From Chapter 2: The Physical Dimension
In the discussion of the neurobiology of ADHD (chapter 1), we learned that the irregular distribution of certain neurotransmitters seems to be responsible for ADHD. For this reason, the brain functions at a lower level, resulting in a narrower ability to pay attention and stay focused. The ADHD brain constantly searches for something that will stimulate it, because if the brain feels as if it is stimulated, then brain functionality, the ability to pay attention and stay focused, is raised to a normal level.
Seemingly ongoing and relentless, the issues of distractibility, restlessness, inattention, and impulsivity can create a significant amount of discomfort. A person who has ADHD wants to find a way to get rid of the discomfort and, understandably, takes hold of anything that seems to get the job done. Many people with ADHD consult their doctors and are prescribed medication for this purpose, but unfortunately, many others opt to self-medicate to help get rid of the troublesome symptoms of ADHD. Self-medication can run the gamut, with many methods used, some legal and others illegal, but all have the propensity to become problematic.
In her book The Link between A.D.D. and Addiction, Wendy Richardson (1997) describes three reasons for self-medicating: to alter how we feel and how we function, out of the belief that we function better when we’re under the influence of substances, and to be intoxicated. While these reasons can be applied to everyone, people with ADHD are especially susceptible to the first two reasons. Through self-medication the ADHD brain feels quieter; better able to organize thoughts and feelings, and, subsequently, to pay attention; and more alert and focused. The phrase that I hear over and over again from my clients who have ADHD is, “I feel normal after I _________” (have an energy drink, drink a pot of coffee, smoke cigarettes, throw down a cocktail or two, puff some weed, or snort a line of cocaine); in other words, “I feel normal after I self-medicate.” The brain feels quieter for a time, and the person with ADHD is able to think more clearly, focus on one thing at a time, and complete a task. If someone who has ADHD believes that after ingesting a substance, she is able to function more efficiently, then there is less motivation to give up the substance she is using, whether it be coffee, cigarettes, alcohol, marijuana, cocaine, or anything else. The feeling of being able to perform at optimal levels is quite seductive, so it’s no wonder that people with ADHD have such a high rate of substance abuse (Smith, Molina, and Pelham 2002). As with many other people, those who have ADHD also self-medicate to cope with emotional problems, but it is possible that initially, at least, the use of substances is for the purpose of offsetting the problems caused by ADHD: distractibility, restlessness, inattention, and impulsivity.