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Got ADHD? The Answer May Not Be What You Think.

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Photo by MattysFlicks


ADHD is commonly understood as difficulty sustaining attention, disregarding irrelevant stimuli, and organizing information toward goal directed behavior, and in many cases, reduced motivation, and somewhat unsurprisingly, it’s rates have experienced a dramatic upward trajectory in the last decade.

But while we may point to our Smartphones, ipads, and our addiction to them (which although not recognized by the DSM 5, for many falls under the long recognized construct of technology addiction), some researchers argue that the problem of ADHD may just have more to do not with our addictions themselves but the way they hijack our dopamine reward system. See more about this here.

Nora Volkow, Director of the National Institute on Drug Abuse and Gene-Jack Wang, Brookhaven’s medical department chair used positron emission tomography (PET) to measure two markers of the dopamine system – dopamine receptors, to which the chemical messenger binds to propagate the “reward” signal, and dopamine transporters, which take up and recycle excess dopamine after the signal is sent – in 53 adult ADHD patients who had never received treatment and 44 healthy control subjects who had been carefully screened to eliminate potentially confounding variables.

The results showed something interesting: it wasn’t just that ADHD patients had lower levels of dopamine receptors and transporters, it was that they showed up in the accumbens and midbrain – two key regions of the brain directly involved in processing motivation and reward. And when these deficits showed up, participants exhibited all of the classic symptoms of ADHD.

According to Nora Volkow, “These deficits in the brain’s reward system may help explain clinical symptoms of ADHD, including inattention and reduced motivation, as well as the propensity for complications such as drug abuse and obesity among ADHD patients. Our findings imply that deficits in the dopamine reward pathway play a role in the symptoms of inattention in ADHD and could underlie these patients’ abnormal responses to reward.”

Abnormal responses to reward. A clinical term for poor attention, impulse control problems, addictions, and probably obesity. Or simply a form of compensation. As Wang says: “Patients who abuse drugs or overeat may be unconsciously attempting to compensate for a deficient reward system by boosting their dopamine levels.”

This is also why stimulant medications, the most common pharmacological treatment for ADHD, are effective – they elevate the brain’s levels of dopamine. Just if there is another way to elevate dopamine may not have been a question that Mihalyi Csikszentmihalyi had in mind when he began his studies of optimal experience — a state characterized by absorption in an intrinsically rewarding activity, the feeling of loss of self-consciousness, time dilation, intense focus (hyperfocus), merging of action and awareness, and a feeling of control over the situation.

However, in the outcome of his studies Csikszentmihalyi found his answer: after studying the percentage of time that children spend in flow, he found a direct correlation between how much flow a person experiences and their life long likelihood of drug abuse, obesity, and ADHD.

The kids who reported more frequent optimal experience were as much as twenty percent less likely to experience addiction to drugs or food, and as much as forty percent less likely to be put on medication for ADHD. As adults these same children reported higher levels of life satisfaction, enjoyed their work more, and had better relationships.

So if being in flow acts like an antidote to ADHD, the question we should be asking is how do we get more flow.

According to Csikszentmihalyi, flow requires three conditions:

  1. We must be involved in an activity with a clear set of goals and progress. This adds direction and structure to the task.
  2. The task must have clear and immediate feedback. This helps us negotiate any changing demands and allows us to adjust our performance to maintain the flow state.
  3. There must be a balance between our perceived skills and our perceived challenges of the task. We must have confidence in our ability to complete the task at hand (Csiksentmihalyi, 2008).


The last condition might just be the most important. Because unlike playing on our smartphones, activities that bring challenge don’t only activate our dopamine rewards system but refine, elevate, and improve our skills — which comes with it’s own reward. The result is not an improved sense of self, it is an expanded sense of self – one that incorporates the experience of risk, difficulty, and stress in a process that seeks not to manage them, but rather to use them.

And this might be the biggest argument we can make for flow: that flow directs our energy into a system that pays dividends. Unlike synchronization with the material world, flow involves synchronization with ourselves – with clear psychic rewards.



Csikszentmihalyi, M. (2008). Flow: The Psychology of Optimal Experience. New York, Harper Perrenial Classics.

DOE/Brookhaven National Laboratory. (2009). Deficits In Brain’s Reward System Observed In ADHD Patients; Low Levels Of Dopamine Markers May Underlie Symptoms. ScienceDaily, 10 September 2009.


Claire Dorotik-Nana is the author of Leverage: The Science of Turning Setbacks into Springboards. For more information on Claire or her work, just visit


Got ADHD? The Answer May Not Be What You Think.

Claire Dorotik-Nana, LMFT

Claire Dorotik-Nana LMFT is a licensed marriage and family therapist specializing in post-traumatic growth, leveraging adversity, and other epic human achievements. Claire has written multiple continuing education courses for Professional Development Resources, Zur Institute, and International Sport Science Association. Claire has also authored multiple books, including:
Leverage: The Science of Turning Setbacks into Springboards and On The Back Of A Horse: Harnessing The Healing Power Of The Human-Equine Bond. For more information about Leveraging Adversity or Claire, visit

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APA Reference
Dorotik-Nana, C. (2016). Got ADHD? The Answer May Not Be What You Think.. Psych Central. Retrieved on October 1, 2020, from


Last updated: 28 May 2016
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