Unpacking ADHD: Part 8 - Empowering Understanding and Support

Empowering Understanding and Support

ADHD is a complex brain-based condition with many contributing factors, from our genes to our environment (Cortese & Castellanos, 2019; Kolar & Cortese, 2019). It's linked to identifiable differences in brain structure and function, particularly evident during childhood, affecting key areas involved in executive functions, attention, and reward processing (National Center for Biotechnology Information, 2020; Cortese et al., 2021). The way the brain develops in ADHD suggests it might be more of a developmental delay than a fixed problem, with many structural differences even out as individuals grow up (Cortese et al., 2021).

A major recent scientific discovery is that stimulant medications can actively help normalize specific brain differences in children with ADHD, such as those in the right insula and left nucleus accumbens (Wu et al., 2024). This points to a positive impact on brain development and the potential for building "better pathways." This indicates that stimulants might act as "neurodevelopmental modulators," actively guiding the brain toward more typical development (Dutta et al., 2022).

However, despite these exciting advancements, current brain imaging research isn't yet precise enough to diagnose ADHD in individuals or guide specific treatment decisions (Cortese et al., 2021; Neuroimaging and ADHD, 2013). This is due to research challenges, subtle differences, and the wide variation among individuals (Cortese et al., 2021). While incredibly valuable for understanding ADHD at a group level, it is crucial to manage expectations about its direct use in a PMHNP's office (Cortese et al., 2021; Neuroimaging and ADHD, 2013).

Society's "familiarity" with ADHD is a mixed bag. While its commonness means many people have heard of it, this often comes with significant misunderstandings, negative stereotypes, and stigma (Visser et al., 2024). This superficial understanding creates major obstacles to accurate diagnosis, effective treatment, and overall well-being for people living with ADHD (Visser et al., 2024).

Looking ahead, continued rigorous research, especially studies that follow people over many years, is essential to fully understand the complex lifelong effects of ADHD and its treatments, including the intriguing question of potential brain protection later in life (Dutta et al., 2022). At the same time, ongoing efforts in public education are absolutely vital to fight widespread misconceptions and create a more informed and supportive world for everyone affected by ADHD (Visser et al., 2024).

HC Telepsych NP

References

American Psychiatric Association. (2025, February 10). ADHD in adults: New research highlights trends and challenges. https://www.psychiatry.org/news-room/apa-blogs/adhd-in-adults-new-research-highlights

Cortese, S., & Castellanos, F. X. (2019). The neurobiology of ADHD: Still an enigma? Frontiers in Human Neuroscience, 13. https://doi.org/10.3389/fnhum.2019.00042

Cortese, S., Solmi, M., & Fusar-Poli, P. (2021). Neuroimaging of attention-deficit/hyperactivity disorder: A narrative review of recent findings. Current Opinion in Psychiatry, 34(2), 108–114. https://doi.org/10.1097/YCO.0000000000000674

Dutta, C. N., Christov-Moore, L., Ombao, H., & Douglas, P. K. (2022). Neuroprotection in late life attention-deficit/hyperactivity disorder: A review of pharmacotherapy and phenotype across the lifespan. Frontiers in Human Neuroscience, 16. https://doi.org/10.3389/fnhum.2022.938501

Kolar, A., & Cortese, S. (2019). The neurobiology and genetics of Attention-Deficit/Hyperactivity Disorder (ADHD): What every clinician should know. Current Psychiatry Reports, 21(10), 96. https://doi.org/10.1007/s11920-019-1088-7

National Center for Biotechnology Information. (2020). Attention-Deficit Hyperactivity Disorder. In StatPearls. StatPearls Publishing.

Neuroimaging and ADHD: fMRI, PET, DTI findings, and methodological limitations. (2013). J

Journal of Attention Disorders, 17(6), 455–469. https://pubmed.ncbi.nlm.nih.gov/23682662/

Visser, J., van der Meer, S., van der Heijden, P. T., & de Jong, J. T. (2024). Unmet needs and priorities for stigma reduction in ADHD: A qualitative study with young adults, parents, teachers, and mental health care professionals. BMC Psychiatry, 24(1), 847. https://doi.org/10.1186/s12888-024-05459-y

Wang, S. Y. A., Manza, P., Tomasi, D., Volkow, N. D., Wang, G. J., & Zhang, Y. (2023). Shared and distinct neurobehavioral phenotypes of child obesity and ADHD. Translational Psychiatry, 13(1), 74. https://doi.org/10.1038/s41398-023-02359-x

Wu, F., Zhang, W., Ji, W., Zhang, Y., Jiang, F., Li, G., Hu, Y., Wei, X., Wang, H., Wang, S. Y. A., Manza, P., Tomasi, D., Volkow, N. D., Gao, X., Wang, G. J., & Zhang, Y. (2024). Stimulant medications in children with ADHD normalize the structure of brain regions associated with attention and reward. Neuropsychopharmacology.