ADHD is everywhere right now. From Kendrick Lamar records to the White House — ADHD diagnoses are giving adults everywhere the answers to questions that have long plagued them. Rates are up, support is more widely available and fewer children are left asking feeling like there’s something wrong with them.
And amid this “age of ADHD,” new research is validating a theory that Motley Bloom has been deeply invested in: What if the real story isn’t that ADHD is an epidemic, or even just overdiagnosed, but that we’ve been treating very different brains as if they were all the same?
A new study published in JAMA psychiatry analyzed brain scans from more than 1800 young ADHDers to examine structural brain differences associated with ADHD. And instead of focusing on behavioral patterns or averaging everybody together, they looked for patterns that made them different… and the same. The study found that ADHD does not appear to involve a single brain pattern. Rather, evidence suggested three distinct neurological “biotypes.”
The study found that ADHD does not appear to involve a single brain pattern. Rather, evidence suggested three distinct neurological “biotypes.”
And this probably isn’t going to surprise a lot of us ADHDers, but it will likely validate what they’ve long tried to explain anecdotally.
Most of us have gotten to know our brains through our behavior — what feels natural and what feels wrong.
In this study, each biotype showed different brain regions being altered, and each being associated with those different ways ADHD may show up in daily life — fidgeting versus impulsivity versus emotional dysregulation.
Put simply, the study found:
- The group of ADHDers that found focus, planning and staying organized to be the most difficult, showed neurological differences in executive control networks.
- Those with patterns of impulsivity, often bored and seeking novelty, actually showed differences in reward and motivation circuits.
- And the third group, who often fidget, self-soothe with movement and have difficulty sensory regulating showed changes in sensorimotor networks.
The different brain patterns may explain precisely why ADHD can look so different from person-to-person.
For years, those of us with ADHD have been misdiagnosed with bipolar, anxiety disorders, depression or mood disorders. Some of us have wondered why the ADHD medication that seemed to be life-changing for others, doesn’t work for us. One productivity system doesn’t work for everyone, which can feel frustrating for someone seeking support.
But as it turns out, one stereotype doesn’t capture the full experience, and one experience doesn’t capture the full image.
This research suggests these differences aren’t just personality quirks. As DelBello, MD, Dr. Stanley and Mickey Kaplan told National Geographic, “Some of what this study has shown is what we clinically do anyway… trying to match the symptoms to the actual most effective treatments that we know.”
But as it turns out, one stereotype doesn’t capture the full experience, and one experience doesn’t capture the full image.
“But it’s really nice to have the data to show that our clinical impressions based on years of treating these patients have some biological validity to it,” she said.
This study doesn’t mean ADHD is three separate conditions, or that it’s time to consider fixing these three different kinds of brains. Instead, it reinforces something the neurodivergent community has long understood: ADHD is a spectrum of cognitive styles, with unique differences in what make the neurological gears turn. And recognizing that could change how we support ADHD minds in school, work and everyday life.
