The Dopamine Deficit: Understanding Under-Arousal in ADHD and Anxiety

Your brain's frontal lobe manages everything that makes you uniquely human—focus, emotional control, planning, and decision-making. But what happens when this crucial brain region isn't firing on all cylinders?

This isn't about laziness or lack of willpower—it's about a brain that physically cannot generate enough activity to function optimally, particularly in the prefrontal cortex.

At the heart of this condition often lies a dopamine regulation problem. 

Read the whole article version "The Underaroused Brain: Why Dopamine Matters—and What You Can Do About It" here

Ready to learn how to naturally support your brain's dopamine system? Don't miss Part 2 of this illuminating series.

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Chapters

• 0:00 Understanding Brain Under-Arousal
• 1:32 The Dopamine Connection Explained
• 2:37 Medication Limitations and Better Alternatives
• 4:52 Neurofeedback Approach and Next Steps

Transcript

Speaker 0: 0:32

the under-aroused brain, why dopamine matters and what you can do about it. Hi, this is Dr Randy Kale, and in today's episode we're diving into a crucial but often overlooked brain state that I see frequently in my neurofeedback practice. Thank you for joining us. The brain state I am referring to is called under-arousal, and it may be one of the most critical brain patterns to understand if you or your child struggles with attention, motivation, adhd, panic or anxiety attacks, ocd, as well as emotional ups and downs or even anxiety. Now, this isn't just a label I toss around casually. Under arousal is a documented neurological condition repeatedly confirmed by brain imaging like fMRI, qeeg and SPECT scans. It shows up most often in the prefrontal cortex, the part of the brain responsible for executive functions like focus, planning, emotional control and impulse regulation. When the brain is under-aroused, these functions go offline, and here's the key At the core of this under-aroused state is often a dopamine problem Not always, but it is one component you can begin to manage better for you or your child. Let's unpack that. What exactly is under-arousal? Under-arousal means the brain, particularly the frontal lobe, isn't generating or maintaining enough activity to function at its best From a neurological perspective. The lights are on, but dim and not well regulated. This isn't generating or maintaining enough activity to function at its best From a neurological perspective. The lights are on, but dim and not well regulated. This isn't just about being unfocused, distractible or anxious. It is more than that. It's about the front lobe of the brain, which manages all things human. That is idling rather than focusing, processing, managing emotions, making wise choices, etc. The engine is ready, but the accelerator cannot activate the frontal lobe enough to thrive. This often shows up in children as ADHD, distractibility, impulsivity, daydreaming, anxiety, worry, ocd or emotional meltdowns. In adults it may look like all of the above and perhaps more chronic procrastination, brain fog, low motivation and that constant feeling of being one step behind in life. Here's the part most people miss. These are not personality flaws. They're symptoms of a brain that cannot stimulate the frontal lobe adequately. That problem, as seen in the QEEG mapping, is often tied to low or poorly regulated dopamine. The dopamine under arousal connection. So what is dopamine exactly? Is often tied to low or poorly regulated dopamine the dopamine under arousal connection. So what is dopamine exactly?

Speaker 0: 3:00

Dopamine is a neurotransmitter, one of the brain's chemical messengers, and plays a central role in motivation, reward, anticipation, energy, pleasure, focus and emotional resilience. We feel alert, focused and capable. When dopamine is available and balanced, we can plan, follow through and enjoy the process along the way. But when dopamine is low or not used properly by the brain, everything starts to slip. Tasks feel overwhelming, joy feels distant, focus feels impossible and emotional reactivity tends to increase. And this is what underarousal means. On a chemical level, the brain isn't receiving the dopamine it needs to maintain optimal function in the frontal lobes. These regions help us resist impulses, calm ourselves when overwhelmed and hold steady, organized thinking throughout the day.

Speaker 0: 3:49

Now, in traditional medicine, this underarousal is sometimes managed with stimulant medications, because these do boost dopamine temporarily, but they also come with risks, side effects, tolerance, dependency and often a return of symptoms when the medication wears off. What's more, these medications don't teach the brain to self-regulate. They only mask the issue for as long as the chemical is present. In our practice, we do things differently. At Capital District Neurofeedback, we use real-time neurofeedback feedback to retrain the brain to generate more stable and appropriate activation levels in these frontal networks. And yes, this includes training the brain to regulate dopamine more effectively over time. However, we also coach our clients on naturally supporting dopamine to get the best results. In Part 2 of this series, you will learn about common strategies to enhance your available dopamine without medication or psychotherapy. Please check it out here. Thank you.