Why We Want What We Want: Incentive Salience and the ADHD Brain

By Tim Aiello, MA, LPC, NCC, ADHD-CCSP, ASDCS

Clinical Director, Myndset Therapeutics

When you live with ADHD, motivation can feel like a magic trick you can’t quite perform on command. One minute you’re laser-focused on something you love, and the next, even brushing your teeth feels like a monumental task. If you’re an ADHD adult, you’ve likely heard all the clichés—lazy, disorganized, unmotivated—but science paints a far more compassionate and fascinating picture. At the heart of this picture is something called incentive salience.

Let’s talk about it.

What Is Incentive Salience?

Incentive salience is a neurobiological concept that describes how certain stimuli become attractive or "wanted" because of how our brains assign them motivational importance. It’s the feeling of being drawn to something, not because you consciously chose to value it, but because your brain tagged it as important.

This "tagging" happens mostly in the mesolimbic dopamine system—the same pathway responsible for reward, pleasure, and motivation. In people with typical brain wiring, this system reliably lights up for tasks that are necessary but not necessarily exciting: paying bills, answering emails, folding laundry. For ADHD brains, this circuitry often misfires.

ADHD, Dopamine, and Salience Tagging

ADHD is strongly linked to dopamine dysregulation. Dopamine isn’t just the “pleasure” neurotransmitter—it’s a key player in learning, reward prediction, and, you guessed it, incentive salience. What happens when the dopamine system isn’t functioning in a typical way?

Well, for one, things that should feel important often don’t. This means adults with ADHD struggle with motivation not because they don’t care, but because their brain literally doesn’t flag certain tasks as motivating or rewarding. On the flip side, hyperfocus often kicks in when something does feel novel, interesting, or personally meaningful—dopamine spikes, and suddenly, you can’t pull yourself away.

Studies using functional MRI have shown that adults with ADHD display altered activity in the ventral striatum and nucleus accumbens—regions crucial to incentive salience processing (Plichta et al., 2009; Scheres et al., 2007). This altered signaling impacts how rewards are perceived and how motivation is distributed across tasks.

“Laziness” Isn’t the Problem—Misdirected Motivation Is

One of the hardest parts about having ADHD as an adult is the internalized shame that can come from years of being misunderstood. When you procrastinate, miss deadlines, or abandon goals, it’s rarely because you’re lazy. It’s more often because the task didn’t register as rewarding enough for your brain to activate and sustain attention.

Incentive salience theory helps explain this. It’s not just that you’re disinterested—it’s that your brain fails to assign wanting to things that are necessary but not stimulating.

This disconnect leads to inconsistent performance, especially in environments where rewards are delayed or abstract—like the workplace or adult responsibilities.

The Trouble With “Just Try Harder”

If you’ve ever been told to “just try harder,” you know how invalidating it feels. Here’s the issue: trying harder doesn’t rewire how your brain assigns value to tasks. If something doesn’t feel salient, no amount of shame or external pressure is going to suddenly make it rewarding.

This is where the concept of motivational scaffolding comes in. ADHD-friendly strategies often include gamification, immediate rewards, novelty, or social accountability—not because you’re childish or need shortcuts, but because these tools artificially create incentive salience for your brain.

What Helps? Reframing the Role of Reward

We can’t change the way your brain is wired, but we can work with it. Here are a few evidence-based ways to use incentive salience to your advantage:

1. Immediate Rewards

Break tasks into smaller chunks and reward yourself immediately after each step. This boosts dopamine and creates a sense of completion (Volkow et al., 2011).

2. Gamify the Mundane

Using apps, timers, or point systems turns boring tasks into games. Gamification works for ADHD brains because it introduces novelty and structure—two things our brains crave.

3. Use Interest as a Lever

Start your day with something you enjoy. This primes your brain for dopamine release and can help build momentum toward less stimulating tasks.

4. Outsource Executive Function

Sometimes, external systems (planners, digital reminders, accountability partners) act as surrogate dopamine triggers by creating urgency or structure.

5. Self-Compassion

This isn’t just a nice idea—it’s a necessity. Shame shuts down the prefrontal cortex, where executive function lives. Understanding how your brain works helps you work with it, not against it.

Final Thoughts

If you’re an adult with ADHD, incentive salience might explain why certain tasks feel like climbing a mountain while others feel like sliding down a fun hill. It’s not about discipline or willpower—it’s about how your brain assigns value, and how you can learn to co-create that value through structure, curiosity, and kindness.

Your brain might not always flag the "right" things as rewarding, but that doesn’t mean you’re broken. It just means you’re wired differently—and there’s a way forward that honors that truth.

References

• Plichta, M. M., Vasic, N., Wolf, R. C., Lesch, K. P., Brummer, D., Jacob, C., & Fallgatter, A. J. (2009). Neural hyporesponsiveness and hyperresponsiveness during immediate and delayed reward processing in adult ADHD. Biological Psychiatry, 65(1), 7–14. https://doi.org/10.1016/j.biopsych.2008.07.008

• Scheres, A., Milham, M. P., Knutson, B., & Castellanos, F. X. (2007). Ventral striatal hyporesponsiveness during reward anticipation in attention-deficit/hyperactivity disorder. Biological Psychiatry, 61(5), 720–724. https://doi.org/10.1016/j.biopsych.2006.04.042

• Volkow, N. D., Wang, G. J., Kollins, S. H., Wigal, T. L., Newcorn, J. H., Telang, F., ... & Swanson, J. M. (2011). Evaluating dopamine reward pathway in ADHD: Clinical implications. JAMA, 302(10), 1084–1091. https://doi.org/10.1001/jama.2009.1308