ADHD Does Not Equal Low Dopamine

Did you know that ADHD people don’t innately have low dopamine?

While the official line I’ve heard from many professionals is that ADHD traits are caused by low dopamine, this is a mistake of treating correlation as causation.

ADHD people do tend to have low dopamine. But not all of us do and not all the time.

A noteable number of ADHDers do not experience symptoms of low dopamine or only experience these symptoms during times of high stress.

Low dopamine cannot be an innate trait of ADHD because it’s not consistent across the ADHD community and because dopamine-depletion can be directly tied to time periods of stress, trauma, and masking.

But, the fact is, many ADHDers do have low dopamine.

So the question is, how are we losing our dopamine?

Mammals make adrenaline out of dopamine! The bio pathway goes from dopamine to noradrenaline to adrenaline. The body uses dopamine as a building block to make noradrenaline and then uses noradrenaline to make adrenaline.

When we ADHDers routinely use adrenaline to respond to trauma and to adapt to neurotypical culture and to do what is required of us by external forces (school systems and employers especially), that results in low dopamine.

Executive dysfunction due to low dopamine levels is not an innate part of ADHD - low dopamine is a reaction to our environment. Low dopamine and executive dysfunction are evidence that our environment is hostile to the ADHD neurotype.

IF we lived in a world without all this pressure to get shit done and without so much stress and trauma, IF we lived in a place we had lots of access to nature to help regulate our dopamine responses, our natural ADHD dopamine levels would allow us to do the things we actually *want* to do.

ADHD brains have interest-driven dopamine systems, meaning they like to give us dopamine for things we are spontaneously and genuinely interested in rather than what we are told is important to pay attention to. Forcing ourselves to pay attention to something that we don’t have a natural dopamine release for uses adrenaline and thus depletes dopamine such that our natural/spontaneous interest can fade away.

The more we are required to use up dopamine to sustain our adrenaline responses for things we HAVE to do, the more likely we are to struggle with executive dysfunction and task inertia around things we WANT to do, because our dopamine stores will be depleted.

The low dopamine experience is also common for people with Parkinson’s disease. ADHDers can learn a lot from neurodivergent bloggers in the Parkinson’s field. If you want more specific details on the dopamine—>adrenaline pathway, check out these essays written by Gary Sharpe:

https://www.madinamerica.com/2024/03/how-chronic-stress-feeds-suffering-by-eating-up-our-dopamine/

https://www.outthinkingparkinsons.com/articles/noradrenaline

Note: This essay is NOT an attempt to fully explain the ADHD neurotype. I am addressing one common myth from the perspective of the neurodiversity paradigm. This is a small piece of a very complex conversation. ADHD is a genetic neurotype like autism, with distinct core traits. ADHD is not a trauma response, but trauma does make the genetic neurotype more clinically noticeable. For more on this topic, check out my essay on innate adhd vs distress symptoms.