What is the connection between ADHD and Trauma?

Unless you’ve been living off the grid for the last few years you’ll know there has been a massive increase in online content surrounding adult ADHD. All of this content can be overwhelming or validating depending on how long or how desperately you’ve been struggling with your symptoms. But what is less well known, is the connection between past trauma and adult ADHD (attention deficit hyperactivity disorder). If you suspect you have adult ADHD or have recently been diagnosed, keep reading, because addressing your trauma history is just as important to your long term mental health as your ADHD symptoms. Keep reading to learn more about the connection between adhd and trauma.

What are the symptoms of Adult ADHD?

While adult Attention-Deficit/Hyperactivity Disorder (ADHD) can manifest in number of different ways, and the symptoms present differently in everyone, common symptoms of adult ADHD include:

  1. Inattention:
    • Difficulty sustaining attention in tasks or leisure activities
    • Frequent careless mistakes in work or other activities
    • Difficulty organizing tasks and activities
    • Avoiding or being reluctant to engage in tasks that require sustained mental effort
    • Often losing items necessary for tasks or activities (e.g., keys, phone, paperwork)
    • Easily distracted by unrelated thoughts or external stimuli
    • Forgetfulness in daily activities (e.g., appointments, paying bills)
  2. Hyperactivity:
    • Feeling restless or fidgety, inability to sit still for long periods
    • Talking excessively
    • Difficulty engaging in activities quietly
  3. Impulsivity:
    • Interrupting or intruding on others’ conversations or games
    • Difficulty waiting one’s turn
    • Making hasty decisions without considering the long-term consequences
    • Intrusive thoughts
    • Other types of impulsive behavior such as substance abuse
  4. Emotional Regulation Issues:
    • Frequent mood swings
    • Short temper
    • Difficulty handling stress

It’s also worth remembering that the symptoms of ADHD can change as a person moves from childhood to adulthood. While hyperactivity might be overt and obvious in children (e.g., running around, climbing on things inappropriately), it can become more internalized in adults, manifesting as frustration with others or yourself, feeling overwhelmed, risk-taking, impatience, or having a mind that never wants to relax.

Can trauma cause ADHD in adults?

ADHD is a neurological/neurodevelopmental executive functioning disorder that primarily affects the prefrontal cortex (PFC). The prefrontal cortex is responsible for decision making, impulse control, working memory, and goal oriented behavior… in short, the symptoms associated with ADHD.

While atypical development of the PFC can happen for a number of reasons (brain injury, genetics, etc), studies have shown that when a child, whose brain is still developing, is exposed to a traumatic event, healthy connections between the PFC and the hippocampus are diminished. These children cannot accurately recognize what is and is not a threat, nor can they adequately regulate their behavioral response.

Additionally, traumatized children show repeated activity in the pituitary gland, which elevates cortisol levels along with other stress-related hormones. In children, high levels of cortisol (which is caused by traumatic stress) are considered toxic, further diminishing cortical functioning.

Your brain’s number one job is to keep you alive and it does whatever it takes to adapt to the toxic stress you experienced as you were growing up. This can explain why some people don’t experience symptoms of ADHD at all until they are adults. A lifetime of trauma may, over time, slow down your executive functioning.

If a child is exposed to early childhood trauma and is surrounded by supportive and nurturing caregivers who recognize PTSD symptoms on children and they, with the help of a professional, help them process the traumatic event, they may never develop any long term symptoms of executive dysfunction. But a child who is exposed to physical, mental, or emotional abuse on a regular basis can develop any number of neurological issues, chronic stress, including adhd like symptoms, a mood disorder (such as anxiety), or struggle with a long term mental illness that they just can’t seem to nail down.

When your brain spends most of it’s energy regulating your nervous system and trying to deal with toxic levels of stress hormones, it just doesn’t have the energy to devote to executive functioning.

Is it post traumatic stress disorder or undiagnosed ADHD?

Since several symptoms between PTSD and ADHD overlap, it’s best to be evaluated by a mental health professional who has experience with developmental trauma and complex trauma. However, if your symptoms began and are primarily associated with a single traumatic experience (such as a car accident or assault) or series of events (such as living in a war zone), than an ADHD diagnosis is unlikely. If this is the case, you may find significant relief with therapies like EMDR, cognitive behavioral therapy, or psychoanalysis.

However, if you can’t really pinpoint what caused your symptoms or when they started, or if you lived through several adverse childhood experiences, chances are you have a lot more going on than an mood swings or an inability to focus. If you have had, or suspect an adhd diagnosis or have experienced similar symptoms, we can help.

How do you treat ADHD that may have been caused by trauma?

Most people find that stimulants and similar ADHD medication (caffeine, Adderall, Vyvance, Ritilan, etc.) can help them focus, which reduces some of their symptoms. Medication can certainly be effective as far as ADHD treatment goes. But they also discover that it doesn’t take long before they need to increase the frequency or dosage to get the same effect they got in the beginning. They also discover a number of negative side effects that they have to deal with (such as insomnia, which may cause them to take even more medication). And even if these medications work for a long time, they don’t resolve the underlying trauma that caused your brain to adapt this way to begin with.

Here at Utah Therapy Works, we take a different approach. We use a combination of neurotherapy and ego-state trauma therapy to help rewire your brain to both reduce the symptoms of ADHD, and heal it from the underlying trauma that has been holding you hostage. This two-pronged approach helps relieve symptoms faster than traditional or behavioral therapy alone, and without the side effects you may experience with medication.