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 attentiondeficit hyperactivity disorder,you're wired to have troublegetting things startedor following through.ADHD is a brain disorder whereyou struggle with attention,concentration, impulsivity,distractibility,or hyperactivity.And you may not have all ofthese things going on at once,but you usually have some of them.With the inattentive type, youdon't have the hyperactivityand the main problem is around the focusand concentration issues.But a symptom that's nottalked about that muchis impaired motivation,and this is a huge problem with ADHD.It's a symptom that causesconflicts with othersand can affect how youthink about yourself.You can think, "Why can't I just do this?"You can have somethingthat you need to get doneand it just feels physically painfulto break through the inertia to do it.And it may not even be allthat 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 yourlife who are affectedby your failure to followthrough with somethingcan conclude that you'rejust lazy and unreliable.But it's not lazy, it's a brain problem.Researchers have seen throughpositron emission tomography,which is a brain scan,that people with ADHD have a disruptionin the dopamine rewardpathway in the brain.What is the dopamine reward pathway?Well, here's a quickexplanation of dopamine.There's four dopaminepathways in the brain.Think of the pathways as messaging systemsthat use nerves to transport dopaminefrom one part of the brain to the next.Within each of these pathways,dopamine sends specific messagesto the end-point destinationthat tells it what to do.Two of the pathways affect motivation.The first one is the mesolimbic pathwaywhere you get dopaminetraveling from your midbrainto structures in your limbic system.Your limbic area processesemotional memory.Therefore, when you experiencesomething that's pleasurablethis part of the brainis activated by dopamineand you learn that thisactivity brings pleasure.That pleasure can be basicneeds, like food and sex,or more complex gratification,like praise and validation.And this is what we mean by reward.You do something, likeeat a piece of chocolate,and you learn that thechocolate feels goodand you desire to eat more chocolate.Likewise, if you prepare fora task and you're successful,you learn that hard workproduces success at some level.The second important pathwaythat affects the ADHD brainis the mesocortical pathway.With this pathway,dopamine is produced bynerve cells in the midbrainand it travels to your prefrontal cortex.This area of your brain isresponsible for motivationand executive functions.Executive functions arethings like working memory,thinking, and decision making.Stimulants, like Adderall,Ritalin and Vyvanse,work to increase dopamine in this pathway.So with ADHD, thisreward system is impairedbecause you have lessdopamine transport proteinsto carry the dopamine along the trackto get to its intended destination.It's like having a massivesupply chain shortagewhen it comes totransporting your dopamine,so you don't get theproper dopamine signalsto reinforce positiveand productive behaviors.Without this reinforcement,your efforts don't feel satisfyingand you lose motivation.So we've established thatlow motivation in ADHDcomes from a dopaminetransporter low supply problem,how can you make it better?Stimulant medicationswork predominantly inthe mesocortical pathwayand the effect lasts only aslong as the medication lasts.So even if you take medication,and not everyone does,you may still struggle with motivation.Motivation in ADHD isdriven by four factors,interest, urgency, degreeof challenge, and novelty.Things are novel whenthey're fresh and new.So what you do to increase your motivationis to find ways toincrease these four factorsfor any given task.The need for urgency is whyyou work better under pressure.If the deadline's too far away,you don't feel motivated to start.But urgency gives youthe kick that you needto power through and getit done, or at least start,even if it feels stressful to youbecause you waited until the last minute.Now, you may be someone who says,"I do my best work thenight before it's due."And in general, last minute isstill not a great way to workbecause things don't always come togetherthe way you want them to,especially if the task requiresinput from other people.Also, if last minutework makes you anxious,then this strategy causes other problems.A workaround to thisis to find another way to create urgency,like using a timer while you're working.Let's say you have somethingthat'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 itinto a challenge for youwhich can also make it more interesting.Another thing the timercan do for your mindsetis to take this projectthat may seem like it'll take foreverand make it time limited.You've got one hour to do the workand after that hour you're done working,even if the task isn't complete.Then you plan to do somethingthat you really enjoy,like spend 30 minutes on TikTok.Another thing you can do to add interestis to work alongside someone.Some people refer tothis as body doubling.You could do homework withsomeone over video chat.You're both working ondifferent assignments,but the other person'spresence can be reassuring,like we're all in this together.Or they can be a model for you,showing you how to workcalmly and stay focused.You need to choose the personthat you work alongside carefully.It needs to be someonethat you can work withwithout distracting you.It also should be someonewho can watch you workwithout shaming you when youstruggle to stay focused.If you don't have someonethat you can do this with,there's plenty of bodydoubling videos on YouTubefor studying, cleaning, and other chores.If you want to add noveltyto 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 shopwill 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 agreat setting for you,but it's not a given that anybusy setting will distract youbecause remember, with ADHD,you can hyper focus on thingsthat you're interested in.So if sitting in a cozy coffee shopwith the smell of pastriesand people chattingmakes you feel warm and fuzzy,that mood and attitude change may help youstay engaged with your taskdespite the distractingelements in your environment.One last suggestion on howto improve your motivationis to try the Pomodoro Technique.This is a time management systemthat's been around for 30 yearsand works by alternatingperiods of timed workwith short breaks.It's usually difficult for the ADHD brainto sustain focus onsomething for a long timewithout getting distracted or bored.With the Pomodoro Pattern, youwork for 25 minutes at a timeand then you take a five minute break.This is one 30 minute cycle.After four cycles, you takea longer break of 30 minutes.I have a cheat sheet for youthat you can get as a freedownload from my website.The link is in the description.So here's what I've told you today.Low motivation with ADHD is partly causedby inadequate dopamine inyour brain's reward pathway.To overcome this, you can do thingsto make tasks fun and interesting,make them urgent or challenging,or make them feel fresh and new.I gave you examples of usinga timer to create urgency,doing the task in a new location,working alongside a body double,and breaking up thetask into timed segmentsusing the Pomodoro Techniqueor some version of it.Take a look at my ADHDSkills Training Playlistfor more tips on how manage your ADHD.Thanks for watching. See you next time.
