Imagine you have been presented with a box full of puzzle pieces. You are instructed to put it together in an allotted amount of time, but to do so with no reference image. You look around you. Your peers have been given the exact same puzzle. Unfortunately for you, they all seem to know what the finished product should look like. As you fumble around blindly, with an anxiety-ridden sense of urgency, you work harder than everyone else but get nowhere even faster. You become agitated and you impulsively throw the box of puzzle pieces away in frustration. In the process, you mix all your pieces with your peers’, lowering their chances of progression along with your own. Everyone is mad at you, but more importantly, you are angry with yourself. Thus begins the cyclical pattern of self-doubt and deprecation.
This is how it can feel to have ADHD. The constant looming feeling of shame and failure is ever present.
ADHD: A Quick Overview
Attention-deficit hyperactive disorder, known as ADHD, is one of the most prevalent conditions in mental health today. Yet, it is consistently misdiagnosed and misunderstood by the general population. Sometimes seen as an excuse or failing in oneself, there are still people who think it’s “not real”. Until relatively recently, ADHD in adults was not well understood. For those of us who have battled it their entire lives and struggle with its symptoms daily, it is all-encompassing and there is nothing contentious about it.
Those who suffer from its more malignant characteristics know that they are walking on a razor’s edge between doing it all and losing it all. The ADHD brain’s emotional dysregulation keeps one perpetually in extremes. It is always all or nothing, now or never, take it or leave it, love you or hate you. We do not enjoy dwelling in the grey area which presents many challenges.
Is ADHD a Precursor to Addiction?
There are certainly genetic factors at play when it comes to ADHD. The combination of heredity and environment have a central role in its development. Recent studies have found that the likelihood of someone with ADHD misusing substances is shockingly high. Impulsivity is one of the many metrics used to determine if someone has ADHD. It may also be the most important piece in the link between ADHD and addictive behaviours. Exploring impulsivity will help us better understand this connection.
Below is a chart of possible comorbities that accompany ADHD.
Impulsivity and its Implications
What exactly is impulsivity? It is an action that lacks foresight. It is acting without thinking, so to speak. Impulsivity is the crowning jewel of ADHD. It is arguably the most detrimental symptom in its arsenal. It can easily destroy relationships with the reverberations of its consequences. For some, it is a constant uphill battle and it is exhausting.
Having ADHD is like being a perpetual gambler. Everything you do is with the mindset of a high roller. The risks you take may reap huge rewards or bring about a cascade of negative consequences. Both options can be somewhat exciting for the brain whose dopamine is in short supply. Sometimes you will do anything to give your brain the hit of dopamine it lacks and desires.
The Science Behind ADHD
Noreprinephrine is both a neural transmitter and a stress hormone. It is liken to the adrenaline in our bodies, except it is the ‘adrenaline’ for our brains. ADHD brains lack both noreprinephrine and dopamine production, making the body seem to scream out for self-medication.
There has been an increased awareness of recent years relating ADHD and addiction. There are numerous scientific and clinical inquiries focusing on the co-occurrence of attention-deficit hyperactivity disorder (ADHD) and psychoactive substance use disorder (PSUD). You will find many excellent scientific articles and clinical studies at sciencedirect.com.
Medications Used to Treat ADHD
To better understand an ADHD brain is to look at the medications used to combat its symptoms. Some of the stimulant medications used to treat ADHD are amphetamines, methamphetamines, dextroamphetamines, and methylphenidate. They work similarly, either blocking the reuptake of norepinephrine and dopamine or by increasing the production, but both allowing the ADHD brain to “slow down” and focus. Although it seems counterintuitive to have a stimulant medication calm a hyperactive mind, that is exactly what it does.
Medication is not for everyone and it is one of many pieces needed for success. Only along with therapy may its efficacy be measured in real terms. If the underlying issues are not addressed, there will be limited progress.
Childhood Trauma and Healing
Dr. Gabor Mate famously speaks about ADHD as a childhood trauma-related affliction. Having spent many years immersed in the homeless population of the downtown eastside in Vancouver, his insights on addiction are compelling. Having ADHD himself, he saw no difference in his patients’ addictive behaviours from his own. Although the addictions were of vastly different consequence, the underlying principles were identical. He was a self-proclaimed workaholic, and although his addiction brought him praise, achievement, and accolades, he suffered many of the same ills that accompanied the addiction to stigmatized substances/actions.
His insightful book, Scattered Minds, is a fantastic read on ADHD and its origin, rooted in childhood trauma.
Hyper-focus, What is it?
Like an albatross on the high seas, the ADHD brain flies over the vast ocean (of thoughts) for endless miles and being able to land (on any one) is a luxury one seldom enjoys. When it finally does happen, another odd symptom activates, hyper-focus. Those with ADHD will recognize this sometimes fruitful, oftentimes detrimental, oddity. There will be a period of complete obsession. An obsession that will entirely engulf one’s psyche. The deep dive that ensues will see a period of extreme devotion and then there will come a point when the passion subsides. When this occurs, whatever it was that you could not “live without” will fade off and interest will be lost suddenly and completely. It will be added to the pile of failures that keeps growing.
It is difficult for the ADHDer to know when to stop. This can apply to anything, whether it be working on a task that interests them or engaging in activities that are detrimental to themselves or others.
Self-sabotage is another behaviour exhibited by many with ADHD. Something you don’t even know you are doing until it’s too late. Sometimes the ADHD brain resembles that of a child, and in a way, it has been stuck in that state – especially if the symptoms are not being addressed or treated.
Along with impulsivity, hyper-focus and self-sabotage constitute a breeding ground for addictive inclinations.
What Does This Tell us?
The tiresome vibration of thoughts, the restless unease, the overwhelm of turbulent emotions, the exhaustion from “failing”, the unfinished projects, the botched social relationships – all this can lead to a sense of dreaded psychological bankruptcy.
There are many reasons people fall into the false cradle of ‘safety’ that drug and/or alcohol dependency can provide. Short term escape may seem attractive to those that want some relief from a constantly chattering brain. There is definitely something important to be examined when it comes to the disproportionate number of the ADHD-afflicted that turn to addiction.
When ADHD is not treated or acknowledged, its cost on someone’s self-esteem can seem irreparable. The symptoms of ADHD can look like a blueprint for addictive behaviour. Acknowledging this will help with prevention. An awareness of the connection between ADHD and addiction is vital.
You’re the Variable That Matters
At the end of the day, the power someone has over their own actions is paramount. No labels can control one’s fate. You author your own life.
- Sibley, M. H., Pelham, W. E., Jr., Molina, B. S. G., Coxe, S., Kipp, H., Gnagy, E. M., Meinzer, M., Ross, J. M., & Lahey, B. B. (2014). The role of early childhood ADHD and subsequent CD in the initiation and escalation of adolescent cigarette, alcohol, and marijuana use. Journal of Abnormal Psychology, 123(2), 362–374. https://doi.org/10.1037/a0036585
- Mate, Gabor (2000). Scattered Minds (1st edition). Vintage Canada
- Ellison, A.T., Goldstein, Sam (2002). Clinician’s Guide to ADHD. Elsevier Inc.