How trauma informed care could help identify and treat ADHD

How trauma informed care could help identify and treat ADHD

Many things can contribute to what we understand as ‘trauma’. For many, adverse childhood experiences (ACE’s), whether this be neglect, abuse, a particularly bad split or divorce, a parent with an addiction or mental illness, can all lead to developing some kind of trauma disorder later on in life. ADHD is understood as a developmental neurodiverse disorder, but can trauma inform how we identify and treat it from an earlier age?

Firstly, to understand ADHD’s links to trauma disorders it is important to distinguish between post-traumatic stress disorder (PTSD) and complex PTSD (CPTSD)

PTSD, often but not always, develops as a result of a particularly traumatising event. NHS mentions events such as an attack or assault, vehicle crash, serious health problems, childbirth. PTSD UK also links the likelihood of developing the disorder to natural disasters. PTSD is also frequently associated with military service, as it was first recorded in war veterans, known then as ‘shell shock’.

According to Mind, common symptoms of PTSD include, ‘vivid flashbacks, intrusive thoughts or images of the trauma, nightmares, easily upset or angry, hypervigilance, lack of sleep, irritability’. Another important aspect of PTSD is actively avoiding thinking about the trauma or avoiding reminders, these include: ‘keeping busy, avoiding, feeling emotionally numb, feeling physically numb or detached from your body’.

CPTSD includes many of the same symptoms of PTSD with some important additions, especially as they relate to ADHD. CPTSD is frequently related to those who have experienced early childhood trauma, multiple traumas, and ACE’s. Mind lists some of the following symptoms:

  • difficulty controlling your emotions
  • feeling angry or distrustful
  • feeling as if you’re damaged or worthless
  • feeling like nobody can understand what happened to you
  • avoiding friendships and relationships, or finding them very difficult
  • dissociative symptoms such as depersonalisation or derealisation
  • headaches, dizziness, chest pains, stomach ages
  • emotional flashbacks.

When discussing the similarities between PTSD and ADHD, an article by ADDitude, a publication focusing on the experiences of people with ADHD and raising awareness around it, said that “Seasoned professionals struggle to decipher the differences and overlap between the two conditions”.

The same article also notes how specific symptoms such as poor impulse control, lack of focus, irritability, poor memory, anxiety, and sensitivity to sensory stimuli are all common across PTSD and ADHD.

How are ADHD and PTSD/CPTSD similar?

ADHD is a neurological disorder that specifically impacts the area of the brain that regulates emotions, self-awareness and impulsivity. PTSD and especially CPTSD, as its most commonly a diagnosis given to people who have experienced trauma in their childhood, rewires neural pathways and especially in cases of childhood trauma, affects brain development.

Interestingly, the area of the brain that is impacted by early childhood trauma is the same area involved in ADHD: the prefrontal cortex, which means many PTSD and especially CPTSD survivors experience the same problems with emotional regulation, self-awareness and impulsivity.