12 Days of ADHD 1: Action Potential
Sunday 17th October, 2021

October is ADHD Awareness Month. I've decided that I'm going to use that as a writing prompt, and to set myself a challenge. For the next twelve days, I'm going to write something about my experiences learning about ADHD as a very recently diagnosed adult.

I've been off my stimulant medication for three days, something which I will occasionally do to give myself a break, try and not build up a tolerance, and save a bit of money. Day three has been particularly trying, when it comes to checking things I wanted to do off of my to-do list. Rather than getting any of it done, I spent the day in a frustrated fog. It however did at least give me my first thing to write about - having spent most of the day glancing wistfully at my running shoes and thinking "If only I had the Action Potential for this shit."

Action Potential is the change in electric potential between two sides of a cell. It's something that plays a central role in neuron-to-neuron communication in your brain. Dopamine happens to be one of the neurotransmitters which is usually shunted around your brain via exocytosis, the cause of which is... action potentials! Dopamine has a myriad of uses in the brain, and it's a deficit of dopamine which is associated with ADHD.

Spoon Theory is a metaphor oft used to describe the varying energy reserves an individual person may have on a day-to-day basis - anyone can start off their day with finite energy to do particular mental or physical tasks.

I totally get the idea of spoon theory, but I'd not ever use it when referring to myself. Never, "I don't have spoons for this". As it was a term coined by a chronic illness sufferer - for people who are having to manage their pain all day long - it feels a little appropriative for me to use... Err... Spoonerisms... when I can't figure out why it's so difficult to do laundry.

But damn, some days I do not have the dopamine to be doing things.

There's a paradox with ADHD - I'm sure we've all had times when we've been glued to the sofa, finding it difficult to go start something which we actually want to do. What happens to some of us, though - is that the threshold for action is a lot greater. We can literally be lying there looking very docile on the surface whilst [screaming internally] at ourselves to go do the Thing. And of course, the natural solution is to just go and do it! You'll Feel Better If You Just Try™! But despite the conscious desire and the external pressure, the Thing remains undone.

People with Parkinson's also have reduced levels of dopamine. This can create a marked difficulty with performing actions which involve the brain shunting about a lot of dopamine - repetitive movements, tasks with complex orders of actions, walking through doors (giving rise to the "Doorway Effect"). There are some very clear signs that there's not enough dopamine to go around - people report themselves literally feeling frozen mid-action in what feel to be very specific situations.

It strikes me that Action Potential is a pretty good double entendre to describe the dopaminergic mental reserves we have at any given moment. Having a tough day? Paradoxically tired but restless? Can't concentrate? Can't remember things? Can't put things in order? Finding it difficult to keep track of time? Sleep cycle out of whack with daylight? Sensitive to lights and sounds? Getting your words jumbled as they come out of your mouth? Clumsy? Finding it difficult to read because every strong edge you look at leaves an after-image? Visual snow? Several lines of the Malcolm In The Middle theme tune been on loop in your head since you woke up? Would be able to out-sprint an apex predator should the need arise, but in between taking the laundry out of the machine and hanging it out, you need a good several hour sit down? Is staring at walls becoming a fascinating hobby? Does it feel like your brain has had a chemical bath and been rinsed of The Good Stuff and you need to go back to bed and restart everything tomorrow? Having trouble finishing lists of

Maybe you're lacking Action Potential today! As in, you lack the Potential for Action - because you don't have enough of the main neurotransmitter responsible for signalling throughout large parts of the brain and nervous system. And therefore, you should be kinder to yourself. You don't have enough spoonfuls of action. Maybe you had a particularly busy and productive day yesterday, or a stressful exam, or you drove for a couple of hours, or you had to interact with large crowds of people for the day, or a bad night's sleep, or all of those things, or none of those things - maybe everything was going swell and your brain just decided to screw with you today.

That won't stop you from chastising yourself for being a Lazy Garbage Fire, but at least you'll have compassion for others, and you'll have a short and snappy new term to use with your friends when you find yourself Unable.

It's not tiredness - although a lack of sleep does have a big effect on how we function. But you can be perfectly well rested and still have the same difficulties. Which is what makes it so tricky to explain to people sometimes - it's not "lacking discipline" or "needing motivation". It's something more fundamental, more physical, more chemical than that. It's difficulties regulating executive function and working memory, and treating it the same you would any physical ailment.