ADHD & How Anyone Can Improve Their Focus | Huberman Lab Essentials
Date: 2025-07-31 | Duration: 00:37:54
Transcript
0:00 Welcome to Huberman Lab Essentials, where we revisit past episodes for the most potent and actionable science-based tools for mental health, physical health, and performance. I’m Andrew Huberman, and I’m a professor of neurobiology and of ophthalmology at Stanford School of Medicine. Today we are going to talk all about attention deficit hyperactivity disorder or ADHD. Now, just a quick reminder that anytime we discuss a psychiatric disorder, it’s important that we remember that all of us have the temptation to self-diagnose or to diagnose others.
0:30 The clear and real diagnosis of ADHD really should be carried out by a psychiatrist, a physician, or a very well-trained clinical psychologist. Right now the current estimates are that about 1 in 10 children and probably more have ADHD. Fortunately, about half of those will resolve with proper treatment, but the other half typically don’t.
1:00 The other thing that we are seeing a lot nowadays is increased levels of ADHD in adults. For sake of today’s discussion, attention, focus, and concentration are essentially the same thing. People with ADHD have trouble holding their attention. What is attention? Well, attention is perception. It’s how we are perceiving the sensory world. For instance, right now you’re hearing sound waves.
1:30 You are seeing things. You are sensing things against your skin, but you are only paying attention to some of those. And the ones that you’re paying attention to are your perceptions. So if you hear my voice, you are perceiving my voice. You are not paying attention to your other senses at the moment. You might even be outside in a breeze and until I said that, you might not be perceiving that breeze, but your body was sensing it all along. So attention and focus are more or less the same thing,
2:00 but impulse control is something separate because impulse control requires pushing out or putting the blinders on to sensory events in our environment. It means lack of perception. Impulse control is about limiting our perception. People with ADHD have poor attention and they have high levels of impulsivity. Yes, they are distractible. Yes, they are impulsive. Yes, they are easily annoyed by things happening in the room. They sometimes have a high level of emotionality as well.
2:30 However, people with ADHD can have a hyperfocus, an incredible ability to focus on things that they really enjoy or are intrigued by. Now, this is a very important point because people with ADHD have the capacity to attend, but they can’t engage that attention for things that they don’t really want to do. There are a couple other things that people with ADHD display quite often.
3:00 One is challenges with time perception. People with ADHD often run late. They often procrastinate. But what’s interesting and surprising is that if they are given a deadline, they actually can perceive time very well. And they often can focus very well if the consequences of not completing a task or not attending are severe enough. If they’re not really concerned about a deadline or a consequence, well, then they tend to lose track of time and they tend to underestimate how long things will take.
3:30 The other thing that people with ADHD have real trouble with is so-called working memory. Now, you might think that people with ADHD would have really poor memories, but in fact, that’s not the case. People with ADHD often can have a terrific memory for past events. They can remember upcoming events quite well. Their memory is clearly working. However, one aspect of memory in particular that we call working memory is often disrupted.
4:00 Working memory is the ability to keep specific information online to recycle it in your brain over and over again so that you can use it in the immediate or short term. A good example of this would be you meet somebody, they tell you their name, they give you their phone number verbally, and you have to walk back to your phone and enter it into your phone. People without ADHD might have to put some effort into it. It might feel like a bit of a struggle, but typically they will be able to recite that phone number in their mind over and over and then put it into their phone.
4:30 People with ADHD tend to lose the ability or lack the ability to remember things that they just need to keep online for anywhere from 10 seconds to a minute or two. Okay, so we’ve more or less established the menu of items that people with ADHD tend to have. Some have all of them, some have just a subset of them. Their severity can range from very intense to mild. But in general, it’s challenges with attention and focus, challenges with impulse control, they get annoyed easily,
5:00 they have an impulsivity, they can’t stay on task, time perception can be off, and they have a hard time with anything that’s mundane that they’re not really interested in. But again, I just want to highlight that people with ADHD are able to obtain heightened levels of focus, even hyperfocus for things that are exciting to them and that they really want to engage in. So, let’s drill into this issue of why people with ADHD actually can focus very intensely on things that they enjoy and are curious about.
5:30 Now, enjoyment and curiosity, they’re just the way that we describe our human experience of liking things, wanting to know more about them. But from a neurobiological perspective, they have a very clear identity and signature. And that’s dopamine. Dopamine is released from neurons. It’s what we call a neuromodulator. And in particular, dopamine creates a heightened state of focus. It tends to contract our visual world. And it tends to make us pay attention to things that are outside and beyond the confines of our skin.
6:00 It’s what we call exteroception. So, as I mentioned earlier, you have all these senses coming in and you can only perceive some of them because you’re only paying attention to some of them. Dopamine when it’s released in our brain tends to turn on areas of our brain that narrow our visual focus and our auditory focus. So, it creates a cone of auditory attention that’s very narrow. Creates a tunnel of visual attention that’s very narrow. Whereas, when we have less dopamine, we tend to view the entire world.
6:30 We tend to see the whole scene that we are in. We tend to hear everything all at once. So, as I describe this, hopefully you’re already starting to see and understand how having dopamine release can allow a person, whether or not they have ADHD, to direct their attention to particular things in their environment. So now what we’re doing is we’re moving away from attention as this vague ambiguous term and we’re giving it a neurochemical identity, dopamine, and we are giving it a neural circuit identity.
7:00 And just to put a little bit of flavor and detail on which neural circuits those are, I wanted to discuss two general types of neural circuits that dopamine tends to enhance. The first one is called the default mode network. The default mode network is the network of brain areas in your brain, in my brain, and in everybody’s brain that is active when we’re not doing anything, when we’re just sitting there idle at rest.
7:30 The other set of circuits that we’re going to think about and talk about with respect to ADHD are the task networks, the networks of the brain that make you goal oriented. And those are a completely different set of brain areas. However, the default mode network and these task networks are communicating with one another and they’re doing that in very interesting ways. Frontal cortex, no surprise, is in the front. And you have a dorsolateral prefrontal cortex.
8:00 And then you have a brain area called the posterior cingulate cortex. And then you have an area called the lateral parietal lobe. Again, you don’t need to remember these names, but these are three brain areas that normally are synchronized in their activity. So when one of these areas is active in a typical person, the other areas would be active as well. And in a person with ADHD or even a person who has subclinical ADHD or in any human being who hasn’t slept well, what you find is the default mode network is not synchronized.
8:30 These brain areas are just not playing well together. Now the task networks include a different set of structures. It still involves the prefrontal cortex, but it’s a different part of the prefrontal cortex. Tends to be the medial prefrontal cortex. And there are some other brain areas that the medial prefrontal cortex is communicating to all the time mainly to suppress impulses. Anytime you’re restricting your behavior, these task-directed networks are very active.
9:00 Now, normally in a person without ADHD, the task networks and the default mode networks are going in seesaw fashion. They are actually what we call anti-correlated. In a person with ADHD, they actually tend to be more correlated. The default mode networks and the task networks are actually more coordinated. And we can now confidently say based on brain imaging studies that when somebody gets better when they’re treated for ADHD or when they age out of ADHD as sometimes is the case,
9:30 that the default mode networks and the task networks tend to become anti-correlated again. What dopamine is doing in this context is dopamine is acting like a conductor. Dopamine is saying this circuit should be active then that circuit should be active. It should be default mode network and then when the default mode network is not active then it should be the task network. And in ADHD there’s something about the dopamine system that is not allowing it to conduct these networks and make sure that they stay out of phase to be anti-correlated.
10:00 So, what exactly is going on with the dopamine system in people with ADHD? And what’s going on with the dopamine system in people that have terrific levels of attention for any task? Well, in the year 2015, an important paper came out and it formalized the so-called low dopamine hypothesis of ADHD. It turns out that if dopamine levels are too low in particular circuits in the brain, it leads to unnecessary firing of neurons in the brain that are unrelated to the task that one is trying to do
10:30 and that is unrelated to the information that one is trying to focus on. So if you think back before, you’ve got this default mode network and a task-related network and they need to be in this concert of anti-correlation and in ADHD they’re firing together. Well, the problem seems to be that when dopamine is low, neurons fire more than they should in these networks that govern attention. This is the so-called low dopamine hypothesis. And if you start looking anecdotally at what people with ADHD have done for decades,
11:00 what you find is that they tend to use recreational drugs or they tend to indulge in non-drug stimulants. So things like smoking a half a pack of cigarettes and drinking four cups of coffee a day, or if the person had access to it, using cocaine as a recreational drug or amphetamine as a recreational drug. All of those substances that I just described, in particular, cocaine and amphetamine, but also coffee and cigarettes, increase levels of multiple neurotransmitters,
11:30 but all have the quality of increasing levels of dopamine in the brain and in particular in the regions of the brain that regulate attention and these task-related and default mode networks. Now, young children fortunately don’t have access to those kinds of stimulants most of the time. But if you look at children, even very young children with ADHD, they show things like preference for sugary foods, which also act as dopamine-inducing stimulants. For a long time, it was thought that children with ADHD
12:00 consume too many sugary foods or drink too much soda or adults with ADHD