Often, the symptoms of trauma and ADHD are so similar they can be mistaken for each other. Their comparable symptoms often make it difficult to diagnose the source. . With so much overlap, it begs the question: Does trauma contribute to ADHD?
ADHD diagnoses have been on the rise throughout the past few years. Millions of children and adults are being diagnosed with ADHD, and the numbers continue to rise. What has contributed to the growing numbers? A possible contribution could be that we are becoming more aware of the nuances of the condition and are becoming better at recognizing and treating it accurately.
As we understand more about the neurodevelopmental condition, we can see that genetic, neurobiological, and environmental factors are at play. However, some studies indicate that children with ADHD are more likely to have trauma histories, experiencing a traumatic event, Post Traumatic Stress Disorder, or Complex trauma. While everyone’s exposure and experience are different, research suggests that childhood trauma could affect the development of ADHD and vice versa.
Why is it often difficult to differentiate between trauma and ADHD?
The common symptoms of ADHD and trauma can often appear in very similar ways. Shared symptoms of both trauma and ADHD include:
- Inattention: People with both ADHD and trauma struggle from a lack of focus on tasks or activities, becoming distracted by unrelated and unwanted thoughts or stimuli. They may also struggle to follow through on instructions or organize tasks.
- Impulsivity: Impulsive behavior is a hallmark of ADHD and can be frequent in trauma. People with ADHD can often act without thinking about the consequences. They may interrupt others, blurt out answers, or have difficulty waiting their turn. Trauma survivors may partake in risky or anti-social behavior.
- Forgetfulness: Individuals with ADHD and trauma often experience memory issues and lose track of personal items or necessary appointments. They may also have difficulty remembering to complete tasks or follow through on commitments.
- Difficulty with relationships: The symptoms of ADHD and trauma can also impact relationships, leading to misunderstandings, impulsive reactions, or forgetfulness that affect the ability to maintain connections with others. People who have undergone trauma may experience trust issues and feel misunderstood, driving them to either withdrawal or isolation and struggling to establish suitable boundaries, vacillating between trusting everyone or no one.
- Emotional dysregulation: Individuals with ADHD may struggle to regulate their emotions, experiencing mood swings, irritability, or trouble coping with stress. Individuals with a history of trauma may be in survival mode. In this state, most of their mental energy is dedicated to scanning for potential threats, making it challenging to regulate their emotions.
- Dissociated feelings: As a protective strategy utilized by the brain and the body, individuals with both ADHD and trauma may “zone out” and shut down when they feel overwhelmed
- Negative beliefs about themselves and the world: Those coping with both ADHD and trauma frequently grapple with negative beliefs or feelings about themselves and the world around them. Other symptoms from these conditions create a feedback loop that creates a negative memory bias, contributing to self-doubt, low self-esteem, and pessimistic perceptions of the world.
- Co-existing conditions such as Depression and Anxiety: Depression, anxiety disorder, and other comorbid disorders are common in both ADHD and trauma. The coexistence of conditions such as depression and anxiety is a common and intricate aspect of both trauma and ADHD. Individuals navigating these challenges could find themselves contending with overlapping symptoms and complexities. The emotional aftermath of trauma can give rise to depressed feelings and heightened anxiety, complicating the healing process. Similarly, individuals with ADHD may grapple with persistent difficulties in attention, impulsivity, and hyperactivity, often leading to feelings of frustration and anxiety.
How could trauma’s effect on the brain contribute to ADHD?
Although ADHD is considered a neurodevelopmental disorder, research suggests that childhood trauma significantly affects the development of specific brain areas related to stress responses and cognitive functions. This helps us understand how trauma can contribute to the emergence and worsening of ADHD symptoms.
Under the right circumstances, genes, environment, and lifestyle can all contribute to the emergence of pre-existing ADHD.
Researchers suggest that persistent exposure to Adverse Childhood Experiences (ACEs) elevates stress to potentially harmful levels, adversely affecting both physical and mental well-being. Additionally, there appears to be a heightened likelihood of experiencing moderate to severe ADHD symptoms in individuals with a history of childhood trauma.
Several parts of the brain and body are affected:
- Neurobiological Changes: The chronic release of stress hormones such as cortisol and adrenaline can impact the brain’s circuitry and neurotransmitters, affecting attention, impulse control, and hyperactivity.
- Prefrontal Cortex Dysfunction: The prefrontal cortex is responsible for delegating the performance of executive functions such as attention, working memory, and behavioral control. Excessive stress hormones may even lead to the death of brain cells, particularly in the prefrontal cortex. Changes in this part of the brain due to trauma may make the challenges for individuals with ADHD even more complicated, causing problems in focusing, organizing tasks, and controlling impulsive behavior.
- Hippocampal Changes: The hippocampus, a brain region involved in learning, memory formation, and emotional regulation, can be affected by trauma. Changes in the hippocampus may contribute to difficulties in memory and emotional regulation, common challenges in both trauma-exposed individuals and those with ADHD.
- Amygdala Hyperarousal: Trauma can sensitize the amygdala, a brain region central to processing emotions, especially fear and anxiety. As the amygdala is responsible for scanning the environment for danger, it is more frequently active in trauma sufferers. This heightened sensitivity may contribute to emotional dysregulation in individuals with ADHD, intensifying mood swings and making it challenging to cope with stress.
- Dissociation and “Zoning Out”: In times of trauma, individuals may respond by fighting, fleeing, or freezing as a protective mechanism. Trauma’s impact on the brain may lead to dissociative states, where individuals “zone out” or disconnect from their surroundings as a coping mechanism. In ADHD, dissociation can worsen issues with attention and focus.
- Alterations in Dopamine Function: People with ADHD have a gene that makes it hard for their brain cells to respond to dopamine. Dopamine is the neurotransmitter responsible for feeling pressure and driving motivation by activating the reward system. Trauma-induced changes in dopamine function may influence the reward system, potentially contributing to difficulties in maintaining attention and focus in individuals with ADHD.
How Could ADHD contribute to trauma?
If not properly treated, the symptoms of ADHD may put children and adults at greater risk of experiencing trauma. There are some of the factors that could contribute:
- Impulsivity: People with ADHD often exhibit impulsivity, acting without considering the consequences. This impulsive behavior can expose them to risky situations that might lead to traumatic experiences.
- Inattention: Difficulty in sustaining attention and staying focused can make individuals with ADHD more prone to accidents or incidents that may lead to trauma.
- Challenges with Social Interactions: People with ADHD may often find socializing challenging. Peers may have difficulty understanding ADHD symptoms like interrupting, misinterpreted cues, and distraction in conversations. People with ADHD may also have trouble with self-regulation actions and reactions and boundary setting, which could create strain on relationships. As a result of these difficulties, ADHDers may experience feelings of isolation and disconnection. Navigating social situations becomes harder, increasing the risk of involvement with peers who might expose them to potentially traumatic experiences.
- Substance Abuse and Negative Coping Strategies.: To cope, people with ADHD may turn more frequently to self-medication, turning to self-harm or substances in a way to soothe their symptoms. Both of these scenarios could increase the risk of involvement in risky behaviors and traumatic events.
- Struggles with Emotional Regulation: ADHD frequently includes challenges in managing emotions and stress, resulting in heightened emotional responses and the potential for conflicts or situations that could lead to trauma.
- Rejection Sensitivity Dysporhia (RSD) A lesser-known but impactful symptom of ADHD is Rejection Sensitivity Dysphoria (RSD), where individuals with ADHD are susceptible to perceived rejection or criticism, often experiencing intense emotional reactions. This heightened sensitivity can contribute to a heightened fear of rejection, leading to social anxiety and avoidance of situations where individuals may be more likely to anticipate rejection. In some cases, this fear may result in a reluctance to form new relationships or engage in social activities. Over time, consistent experiences of rejection, whether real or perceived, can contribute to the development of trauma. The emotional toll of repeated feelings of inadequacy or rejection may have a lasting impact on an individual’s mental well-being, exacerbating the challenges associated with ADHD and potentially leading to the development of trauma-related symptoms.
Understanding how overlap between Trauma and ADHD affects treatment
Identifying the source of difficulties in ADHD poses challenges in distinguishing between neurobiological factors and significant traumatic influences. Establishing a precise diagnosis can also be complex when considering trauma, PTSD, C-PTSD, and ADHD. As there is quite a bit of overlap in symptoms and interplay between the two conditions, a trauma-informed understanding is required to find the best trajectory in moving forward.
In proceeding with treatment, a therapist must gain a profound understanding of a client’s history and potential factors contributing to their condition while delivering appropriate care.
How ART can help with treating the symptoms of ADHD
ART-trained professionals are trauma-informed and intent on developing a comprehensive and clear understanding of an individual’s story before moving forward with treatment.
Since trauma can worsen symptoms, ART can aid in resolving the underlying trauma that may be contributing to the corresponding ADHD symptoms. Accelerated Resolution Therapy employs techniques such as eye movements, Gestalt, CBT, and brief psychotherapy to offer a tailored approach for individuals with ADHD.
ART uses rescripting, which involves revisiting and restructuring traumatic memories specific to ADHD challenges, enabling a rewriting of the narrative and diminishing their emotional impact.
Reframing, another key element of ART, empowers individuals with ADHD to see past experiences in a new light, revealing growth opportunities within adversity and promoting adaptability.
Positization, another crucial aspect, introduces positivity into the emotional landscape, reinforcing belief in innate strengths and the ability to overcome ADHD-related challenges. By combining these tools, ART not only addresses trauma associated with ADHD but also equips individuals with the skills to navigate and thrive in the face of life’s trials.
As a result, ART can contribute to managing ADHD symptoms by:
- Improving emotional regulation
- Reducing the impact of traumatic memories
- Enhancing focus and attention
- Creating positive behavioral changes
- Reducing anxiety
- Improving self-esteem
- Creating more self-love and self-compassion around struggles
If you struggle with ADHD or trauma, get to the bottom of your symptoms. Many ART therapists have been trained in ADHD treatment. Find an ART therapist and inquire about their training in treating ADHD.
If you are an ART-trained therapist interested in treating ADHD with ART, learn more about Inquiring Minds, a supplementary ART training with updated scripts for addressing trauma, ADHD, and other mental health issues.
Find an ART-trained practitioner near you.