There is an increasing body of research that shows the close association between ADHD and trauma. For instance, evidence shows that trauma may exacerbate pre-existing ADHD symptoms in children.1
Additionally, traumatic events can cause children to respond and behave in a way that mimics the symptoms of ADHD. For example, constant emotional arousal can resemble impulsivity and hyperactivity. This isn’t to say that trauma causes ADHD, but rather, the two can be inextricably linked, hence the growing movement for trauma-informed care interventions regarding managing ADHD.2
This article discusses the connection between ADHD and trauma and how the latter can affect the diagnosis and treatment of ADHD.
The Connection Between ADHD and Trauma
While there is no causal relationship between ADHD and trauma, the two conditions are linked and can sometimes even co-occur.
This is supported by a growing body of research that has linked the onset and severity of ADHD to stressful events, life experiences, and memory processes.3 As well as the onset of other psychiatric disorders, such as depression and anxiety.4
ADHD and Trauma May Affect the Same Parts of the Brain
While more research is needed to uncover the reasons for the link between ADHD and childhood trauma, it is theorized to be due to both conditions affecting the same areas of the brain, specifically the prefrontal cortex and hippocampus, which are vital for memory functioning and cognitive control.5
This isn’t to say that trauma will cause someone to develop ADHD, but rather, trauma can be a contributing factor to the emergence, persistence, and severity of ADHD symptoms, as well as inattention, hyperactivity, and impulsivity symptom clusters in those without it.6
ADHD and PTSD
Individuals with ADHD also have an increased risk of experiencing trauma. For example, it has been estimated that children with ADHD receive 20,000 more negative messages by the age of 12 than those without it.7
People With ADHD More Likely to Have PTSD
Additionally, it is also estimated that people with ADHD are roughly six times more likely to experience post-traumatic stress disorder (PTSD) than those without it.8
The reasons for this vary; however, it is thought to result from ADHD increasing an individual’s likelihood of rejection, social isolation, and the negative bias sometimes directed toward them.9
There is some evidence to suggest that there are specific genetic risk factors that are common to both ADHD and PTSD that may cause this, such as polymorphisms of the cannabinoid receptor gene and dopamine transporter gene.10
Complications of ADHD and Trauma
Trauma, traumatic events and PTSD can exacerbate or contribute to ADHD symptoms, which is why it is important to be mindful of their comorbidity.
For example, in children, undiagnosed PTSD has been shown to lead to the development of major depression, substance abuse and dependence, aggression, and suicide.11 The same study also found that it could also lead to physical comorbidities, such as irritable bowel syndrome, fibromyalgia, and chronic fatigue.
Furthermore, a recent 2020 study on alcohol use disorder (AUD) in adult inpatients found that PTSD prevalence was higher in those with ADHD—indicating a possible link between ADHD, PTSD, and alcohol abuse.12
It is important to note that AUD has been found to negatively impact an individual’s health, career, finances, relationships, and life. Thus, its co-occurrence with ADHD and trauma can be detrimental and affect an individual’s ability to keep a consistent treatment plan and also lead to further health complications.13
Diagnosis of ADHD and Trauma
Particularly in children, PTSD symptoms can mimic ADHD, and this symptom overlap is something that can also persist in adults. This crossover can make it difficult to differentiate the two; however, unlike ADHD, PTSD symptoms are triggered by a traumatic experience.
Therefore, medical professionals will likely do a comprehensive assessment of both conditions, which involves a comprehensive review of any symptoms and their onset, to establish a thorough historical timeline as a means to construct an accurate treatment plan.14
Some of the symptoms to look out for are listed below:15
Overlapping Symptoms
- Difficulty concentrating
- Distractibility
- Poor self-esteem
- Disorganization
- Inattention
- Difficulty with sleeping, working, schooling etc
- Restlessness
General Symptoms Unique to ADHD
- Hyperactivity
- Impulsivity
- Forgetfulness
General Symptoms Unique to Trauma
- Dissociation
- Nightmares
- Flashbacks
- A sudden burst of angez
Treatment of ADHD and Trauma
While there is no specific treatment method available for treating ADHD and trauma, a multifactorial treatment approach is the most beneficial.16
This involves treating ADHD and trauma symptoms concurrently and adjusting the treatment plan as and when necessary—according to a person’s unique circumstances.
Medication
- Stimulant-based medications are the most common types of medications prescribed for treating ADHD. They work by increasing the availability of certain chemicals in the brain, and they’ve been found to lessen ADHD symptoms in 70% to 80% of people who take them.17
- Non-stimulant-based medications are also used to treat ADHD, and they’re prescribed for individuals who experience severe side effects from stimulants, those with certain heart conditions, those with a history of drug use, and individuals who don’t respond to stimulants in general.18
Zoloft and Paxil
For PTSD, the two medications approved by the FDA are sertraline (Zoloft) and paroxetine (Paxil).19 These medications both belong to the same class of selective serotonin reuptake inhibitors (SSRIs), and they’re usually prescribed for treating depression and anxiety.
Regarding PTSD, they are effective at helping people manage their symptoms. Additionally, SNRIs or serotonin-norepinephrine reuptake inhibitors have also been found effective, though more research in this area is needed for more alternatives.20
Psychotherapy
Psychotherapy, or talk therapy, refers to the evidence-based techniques and practices used to help individuals change their behavior, emotions, and thoughts as a means to help reduce any problems causing distress.21 It is administered by many types of medical professionals, and there are many different types, such as behavioral therapy, humanist therapy, psychoanalytic therapy, cognitive-behavioral therapy (CBT), and cognitive therapy.22
- For both PTSD and ADHD treatment, the recommended form of psychotherapy is CBT. This type of therapy is based on the principle of thoughts having a powerful influence on mental and emotional well-being. CBT works by helping individuals to identify any distorted or negative thinking patterns and challenge and change them.23
- For PTSD alone, eye movement desensitization and reprocessing (EMDR) has also been found to be highly beneficial. EMDR can be understood as a type of psychotherapy that utilizes bilateral sensory input—such as side-to-side eye movements—to help individuals process difficult memories, emotions, and thoughts related to a traumatic event.24
Coping With ADHD and Trauma
In addition to medication and psychotherapy, other various coping mechanisms can also be implemented to help with ADHD and trauma. These include:
- Lifestyle changes: Eating a healthy diet and exercising may be effective at helping ADHD symptoms.25 Additionally, various alternative medicines effectively treat PTSD and trauma. These include trauma-sensitive yoga, acupuncture, hypnotherapy, meditation, and more.26
- Supportive connections: Spending time with supportive friends and family members can also make a significant difference.
Additionally, there are resources in local and online communities that can point people toward support groups, classes, and community meetings. Not only do these help individuals feel less isolated, but they can also further help them discover emerging treatment options and specialized providers.