Medication and Dopamine, Noradrenaline (norepinephrine) and Adrenaline (epinephrine) [the key ADHD neurotransmitters].
There are around 15 different forms of medication that can work for you, some can stack, some shouldn’t (stack means work together well). There are that many because there are lots of different types of ADHD, and the “typical” meds may not be the ones that work for you (amphetamines and methylphenidate [Ritalin]). That being said, understanding how they (the primary two forms) work, and why, is very helpful.
Methylphenidate primarily strongly helps your dopamine receptors be more efficient with the use of dopamine. They also weakly help your noradrenaline receptors be more efficient with the use of noradrenaline. This gives you a virtual “more” effect, without changing the actual quantity of dopamine or noradrenaline that you have.
Amphetamine medication does that, plus it helps your brain make a bit more Dopamine in the first place. It doesn’t matter if your Dopamine and Noradrenaline receptors are more efficient if you don’t have enough Dopamine in the first place. It is hard to be conservative with the chemical you don’t have.
Our brains create Dopamine locally, since the Dopamine made in our Adrenaline glands (epinephrine glands) above our kidneys can’t get to our brain due to the Blood Brain Barrier. From Dopamine, our brains create Noradrenaline, which strongly affects our mood. If you don’t have enough Dopamine, it makes it hard to make Noradrenaline.
If Noradrenaline is low (common for ADHDers) or high (uncommon for ADHDers) compared to the goldilocks zone (the nice zone where you have approximately the best amount for the situation), you’ll feel anxious, depressed or agitated depending on your brain.
From Noradrenaline you make neuronal Adrenaline (epinephrine), which is the key contributor to doing tasks when present and being depressed when absent. If you don’t have enough Noradrenaline, it’s hard to make neuronal Adrenaline.
A combination of out of goldilocks Noradrenaline and insufficient Adrenaline leads to crisis (neurotypicals), often referred to as meltdowns for Autistic people, or anxiety / panic attacks in ADHDers or people diagnosed with anxiety disorders. It’s the same thing, just slightly different presentations. (Crisis can also be triggered by low blood sugar because you forgot to eat).
Changing how our Dopamine works automatically changes the Noradrenaline and Adrenaline. It can be a good effect for some (if you were low), no effect, or a bad effect for others (if you were high in the goldilocks zone or above it).
If you find yourself too agitated, angry or anxious, and or the number of crises increases when you use the standard two types of medications (methylphenidate or amphetamine), then use a beta blocker to counteract the secondary effect without disturbing the effect on dopamine.
There are many other types of medication that affect each of these neurotransmitters, and if you can’t get the primary two working, ask your psychiatrist about the other medications to see if they will help you. Most of the people I meet with ADHD who say that the medication is awful haven’t used beta blockers in tandem, nor the other medications beyond the primary two, and that is a shame since it is very hard to compensate for ADHD neurotransmitters without medication (that’s why it is a diagnosable disorder – if you can easily manage it without meds, is it really ADHD?).