I liked the actual science discussed in the article and the results showing our advancing understanding of dopamine's role in ADHD. It was educational and interesting. However, I really disliked...
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I liked the actual science discussed in the article and the results showing our advancing understanding of dopamine's role in ADHD. It was educational and interesting. However, I really disliked the overall framing and tone that the author used to discuss this information.
I will first note that almost everything with even the thinnest scientific veneer that I've read about ADHD from those who focus on the condition has noted the connection to dopamine in a more nuanced way that seems to better reflect our current understanding of the science better than the simplistic "low dopamine" idea. How detailed they'll get varies, but most will at minimum give an acknowledgement that "low dopamine" is a simplification, and most attempt a somewhat simplified explanation of what we know about dopamine's role that's got more nuance than "low dopamine."
I also think this article works far too hard against the "misconception" that ADHD is related to low dopamine to an extent that it seems to misframe its own scientific evidence. It consistently describes the evidence of ADHD's strong relationship with dopamine, but then even upon discussing research that does show lower dopamine levels for individuals with ADHD individuals in some parts of the brain, it immediately attempts to reframe this as being somehow counter to the idea that ADHD is caused by "low dopamine", even though the clearest surface reading of that evidence is that ADHD is indeed caused by low dopamine. I can read between the lines that they're pointing out additional nuance added by these studies, in that there's more variation and less universality involved, but the author of this piece does not do a good enough job actually connecting these results to their argument that the "low dopamine" thing is a misconception.
Moreover, I'm very much not convinced that this misconception, which is really more of an oversimplification if anything, is actually harmful. The actual relationship between dopamine and ADHD is very complex and not yet fully understood. The simplified "not enough dopamine" explanation imo does a half-decent job explaining the broad strokes of why certain ADHD symptoms and treatments work the way they do without expecting them to get a neuroscience degree. It approximates the truth closely enough imo. The only thing that comes close to an attempt to justify the claim that this is a harmful misconception is the second-to-last paragraph, which does not provide any evidence:
The portrayal of ADHD as a dopamine deficit is common in popular media, but it can lead to an oversimplified and even harmful view of the condition, MacDonald says. “It can potentially lead to the message that low is bad, more is good, and even more is better.”
I'm not convinced that the simplified view is *over-*simplified, especially since it allows for explanations of motivation-based symptoms that counteract the actual oversimplified understanding most people have of ADHD. The idea that ADHD is a dopamine deficit is absolutely not common in popular media. It's common in pop science targeted at people with ADHD and their families. Popular media still depicts ADHD as "oh, squirrel!" or as sucking in school or as the standard hyperactive white boy stereotype. If that. There's actually woefully little straight-up ADHD representation in popular media at all if you exclude obvious jokes and characters where the only direct textual evidence mentioning taking Adderall (or some other stimulant that's both a study drug and ADHD). While we've got plenty of ADHD-coded characters in media, it is exceptionally rare for a character to actually be established to have ADHD in a piece of media rather than just having it hinted at or mentioned by the creators outside the actual media. Popular media absolutely does not have enough representation of ADHD to even contain this misconception about dopamine, much less have it be common, and I can only assume the author is in a really weird bubble if they think that's the case. Either that or they're using "popular media" to refer to a completely different set of things than it's used for in any other context.
Moreover, I don't think "it can potentially lead to the message that more is good and even more is better" is a particularly good argument for the potential harm of this simplification. I think it's extremely infantalizing to assume people can't comprehend "too little or too much of this thing are both bad". Not to mention that the thing that is actually common in popular culture are things like "dopamine fasts" that exhibit a misunderstanding of what dopamine is to an extent that far exceeds the degree to which "ADHD is a dopamine deficit" is an oversimplification. Moreover, drugs that increase the dopamine levels in the brain are still the effective treatment for ADHD, and they're a treatment that the US government has already made noise about withholding from us, so I don't think that people whose misunderstanding of ADHD is an oversimplified in understanding of dopamine's role in our brain chemistry are remotely close to an important threat for people with ADHD in the current climate.
Thank you for spelling all this out. The common misconceptions about ADHD are indeed more along the lines of "It doesn't exist", "It's those people with self-discipline issues" etc. Most laypeople...
Thank you for spelling all this out.
The common misconceptions about ADHD are indeed more along the lines of "It doesn't exist", "It's those people with self-discipline issues" etc. Most laypeople probably don't even know what dopamine is. I would be extremely grateful to anyone who managed to educate the general public so well that they adopt the "It's about low dopamine" idea.
(Source: I live in a European country that is considered to have a great public education system and where people are generally quite informed.)
If anyone asks me, I usually tell them it's about dopamine dysregulation (which then either leads to further discussion and explanations, or not). I'm planning to read the article at some point to see how far off I am.
I'd say a lot of laypeople know about it, but think it is a "pleasure chemical" because of the discussions like "social media makes us dopamine-addicted", "we need a dopamine detox", etc. Which...
Most laypeople probably don't even know what dopamine is
I'd say a lot of laypeople know about it, but think it is a "pleasure chemical" because of the discussions like "social media makes us dopamine-addicted", "we need a dopamine detox", etc. Which are all a pretty incorrect view of what dopamine is, yes, but still a lot of people are aware of it.
So I agree with your overall sentiment, but in general I think it's always good to try to better explain over-simplifications and correct misconceptions, even if they appear to be inconsequential....
So I agree with your overall sentiment, but in general I think it's always good to try to better explain over-simplifications and correct misconceptions, even if they appear to be inconsequential. We should show that, actually, nature (and by extension, the brain) is very complex, and we can have these basic ideas of things that aren't complete, because demonstrating this complexity can hopefully change these cultural perspectives.
For instance, if someone hears "ADHD = low dopamine" then they may think the problem is easy to fix (especially if they're neurotypical); all you need to do is give someone more dopamine. Just like the over-simplification of "Exercise improves mood" can lead to "Depressed people need to exercise more". Is this article going to change everyone's minds about ADHD and cause large-scale cultural shifts in its perception? No. But hopefully by showing how our understanding has changed and showing how complex this condition is it can help some people appreciate the difficulties with it, on top of helping people who aren't as responsive to conventional treatments feel a bit better.
But the established treatment for ADHD is essentially giving us more dopamine, insofar as both stimulant and non-stimulant medications for ADHD raise dopamine levels in the brain through various...
But the established treatment for ADHD is essentially giving us more dopamine, insofar as both stimulant and non-stimulant medications for ADHD raise dopamine levels in the brain through various mechanisms. And despite stimulant medication's demonstrated efficacy, there are significant cultural and political forces opposing this. In fact, the idea that stimulant medication for ADHD is "just meth" and that it's harmful/addictive when taken as prescribed is an actual common misconception among the general public that can materially harm people with ADHD, unlike the "ADHD is a dopamine deficiency" misconception, which I have only heard in ADHD-focused popsci spaces.
If anything, I think people skimming this article and coming to incorrectly believe that people with ADHD shouldn't take stimulant medication because "ADHD isn't caused by a dopamine deficiency" is an equal or even greater risk than whatever the article's author believes will happen if people believe a simplified explanation of ADHD's relationship with dopamine levels (and they don't, like, actually say what concrete things they consider there to be a risk of happening in that case in the article whatsoever). Both these things are pretty unlikely, of course, but I don't think the unspecified fears of the author in this article are any more likely -- especially in our current cultural climate.
I like learning more about the details of what we know about the relationship between dopamine and ADHD and how our understanding has evolved with new research, and I liked that part of the article, but I think the framing around it was really flawed in ways that undermine the article as a whole.
As Lia said, thank you for writing it down so well. I actually disliked the article and felt like it didn't even begin to explain the science behind these new findings. I also agree that I never...
As Lia said, thank you for writing it down so well.
I actually disliked the article and felt like it didn't even begin to explain the science behind these new findings. I also agree that I never heard anyone mention ADHD as being "low dopamine" and and I also agree if it was what the general population thought, it would be a step in the right direction.
Every time I see ADHD mentionned, it's always the symptoms: forgetting things, being disorganized, doing one thing and another right after, being hyperactive, etc. This notion that it's been seen as "low dopamine" is just not true, imo.
I would have loved to see more science behind these apparent new findings but it pretty much only says "we need more research". It's interesting, but kinda meh. I was hopeful to get some more info from this article (from Nature!) but left disappointed.
At least the citations are there! The actual papers on some of the new research might scratch that itch for you. I didn't click through them because I think neuroscience papers are probably a bit...
At least the citations are there! The actual papers on some of the new research might scratch that itch for you. I didn't click through them because I think neuroscience papers are probably a bit much for me even when I've taken my meds that day lol.
I'm going to avoid posting a summary to encourage my fellow attention deficiters to actually read the article (I know your instincts!), but I will post some food for thought: there are any...
I'm going to avoid posting a summary to encourage my fellow attention deficiters to actually read the article (I know your instincts!), but I will post some food for thought: there are any misconceptions about the brain that seem to have a lot of cultural inertia (and this isn't isolated to Neuroscience either). Why do these misconceptions stick around and why are they so hard to correct? Is it because they offer a simple, just-so explanation? Is it that they are the first thing we often hear about and they are repeated by enough people it becomes cemented in our minds? I'm inclined to think it's a mix of both.
Damn you, you caught me, I was looking at the comments for a summary ;) I ended up reading the article, as per your suggestion, and it's definitely interesting. I will note that when I attended my...
Damn you, you caught me, I was looking at the comments for a summary ;)
I ended up reading the article, as per your suggestion, and it's definitely interesting.
I will note that when I attended my neurology / psycho-pharmacology classes in the mid 2010s, there were already prevailing ideas of ADHD being related to the transmitter mechanisms, not the neurotransmitter themselves. So I wonder if these misconceptions are as ubiquitous as the article suggests, or if it's indeed just people repeating things they don't really understand, but they recognise the word 'dopamine'.
I had a similar experience to you regarding learning about these hypotheses in college, but I think a lot of people get information about this sort of stuff from friends or social media. For...
I had a similar experience to you regarding learning about these hypotheses in college, but I think a lot of people get information about this sort of stuff from friends or social media. For instance, the idea that people doom-scroll because they want dopamine, when a lot of the science points to other molecules associated with feelings of pleasure (not even getting into the idea that it's not the molecules themselves but the neuronal networks they act on).
I find that the best way to balance "I want people to read this" and "I want to encourage people to participate and have lots of people comment" is to pull out a few interesting sections as quotes...
I find that the best way to balance "I want people to read this" and "I want to encourage people to participate and have lots of people comment" is to pull out a few interesting sections as quotes without actually summarizing.
I mean, the alternative if there isn't a summary is probably just not engaging with the material at all. 😅 A summary and then some added thoughts from the commenter/poster about additional things...
I mean, the alternative if there isn't a summary is probably just not engaging with the material at all. 😅 A summary and then some added thoughts from the commenter/poster about additional things found within that are worth looking at, but not explicitly summarized, is what usually makes me want to go read the full thing. In this case it feels big enough to see a Nature article posted I'll check this one out.
Because I agree, a summary alone is often enough to sate my curiosity. But if there's no summary I personally am even less likely to click though for some reason. Brains are weird.
It's the activation difficulty, it's just a lot of "work" to click through. Tbf I really had a hard time reading this today, because it is not written for the neurodivergent person. But it was...
It's the activation difficulty, it's just a lot of "work" to click through. Tbf I really had a hard time reading this today, because it is not written for the neurodivergent person. But it was interesting to see how our understanding has evolved
Great question. I think blaming low dopamine sounds complex enough to be credible yet simple enough that the average person without a relevant scientific background can understand it (and also...
Great question. I think blaming low dopamine sounds complex enough to be credible yet simple enough that the average person without a relevant scientific background can understand it (and also spread the word). Similar to how serotonin is often spoken about as the 'happiness chemical'.
The thing is, even if you spend a few years at Uni studying neuroscience and pharmacology it's near impossible not to fall victim to the dunning Kruger effect until you're a decade or so into your career.
I think about this all the time. The media often oversimplifies and misrepresents things. Science is rarely stuck in stone when it comes to medicine and psychiatry. Even simple things like the recommended dose of paracetamol/acetaminophen varies by country. My prediction is that our understanding, characterisation and treatment of ADHD and ASD will change drastically in the next 10-20 years.
I think the concept of 'science doesn't have all the answers' is one of the most difficult to accept.
I wholeheartedly agree. We're talking about such complex topics that popular media has to simplify it in some way. Those little factoids, whether they are oversimplifications or misconceptions,...
I wholeheartedly agree. We're talking about such complex topics that popular media has to simplify it in some way. Those little factoids, whether they are oversimplifications or misconceptions, are easily digestible and thus stick with us.
Regarding your last sentence - that is something I try to emphasize to my students. The stuff I teach them in class are often approximations or best guesses about what is going on. It's important that we become OK with not knowing all of the answers.
IME it's because I know it's inaccurate but usually the person I'm speaking to does not, so I'll stick with the simple, just-so explanation. It's much easier to say there's a dopamine irregularity...
Is it because they offer a simple, just-so explanation?
IME it's because I know it's inaccurate but usually the person I'm speaking to does not, so I'll stick with the simple, just-so explanation. It's much easier to say there's a dopamine irregularity and leave it at that. People tend to understand that even if it's technically incorrect.
to encourage my fellow attention deficiters to actually read the article
I liked the actual science discussed in the article and the results showing our advancing understanding of dopamine's role in ADHD. It was educational and interesting. However, I really disliked the overall framing and tone that the author used to discuss this information.
I will first note that almost everything with even the thinnest scientific veneer that I've read about ADHD from those who focus on the condition has noted the connection to dopamine in a more nuanced way that seems to better reflect our current understanding of the science better than the simplistic "low dopamine" idea. How detailed they'll get varies, but most will at minimum give an acknowledgement that "low dopamine" is a simplification, and most attempt a somewhat simplified explanation of what we know about dopamine's role that's got more nuance than "low dopamine."
I also think this article works far too hard against the "misconception" that ADHD is related to low dopamine to an extent that it seems to misframe its own scientific evidence. It consistently describes the evidence of ADHD's strong relationship with dopamine, but then even upon discussing research that does show lower dopamine levels for individuals with ADHD individuals in some parts of the brain, it immediately attempts to reframe this as being somehow counter to the idea that ADHD is caused by "low dopamine", even though the clearest surface reading of that evidence is that ADHD is indeed caused by low dopamine. I can read between the lines that they're pointing out additional nuance added by these studies, in that there's more variation and less universality involved, but the author of this piece does not do a good enough job actually connecting these results to their argument that the "low dopamine" thing is a misconception.
Moreover, I'm very much not convinced that this misconception, which is really more of an oversimplification if anything, is actually harmful. The actual relationship between dopamine and ADHD is very complex and not yet fully understood. The simplified "not enough dopamine" explanation imo does a half-decent job explaining the broad strokes of why certain ADHD symptoms and treatments work the way they do without expecting them to get a neuroscience degree. It approximates the truth closely enough imo. The only thing that comes close to an attempt to justify the claim that this is a harmful misconception is the second-to-last paragraph, which does not provide any evidence:
I'm not convinced that the simplified view is *over-*simplified, especially since it allows for explanations of motivation-based symptoms that counteract the actual oversimplified understanding most people have of ADHD. The idea that ADHD is a dopamine deficit is absolutely not common in popular media. It's common in pop science targeted at people with ADHD and their families. Popular media still depicts ADHD as "oh, squirrel!" or as sucking in school or as the standard hyperactive white boy stereotype. If that. There's actually woefully little straight-up ADHD representation in popular media at all if you exclude obvious jokes and characters where the only direct textual evidence mentioning taking Adderall (or some other stimulant that's both a study drug and ADHD). While we've got plenty of ADHD-coded characters in media, it is exceptionally rare for a character to actually be established to have ADHD in a piece of media rather than just having it hinted at or mentioned by the creators outside the actual media. Popular media absolutely does not have enough representation of ADHD to even contain this misconception about dopamine, much less have it be common, and I can only assume the author is in a really weird bubble if they think that's the case. Either that or they're using "popular media" to refer to a completely different set of things than it's used for in any other context.
Moreover, I don't think "it can potentially lead to the message that more is good and even more is better" is a particularly good argument for the potential harm of this simplification. I think it's extremely infantalizing to assume people can't comprehend "too little or too much of this thing are both bad". Not to mention that the thing that is actually common in popular culture are things like "dopamine fasts" that exhibit a misunderstanding of what dopamine is to an extent that far exceeds the degree to which "ADHD is a dopamine deficit" is an oversimplification. Moreover, drugs that increase the dopamine levels in the brain are still the effective treatment for ADHD, and they're a treatment that the US government has already made noise about withholding from us, so I don't think that people whose misunderstanding of ADHD is an oversimplified in understanding of dopamine's role in our brain chemistry are remotely close to an important threat for people with ADHD in the current climate.
Thank you for spelling all this out.
The common misconceptions about ADHD are indeed more along the lines of "It doesn't exist", "It's those people with self-discipline issues" etc. Most laypeople probably don't even know what dopamine is. I would be extremely grateful to anyone who managed to educate the general public so well that they adopt the "It's about low dopamine" idea.
(Source: I live in a European country that is considered to have a great public education system and where people are generally quite informed.)
If anyone asks me, I usually tell them it's about dopamine dysregulation (which then either leads to further discussion and explanations, or not). I'm planning to read the article at some point to see how far off I am.
I'd say a lot of laypeople know about it, but think it is a "pleasure chemical" because of the discussions like "social media makes us dopamine-addicted", "we need a dopamine detox", etc. Which are all a pretty incorrect view of what dopamine is, yes, but still a lot of people are aware of it.
So I agree with your overall sentiment, but in general I think it's always good to try to better explain over-simplifications and correct misconceptions, even if they appear to be inconsequential. We should show that, actually, nature (and by extension, the brain) is very complex, and we can have these basic ideas of things that aren't complete, because demonstrating this complexity can hopefully change these cultural perspectives.
For instance, if someone hears "ADHD = low dopamine" then they may think the problem is easy to fix (especially if they're neurotypical); all you need to do is give someone more dopamine. Just like the over-simplification of "Exercise improves mood" can lead to "Depressed people need to exercise more". Is this article going to change everyone's minds about ADHD and cause large-scale cultural shifts in its perception? No. But hopefully by showing how our understanding has changed and showing how complex this condition is it can help some people appreciate the difficulties with it, on top of helping people who aren't as responsive to conventional treatments feel a bit better.
But the established treatment for ADHD is essentially giving us more dopamine, insofar as both stimulant and non-stimulant medications for ADHD raise dopamine levels in the brain through various mechanisms. And despite stimulant medication's demonstrated efficacy, there are significant cultural and political forces opposing this. In fact, the idea that stimulant medication for ADHD is "just meth" and that it's harmful/addictive when taken as prescribed is an actual common misconception among the general public that can materially harm people with ADHD, unlike the "ADHD is a dopamine deficiency" misconception, which I have only heard in ADHD-focused popsci spaces.
If anything, I think people skimming this article and coming to incorrectly believe that people with ADHD shouldn't take stimulant medication because "ADHD isn't caused by a dopamine deficiency" is an equal or even greater risk than whatever the article's author believes will happen if people believe a simplified explanation of ADHD's relationship with dopamine levels (and they don't, like, actually say what concrete things they consider there to be a risk of happening in that case in the article whatsoever). Both these things are pretty unlikely, of course, but I don't think the unspecified fears of the author in this article are any more likely -- especially in our current cultural climate.
I like learning more about the details of what we know about the relationship between dopamine and ADHD and how our understanding has evolved with new research, and I liked that part of the article, but I think the framing around it was really flawed in ways that undermine the article as a whole.
As Lia said, thank you for writing it down so well.
I actually disliked the article and felt like it didn't even begin to explain the science behind these new findings. I also agree that I never heard anyone mention ADHD as being "low dopamine" and and I also agree if it was what the general population thought, it would be a step in the right direction.
Every time I see ADHD mentionned, it's always the symptoms: forgetting things, being disorganized, doing one thing and another right after, being hyperactive, etc. This notion that it's been seen as "low dopamine" is just not true, imo.
I would have loved to see more science behind these apparent new findings but it pretty much only says "we need more research". It's interesting, but kinda meh. I was hopeful to get some more info from this article (from Nature!) but left disappointed.
At least the citations are there! The actual papers on some of the new research might scratch that itch for you. I didn't click through them because I think neuroscience papers are probably a bit much for me even when I've taken my meds that day lol.
I'm going to avoid posting a summary to encourage my fellow attention deficiters to actually read the article (I know your instincts!), but I will post some food for thought: there are any misconceptions about the brain that seem to have a lot of cultural inertia (and this isn't isolated to Neuroscience either). Why do these misconceptions stick around and why are they so hard to correct? Is it because they offer a simple, just-so explanation? Is it that they are the first thing we often hear about and they are repeated by enough people it becomes cemented in our minds? I'm inclined to think it's a mix of both.
Damn you, you caught me, I was looking at the comments for a summary ;)
I ended up reading the article, as per your suggestion, and it's definitely interesting.
I will note that when I attended my neurology / psycho-pharmacology classes in the mid 2010s, there were already prevailing ideas of ADHD being related to the transmitter mechanisms, not the neurotransmitter themselves. So I wonder if these misconceptions are as ubiquitous as the article suggests, or if it's indeed just people repeating things they don't really understand, but they recognise the word 'dopamine'.
I had a similar experience to you regarding learning about these hypotheses in college, but I think a lot of people get information about this sort of stuff from friends or social media. For instance, the idea that people doom-scroll because they want dopamine, when a lot of the science points to other molecules associated with feelings of pleasure (not even getting into the idea that it's not the molecules themselves but the neuronal networks they act on).
They seemed to be referring to dopamine misconceptions as a layman misunderstanding rather than academic, or so it seemed to read to me.
I find that the best way to balance "I want people to read this" and "I want to encourage people to participate and have lots of people comment" is to pull out a few interesting sections as quotes without actually summarizing.
I usually do that, but I was poking fun at people with ADHD (myself included) as we tend to just read summaries and not engage with the full material.
I mean, the alternative if there isn't a summary is probably just not engaging with the material at all. 😅 A summary and then some added thoughts from the commenter/poster about additional things found within that are worth looking at, but not explicitly summarized, is what usually makes me want to go read the full thing. In this case it feels big enough to see a Nature article posted I'll check this one out.
Because I agree, a summary alone is often enough to sate my curiosity. But if there's no summary I personally am even less likely to click though for some reason. Brains are weird.
It's the activation difficulty, it's just a lot of "work" to click through. Tbf I really had a hard time reading this today, because it is not written for the neurodivergent person. But it was interesting to see how our understanding has evolved
Great question. I think blaming low dopamine sounds complex enough to be credible yet simple enough that the average person without a relevant scientific background can understand it (and also spread the word). Similar to how serotonin is often spoken about as the 'happiness chemical'.
The thing is, even if you spend a few years at Uni studying neuroscience and pharmacology it's near impossible not to fall victim to the dunning Kruger effect until you're a decade or so into your career.
I think about this all the time. The media often oversimplifies and misrepresents things. Science is rarely stuck in stone when it comes to medicine and psychiatry. Even simple things like the recommended dose of paracetamol/acetaminophen varies by country. My prediction is that our understanding, characterisation and treatment of ADHD and ASD will change drastically in the next 10-20 years.
I think the concept of 'science doesn't have all the answers' is one of the most difficult to accept.
I wholeheartedly agree. We're talking about such complex topics that popular media has to simplify it in some way. Those little factoids, whether they are oversimplifications or misconceptions, are easily digestible and thus stick with us.
Regarding your last sentence - that is something I try to emphasize to my students. The stuff I teach them in class are often approximations or best guesses about what is going on. It's important that we become OK with not knowing all of the answers.
IME it's because I know it's inaccurate but usually the person I'm speaking to does not, so I'll stick with the simple, just-so explanation. It's much easier to say there's a dopamine irregularity and leave it at that. People tend to understand that even if it's technically incorrect.
Yes boss..
That makes sense. When I was trying to explain what my doctoral research was about I had to take a lot of shortcuts to make easily digestible.