[MrMetric]

You... what? You can't be serious. Simply putting "exercise and adhd" into Google® got me multiple studies which say that exercise helps, along with many other websites (some reputable and others possibly not) all saying essentially the same thing. You can easily find licensed physicians giving this same advice to their patients, and they observe that it works. And, off the top of my head, exercising elevates dopamine and some other neurotransmitters, which are well-known to be deficient in people with ADHD. That's one of the reasons the drugs work: stimulants raise the levels of those neurotransmitters. Personally speaking, I've found that any activity or action that raises my dopamine level has the same effect on my executive function as a stimulant drug, although this can be a very short-lived improvement (worst case, it comes and goes entirely within ~5 minutes).

You may also consider this from an evolutionary angle. Mammals such as us are not meant to sit inside at a desk all day (whether that's school or any other menial work), so it's no surprize that doing that alters and impairs development versus the conditions we evolved to live in. It's really easy to encounter the biological equivalent of undefined behaviors and invalid state in modernity. If you don't know what I mean, here's an easier to see example: It's well-known in recent years that myopia (shortsightedness) is predominantly caused by insufficient exposure to sunlight as a child. As an aside, I find it very interesting that the reason sunlight exposure matters is it elevates dopamine in the retinas, and eyes with dopamine deficiency don't develop correctly.

Another angle is mental exercize: It's more difficult to physically exercize with ADHD, but it's possible, so mentally pushing past the difficulty (or, more likely, having someone encourage you and help you) can train you to do that with other things and teach you how to self-manage your symptoms with mental decisions / willpower. This is a pretty poor solution on its own, but it's a great force multiplier when combined with other strategies.

[LoganDark]

> And, off the top of my head, exercising elevates dopamine and some other neurotransmitters, which are well-known to be deficient in people with ADHD.

As far as I know, stimulant medications for ADHD treatment act as a reuptake inhibitor for those neurotransmitters. The end result is still somewhat the same (levels become higher on stimulants, and it absolutely can help with ADHD), but I've never really seen it stated that people with ADHD have a deficiency in dopamine, just that their brain needs more of it in order to catch their interest. Presumably because dopamine disappears way too quickly even if it's a perfectly fine amount of dopamine.

As someone with ADHD, I'm constantly multitasking because one task is often not enough to keep my interest. If I do many things at once though, it's much easier for me to stay focused. To my knowledge, this is also why music helps me focus while I work.

So I believe it's not necessarily anhedonia that leads to ADHD. Sure, depression-induced anhedonia can result in executive dysfunction, but depression's not what ADHD is (even though ADHD can easily cause depression). Things can keep my interest if they are rewarding enough to overpower my brain's natural "dopamine floor", I guess. I don't mean to imply that everyone with ADHD is the same, or that this can't be a source of symptoms for others, just that I don't see how a lack of exercise would be to blame for it.

> It's well-known in recent years that myopia (shortsightedness) is predominantly caused by insufficient exposure to sunlight as a child.

I think it can also be caused by staring at nearby objects too much of the time, like computer screens. IIRC your eyeballs use the sharpness of your peripheral vision to know whether to stop growing, and if you're always staring at nearby objects, then the persistent lack of sharpness in your peripheral vision will cause your eyeball to elongate too much, resulting in myopia. I am sure sunlight also affects it, but being in sunlight also often has the side effect of being outside where there are often faraway objects to focus on, which if done regularly will also signal to your eyes that they are done growing.

> mentally pushing past the difficulty [...] can train you to do that with other things and teach you how to self-manage your symptoms with mental decisions / willpower

So far I haven't seen evidence for myself that trying harder helps. Sometimes things happen (things like trauma) that manage to keep me motivated and functional for a while, but I haven't found a working strategy to manufacture this motivation at will yet.

[bbor]

Great convo, love all the details on both sides! There's shockingly little long-term study of executive dysfunction because it's so new, so I understand your dubiousness. I never read that before about neurotransmitter reuptake, but it seems plausible -- it's really hard to say. My fave AD(H)D site (low bar...) quotes a doctor saying (in 2024);

  ADHD was the first disorder found to be the result of a deficiency of a specific neurotransmitter — in this case, norepinephrine — and the first disorder found to respond to medications to correct this underlying deficiency. 

- https://www.additudemag.com/adhd-neuroscience-101/

But then a basic search on the actual lit paints a much murkier picture:

  We found no significant differences in NET availability or regional distribution between patients with ADHD and healthy controls in all investigated brain regions (F1,41 < 0.01; P = .96). Furthermore, we identified no significant association between ADHD symptom severity and regional NET availability.

- https://pmc.ncbi.nlm.nih.gov/articles/PMC4699255/

Which is a synechdoche of the broader dynamics around the disease IMO; lots of confident people with degrees saying stuff, often while trying to sell you services or medications, but the lit is still mostly vague. The only solid finding I know about ADHD is that it lowers life expectancy... TL;DR: I wouldn't personally be so confident it's about reuptake rather than production.

To give my hot science take, I think this is a somewhat inevitable result of our differential-diagnosis-based psychiatry system. ADHD is, objectively speaking, a set of symptoms. Common sense tells us that there's some common causes in the population, sure, but treating it as a causal condition rather than a opaque descriptor leads to a lot of confusion and heartache, IMHO. Such as;

  Sure, depression-induced anhedonia can result in executive dysfunction, but depression's not what ADHD is (even though ADHD can easily cause depression).

I don't have an issue with any of these specifics per-se, and I'm sure you're accurately describing your life (and mine, tbh!), but I don't believe this level of ontological separation is helpful in the longterm. Some people with depression and ADHD might have a completely different cause than people with one of either, or even than other people with both. This is why I like the 'software debugging' metaphor; it's easier to iteratively try improvements to an opaque system than it is to find the "true" cause or "real" solution. E.g.:

  So far I haven't seen evidence for myself that trying harder helps. Sometimes things happen (things like trauma) that manage to keep me motivated and functional for a while, but I haven't found a working strategy to manufacture this motivation at will yet.

You're not broken for being imperfect, you're just human - I would encourage you not to let this dissuade you from pushing yourself! I consider failure-to-motivate as a cognitive event in a system with a million inputs, not a subconscious choice you made because you're broken/sinful/lazy.

In those terms, I agree with your interlocutor; regular moderate exercise can really only help, in 99% of cases. It doesn't have to fix to help :)