This is how the brain of people with ADHD works

Conspicuous and loud – or clumsy and absent. This is how ADHD can manifest itself externally. But there's much more to it than that. A rendezvous with the "erratic conductor" in the mind of those affected by ADHD.

The wild child and the Jack-in-the-box: These are probably the two most familiar images when thinking of children and adults with ADHD. "ADHD-HI" is the medical term for hyperactive ADHD sufferers, "ADHD-I" for daydreamers (formerly known as "ADS") . But ADHD isn't just about hyperactivity or inattention. The syndrome is closely linked to the "executive functions" of the frontal lobe . These, taken together, are something like the "inner conductor" or "caretaker" in our heads .

In the frontal lobe: four circuits that move a lot 

The prefrontal cortex, or frontal brain, plays a central role in executive functions. Four primary circuits have been identified within this area:

The "What" circuit: This is all about working memory.
It is something like the notebook of our brain.

Example: Remember a shopping list or recall details from a meeting without taking notes.

The "when" circuit: The brain's internal clock.

Example: Knowing when the best time is to ask your boss for a raise or finding the right time to have a difficult conversation.

The "why" circuit: It is connected to our feelings.

Example: Choosing a movie based on your mood or deciding to avoid certain topics with a sensitive friend.

The "Who" circuit: The circle of self-awareness.

Example: Recognizing when you are stressed and taking steps to relax, or understanding when you are the cause of a conflict and taking responsibility.

Specific tasks of the executive functions 

The following tasks are carried out every day in the frontal lobe , in a highly complex interaction of millions of nerve cells:

- Prioritize tasks: Decide what's urgent and what can wait. For example, we might choose to finish a work report instead of watching a TV show. Or the decision to pay bills before buying a new smartphone.

- Time management: Allocate appropriate time to tasks and ensure they get completed. For example, divide a project into smaller tasks and set a deadline for each. Or reserve specific times of the day for relaxation and self-care.

- Making decisions: Weighing options and choosing the best course of action. For example, deciding whether to accept a new job offer or stay in your current position. Or choosing between two vacation destinations based on your budget and interests.

ADHD: Impairment of executive functions 

ADHD is closely linked to the function of the neurotransmitter dopamine . Dopamine is a central neurotransmitter in the brain and influences a variety of processes, including mood, behavior, and cognitive functions. Dopamine also plays a role in regulating blood flow to the brain and other processes critical for the proper functioning of the brain's executive functions .

The dopamine imbalance in ADHD contributes to the executive functions— that important "inner conductor"—becoming erratic and insecure . Things are only considered but not addressed, tasks are abandoned halfway through, routines are forgotten, the sense of time is lost, objects are misplaced, and much more.

The effects on children: A closer look 

- Prioritizing tasks: A child with ADHD may have difficulty deciding which homework to start with and often chooses the task they enjoy most over the most urgent one. For example, they may choose to color a picture for art class before completing the math assignment due the next day.

- Time management: Children with ADHD can easily lose track of time. A 10-minute break to play with toys can turn into an hour, leaving them with less time for homework or chores. For example, a mother might ask her child to get ready for bed in 10 minutes, but the child becomes engrossed in their game and forgets, leading to a delayed bedtime.

- Decision-making: Simple decisions can become overwhelming. A child may spend too much time deciding what cereal to eat in the morning or what shirt to wear, making the morning routine tedious and stressful.

- Impatience: At school, children with ADHD often blurt out answers without waiting for their turn, which can frustrate teachers. Or, the child may have difficulty completing tasks that require patience, such as a math worksheet with 20 very similar problems.

- Emotional regulation: Children with ADHD are more likely than not to exhibit intense emotional reactions . A minor disappointment, such as a rainy day at a game, can lead to destructive emotional outbursts. Conversely, the excitement of a birthday party can become so overwhelming that it leads to overstimulation and tears.

- Self-motivation: Without immediate rewards, these children may find it difficult to complete tasks. For example, they may need constant encouragement and small gestures to complete a week-long project, while other children may complete it with discipline and the promise of a grade in the distance.

- Planning and problem-solving: A child with ADHD may have difficulty with multi-step tasks. For example, if asked to clean their room, they may feel overwhelmed and unsure where to begin, often leading them to avoid the task altogether or begin several subtasks without completing any of them.

conclusion 

Understanding the relationship between ADHD and executive functioning provides valuable insight into the daily challenges faced by those with ADHD. For parents, understanding these challenges is the first step in providing the right support.

When you recognize that your child isn't simply "difficult" or "lazy," but is genuinely struggling with tasks that are much easier for neurotypical children to handle, you can develop more empathy and effective strategies to help your child cope with everyday life. This will also pave the way for them to lead a fulfilling adult life—despite and with ADHD .