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ADHD is thought to develop from a stressful early childhood. The brains of abused or neglected children show reductions of the size of several brain structures, including the prefrontal cortex. A stressful childhood can result in an overactive stress response in later life, and the overactive stress response of those who had a stressful childhood leads to an overvaluation of short-term relief. All of this can interfere with one’s ability to maintain motivation and focus toward delayed rewards. It may also contribute to impulsivity, as those with such impairments struggle to see the long-term harm of their actions.

I hypothesize that hyperactivity is the aftermath of impulsivity. It’s not low levels of dopamine, but low levels of dopamine receptors. The impulsive indulgence in short-term gratification causes down-regulation of dopamine receptors overtime, and lower dopamine receptor quantities cause cravings to bring dopamine back to balance. Those with ADHD may need constant stimulation through behaviors such as fidgeting to maintain adequate dopamine levels.

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