What does an ADHD brain look like?

Alright, so this post MAY get a bit technical here and there, but I will attempt to cut the "science-talk" so it is easier to understand.  I have been looking into what an ADHD brain actually looks like compared to a neurotypical brain.  While it is unclear what entirely causes ADHD, it has been recently discovered (around 2009) that it is a combination of  genetics and environmental factors while in the womb.  

As a brain is developing it turns from a smooth "blob" into the curvy lumpy thing we recognize from zombie movies 😆.

All of those curves and crevices are what we call "cortical folds".  In an ADHD brain, the cortical folds are not as prominant as those in a neuro-typical brain.  From my understanding of this study, it means that people with ADHD brains have similar brain volume (how much brain fills their skull) but smaller brain surface area (how deep and thick the folds/wrinkles and crevices are on the brain itself).  It's kind of like the process of a grape turning into a raisin.  This brain folding occurs in approximately gestational weeks 16-40.  As the brain grows, it forms folds and wrinkles along the surface of the brain, which contain neurons.   ADHD brains don't form as many or as deep of wrinkles, so the surface area of ADHD brains is smaller than those of neuro-typical brains. The larger the surface area, the more neurons there are to make connections with, thus ADHD brains have fewer neurons to work with.  .  

People with autism, schizophrenia, and bi-polar disorder also have brains with with marked differences in cortial folding.  These differences in folding means that the connections or circuits that happen when the brain is working are different in people's brains who have these disorders than from a neutro-typical brain.  Parts of the ADHD brain mature at a slower pace (approximately one to three years) and never reach the maturity of a person who does not have ADHD.  More specifically, ADHD brains have low levels of circuit connections between the pre-frontal cortical area (responsibe for emotional responses, behaviour, and judgement) and the basal ganglia (responsible for motor function).  

Fewer connections in these areas of the brain can cause the following:

-lack of alertness/concentration

-shortened attention span

-decreased efficiency of working

-poor short-term memory

-difficulty initiating and sustaining activies

-the inability to distinguish and ignore distractions

-difficulty regulating emotional response

-constant figiting

-making careless mistakes when working

-being unable to follow instructions and complete tasks

-avoiding tasks that require mental effort

-talking excessively 

-acting without thinking

-having little or no sense of danger

-interrupting other people's conversations or activities

-being restless

-running or climbing in inappropriate situations

-being unable to engage in quiet leisure activities

-having problems organizing tasks

-being forgetful and frequently losing things

-appearing not to listen

-severe procrastination

As I can testify, having struggles in this area creates a lot of mental exhaustion.  Tasks that are easy for neuro-typical people, exhaust ADHDers must faster and require more effort.  Not knowing I had ADHD until I was diagnosed at 32 forced me to create some coping strategies to help me function easier.  I set alarms on my phone to remind me to do things (take meds, work shifts, pick up kids from school etc.) which, even though I did these things every day, I would lose track of time or forget about them while immersed in another activity.  I also make sure I write things down.  I have found that when I write something with my hands rather than saying it out loud or attempting to commit it to memory, I am more likely to have it imprinted in my brain.  So when studying for exams in university, I would re-write my notes to help me retain the information.  Here is a good list of other helpful coping mechanisms I found. 

So what does all this mean?  It means that ADHD is not, as some believe, a "made-up disorder" or something that can be corrected with harsh punishments and behaviour modification.  There are stimulant medications (and non-stimulant medications) that help to increase and/or sustain the serotonin and dopamine levels in ADHD brains, making it easier to make connections in the brain.  It removes some of the exhaustion from completing tasks that are difficult.  It helps to regulate emotional outbursts.  I helps to block out some of the distractions and focus on what is important in that moment.  There are now MANY different meds for ADHD that work in different ways, depending on the severety and type of ADHD that you have. 

Many people will be able to identify with some of the things on the list above.  That does not mean that you have ADHD.  If most or all of these things are things that you (or your child) struggles with mutliple times a day, every day, then it might be worth speaking to a doctor about.  You can take any number of "diagnostic" ADHD tests on the internet, but they are not the real thing.  You would need to speak with a registered psychologist to diagnose ADHD accurately and discuss a treatment plan.  

In summary, ADHD is not just a behavioural disorder.  It is a physical difference of the brain itself.  While scientists are still working to understand exactly what causes it, we have come a long way from the research done 30 years ago on the subject.  Please do not feel that taking medication to make up the difference is a negative thing.  Sometimes bodies have difference that need a bit of help from the scientific community.  You wouldn't shame a diabetic for needing insulin to help their pancreas function properly, and neither should you shame a person with ADHD for needing medication to help their brain function properly.  Medicine and medical advancement and research is there to help you.