Sober October and ADHD Awareness: Why the ADHD Brain Is Wired for More

Dear Near & Dear Reader,

Welcome to my blog — a space where I hope to bring you information rooted in research, guided by compassion, and aligned with the Hippocratic principle:

“First, do no harm.”

My goal is to present the best scientific information I can — evaluated both by peer review and my own lens as a therapist working directly with real people. Psychological research is abstract and imperfect, but through experience, theory becomes practice — and that’s the bridge I hope to share here.

Quick Summary

October brings together two important conversations: ADHD Awareness and awareness around substance use through Sober October — which is exactly what it sounds like.

Think of it as the reflective cousin to Octoberfest.Where one celebrates indulgence, the other invites clarity.

If you’ve been following my Sober October posts, you know I define sobriety as more than “use” or “no use.”It’s the ability to face reality as it truly is — without reaching for escape.

Substances are the ultimate escape.And ADHD?Well, those of us with ADHD are often the ultimate escape artists.

Maybe you’re just curious about what this could mean for you — without giving anything up completely — or maybe you’re ready to reduce your costs of “partying” altogether.Either way, this one’s for you.

A Common Thread

At first, ADHD and sobriety might seem unrelated — one about attention and focus, the other about alcohol and abstinence.

But beneath both is the same story:

We need to be able to regulate ourselves continuously — or restlessness sets in.

When awareness fades, habits take over.

For many people with ADHD, this is a lifelong theme. High sensitivity creates stress, which leads to the search for quick relief — from something.

Whether that “something” is a substance, a screen, food, caffeine (which, ironically, some ADHDers swear helps them focus), or constant activity — these tools help self-medicate a nervous system that struggles to find balance.

ADHD often brings heightened empathy: a deep awareness of others’ emotions, “reading the room,” and feeling those “vibes” more intensely than most.

That empathy can become exhausting without regulation skills — and self-medication becomes the shortcut.

The Dopamine Connection: A Brain Wired for Reward

People with ADHD live with a unique dopamine profile.

Neuroimaging studies show ADHD and addiction share overlapping reward circuitry.Both involve reduced dopamine availability in the striatum and prefrontal cortex, leading to chronic under-stimulation and risk-seeking behavior (Frontiers in Psychiatry, 2024).

Excitement and stimulation seeking are common.The un-fun solution? Learning to sit still and silent. (Mindfulness!)

That said, if you find yourself drawn to “self-medicate,” it makes sense.The same circuitry that makes ADHD brains crave novelty also makes them sensitive to quick hits of pleasure or focus.

Simply put: if this sounds like you, you’re not broken — you’re under-regulated.

Your brain is constantly seeking stimulation to feel normal.That cycle can create shame after overindulgence, followed by self-blame and rejection sensitivity.

So when someone with ADHD says they “can’t relax without a drink,” or “hyperfocus on work then crash into binge-scrolling,” it’s not a moral failure — it’s neurobiology.

ADHD and Addiction: The Hidden Overlap

Studies show ADHD significantly increases the risk for substance use disorders:

• Lee et al. (2011) found that children with ADHD are 2–3 times more likely to develop substance use disorders later in life.  

• van Emmerik-van Oortmerssen et al. (2013) reported that nearly 25% of adults seeking addiction treatment met criteria for ADHD—often undiagnosed.  

• Volkow et al. (2009) and Frontiers in Psychiatry (2024) confirmed overlapping dopamine reward circuits between ADHD and addiction, showing why self-medication feels like survival, not choice.

 The takeaway: Many people don’t realize they’re self-medicating an unregulated nervous system until the coping strategy becomes the problem.

Why “Just Stopping” Doesn’t Work

For ADHD brains, the goal isn’t just sobriety — it’s substitution.

Removing stimulation without replacing it leaves a vacuum that the nervous system rushes to fill.

We’re motivated by joy.And the ADHD mind often has a stubborn alliance to fun over discipline.

Without the substance or stimulation, it can be hard to process the flood of sensations — both internal and external.Substances regulate the body, but also block awareness, leaving anxiety and depression in their wake.

That’s why somatic and mindfulness-based therapies matter.

The body already holds the answers you need to meet your needs and follow your dreams.But if you’ve been disconnected for too long, going inward can feel like trying to find an M&M in a pile of Skittles.

Start small.

Mindfulness, meditation, and movement help retrain your brain to seek body-based regulation, not mental problem-solving.

By keeping gentle attention on your body throughout the day, you gain access to an internal compass that guides you toward balance and authenticity.

Healing the Reward System

True recovery for ADHD isn’t just about cutting out — it’s about building capacity.Capacity to recreate the false regulation that substances once offered.

That means learning to recognize:

• What feels like stimulation vs. what feels like safety.

• When excitement crosses into overwhelm.

• How to downshift without shame.

We all get out of control sometimes. The key is noticing and re-aligning — not punishing ourselves.

Somatic and trauma-informed therapy helps re-pattern the nervous system so that presence feels rewarding, not boring.Eventually, it becomes like a warm blanket you can carry through your day.

Sober October as Experiment, Not Punishment

How was it?Did you follow the daily reflections this month?

Sober October isn’t about deprivation — it’s about curiosity.

Even if you didn’t go completely “chemical-free,” maybe you reflected on what helps or harms you.Maybe you discovered that stillness doesn’t equal emptiness — but relief.

And if you missed it?No problem. You can always join us for Dry January.

Key Takeaways

• Both ADHD and addiction involve dopamine dysregulation and reward sensitivity.

• Substances, screens, and stimulation often become self-regulation strategies, not moral failings.

• Somatic practices help retrain the nervous system to find safety without constant stimulation.

• Sobriety isn’t absence — it’s space to rediscover balance and meaning.

  
  

An Invitation to Begin Differently

If this resonates, take a breath. Place a hand over your chest. Notice your body.

Ask yourself — what is my nervous system truly asking for?

You don’t have to give everything up all at once.Start by adding what nourishes you: movement, breath, connection, stillness.

Every small act of awareness rewires your reward system toward real balance.

And if you’re ready to explore this further — therapy can help you discover what regulation, peace, and presence might feel like for you.

Learn more at Near & Dear Therapy

References

Frontiers in Psychiatry. (2024). ADHD and substance use disorders: Shared neurobiology and clinical implications. Frontiers in Psychiatry, 15, Article 1409555. https://doi.org/10.3389/fpsyt.2024.1409555

(Full text: https://pmc.ncbi.nlm.nih.gov/articles/PMC11604610/)Lee, S. S., Humphreys, K. L., Flory, K., Liu, R., & Glass, K. (2011). Prospective association of childhood attention-deficit/hyperactivity disorder (ADHD) and substance use and abuse/dependence: A meta-analytic review. Clinical Psychology Review, 31(3), 328–341. https://doi.org/10.1016/j.cpr.2011.01.006

(Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3180912/)Molina, B. S. G., Howard, A. L., Swanson, J. M., Stehli, A., & Mitchell, J. T. (2018). Substance use through adolescence into early adulthood after childhood-diagnosed ADHD: A longitudinal study of risk and protective factors. Journal of Child Psychology and Psychiatry, 59(11), 1177–1186. https://doi.org/10.1111/jcpp.12906

(Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5985671/)Rubia, K., Halari, R., Cubillo, A., Mohammad, A. M., Brammer, M., & Taylor, E. (2009). Methylphenidate normalises activation and functional connectivity deficits in attention and motivation networks in medication-naïve children with ADHD during a rewarded continuous performance task. Neuropharmacology, 57(7–8), 640–652. https://doi.org/10.1016/j.neuropharm.2009.08.013

(PubMed: https://pubmed.ncbi.nlm.nih.gov/19715709/)van Emmerik-van Oortmerssen, K., van de Glind, G., van den Brink, W., Smit, F., Crunelle, C. L., Swets, M., & Schoevers, R. A. (2013). Prevalence of attention-deficit hyperactivity disorder in substance use disorder patients: A meta-analysis and meta-regression analysis. Drug and Alcohol Dependence, 132(1–2), 1–13. https://doi.org/10.1016/j.drugalcdep.2013.12.008Volkow, N. D., Wang, G. J., Newcorn, J., Telang, F., Solanto, M. V., Fowler, J. S., Logan, J., Ma, Y., Wong, C., & Swanson, J. M. (2007). Evaluating dopamine reward pathway in ADHD: Clinical implications. Journal of the American Medical Association, 298(9), 1008–1016. https://doi.org/10.1001/jama.298.9.1008 (Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2958516/)

Volkow, N. D., Wang, G. J., Kollins, S. H., Wigal, T. L., Newcorn, J. H., Telang, F., Fowler, J. S., Zhu, W., Logan, J., Ma, Y., Pradhan, K., Wong, C., & Swanson, J. M. (2009). Evaluating dopamine reward pathway in ADHD: Clinical implications. American Journal of Psychiatry, 166(6), 664–672. https://doi.org/10.1176/appi.ajp.2008.08060862 (Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2958516/)