Hi, I'm Dr Tracey Marks, a psychiatrist, and I make mental health education videos. Anyone can be unmotivated to do something, but when you have attention deficit hyperactivity disorder, you're wired to have trouble getting things started or following through. ADHD is a brain disorder where you struggle with attention, concentration, impulsivity, distractibility, or hyperactivity.
And you may not have all of these things going on at once, but you usually have some of them. With the inattentive type, you don't have the hyperactivity and the main problem is around the focus and concentration issues. But a symptom that's not talked about that much is impaired motivation, and this is a huge problem with ADHD.
It's a symptom that causes conflicts with others and can affect how you think about yourself. You can think, "Why can't I just do this? " You can have something that you need to get done and it just feels physically painful to break through the inertia to do it.
And it may not even be all that much that you need to do, but if your head isn't in it, those five steps can seem like a thousand, and the people in your life who are affected by your failure to follow through with something can conclude that you're just lazy and unreliable. But it's not lazy, it's a brain problem. Researchers have seen through positron emission tomography, which is a brain scan, that people with ADHD have a disruption in the dopamine reward pathway in the brain.
What is the dopamine reward pathway? Well, here's a quick explanation of dopamine. There's four dopamine pathways in the brain.
Think of the pathways as messaging systems that use nerves to transport dopamine from one part of the brain to the next. Within each of these pathways, dopamine sends specific messages to the end-point destination that tells it what to do. Two of the pathways affect motivation.
The first one is the mesolimbic pathway where you get dopamine traveling from your midbrain to structures in your limbic system. Your limbic area processes emotional memory. Therefore, when you experience something that's pleasurable this part of the brain is activated by dopamine and you learn that this activity brings pleasure.
That pleasure can be basic needs, like food and sex, or more complex gratification, like praise and validation. And this is what we mean by reward. You do something, like eat a piece of chocolate, and you learn that the chocolate feels good and you desire to eat more chocolate.
Likewise, if you prepare for a task and you're successful, you learn that hard work produces success at some level. The second important pathway that affects the ADHD brain is the mesocortical pathway. With this pathway, dopamine is produced by nerve cells in the midbrain and it travels to your prefrontal cortex.
This area of your brain is responsible for motivation and executive functions. Executive functions are things like working memory, thinking, and decision making. Stimulants, like Adderall, Ritalin and Vyvanse, work to increase dopamine in this pathway.
So with ADHD, this reward system is impaired because you have less dopamine transport proteins to carry the dopamine along the track to get to its intended destination. It's like having a massive supply chain shortage when it comes to transporting your dopamine, so you don't get the proper dopamine signals to reinforce positive and productive behaviors. Without this reinforcement, your efforts don't feel satisfying and you lose motivation.
So we've established that low motivation in ADHD comes from a dopamine transporter low supply problem, how can you make it better? Stimulant medications work predominantly in the mesocortical pathway and the effect lasts only as long as the medication lasts. So even if you take medication, and not everyone does, you may still struggle with motivation.
Motivation in ADHD is driven by four factors, interest, urgency, degree of challenge, and novelty. Things are novel when they're fresh and new. So what you do to increase your motivation is to find ways to increase these four factors for any given task.
The need for urgency is why you work better under pressure. If the deadline's too far away, you don't feel motivated to start. But urgency gives you the kick that you need to power through and get it done, or at least start, even if it feels stressful to you because you waited until the last minute.
Now, you may be someone who says, "I do my best work the night before it's due. " And in general, last minute is still not a great way to work because things don't always come together the way you want them to, especially if the task requires input from other people. Also, if last minute work makes you anxious, then this strategy causes other problems.
A workaround to this is to find another way to create urgency, like using a timer while you're working. Let's say you have something that's due in three days. Rather than start it the night before, do part of the work using a timer.
See if you can beat the timer. Using the timer turns it into a challenge for you which can also make it more interesting. Another thing the timer can do for your mindset is to take this project that may seem like it'll take forever and make it time limited.
You've got one hour to do the work and after that hour you're done working, even if the task isn't complete. Then you plan to do something that you really enjoy, like spend 30 minutes on TikTok. Another thing you can do to add interest is to work alongside someone.
Some people refer to this as body doubling. You could do homework with someone over video chat. You're both working on different assignments, but the other person's presence can be reassuring, like we're all in this together.
Or they can be a model for you, showing you how to work calmly and stay focused. You need to choose the person that you work alongside carefully. It needs to be someone that you can work with without distracting you.
It also should be someone who can watch you work without shaming you when you struggle to stay focused. If you don't have someone that you can do this with, there's plenty of body doubling videos on YouTube for studying, cleaning, and other chores. If you want to add novelty to something that was boring, try doing it in a different setting.
Let's say you need to write a paper, maybe sitting in a coffee shop will make the process more interesting. You may say, "How can a person with ADHD "stay focused in a busy coffee shop? " Well, this may not be a great setting for you, but it's not a given that any busy setting will distract you because remember, with ADHD, you can hyper focus on things that you're interested in.
So if sitting in a cozy coffee shop with the smell of pastries and people chatting makes you feel warm and fuzzy, that mood and attitude change may help you stay engaged with your task despite the distracting elements in your environment. One last suggestion on how to improve your motivation is to try the Pomodoro Technique. This is a time management system that's been around for 30 years and works by alternating periods of timed work with short breaks.
It's usually difficult for the ADHD brain to sustain focus on something for a long time without getting distracted or bored. With the Pomodoro Pattern, you work for 25 minutes at a time and then you take a five minute break. This is one 30 minute cycle.
After four cycles, you take a longer break of 30 minutes. I have a cheat sheet for you that you can get as a free download from my website. The link is in the description.
So here's what I've told you today. Low motivation with ADHD is partly caused by inadequate dopamine in your brain's reward pathway. To overcome this, you can do things to make tasks fun and interesting, make them urgent or challenging, or make them feel fresh and new.
I gave you examples of using a timer to create urgency, doing the task in a new location, working alongside a body double, and breaking up the task into timed segments using the Pomodoro Technique or some version of it. Take a look at my ADHD Skills Training Playlist for more tips on how manage your ADHD. Thanks for watching.
See you next time.
