In my experience with ADHD medications, I have discovered some things about ADHD. Dopamine and norepinephrine are vital in motivation and attention. It's not that people with ADHD have problems in creating dopamine and norepinephrine, because as soon as they take amphetamine, they can focus. So the problem is the release of dopamine/norepinephrine and its existence in the synapses. When people without ADHD sit down to study some college material, they focus on what they have to study and because they want to do well and also are aware of that focus of wanting to do well, dopamine is released to help them stay motivated to focus.

In one study done on dopamine, it was shown that dopamine is released in response to pain as well. http://www.biopsychiatry.com/dopamine/pleasure-pain.html
This is because the person in pain wants to experience relief from the pain, and the greater the pain the more of a personal want there is in relieving the pain. So basically, dopamine releases in response to focusing or thinking about what you really want, no matter what it is. Typically, whatever it is that people really want, is highly dependent on the person. When some people say they want to do well in school, they really mean it, and it is shown by their work and the results of their hard work. I think a lot of people say things that they don't really mean. "Sugarcoating" can be one area of this, as people tend to be nice when explaining certain perceived truths to others.

Example: Usually the person asking the question, "do these jeans make my *** look fat?" has problems with their own perception and sometimes cannot honestly tell that their *** is indeed fat. So in order to prevent stress, which is the inability to adapt to change, people will sugarcoat their response and even lie. How would saying "no, these jeans do not make your *** look fat, your *** IS fat and will look fat as long as it is fat" cause stress? Well someone who would give that response is someone who has failed to adapt to the change of how our society is today. Today, society values and accepts somebody that makes them feel, not somebody that makes them think. And usually they are generally looking for a good feeling. If you say, "not at all, those jeans look perfect on your perfect ***", the girl will not think about it as much as she would be thinking about "damn, how can I make my *** look smaller.. how how how.." if you had told her she had a fat ***. This has nothing to do with getting a girl, this has to do with how people accept one another in society today. Today, most of us base our views on others based on how they make us feel. Even a boss who has to evaluate an employee may give them a poor score because the person is annoying to them, even though they are a great worker for the company.

Depending on the way that one is raised, they may develop a relationship with their parents that is not based on truth but is based on image. Maybe they have found out that truth gets them in trouble causing stress and to avoid that stress, to be able to adapt, they begin lying to their parents. Maybe their parents have irrational fears, and the kid knows that he is not doing anything truly harmful, so he lies and does not get in trouble. This system of hiding the truth and being positively reinforced for being fake due to the lack of discipline or pain (same as in the study above) becomes natural for the kid. That becomes his learned behavior. So within this child, lies a conflict. The true way they feel about things and the way they have to appear to feel about things. They develop an amazingly complex system for "reading people", because the irrational thought of appearing to be good becomes vital for their wellbeing. They 'have' to know how people feel about them at all times because they know that a lot of people, like themselves, say one thing and mean something completely different. With all of this analysis of knowing when to express the truth of what they want, or saying what they perceive that people want them to say, along with constantly reading people and analyzing their own behavior to make sure it is consistent with what they are saying, behaving, etc. it creates a lot of introspection. This system of thinking is then applied to all aspects of their social lives. It keeps them ignorant to what they really want. It does this to the point that they do not even know what they want, when they try to determine what they want. It creates, within them, a complex inability to know what they want. Is this even possible, you might be asking yourself. Think about how humans respond to stress and what they do to adapt to that stress. Think about how a behavior can adapt and change to adapt to stress. Scientists say that this disorder is genetic, and that is probably true. If the same parenting style has been perpetuated for generation upon generation, even before a name for the disorder existed, it would be pre-wired in the brain, like an instinct. Just like how a baby bird knows how to fly before it is taught, behaviors that pass through generations can become pre-wired within ones brain. This inability to know what one wants can pass through generations, as many diagnosed with ADD have a parent that has it as well.

This theory of having an inability to know what one wants is hard to see by trained professionals, because there is really not a specialist that looks at all of these factors. A doctor will only treat the symptoms. A psychiatrist will ask more questions than a doctor, but only treat symptoms. A psychologist or a counselor would not look deeper than the ADD diagnoses at what is really causing the symptoms, because if something requires a deeper understanding about something that is difficult to explain, might as well just put it under ADHD and keep the easy patients monthly fee. Some psychologists and counselors know better, but refuse to speak up because they may get dismissed by their patients, the medical, or drug companies before they can finish asserting their more complex explanation. Instead its far easier and produces more money to gather all the symptoms and create a new disorder even though there are no clearly given scientific reasons for the disorder. The only thing they can prove is what they see through their microscopes and brain scanners. This only proves the symptoms, which are common for many other mental disorders as well. Because of the ease of creating disorders, we have disorders like "Seasonal Affective Disorder" instead of just classifying it as depression. If it was classified as depression, people who do feel slightly more sad during the winter time might not pay money to get their Wellbutrin script during the winter. They might deal with it, like they did the year before instead. So drug co's see that potential market and cash in heavily upon it.

So as stated above, dopamine releases in response to focusing or thinking about what you really want, no matter what it is. What happens when you honestly do now know what you want? People with ADD try extremely hard to focus on their own. What if their behavior and thinking are so affected in the subsurface, that even if they think they know what they want, it doesn't register with the brains automatic dopamine release response as being valid? It's like they are staring at a television in their room looking for answers, when the answer is right there and almost understood when the channel changes and keeps changing, when the answer was almost within grasp. With an inability to know and understand what one wants, does the dopamine wait in the storage vesicles for what seems like an unhealthy, prolonged time? This takes away the reward system when applied towards decision making and motivation. People with ADHD know that they get bored very easily and need varying stimulation usually created by varying, random thoughts that begin passing through their minds. Think about this. Is it really that uncommon for children these days to be raised in ways where they feel like they have to create a certain perception for their parents to see? Whether the amount of pressure has increased on children today or stayed the same, or perhaps their sensitivity to it has increased, either way it affects them in negative ways.

Think about the parent's perspective and motives. Most parent's really do love their children a lot. They would do anything for them. Parents are probably confused on this whole parenting thing. I would like to see a study that shows the age rank of the child or children with ADD compared to their siblings age. Most parents have not researched the "best" way to raise their children. What influences how a parent raises their child? For people with ADHD in the family, I would say their emotions first, tough love. Then it would be also based on their culture, how they were raised, their perception on how dangerous the world is for their baby. People who demand a lot from their child or discipline their child in ways that leaves a child confused as to what they have done, usually do it out of love which may be right underneath an emotional outburst of anger. The reason they place high standards on their child is because they want them to be successful in this perceivably dangerous world. They discipline them, without properly conveying the consequences to the child, of their actions beforehand, in hopes that they can create a child that does not stray into trouble when they get older. Sometimes the best intentions can cause confusing and complicated problems. This is evident when the parent finds out their child has been diagnosed with ADD. They must be thinking, "why did it have to be my child". All those high expectations and for what. They must feel as if they have failed at parenting after putting forth so much energy on their part. The parents don't understand why their child is like this. Doctors can provide no real answer. Children just want relief and are trying to absorb how this disability is going to impact their lives. This is why many of the newer drugs that doctors recommend, like Vyvanse, are still paid for by the parents, even if though it is not covered by a lot of insurances. They still pay for it cause, the doctor said this would be best for their child, and they trust their doctor and especially want the best for their child.

The child grows up knowing that they have a mental disorder. This is a cause of low self-esteem. One cannot feel good about themselves when they feel as if they lack achievement, when they lack motivation to make decisions and take actions that will allow them to build up their self-confidence. They cannot feel good about themselves, especially if they are more concerned with how people view them. This is their want, to appear to fit in no matter what, and ADHD reinforces their thinking of wanting to fit in even more, because the title ADHD makes them feel even more different and mentally handicapped by a "mental disorder". Those who see a psychiatrist sit in the same waiting room filled with disillusioned schizo's, bipolar's, and other visually ill people, that they can't help but notice, as they wait for their medication script. How do you think this impacts their attitude, especially when it comes to learning?

Having low dopamine in the brain causes one to be more willing to take dangerous risks and commit unsafe behavior. A lot of people with ADHD have experimented with drugs. Some of these people will use upper's to give them that dopamine rush that they crave. Or they will use downer's to take away their generalized anxiety or social anxiety, or just to shut up the negative self-thinking that occurs when one feels helpless. People with ADHD can become happy on occasion, when they do something dangerous or risky to boost their dopamine and norepinephrine, but after that release, things will settle back down to a depressive base line.

Even more horrible about this entire situation for people diagnosed as ADHD, is that the dopamine system reinforces what somebody really wants no matter what it is. So the dopamine rewards this type of thinking system, the system based on living life based on ones perceptions of others while disregarding ones own needs and losing their sense of who they truly are, all in the process. It rewards the spontaneous behavior, providing temporary dopamine boosts, temporary happiness. This dopamine boost also reinforces other mental disorder's flawed thinking and perceptions, allowing the condition to continue forever, unless a conscious action to change takes place.

So whats wrong with just medicating the symptoms? Seems like an easy solution right? After all, cognitive behavioral therapy will take too long in the fast paced world that we live in, right? Talk to anyone who has been on stimulant medication for extended years and you will see how unsatisfied they are with the medication. The brain naturally does not release dopamine spontaneously at random times, so why would you release dopamine at breakfast and afternoon? Those are the times that children take their Ritalin. Now they have extended release formulations of amphetamine that release dopamine for 12 hours. The brain is supposed to release dopamine in response to specific events that take place daily, not just leave the dopamine tap running for 12 hours to flood brain for any and all events that happen during that time. Maybe this is one of the underlying reasons why people who have been on stimulant medications for years are not satisfied with this form of therapy. People don't take time to realize how important the brain really is or how complex it is. People don't take time to learn that recently in neuroplasticity, the brain was shown to always create new brain cells, at any age, and if an area of the brain was damaged, a key function could be transferred or "learned" to take a place in a new and different section and perform just as good. Neuroplasticity has shown that the brain is very malleable is more than capable of learning new things, new accurate behavior changing thoughts, that could eliminate ADD at the root.

I dunno. I might be way off base, but being someone who has been diagnosed with ADD, this post summarizes how I am thinking about it these days. BTW, I wrote that on Dexedrine.

What do you all think?

too much reading...

Well, take your medicine and come back and read it because you probably have never heard of this type of theory before. :)

WOW!!!!!

What do i think? I think someone should give you a grant!!!!!

I will admit I haven't read everything you wrote, but sort or ran over the passages. What stuck with me is the role of pain and motivation in ADD that you mentioned, since I have been thinking along these lines myself for a while. In general, there are two types of motivation - pleasure/reward (positive reinforcement), and pain or more specifically avoidance of pain (negative reinforcement). Pleasure can come in various ways (eating, getting promotion, pleasure of feeling healthier after some exercise, etc.) as well as pain (ridiculating oneself, failing a class, etc.). I don't fully agree with you that ADD is due to the fact that a person with ADD doesn't know what he/she wants. I think its more likely that ADD is the result of brain receptors and your responses to stimuli being simply dulled, or greatly inhibited. For instance - food. Everyone needs food, so the body creates the feeling of hunger, which is motivation to eat. A person suffering from depression, and probably ADD, may not have this feeling of hunger, or have it to a much lesser extent (talking from my own experience). Its probably not due to the fact, that you don't know whether to eat or not. You don't need to know it. The body naturally tells it to you. But a depressed person simply doesn't get enough motivation (stimuli) to create the urgency to eat, and satisfaction from eating. Same goes to all other experiences.

I will admit I haven't read everything you wrote, but sort or ran over the passages. What stuck with me is the role of pain and motivation in ADD that you mentioned, since I have been thinking along these lines myself for a while. In general, there are two types of motivation - pleasure/reward (positive reinforcement), and pain or more specifically avoidance of pain (negative reinforcement). Pleasure can come in various ways (eating, getting promotion, pleasure of feeling healthier after some exercise, etc.) as well as pain (ridiculating oneself, failing a class, etc.). I don't fully agree with you that ADD is due to the fact that a person with ADD doesn't know what he/she wants. I think its more likely that ADD is the result of brain receptors and your responses to stimuli being simply dulled, or greatly inhibited. For instance - food. Everyone needs food, so the body creates the feeling of hunger, which is motivation to eat. A person suffering from depression, and probably ADD, may not have this feeling of hunger, or have it to a much lesser extent (talking from my own experience). Its probably not due to the fact, that you don't know whether to eat or not. You don't need to know it. The body naturally tells it to you. But a depressed person simply doesn't get enough motivation (stimuli) to create the urgency to eat, and satisfaction from eating. Same goes to all other experiences.

What you are saying is sorta true, about the dopamine receptors. People with ADHD have less dopamine receptors and they have a lot more dopamine transporters than people without ADHD. If there is not enough dopamine in the synapses, the dopamine receptor will downregulate, because it does not have a need for dopamine if it isn't going to be there. Dopamine transporters take dopamine out of the synapses. Dopamine is important when it is in the synapses, not when its just waiting in the storage vesicles. What I was going at was a deeper reason. Everyone knows the dopamine system is affected. The question becomes, how and why is the dopamine system affected? I think it will make more sense if you read everything.

Well, I read your whole post now. I must say your writing style is a little bit difficult to follow at times, most likely you are not a native english speaker (me too). Thats why it took me more time to go through it.

I fully agree with you, that parenting style probably plays a very important role in the development of ADD. I liked the paragraph, where you describe parents expectations of a child, and how a child might perceive them, and I agree - it would be very interesting to see some study analyzing the prevalence of ADD between first child, second child, or third child; parent's age and perceived expectations from a child.

What I am not sure - why does ADD develop in some children and not in others (we are keeping the theory that ADD is caused by some specific genes aside for a while). You say it may be because the kids are too confused - I agree with that. But why are they confused? Again, you imply throughout most of your writing, that it is because people and parents in todays society do not tell what they think, they tend to "sugarcoat" their real thoughts, the child is aware of that and thus he/she is confused, because he/she doesn't know if the good things he/she hears are real or not. Well, in order for this to be true, parents of children with ADD should "sugarcoat" more than parents of "normal" children, or chidren with ADD should react to "sugarcoating" much more sensitively than normal children. But do people with ADD really have more "sugarcoating" parents? I don't really think so. Also, I don't think its something unique that we have in todays world. People always smoothen some negative comments, and in the past, for instance in Victorian age, when morals very highly valued, "smoothening" and saying something that would make a person feel good vs. saying whats on the mind was even more prevalent than today. I think the society is much more straight forward nowadays. But going on with confusion idea, I think there may other things, besides sugarcoating, that may leave a child confused. For example, very high expectations placed on a child, when a child gets criticized a lot for failing to meet those high expectations set by parents. Or when a child wants to do smth different from what the parents want, and one hand he/she is sad for dissappointing parents, on another hand he/she doesn't have desire to do what parents want. This may also develop into conflicting feelings of anger and love, and force the child to supress the emotions, turn motivation, because he/she doesn't want to upset parents. It may also happen at a much earlier age, in infancy - if parents fail to respond to child's cry, or respond in a different way, that a child wanted. Or an emotional trauma, which would cause a person to withdraw from emotions, because emotions may just too painful at some moment. Lack of emotions -> lack of response to stimulation -> lack of motivation.

"This theory of having an inability to know what one wants is hard to see by trained professionals."

Actually the majority of tests for depression have a question about indecisiveness. ADD'ers may have indecisiveness as well. But again, does it come with ADD/depression, or does it cause the ADD/depression? I still think ADD/depression comes first. I remember before the onset of my condition, I was much more sure on what I wanted to do, what I wanted to buy in a store, but now I can spend very many hours in the supermarket and still not sure what to buy. Same for other things, like future plans, etc. Its just that my emotions are not getting aroused. For a couple of days when I felt totally normal, my emotions were back to me, I suddenly didn't have problem with decision making again - most of the things just felt natural, I knew for sure if I wanted to go to the gym, or I wanted to start working on smth, etc.