ADHD is a quantitative disorder, not qualitative.

To some extent, everyone gets mild versions of ADHD symptoms, especially if tired/bad nutrition/no exercise, etc.

ADHD is when these symptoms harm quality of life significantly across many domains and since you were prepubescent (it's a brain malformation, not a series of bad habits)

To expand on that, I think it can be clarified somewhat by describing the mechanism at work.

People without ADHD have a generally-working motivation/reward system which is undergirded partially by dopamine. This neurotransmitter is relatively low in ADHD brains, which seems to lead to signal:noise issues. That’s likely a cause of having a highly distractible baseline state, but also leads to bursts of dopamine seeming more salient and arousing. You have a harder time regulating motivation and evaluating perceived rewards.

A lot of what happens in the brain is based on relative states. If your dopamine is always low, something making it spike will seem more interesting than it necessarily should. If your dopamine trends higher, you’re going to have an easier time regulating interest, motivation, and an ability to transition through things you need to do — particularly things you don’t want to do.

The inverse of a dopamine spike is a dopamine drop. This impacts the brain in important ways as well. In a person with ADHD, going from a high to a low can often cause serious declines in mood and energy. In a more typical brain, the same effects are present but less severe.

So while these are all normal challenges people face because they’re the product of the same brain mechanics, a low dopamine baseline makes these mechanics more extreme in people with ADHD. They are primed for distraction and clinging to things which increase their dopamine. This could be video games, relationships, drugs, hobbies, etc. It could even be work too. They’re also primed far harder falls from their highs. This extreme oscillation often means some aspect of life suffers due to a lack of balance. That’s why it can be a disability.

Hopefully that helps explain the quantitative aspect.

It's also why hyperfocus is common and more extreme in ADHD. You can't always control it but when you do get into something everything else becomes a blur and you can go for hours because that high burst of dopamine obliterates everything else.

Thank you for this very straightforward and concise explanation

I'm almost 40 and just realizing that I probably have some version of ADHD and your description of the Dopamine roller-coaster fits perfectly with my experience, both good and bad.

I highly recommend reading up on it if that particular aspect resonates with you. Driven to Distraction is a very useful and informative read with a decent amount of technical information as well as personal accounts to help relate how the condition manifests.

It’s very diverse. It isn’t always bad, but often is, and even people with god outcomes can often benefit from the insight of understanding why they’re different.

And to think psychiatrists are bestowed with the authority to mass-prescribe amphetamines upon accurately deducing the presence of ADHD from brief patient self-evaluations is eyebrow raising.

Looking forward to when a portable EEG monitors are available at an affordable price.

Like most discussions of ADHD it’s hard for people with it to explain because the only terms they have for it are the same terms everyone else has for things, so it sounds like the sort of problems everyone has. But when you have ADHD it’s also different because you can’t “just do X” where X is something that works for people without ADHD because something that you can’t describe is different.

An (imperfect) analogy I saw recently was it’s like talking about debt between someone in a middle class household (non-ADHD people) and someone in a poverty household. Sure a lot of the problems are similar in both word and shape, but the middle class person can’t imagine “had to take out a pay day loan to buy used tires from joes tire shack” and the poverty person can’t understand “we had to replace the AC this year so we cut back our spending, and had to skip the family reunion at the beach until the credit card was paid off”.

Relative to my peers I have often found myself to have lower tolerances in these areas. It sometimes surprised people when I felt something was complex (to work with, not conceptually) when they did not, or at the length of time it could sometimes take me to fix something that involved digging through a lot of code.