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Millions of people continue to live with ADHD every day. While the condition is well-known and well-researched, with multiple risk factors contributing to it, trauma remains one of the least known ones. A rising body of research is finding a positive connection between ADHD and trauma, while some propose that the relationship goes both ways.
Read Also About PTSD And Relationships
Regardless of which of the issues came first, the association is important to understand as it can make a lot of difference when it comes to treating them.
Is ADHD a Trauma Response?
Apart from other factors, such as environmental toxins, genetics, and premature birth, trauma remains a significant risk factor for ADHD. [1] The relationship is likely rooted in toxic stress, i.e., the negative effects due to prolonged activation of the stress management system in the body. Following are some essential concepts to understand when it comes to ADHD trauma response:
Adversity and Stress Response
When someone is exposed to an acute stressor, the body releases adrenaline while activating the fight or flight response. Cortisol, the notorious stress hormone, also appears in the body to help it mobilize energy stores, briefly boost memory, and activate the immune system. When the stress response activates in children in relation to supportive adult relationships, it causes buffering of these physiological effects. In case of unavailability of the buffering relationships, the stress response continues to exist, leading to toxic stress.
Toxic Stress and the CNS
Studies have indicated that longstanding toxic stress can lead to negative impacts on a child’s brain development. The neural regions involved with anxiety, impulsivity, and fear are particularly affected and under an overproduction of the neural connections. On the other hand, the neural connections in the areas associated with behavioral control, planning, and reasoning take a hit. These changes trigger maladaptive behaviors, including anxiety, ADHD, and mood disorders.
Can Trauma Cause ADHD? The Connection
Another way to understand how trauma and the stress it generates leads to attention deficit hyperactivity disorder is by exploring the science behind ACEs or adverse childhood experiences. Experts describe ACEs as traumatic or stressful events that a person goes through before turning 18 years old. These events can have negative impacts on social, emotional, and physical well-being. Some examples of ACEs include the following:
- Abuse: This includes sexual, physical, and psychological abuse.
- Neglect: This covers both physical neglect, such as failure to provide food and shelter, and emotional neglect, such as failure to be there for a child for emotional support.
- Household Dysfunction: This category includes anything that exists within a family that is not considered a part of a healthy household. Some examples of these dysfunctions include domestic violence, divorce, incarceration, mental illness, and substance abuse.
As ACEs begin to accumulate with time, they put a child at a progressively increasing risk of certain health behaviors. Moreover, these events may also eventually direct a child to the most severe outcome: early death. Research investigating more than 17,000 participants found that those who faced more ACEs during childhood were much more likely to participate in risky behaviors. [2] Moreover, their odds of acquiring chronic disease were also found to be higher than the placebo group. The results from the study concluded that individuals who experienced four or more events of ACEs are:
- Up to four times more likely to experience emphysema and chronic bronchitis
- Up to two times more vulnerable to experience a stroke or develop a heart illness
In view of the results mentioned above, many experts are of the opinion that ACEs also put a person at a higher risk of mental health consequences, ADHD being one of them.
Can ADHD Raise Your Risk of Childhood Trauma? The Reverse Relationship Explained
Many people face all types of struggles and hardships while growing up. However, people who had ADHD symptoms while growing up automatically become at a higher risk of experiencing childhood traumas, such as car crashes, accidental injuries, and physical and emotional abuse. These traumas, in turn, set them up for a prolonged and more severe ADHD diagnosis throughout their adulthood.
The following reasons explain the ADHD and trauma overlap and relationship:
Children with ADHD are more likely to get into trouble
Kids with ADHD symptoms find it hard to control their behavior and emotions. While many adults may think they are misbehaving deliberately, it is the underlying condition triggering their behavior. Consequently, such kids are more likely to receive punishments, including physical violence.
ADHD symptoms may not be diagnosed
Evidence suggests that children going through trauma may not be hyperactive but more inattentive. In many cases, their symptoms get missed, and they may not get the help they need. Without treatment, such children continue to face problems maintaining relationships at home and school while increasing their risk of facing ACEs.
Parental mental health may also be compromised
Studies investigating the link between ADHD and trauma have found that parents of children with ADHD are more vulnerable to anxiety, depression, and other mental health disorders. Such parents are also more likely to have underlying ADHD themselves, which may force them to adopt harsh parenting styles.
ADHD and Trauma: Getting a Diagnosis
When it comes to children, the symptoms of cPTSD and ADHD can be very similar. This potential symptom overlap is also seen in adults sometimes, making it difficult to differentiate one from the other. However, a significant factor discriminating the two conditions is that contrary to ADHD, the symptoms of PTSD are caused by a traumatic experience. Hence, most medical professionals prefer conducting a comprehensive assessment for both conditions, focusing on the nature and onset of symptoms and their historical timelines, to establish a diagnosis and construct a treatment plan.
Some of the symptoms to look out for to make a diagnosis include the following:
- Overlapping Symptoms
- Distractibility
- Difficulty concentrating
- Poor self-esteem
- Inattention
- Disorganization
- Difficulty sleeping, working, etc.
- Problems with academics
- Restlessness
Symptoms unique to ADHD
- Impulsivity
- Hyperactivity
- Forgetfulness
Symptoms unique to trauma
- Flashbacks
- Nightmares
- Dissociation
- Sudden anger outbursts
Seeking Help for ADHD and Trauma
While no specific treatment method is available to manage ADHD and trauma, most experts stick to using a multifactorial treatment approach. This approach involves managing the symptoms of both conditions concurrently while adjusting the treatment plan as necessary according to a patient’s unique circumstances.
In general, most treatment plans for complex PTSD and ADHD in adults and children involve a combination of the following:
Medication
Stimulant medications are most commonly used to help manage ADHD symptoms. These medications work by boosting certain chemicals in the brain and have been known to reduce the symptoms in users by up to 80 percent.
Non-stimulant medications can also help manage ADHD, especially in people who have experienced severe side effects due to stimulant use. Moreover, these drugs are more appropriate for people with certain heart issues, a history of drug use, and those who do not respond to stimulants.
In terms of PTSD, the medications can also help with symptomatic management. Sometimes, experts may prescribe serotonin-norepinephrine reuptake inhibitors to increase overall benefits. However, more research is needed to explore their benefits.
Psychotherapy
Also known as talk therapy, psychotherapy involves various evidence-based practices and techniques to help people change their emotions, thoughts, and behaviors to reduce any problems leading to distress. It can be of different types based on what suits a person the best. Some common examples include cognitive behavioral therapy (CBT), psychoanalytical therapy, behavioral therapy, cognitive therapy, and humanist therapy.
For complex PTSD and ADHD in adults, most experts advise going for CBT. This therapy acknowledges that a person’s thoughts have a substantial impact on their emotional and mental well-being. CBT helps them identify negative or distorted thinking patterns and change them with healthier ones.
For those with PTSD alone, experts recommend going for eye movement desensitization and reprocessing or EMDR therapy. This psychotherapy uses bilateral sensory input, particularly side-to-side eye movements, to help people go through difficult emotions, thoughts, and memories associated with a traumatic event.
Daily Tips
In addition to seeking professional help involving therapy and medications, other coping mechanisms can also be used to help manage ADHD and trauma. These include the following:
- Lifestyle changes: Eat a healthy diet and exercise regularly to effectively help manage your ADHD symptoms. [3] Additionally, other ways of alternative medicine, such as acupuncture, hypnotherapy, and trauma-sensitive yoga, can also make a huge difference.
- Supportive connections: Try spending more time with supportive family members and friends and seek help whenever you can to manage your issues. If you have no one to support you through a difficult time, join a local support group.
FAQs
Can you develop ADHD from trauma experienced in childhood?
Various factors, such as your environment, lifestyle, and genes, shape your true personality. While there are many things that determine your risk of developing ADHD, childhood trauma seems to be a significant predictor. Scientists believe that since trauma exposure increases the toxic levels of stress in a person, it negatively affects their mental health and puts them at risk of acquiring moderate to severe forms of ADHD.
What is the difference between ADHD and PTSD?
While the symptoms of ADHD and PTSD may overlap, the condition has many differences. For instance, PTSD occurs due to exposure to a traumatic event severe enough to cause brain changes, whereas ADHD is primarily considered as a heritable disease. ADHD symptoms include behavioral inhibition, attention deficits, and regulation issues, whereas PTSD has hypervigilant and avoidant behaviors with constant re-experience of trauma. For most people, the symptoms of ADHD are pervasive and can significantly limit their daily functioning. PTSD, on the other hand, causes cognitive, emotional, and physiological changes in how an individual processes trauma stressors.
References
1 Vrijsen JN, Tendolkar I, Onnink M, Hoogman M, Schene AH, Fernández G, van Oostrom I, Franke B. ADHD symptoms in healthy adults are associated with stressful life events and negative memory bias. ADHD Attention Deficit and Hyperactivity Disorders. 2018 Jun;10:151-60.
2 Ranjbar N, Erb M. Adverse childhood experiences and trauma-informed care in rehabilitation clinical practice. Archives of Rehabilitation Research and Clinical Translation. 2019 Jun 1;1(1-2):100003.
3 Loewen OK, Maximova K, Ekwaru JP, Asbridge M, Ohinmaa A, Veugelers PJ. Adherence to life-style recommendations and attention-deficit/hyperactivity disorder: A population-based study of children Aged 10 to 11 Years. Psychosomatic medicine. 2020 Apr 1;82(3):305-15.
