Podcast Title: Change Your Brain Every Day
Hosts: Dr. Daniel Amen & Tana Amen
Episode: Why ADHD Hits Harder in Adulthood—and What to Do About It
Release Date: August 11, 2025

Introduction: Understanding ADHD in Adulthood

In this insightful episode of Change Your Brain Every Day, Dr. Steven Storage steps in to discuss the intricate ways ADHD manifests more intensely in adulthood and the strategies to manage it effectively. Building on the foundational work of ADHD as a neurodevelopmental condition, Dr. Storage delves deep into the genetic, physiological, and lifestyle factors that influence ADHD symptoms over a lifetime.

Genetic Foundations and Heritability of ADHD

Dr. Storage begins by emphasizing the genetic underpinnings of ADHD. He explains, “ADHD is primarily genetic. There's a score called heritability. One would mean it's 100% genetic. For ADHD, it's somewhere between 0.7 and 0.9, meaning it's a highly genetic condition, but not a purely genetic condition” (09:30). This high heritability score underscores the significant genetic contribution to ADHD, while acknowledging that environmental factors also play a crucial role in the manifestation and severity of symptoms.

Blood Flow Dynamics: Supply and Demand in the Prefrontal Cortex

A key point of discussion revolves around the concept of blood flow to the prefrontal cortex—a region critical for executive functions such as decision-making, attention, and impulse control. Dr. Storage analogizes ADHD to a “supply and demand issue” regarding blood flow:

“Think of ADHD as a supply-demand issue in blood flow to the prefrontal cortex, keeping up with the demands that are being placed on the prefrontal cortex” (03:15).

He illustrates how, during childhood, the demands on the prefrontal cortex may be manageable, masking ADHD symptoms. However, as individuals transition into roles with increased responsibilities, such as higher education or full-time employment, the existing blood flow supply may falter, leading to the emergence or intensification of ADHD symptoms.

Triggers for Emerging ADHD Symptoms in Adulthood

Dr. Storage identifies several factors that can disrupt the blood flow supply, thereby exacerbating ADHD symptoms in adulthood:

1. Depression: “Depressed brains send less blood to the prefrontal cortex” (05:10). This reduction can unmask previously manageable ADHD traits.

2. Head Injuries: Even minor head traumas can lead to significant changes in brain activity, particularly affecting the prefrontal cortex as observed in SPECT scans.

3. Perimenopause: Hormonal changes during perimenopause can decrease blood flow to the prefrontal cortex, leading to increased ADHD symptoms.

Screen Time: A Double-Edged Sword for ADHD

One of the central themes of the episode is the impact of screen time on ADHD:

“Screen time, if unchecked, can make ADHD substantially worse” (00:00).

Dr. Storage explains that ADHD brains, which are often dopamine-deficient, seek rapid stimulation to achieve dopamine release. Screens—whether through video games, social media, or other digital interactions—are engineered to provide continuous, quick dopamine hits. This relentless pursuit can deplete the brain's dopamine reserves, making it increasingly difficult to focus on less stimulating but necessary tasks.

Notable Quotes on Screen Impact

• Dr. Storage:
  “It's like being at a slot machine in Las Vegas. And it's not dissimilar with social media” (08:20).

• Dr. Storage:
  “People will work for 20 minutes and then feel like they need a mental break. And so they'll pull out their phone and they'll check social media or maybe they'll play a quick video game if they're at home. It is so much harder to switch back to the thing that you were trying to focus on” (11:00).

Strategies for Responsible Screen Use

Addressing the challenges posed by screen time, Dr. Storage offers practical advice for individuals with ADHD and their families:

1. Be Intentional with Screen Time:
   Avoid using screens immediately before tasks that require focus or as a break from such tasks. Instead, opt for activities that replenish dopamine without depleting it, such as physical movement, hydration, or social interactions.

2. Set Parameters Based on Age Groups:

   • Children:
     Prefer educational and longer-form content. Co-watch with parents to contextualize and link screen content to real-world experiences.

   • Teenagers:
     Limit exposure to short-form content like YouTube Shorts or Instagram Reels. Encourage responsible social media usage by setting time limits and fostering awareness about the addictive nature of these platforms.

3. Create Alternative Dopamine Sources:
   Engage in activities that naturally increase dopamine levels without the rapid depletion caused by screens. Examples include outdoor sports, board games, hobbies, and social interactions.

4. Establish Screen-Free Zones and Times:
   Designate specific times, especially before bed, as screen-free to promote better sleep quality by allowing the pineal gland to release melatonin without interference from screen-emitted light.

Understanding Screen Addiction

Dr. Storage highlights the addictive nature of screens by comparing it to substance addiction:

“Screen addiction looks the same as addiction to hard drugs” (19:00).

This comparison underscores the severity of excessive screen use, emphasizing the need for empathy and strategic interventions to help those struggling with screen addiction.

Implementing Behavioral Changes

To combat screen addiction and manage ADHD symptoms, Dr. Storage recommends:

• Weaning Off Gradually:
  Slowly reduce screen time to prevent withdrawal symptoms and allow the brain to adjust.

• Reinforcing Family Traditions:
  Incorporate activities like family board game nights to strengthen bonds and provide alternative sources of enjoyment and dopamine.

• Encouraging New Hobbies:
  Support the exploration of new interests that can provide fulfillment and reduce reliance on screens for dopamine hits.

Additional Insights and Recommendations

Dr. Storage touches upon the importance of diet and supplements in managing ADHD:

• Dietary Factors:
  Consuming brain-healthy foods can support overall brain function and dopamine levels.

• Supplements:
  Supplements like L-tyrosine can aid in dopamine production, providing a biochemical boost to help manage ADHD symptoms.

Closing Remarks: Continuing the Conversation

In conclusion, Dr. Storage recaps the multifaceted nature of ADHD in adulthood, emphasizing the interplay between genetics, physiological changes, and lifestyle factors like screen time. He encourages ongoing education and proactive management strategies to help individuals navigate the complexities of ADHD as they age.

“There's even more to talk about with ADHD, and you can follow me at Dr. Steven Storage on Instagram or on TikTok” (21:08).

Listeners are invited to continue the dialogue through various platforms and stay informed about the latest strategies and treatments for ADHD.

Notable Quotes:

• Dr. Daniel Amen:
  “Every day you are making your brain better or you are making it worse” (00:55).

• Hannah Amen:
  “Do you want to prevent or treat memory problems, anxiety or depression? Do you want to be happier?” (01:09).

• Dr. Daniel Amen:
  “I wear a continuous glucose monitor to track how food affects my brain. When blood sugar is stable, I'm focused and clear. When it's not, I'm tired, irritable and craving sugar” (10:56).

This episode serves as a comprehensive guide for understanding why ADHD may become more pronounced in adulthood and offers actionable steps to mitigate its impact. Whether you’re personally affected by ADHD or supporting a loved one, the insights provided by Dr. Storage equip you with the knowledge to foster a healthier, more balanced brain.