ADHD and trauma: similarities and differences

What is the relationship between ADHD and trauma? Here are the similarities and differences.

Everything we go through in life impacts our day-to-day functioning. And sometimes it can be difficult to say what prompts us to act, think and feel what we are doing.

For example, people with Attention Deficit Hyperactivity Disorder (ADHD) and trauma may have similar symptoms. Learning to tell the difference between them can help you get the right care and support.

ADHD is a mental health problem typically characterized by inattentive, hyperactive, or impulsive behavior.

On the other hand, trauma is a mental, emotional or physical response to a shocking or distressing event or to a series of stressful events.

The two have some common symptoms, but they tend to impact each person differently.

“When considering the links between two psychiatric disorders, it is important to remember that there is no such thing as black and white,” says James M. Greenblatt, MD, medical director of Psychiatry Redefined and author of the book on ADHD “Finally Focused”.

Our health is constantly affected by genetic, environmental and psychosocial factors, among others, he says. And no two people are exactly the same.

So while ADHD and trauma may overlap in presentation, their relationship – and our relationship to each of them – is nuanced.

“At this time, it is not known whether there is a causal relationship between ADHD and trauma, although there is growing evidence to suggest this link,” says Kate Hanselman, psychiatric mental health nurse practitioner. specializes in working with people with ADHD at Thriveworks in Stamford, Connecticut, and lives with ADHD itself.

“We are still discovering [the] cause [of ADHD], but it is clear that it is influenced by genetics and in utero and early exposures to a variety of stresses and traumas, ”she adds.

For example, she explains that potential bullying from peers due to social difficulties resulting from ADHD symptoms increases the risk of:

  • abusive behavior
  • substance use
  • risky behaviors
  • being in potentially traumatic situations

There appears to be a relationship between childhood and trauma and ADHD symptoms.

A 2017 study suggests that stressful life events, including childhood trauma, can predict ADHD symptoms.

Another 2017 study indicates a significant association between adverse childhood experiences (ACE) and moderate to severe expression of ADHD.

Hanselman explains that brain changes caused by childhood trauma may be linked to ADHD symptoms. But timing plays a key role here – because ADHD is a neurodevelopmental disease, trauma that occurs later in life is unlikely to be the root cause of ADHD.

However, early childhood trauma can intensify ADHD symptoms.

“Depending on the nature of the trauma, this can cause children and adults with ADHD to withdraw or have more difficult times socially, or have more difficulty with work or schoolwork, which can lead to worsening. existing symptoms related to ADHD. Adds Hanselman.

Research suggests a relationship between ADHD and post-traumatic stress disorder (PTSD).

Children with ADHD may also be at increased risk for trauma due to their condition.

“The child [with ADHD] is often aware that [they’re] “Different”, which can exacerbate [their] feeling of alienation and erodes self-esteem. Worse, [they] may not understand why this is so and get trapped in a cycle of self-blame, ”says Greenblatt.

“All of this can be intensely [stressful], especially for young children who cannot properly verbalize their lack of control over symptoms and may not understand at all why they are “different,” he adds.

A 2013 study shows that the lifetime prevalence of PTSD was much higher in adults with ADHD than in those without.

Symptoms of PTSD can include:

  • memory problems
  • nightmares
  • flashback
  • irritability
  • difficulty concentrating
  • sudden outbursts of anger
  • difficulty with emotional regulation
  • increased stress response
  • reduced interest in activities
  • sleep disturbances
  • feelings of shame or guilt

Some of them can also be present in people with ADHD. “For this reason, PTSD can contribute to and worsen the underlying symptoms of ADHD,” says Hanselman.

The short answer is yes, it is possible.

“Any brain that is already wired for increased difficulty in maintaining attention, regulating behavior, and impulsivity will most certainly have a harder time under stress or trauma in the present,” says Hanselman.

“Past trauma, especially childhood trauma, has been linked to an increased risk of developing ADHD and the severity of symptoms,” she adds. “Especially with such an overlap of post-traumatic symptoms and ADHD symptoms, we can see how easily the effects of the trauma would worsen existing ADHD.”

Greenblatt adds that there is a high potential for either condition to make the other worse.

For example, he says severe trauma can worsen pre-existing aggressive or impulsive behaviors in children with hyperactive-impulsive ADHD. It can also lead to other sleep problems, which people diagnosed with ADHD (or misdiagnosed with ADHD) already experience.

“The lasting effects of trauma, especially childhood trauma, can include inattention, impulsivity and hyperactivity – the main symptoms of ADHD. So trauma-related symptoms can be similar to ADHD symptoms, and vice versa, ”says Hanselman.

Both experts suggest that trauma and ADHD have the following symptoms in common:

  • restlessness and irritability
  • increased impulsiveness and risk taking
  • disorganization
  • poor self-esteem
  • inattention
  • Distractions
  • concentration problems
  • difficulties with work, school, sleep, household chores, etc.

Meanwhile, symptoms typically unique to ADHD include:

On the other hand, the symptoms generally specific to the trauma are:

If ADHD and trauma share so many symptoms in common, how can you tell them apart?

Greenblatt notes that this can be difficult depending on looks or behaviors. This is because their presentations can be so similar but different.

“There is also enormous variability in the presentation of the two disorders, which can further call into question a diagnosis,” he adds.

Hanselman recommends seeking mental health support from a trained professional if you or a loved one begins to experience signs of ADHD or trauma.

“Trying to differentiate or manage ADHD or trauma-related signs on your own can lead to delays in care, which can lead to worsening symptoms,” she explains. “There is effective, safe and life-enhancing care, and it is now more accessible than ever.

“To prevent the cumulative effects of trauma that unmanaged ADHD symptoms can cause, it is essential to implement a multifactorial treatment approach that targets brain-related deficits and disruptions in the neurotransmitter pathways that cause the symptoms,” explains Greenblatt.

Treatment may include:

ADHD and trauma have many similarities. But they also have their differences. No matter what you are going through, help is available.

If you’re having difficulty in your daily life and think ADHD or trauma might be the underlying cause, consider talking about your symptoms with a mental health professional. They will be able to provide you with a personalized treatment plan that can provide relief.

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