so many years! Finally I can put words to what I’ve been thinking/feeling/intuiting: understanding why I act the way I do! This is a very key part of my current research (into learning disabilities) as well as growing in understanding and healing myself. Not only am I ADHD, but my mother was ADHD, and my father was ADHD, and their original families, and my brothers and sisters and their families—all with unique presentations that are fully explained and understood by your article (in conjunction with the other studying I’ve done). I just can’t thank you enough, and I am so glad I found this article! I will be looking for more from you, I hope the search is not a difficult one. Thank you, thank you, thank you!

  3. I have read many articles from your magazine and always find them interesting & enlightening. However, this one was the one that hit home for me on every single point. I was diagnosed w/both types of ADD (hyperactive & non-attentive), unfortunately late in life, but thankful to have finally gotten an answer/explanation for what has been my crazy life. Many thanks to ADDitude magazine for helping me remember that I’m not alone in this crazy world of “normal” people.

  4. Great article. You describe the state of an ADHD mind in a way that many people can identify with. But I wish you would talk more about the spectrum of ADHD. I say this because if a symptom of having an ADHD mind is “being distracted by stimuli” or “being directed by internal pressure vs. external” then everyone on the planet would be ADHD. And I think this is why so many people can identify with this article. It’s not because everyone is ADHD, but it’s because the characteristics you described are HUMAN characteristics.

    My theory is that the rise in ADHD symptoms are a product of our modern lives. The human mind craves stimulation, and in the past stimulation wasn’t as readily available as it is today. Modern life is basically a stimulation all-you-can-eat buffet and our brains haven’t developed regulation mechanisms to deal with the overwhelming availability of it all.

    But I really liked how you closed the article when you stated that it is important to realize that our neurochemistry effects us more than we know and that what seem like personal failings are not always so. It’s important to be forgiving with ourselves.

    1. The perceived rise in ADHD might also be accounted for by our reward based system enjoying risky sex. In fact that would eventually result in our becoming the plurality hense the norm at some point. However all evidence points to a plateau being reached.
      I seriously cannot wait for a blood test or simple scan to clinically determine its existence. Knowing the Healthcare industry as I do. I am sure the initial cost of such will match the current cost of the battery of pschological tests and their interpretation. Over time it will come down as competing tests are developed.

  5. This is spot on, for me. Just a well written article which outlines many of my “interest” challenges. I will put off tasks until last minute then I get that urgency rush which I imagine is the dopamine. I can’t normally finish these articles due to focus, but this one had me. Thank you.

  6. I am a teacher and I have noticed an increase in students displaying ADHD symptoms. However, with the addition to technology into their environment is it possible they are displaying symptoms of an addition instead?

  7. Oh my goodness! This is such a well-written article. I was not diagnosed with ADHD until age 53. This really explains what’s been going on all my life. Thank you so much for giving me this clear definition. Even at this late stage I’m so glad to know that it’s not just me, that there is a reason.

  8. This is one of the most thorough writings on this subject I have come across. It really covers a lot of the bases and I hope you write more particularly on the management techniques to “psych out” the bran. That would be interesting as well.

  9. This article is 1000000000% my boyfriend, who is almost 38. He is a porn addict who hit rock bottom with it a few months ago and so started therapy. He also is terrible with nutrition. My question is, what can be done? I mean, he already takes 70 mg/day of Vyvanse. So, Meds do not seem to be the complete answer. What can be done to help with these issues?

  10. I came across this article after having a bit of a mental meltdown and came looking for specific answers. So much of this article describes precisely what I have been contending with throughout my life. Of note for me is the reference to self-medication which frankly I feel like I most often self-medicate through negative behaviors due to a lack of impulse control or simply because a positive and/or beneficial solution to what I am struggling with does not present itself in a timely enough fashion for me to stop the run-away train that my negative proclivities can turn into.

    The biggest thing I have noticed likely has to do with eating. I have turned my formerly poor eating habits around over the last five years or so and now if I don’t get enough food intake or I don’t get enough of what I know I need it usually results in my shifting to a negative behavior to fill the void. It may sound strange but it is a pattern I have noticed as being consistent even from my childhood.

  11. You just described me: ADHD and Delayed Sleep Phase Disorder. Two lifelong issues and, to this very day, have never had either of my doctors, psychiatrist for ADHD, among other things, and neurologist for sleep disorders, make the connection between the two.

  12. No wonder I eat so much sweet stuff.

    The part about sleep timing resonates SO much. I always stay up late and get up late because that’s the best time I have to myself and don’t have to deal with anything or anyone.

  13. It is so unnerving that I relate to so many of the symptoms, feelings, etc.in this article. I am convinced I have undiagnosed ADHD. And, I am not sure how to address this with my G.P. or counselor. I am concerned about taking more meds when I already take 2 prescriptions for depression and acid reflux. I have a feeling that in the near future I will also add meds for high blood pressure. I read these articles and think – omg! I have ADHD and that’s why I do the things that I do. Since I recently turned 51 and have been experiencing menopausal symptoms, along with a close family member’s death, my ADHD symptoms are worsening and off the charts. No motivation, easily distracted and unable to focus on tasks that need to be done. So, how do I approach this with my general practitioner and I just started counseling…How do I get her to test me or recommend screening for ADHD to see if I truly have it and get properly diagnosed to address these symptoms?

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