It’s no secret that ADHD makes day-to-day activities, particularly mundane tasks, difficult and frustrating. However researchers have noticed for a long time this doesn’t seem to carry over onto the sports field, and elite athletes have a higher rate of ADHD then the general population. However sports itself is a stimulatory activity, and additionally has been shown to attenuate the symptoms of ADHD, so this is somewhat of a chicken-and-the-egg debate. Does ADHD or some of its symptoms provide a competitive advantage in sports, or does sports serve as a method of stimulation or coping mechanism favorable to the neurological processes that underlie ADHD?

Well I believe the answer is certainly both, but there is definitely a case to make that ADHD helps elite athletes.

What is ADHD? and some relevant details for my argument:

ADHD is almost certainly a multifactorial condition, but it clearly has an evolutionary foundation. 

A defining trait of ADHD is something called behavioral variability, meaning people with ADHD deviate from predictable behavior much more than that of regular people. However it’s important to make clear this doesn’t necessarily mean the same as them being uncontrolled. This is because behavioral variability is something clearly mapped in the research so it may just be behaviour we don’t know how to predict yet. Regardless, this behavioral variability is related with another aspect of ADHD referred to as ‘novelty-seeking’. ADHD is associated with high novelty-seeking and creative personalities, which is why it’s speculated ADHD served as an evolutionary advantage in small conservative groups, and farming societies. 

A person that craved novelty was more likely to take risks which might have a cost to themselves, but had the upside of adding something new to the society helping them progress into the more advanced societies (per se) which we see today. 

The paper “The evolution of hyperactivity, impulsivity and cognitive diversity” reviews this in great detail. For readers with ADHD you will likely find this a very liberating read as it explains how this condition you believe is debilitating may empower you in certain environments. Anyways, for the sake of this topic it’s just important to know that ADHD is strongly associated with novelty-seeking behaviour. 

The novelty-seeking behaviour is likely related to the fact people with ADHD struggle finding satisfaction with tasks that the general population does not have a problem with. To put it simply this is related to the dopaminergic system (which as you know regulates motivation and pleasure) and is underactive in people with ADHD. Since ADHD-brains often have lower dopamine levels (or availability due to dopamine transporter activity), stimulation is sought out.

There are many other contributing factors to ADHD but this is a clear needle mover. 

It’s quite evident that ADHD and the very process of motivation, and moving towards an activity which provides a level of satisfaction and habituation, are very intertwined.  

– Before I continue, I just want to be clear in saying ADHD is a complex polygenic condition, and in various neurotransmitter systems there are genes associated with ADHD (Glutamate, GABA, Histamine, Cholinergic and Serotonin systems). –

So while ADHD is associated with inattention, there is increasingly been inquiry in the research into a ADHD trait called hyperfocus, a state of deep concentration triggered by high-interest activities. From my experience with ADHD, as well as clients and friends with ADHD without exception all of them have experienced this state of hyperfocus when doing a task they found highly stimulating or had what you would call a ‘natural interest’ in. 

Many studies have investigated this topic but with largely contradictory evidence, however I’d like to speculate that this largely due to the fact hyperfocus wasn’t, and is yet to be clearly defined in the literature. Also they primarily investigated ADHD in the educational settings, which is notorious for being inadequately engaging for even neurotypical students, so it’s unlikely they’d experience a state of deep concentration triggered by high-interest activities.

ADHD, Hyperfocus & Sports:

Clearly a state of hyperfocus would be highly beneficial in the context of sports. Many elite athletes describe being “in the zone” during competition, a state that closely resembles hyperfocus. The ability to hyperfocus and react quickly to new stimuli provides an advantage in unpredictable, fast-paced games like basketball, football, and combat sports. You may notice that many professional athletes exhibit traits typical to ADHD, however have a completely different demeanour when it comes to watching, training, playing, and ‘living’ their sport.

Kobe Bryant displayed such high levels of novelty seeking, especially related to competition, that he became habituated, obsessed, and in his case helped him in many ways. See evidence of his ADHD below.

ADHD, Habituation & Sports Excellence:

The elitism of athletes is almost always correlated to their obsession to their craft, involving similar neurochemical pathways to that of addiction. The main difference being they were not addicted to something of hedonistic qualities, that leads to the instant release of a neurotransmitter, typically dopamine. ADHD is very strongly correlated with the development of addiction. 

Typical of addiction is the need to feel ‘other than myself’, very similar to the novelty-seeking behaviour in ADHD. Attention deficiency, addiction, and habituation to something productive are driven by the same neurological processes, however in the case of addiction leads to the instant release of neurotransmitters, whereas someone who achieves excellence in their field has a more sustained release.

The instant release leads to overstimulation from a neurotransmitter at a receptor. In response, the neuron downregulates its receptors to reduce the signal it receives. This is done to protect the neuron from excitotoxicity, which can cause neuronal death (apoptosis).

When receptors downregulate, the same amount of a substance produces less of an effect, and the user needs more of the substance to get the same high. This is referred to as “chasing the magic dragon”.

However the act of scoring a basket in basketball doesn’t compare to the act of an addictive drug in terms of hedonic qualities. 

It may be the case that these elite athletes suffer from ADHD and have the same underlying neurochemistry to that of an addict, however in the absence of exposure to hedonistic substances (drugs, alcohol, pornography), they became habituated to the sport they were naturally interested in. Often these elite athletes were raised by strict parents who rightfully shielded them from exposure to hedonistic pleasures. 

Think of it this way. The average person would feel a level of satisfaction from an hour of shooting a basketball, particularly if they played well. For a person like Kobe Bryant, who was clearly naturally interested in basketball and his career, he would not feel the same satisfaction unless he trained longer and harder. This led to his habituation to his craft. Kobe notoriously made no efforts to develop relationships with his teammates, social connections the average person would find very stimulating and fulfilling. As you can see these neurological pathways are very related to ADHD.

Its likely no coincidence that the only drug in Kobe Bryant’s toxicology report was methylphenidate, which means Kobe Bryant more than likely had ADHD. https://www.nba.com/news/autopsies-show-bryant-passengers-died-instantly

Methylphenidate isn’t banned by WADA if an athlete can provide a prescription.

---

Individuals with a genetic predisposition to ADHD (and addiction) may have a greater need to satisfy themselves than others (novelty-seeking). It’s very common for people with ADHD to describe their impulsive behaviour as ‘looking for something to fill that void’. This could explain why ADHD is very very strongly correlated with addiction and substance abuse.

The same genes and neurological pathways that drive addiction also drive ambition. People with these genes may have a greater need to feel satisfied and they may seek this satisfaction through substances or through other activities. If a person who feels like this does not use hedonic substances, or succumbs to destructive addictions, they may channel that drive into other areas, like their work or sport.

---

ADHD, Sport & Coping Mechanisms

An interesting line of research as of lately has been the role of exercise as soothing for those with ADHD, serving loosely as a coping mechanism of symptoms associated with ADHD>

Researchers have noted for a long time that regular exercise attenuates the systems of ADHD.

But we know now the neurophysiological changes caused by exercise largely align with the neuropathological mechanisms linked to ADHD. Specifically exercise releases catecholamines (dopamine and norepinephrine) which are the two systems that are dysregulated in people with ADHD and the two systems targeted by traditional stimulant medications (adderall and methylphenidate). 

Essentially exercise might compensate for dysregulated catecholamine levels in ADHD and thereby improve cognitive and behavioral functioning. 

This is something I’ve noticed myself. When I took time off from ADHD stimulants in my highschool years, I felt the need to exercise every 3 hours. I would schedule my weeks before exams, with 3 hours of study followed by 1 hour of exercise. 

Furthermore, exercise itself plays a significant role in regulating ADHD symptoms. Physical activity increases dopamine and norepinephrine levels, which are typically dysregulated in ADHD brains. The rise in these neurotransmitters enhances mood, focus, and impulse control, which may explain why so many individuals with ADHD gravitate toward sports in the first place. It’s a form of self-regulation, and a subconscious, natural, self-supplementation of sorts to keep up with the demands the western world requires that are in odds with that of an ADHD brain.

Serotonergic activity & Exercise:

Cardiovascular exercise increases growth factors in the brain (specifically Brain Derived Neurotrophic Factor), promoting neurogenesis and increasing serotonergic activity.

Studies on depressed people and rats have shown that exercise increases the presence of 5-HIAA, a major metabolite of serotonin, in cerebrospinal fluid. This indicates that exercise increases serotonin activity, as serotonin is being degraded more by monoamine oxidase.

I mention this because I feel in any discussion about cognition it is important to consider the Serotonergic system especially.

ADHD is a multifaceted condition with neurological underpinnings that contribute to both challenges and advantages, particularly in the realm of sports. Consider booking a consultation if you wish to learn further.

References:

Evolution and ADHD:

Williams J, Taylor E. The evolution of hyperactivity, impulsivity and cognitive diversity. J R Soc Interface. 2006 Jun 22;3(8):399-413. doi: 10.1098/rsif.2005.0102. PMID: 16849269; PMCID: PMC1578754.

Harpending H, Cochran G. In our genes. Proc Natl Acad Sci U S A. 2002 Jan 8;99(1):10-2. doi: 10.1073/pnas.012612799. PMID: 11782544; PMCID: PMC117504.

Behaviour variability and novelty seeking:

Leth-Steensen C, Elbaz ZK, Douglas VI. Mean response times, variability, and skew in the responding of ADHD children: a response time distributional approach. Acta Psychol (Amst). 2000 May;104(2):167-90. doi: 10.1016/s0001-6918(00)00019-6. PMID: 10900704.

Sagvolden T, Johansen EB, Aase H, Russell VA. A dynamic developmental theory of attention-deficit/hyperactivity disorder (ADHD) predominantly hyperactive/impulsive and combined subtypes. Behav Brain Sci. 2005 Jun;28(3):397-419; discussion 419-68. doi: 10.1017/S0140525X05000075. PMID: 16209748.

Saldana L, Neuringer A. Is instrumental variability abnormally high in children exhibiting ADHD and aggressive behavior? Behav Brain Res. 1998 Jul;94(1):51-9. doi: 10.1016/s0166-4328(97)00169-1. PMID: 9708839.

ADHD and addiction:

Ishii S, Takagi S, Kobayashi N, Jitoku D, Sugihara G, Takahashi H. Hyperfocus symptom and internet addiction in individuals with attention-deficit/hyperactivity disorder trait. Front Psychiatry. 2023 Mar 16;14:1127777. doi: 10.3389/fpsyt.2023.1127777. PMID: 37009127; PMCID: PMC10061009.

Davis C, Cohen A, Davids M, Rabindranath A. Attention-deficit/hyperactivity disorder in relation to addictive behaviors: a moderated-mediation analysis of personality-risk factors and sex. Front Psychiatry. 2015 Apr 20;6:47. doi: 10.3389/fpsyt.2015.00047. PMID: 25941494; PMCID: PMC4403287.

Srichawla BS, Telles CC, Schweitzer M, Darwish B. Attention Deficit Hyperactivity Disorder and Substance Use Disorder: A Narrative Review. Cureus. 2022 Apr 12;14(4):e24068. doi: 10.7759/cureus.24068. PMID: 35573587; PMCID: PMC9097465.

ADHD and genes:

Sklar P. Principles of haplotype mapping and potential applications to attention-deficit/hyperactivity disorder. Biol Psychiatry. 2005 Jun 1;57(11):1357-66. doi: 10.1016/j.biopsych.2005.01.005. PMID: 15950008.

ADHD and Drd4:

Faraone, S. V., Biederman, J., Weiffenbach, B., Keith, T., Chu, M. P., Weaver, A., … Sakai, J. (1999). Dopamine D4 Gene 7-Repeat Allele and Attention Deficit Hyperactivity Disorder. American Journal of Psychiatry, 156(5), 768–770. https://doi.org/10.1176/ajp.156.5.768

https://psychiatryonline.org/doi/full/10.1176/ajp.156.5.768

ADHD and Exercise:

Wigal SB, Emmerson N, Gehricke JG, Galassetti P. Exercise: applications to childhood ADHD. J Atten Disord. 2013 May;17(4):279-90. doi: 10.1177/1087054712454192. Epub 2012 Aug 3. PMID: 22863768.

Mehren A, Reichert M, Coghill D, Müller HHO, Braun N, Philipsen A. Physical exercise in attention deficit hyperactivity disorder – evidence and implications for the treatment of borderline personality disorder. Borderline Personal Disord Emot Dysregul. 2020 Jan 6;7:1. doi: 10.1186/s40479-019-0115-2. PMID: 31921425; PMCID: PMC6945516.

Chaouloff F, Laude D, Guezennec Y, Elghozi JL. Motor activity increases tryptophan, 5-hydroxyindoleacetic acid, and homovanillic acid in ventricular cerebrospinal fluid of the conscious rat. J Neurochem. 1986 Apr;46(4):1313-6. doi: 10.1111/j.1471-4159.1986.tb00656.x. PMID: 2419509.

ADHD and Hyperfocus:

Ashinoff BK, Abu-Akel A. Hyperfocus: the forgotten frontier of attention. Psychol Res. 2021 Feb;85(1):1-19. doi: 10.1007/s00426-019-01245-8. Epub 2019 Sep 20. PMID: 31541305; PMCID: PMC7851038.