The Brain, Love, and ADHD: What’s really going on inside our heads?

The brain on love has been studied, and the impact of ADHD on the brain has been studied. But why has the overlap of the two rarely been studied together? That is a question we may never know, but what we can look at, are some of the correlational overlaps between what the brain looks like in love and how the brain is impacted by ADHD, and how those overlaps impact a couple when one or both partners has ADHD.

Love and the Brain

Let’s start by defining romantic love. Love is defined by psychologists as a motivational state that leads to the desire to start and/or maintain a connected relationship with another person.1 Romantic love can be broken down into three stages.

Stage 1: Lust

The desire phase. Partners are generally focused primarily on sex, driven by our evolutionary need to reproduce. Hormones involved during this stage are primarily testosterone and estrogen. These hormones impact both partners, leading to increased sexual desire and desire for physical closeness.

Stage 2: Attraction

The euphoric and exhilarating phase. This phase is often in the early stages of a romantic relationship. The attraction phase involves the brain pathway for reward behaviors (these are the same pathways that are a large focus of ADHD research and the brain, more on that later). Hormones involved in this phase are dopamine, norepinephrine, and serotonin. Dopamine increases, activating the reward pathway. This plays a role in motivation, addiction, attention, and desire. Often this leads to giddiness, energy, and euphoria by producing feelings of happiness/bliss. Norepinephrine also increases. Leads to increased attraction and arousal. This hormone increases during fight or flight and can lead to an increased heart rate, increased energy, and focus on a partner and it can lead to feelings of anxiety (which are often interpreted in love as butterflies in your stomach). Serotonin, on the other hand, decreases. This leads to an almost OCD-like, obsessive, singular focus on your partner. 

Stage 3: Attachment

Long-term intimacy. Hormones involved in this phase are oxytocin and vasopressin. Oxytocin which is often referred to as the love/bonding hormone creates and promotes pro-social behaviors. Vasopressin, another connection hormone, is also released after physical touch, like oxytocin. The attachment phase brings feelings of calmness, security, comfort, and a desire to protect one another. The attachment phase doesn’t exist only in romantic relationships, it can also be present with other types of bonds such as family and friends.

ADHD and the Brain

The brains of individuals with ADHD are different than individuals without ADHD as evidenced by a large recent study2 that found that overall brain volume and the brain volume in five specific regions was smaller in individuals with ADHD. These five regions are the caudate nucleus, putamen, nucleus accumbens, amygdala and hippocampus.  

Amygdala

The amygdala plays a role in processing emotions. In this study, is is hypothesized that the amygdala is associated with ADHD through its role in regulating emotion. This can help us understand why individuals with ADHD often have a hard time processing and managing their emotions. 

Hippocampus

The hippocampus' role (primarily thought about with memory) it is hypothesized that in individuals with ADHD the smaller volume may impact the interplay of motivation and emotions.

Caudate Nucleus and Putamen

The caudate nucleus and the putamen are part of a group of structures that help coordinate smooth motor activity. These structures work together in the basal ganglia (another part of the brain) to act as the gateway for motor activity. Disorders of these regions can result in hyperactivity of the motor system, which is a common symptom of ADHD.

Nucleus Accumbens

The nucleus accumbens is associated with the reward center, this center helps regulate desire and satiety. For people affected by ADHD, common symptoms include a lack of motivation and impulse control. While this may be related to changes in the volume of the nucleus accumbens, studies have shown a correlation between a deficit in the dopamine reward pathway which negatively impacts the nucleus accumbens. Additionally, the nucleus accumbens may be associated with the motivation and emotional problems in ADHD via its role in reward processing.

Another part of the brain, although not part of the previous study, that is important to talk about with ADHD is the prefrontal cortex. The prefrontal cortex is the most studied area of the brain for individuals with ADHD.

Prefrontal Cortex

Other studies indicate that the prefrontal cortex has a reduced volume. The prefrontal cortex is believed to be the seat of executive functioning, which includes regulation of attention, planning, impulse control, mental flexibility, and the initiation and monitoring of action.

The dopamine hypothesis of ADHD, which indicates that low levels of dopamine are what causes ADHD, is based in part on the idea that the prefrontal cortex is a brain region that is rich in dopamine receptors, and so with a decreased volume as well as a decreased volume in the reward pathway, there is less dopamine available for individuals with ADHD. This hypothesis has recently come under scrutiny, and whether low levels of dopamine lead to ADHD is yet to be figured out.

Overlaps of Love, ADHD, and the Brain

Now let’s look at the overlaps in biology for brains on love and ADHD. The most fascinating overlaps occur during the attraction phase (the new love phase). During this phase, the dopamine and serotonin levels are higher, and this may offset the symptoms of ADHD. So, the blissful start to a relationship when an individual has ADHD (which often is hyper-focus on the relationship, not just normal focus), may not be the same as the long-term relationship once the couple goes into the attachment phase. And once the attachment phase occurs, boundaries may need to be re-drawn and new strategies and connections may need to be discussed, processed, and even grieved as the couple works toward a long-term healthy relationship.

What do we do with the new understanding of ADHD and love? If you want to learn more about how to change your relationship, understand yourself or understand your partner, book an appointment online or over the phone with Dr. Rebecca Branda, Psy.D. today.

1.     Song, H., Zou, Z., Kou, J., Liu, Y., Yank, L., Zilverstand, A., d’Oleire Uquilas F., & Zhang, X. (2015). Love-related changes in the brain: a resting-state functional magnetic resonance imaging study. Frontiers in Human Neuroscience, 9. https://doi.org/10.3389/fnhum.2015.00071

2.     Hoogman, Bralten, J., Hibar, D.P., Mennes, M., Zwiers, M.P., Schweren, L.S.J., van Hulzen, K.J.E., Medland, S.E., Shumskaya, E., Jahanshad, N., Zeeuw, P. de, Szekely, E., Sudre, G., Wolfers, T., Onnink, A.M.H., Dammers, J.T., Mostert, J.C., Vives-Gilabert, Y., Kohls, G., … Ambrosino, S. (2017). Subcortical brain volume differences in participants with attention deficit hyperactivity disorder in children and adults: a cross-sectional mega-analysis. The Lancet. Psychiatry, 4(4), 310–319. https://doi.org/10.1016/S2215-0366(17)30049-4