Are you worried that your teenage son or daughter has difficulty paying attention in
class, or perhaps cannot stay still even while watching TV, or cannot read a book, or
has difficulty controlling their impulses? How is brain chemistry involved in making
sense of these specific behaviours? In this text, we will delve into the fascinating world
of dopamine and its involvement in regulating adolescents with Attention Deficit
Hyperactivity Disorder (ADHD).
What is ADHD?
Attention Deficit Hyperactivity Disorder.
It is a neurodevelopmental disorder that affects children, adolescents, and also adults,
although it is usually diagnosed between the ages of 6 and 12. It can also be
diagnosed at more advanced ages during early or mid-adulthood; it should be noted
that late diagnosis is often a consequence of another underlying condition (drug use,
stress, and anxiety associated with difficulty in professional performance). ((CDC)
2024)Today, it is estimated that 7 million children aged 3 to 17 years have been diagnosed
according to the Centre for Disease Control and Prevention (CDC) (The Centre for
Disease Control and Prevention (CDC) 2022). Among the symptoms of people
diagnosed with ADHD are difficulty concentrating or paying attention to certain
activities, lack of control or impulsiveness of emotions, lack of motivation, frequent
forgetfulness of tasks or events in the person's life, as well as hyperactivity or hyper
focus when a task is enjoyable. One of the main problems faced by people with this
disorder is the deficit in inhibiting certain behaviours, and this is where dopamine plays
a fundamental role.
Among the main causes of ADHD are hereditary factors, low birth weight, the mother's
drug, tobacco, and alcohol use during pregnancy, complications during childbirth or
accidents, as well as environmental factors (The World Federation of ADHD 2019).
Research on this disorder is a focus of the scientific community, and there is evidence
that dopamine is involved in the regulation of ADHD.
Now let's talk about dopamine...
It is a molecule belonging to the family of neurotransmitters known as catecholamines.
It is synthesized through the amino acid tyrosine via an enzymatic process in neurons.
Its function is crucial as it is involved in the regulation of mood and emotions, meaning
our level of depression or anxiety depends on it if there is an imbalance. It also plays
an important role in cognitive functions such as attention, memory, and learning, and
it is strongly involved in the reward and motivation process.
Dopamine as a messenger...
To better understand its role, let's explain how it works in a healthy neuron and one
with ADHD. Neurons communicate with each other thanks to different
neurotransmitters, in this case, dopamine, which is produced inside the neuron in
small sacs called vesicles (see FIG 1 in blue in the presynaptic neuron). The neuron
receives an electrical signal, and the vesicles release dopamine into the space
between the neurons (synaptic space), and it travels in this space until it finds the
postsynaptic neuron where the receptors absorb it (mainly receptors called D1 and
D2), triggering a response in the receiving neuron. Let's say it's like someone sends
us a letter, and the recipient is available to receive, read, and process that information.
FIGURE 1. Schematic representation of dopamine release, reuptake, elimination, and binding to
receptors in the synaptic cleft.
On the contrary, in a neuron with ADHD, the process is a bit more complicated not
only because the recipient is unavailable (lack of attention or focus), but also because
dopamine production in the sacs called vesicles may be deficient, or the release
process may be affected, and the receptors may not be absorbing at the same level
as a neuron without ADHD. In short, when there are high or low levels of dopamine,
the self-regulation of attention and working memory is affected in the prefrontal cortex.
This happens when these D1 and D2 receptors are overstimulated or under stimulated
(Véronneau-Veilleux, Mauro, Fatima, & Philippe 2022).
Although the focus of this text is not to delve into the most commonly used treatments
for ADHD, it is important to highlight a scientific study conducted in 2020 to analyse
the possible non-pharmacological treatments available and effective given the
uncertainty of the long-term consequences of pharmacological treatments, especially
in children and adolescents with developing brains.
This article (Nazarova 2022) provides in-depth clinical studies conducted over the
years, giving us hope in the increasingly frequent use of non-pharmacological
treatments.
It summarizes 695 studies with children, adolescents, and adults, revealing some non-
pharmacological treatments, among which psychological interventions are the most
prominent. There is also an increase in the use of devices and other complementary
or alternative treatments to pharmacological ones, such as:
• Neurofeedback
• Cognitive Behavioural Therapy
• Certain diets or the elimination of, for example, artificial colourings
• Free fatty acid supplements
• Mindfulness
• Hypnotherapy
All have shown positive results, and there is a positive trend in the use of these non-
pharmacological therapies.
Why is it essential to understand the impact and regulation of dopamine and
other neurotransmitters in the function of regulating adolescents with ADHD?
From a scientific perspective, because efforts will be focused by the scientific
community and pharmaceutical companies on developing pharmacological treatments
that help balance the release, absorption, and reception of dopamine. From an
emotional perspective, I believe it is essential to remove the label and stigma
associated with this disorder to help those who suffer from it. Can we simply see it with
an objective and compassionate view and not as a "defect" of the person? After all, if
an environment of acceptance and support is achieved, it will be much easier for those
who suffer from it to accept themselves and develop their full potential.
References and Bibliography
Nazarova, V. A. (2022). Treatment of ADHD: Drugs, psychological therapies, devices,
complementary and alternative methods, as well as the trends in clinical trials.
Frontiers, 2-6.
Prevention, T. C. (2024, May 15). Attention-Deficit / Hyperactivity Disorder (ADHD).
Retrieved from cdc.gov: https://www.cdc.gov/adhd/about/index.html
The Centre for Disease Control and Prevention (CDC). (2022). Data and Statistics on
ADHD. Retrieved from cdc.gov: https://www.cdc.gov/adhd/data/index.html
The World Federation of ADHD. (2019). http://cpo-media.net/ADHD/2019/HTML/.
Retrieved from The World Federation of ADHD: https://www.adhd-federation.org
Véronneau-Veilleux, F., Mauro, U., Fatima, N., & Philippe, R. (2022). A mechanistic
model of ADHD as resulting from dopamine phasic/tonic imbalance during
reinforcement learning. Frontiers, 3.
Gerlach, R. B. F. (2019). The World Federation of ADHD.
Overview: Attention deficit hyperactivity disorder (ADHD). Last Update. (2022)
National Library of Medicine NMD
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