How ADHD Affects Your Brain | Harold Koplewicz | Big Think

How ADHD Affects Your Brain
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Attention-Deficit Hyperactivity Disorder is real, says Koplewicz: the frontal lobes and cerebellums of people which ADHD are significantly different than those of people without it.
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HAROLD KOPLEWICZ:

Dr. Harold Koplewicz is one of the nation’s leading child and adolescent psychiatrists. He is widely recognized as an innovator in the field, a strong advocate for child mental health, and a master clinician. He has also been at the forefront of public education to dispel the myths and stigma surrounding children and adolescents living with psychiatric disorders. Koplewicz has been repeatedly recognized in America’s Top Doctors, Best Doctors in America, and New York Magazine’s “Best Doctors in New York.” In 2006, he was appointed Director of the Nathan S. Kline Institute for Psychiatric Research (NKI), making him the third person to hold that position since the institution’s founding in 1952. He is also the founding president of the Child Mind Institute.
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TRANSCRIPT:

Question: Are there noticeable differences between a “normal” brain and one with ADHD?

Harold Koplewicz: So Attention Deficit/Hyperactivity Disorder is a very misunderstood psychiatric disorder. It’s real. Literally five to eight percent of the population has this disorder. And the important part is that it’s a variation on normal. So, you have children who are more hyperactive, more impulsive, more inattentive than other children their developmental age. And it is a lifetime disorder, so that it will look slightly different, obviously, between a preschooler, a school-aged child, high school student or an adult, but there is still a consistency of inattention, impulsivity, and hyperactivity.

And in fact, most often, we see that hyperactivity disappears as someone gets older. And so when they’re in their late adolescence and early adulthood, that symptom seems to go away. And if we are able to look at the brains of children who have ADHD, they look different than typical children. And in fact, an important study was done about 15 years ago that followed kids over a decade who had Attention Deficit/Hyperactivity Disorder, and these were children who had never taken medication. This was a group of kids who met the diagnostic criteria, were studied at the National Institute of Mental Health, and had parents who said, under no circumstances will we treat our kids with Ritalin or any kind of medication, and were compared to a group of typical, or normal, children of the same age. And they found that there were significant differences in the frontal lobe and in the cerebellum.

The frontal lobe is where you have your executive functioning. Where you are able to prioritize which item should I attack first. What’s the important thing that I should do today and how do I get that done before I go to item two, three, four, or five that are tackling me... as far as my daily tasks.

And the cerebellum is where coordination is. And so it’s really interesting that as these kids got older and hit adolescence, their cerebellum started to look more like the same size as the typical “normal” kids, and it would explain why the hyper-activity symptoms seem to diminish and yet the frontal lobe still seemed significantly smaller than the typical “normal” child.

Question: How do these drugs treat the imbalances in the brain?

Harold Koplewicz: I think it’s important for us to realize that our brains are filled with neurotransmitters. These are brain chemicals that move from one part of the brain to another and take messages with them.

The three big neurotransmitters would be dopamine, norepinephrine, and serotonin. And when you have Attention Deficit/Hyperactivity Disorder, you use your dopamine and your norepinephrine faster in your brain than the average person. And when you don’t have enough of that, you become inattentive or you become more impulsive or you’re more hyperactive.

The centers of the brain that are smaller on these patients who have ADHD seem to be very rich in dopamine and in norepinephrine, so it’s very nice that there’s a neuroanatomical reason for us to be sure that the chemicals that we are talking about are equal.

Now, you can’t take dopamine or norepinephrine or even serotonin and get it to your brain because there’s something in our body called the “blood/brain barrier.” It protects the brain and the spinal cord and the neurotransmitters; those brain chemicals that move back and forth in that space. And so...

[PaddyMacNasty]

Tried to concentrate on this video but kept getting distracted by the fact his shirt seems to be made of pure energy.

[ZioThainE]

One of the problems I have always had that has come with my adhd is the almost complete inability to read a book. If I do it for long enough I will eventually get through it but I fine it near impossible to actually concentrate on the text and often find myself being detracted by my own thoughts once per paragraph and have to go back and read it again. It's like having to read the book twice.

[squirrelterritory]

Does anyone else with ADHD/ADD have a very weak memory of their earliest years?

[aregaminghd]

As someone who's been diagnosed with ADD, I can tell you that it's real, no matter the task I do, I can't sit still/concentrate on anything that isn't hands-on. Even if I enjoy the task, I wouldn't be concentrated on it enough to actually get something done within a normal amount of time, anything that usually takes 10 mins for someone to do would take me 20+ minutes because I am unable to stay focused

[metsot]

I'm surprised why problems regarding mood are rarely discussed when adressing adhd.
Personally I have constant low mood and find that the hardest thing to deal with.

[Zionrael]

I have adhd and I did a physical experiment with my friends who dont have adhd to see how we differ. I seemed to think and react faster than they did. We did another experiment that had to do with noticing detail, I noticed alot more detail then they did.they noticed the basic details, I noticed not only the basic details but all the little things also. I still do have trouble staying still and paying attention in school but in real life situations I think and react faster then the average pers

[Super-J]

I’m a 37yr old very intelligent man who has been cursed by this Bastard of a finding that the older I get, the manifestations of my ADD such as OCD, get more aggressive and prominent in my daily activities. There have been several times where Ive thought about just giving in and letting it consume me. It gets to be frustrating beyond acceptable and is continuing as I’m typing this !

[jacobpohlabel]

This video is the ultimate test to see if you have ADHD. I lost interest after 40 seconds. What was your best time?

[bonmardonov]

I came here to watch the video and get to know my ADD better and after 10 seconds I am in comment session reading and not even paying attention to the video, things like that is always in my life

[apove]

I would think an ADHD expert would know how to speak more clear to people to have it. So what the first 2 minutes told me, after rewinding 5x, is that not getting medication means you still have it as an adult bc your frontal lobes still show small after being denied medication as a child by adults.
That does make sense. My parents denied me even though I knew something was wrong. I used to think I had a hearing problem as a kid but always tested perfect on hearing. Was diagnosed and treated as an adult. Medication improves but not perfect.

[jx]

Me when watching videos like this: pays attention for 1 minute, looses track of what he's saying so the words go straight through me, reads the comments bouncing between each one without finishing them. I wish especially I could watch long videos and films without having to rewind because ive missed about 2 minutes of it daydreaming and thinking of something else

[stunzng]

my god!! I made it through... *cries and drops to knees* I made it, to the end (of the video)... now, what the hell was he just talking about? 😂😂

[reinhardtnilsson]

I’m an adult 48 years old .. and have retained my hyper state since I was a child … I have NEVER lost it … Ritalin calms me to a point where I feel I can function in society as close to a neurotypical as can be … I don’t get were these doctors are saying the hyperactivity fades away as you get older .. mine seems to increase as I got older 😢

[Michael-Hammerschmidt]

As someone with ADHD who is very interested in philosophy and having also have been diagnosed with high functioning Aspergers, (which is likely partially responsible for my intense interest in philosophy) I can say its very hard to be both intensely interested in subjects but not being able to fully concentrate on reading the literature and material for long periods of time without being distracted to the point I quite often forget what I was doing in the first place. This is why books are so hard for me to get through, but also why I love videos like this or shorter summarized explanations like the Stanford Encyclopedia of philosophy. I have worked at becoming a proficient reader over the years. I take very long to read because of lacking reading comprehension due to inattentiveness but once I grasp a conceptual understanding of the interrelated concepts of a subject I am very good understanding their relation to the whole. Such as the understanding of a concepts formal esscence, or in other words it's necessary and sufficient conditions. I also love the Rubik's cube, as playing with it helps me to distract my automatic intensive mode of thought so as to gain the ability to better focus my conscious mode of thought. Entering flow state is rather hard for me, but I love it all the better.

[philvdwalt]

ADHD was an obstacle for me as a kid. I taught my brain to overcome the obstacles, so much so, that I see it in a different light. Still ADHD as an adult, although it does give us a different edge to life. Look at the strong characteristics, and focus on it ;) just for a while. and when that mind starts to wonder, follow it, write it down, and refer back to your not book. Only started taking Ritalin 1st time at 35, and it makes the difference between following through on 10 things instead of 2.

[CKww]

ADHD is VERY real, I watch my sister daily go through life with it.

[algammond]

I watched this at 4x speed because 1x speed is boring to me.

[zakf]

Diagnosed with ADHD emphasis on inattentive and inpulsivity at age 15, denied it for 10 years. Multiple failed and destructive relationships, a freeze naval discharge for inability to conform, debt accrued for stupid and insane reasons, and inability to hold a stable job or complete higher education after multiple attempts. Started taking Adderall in conjunction with CBT (the behavioral modification, not the cannabis oil) my life has taken a 180°. I still have years to correct my past mistakes; due to the condition and my own choices, I feel like an unstoppable force of nature.

[StuartHall-eniu]

I have adhd but that is why people pick on me my mum has it but she diagnosed me herself I need to scream if I am angry I hate it when I am overwhelmed but I don't take medications.

[blrughhhhhhhhh]

lol i was on ritalin, so i lasted almost the whole thing ;)