Did you know that ADHD and trauma can look the same? The two are often misdiagnosed due to the significant overlap between presentations.
ADHD and trauma both present with:
Hyperactivity and restlessness
Poor memory
Difficulty concentrating
Anxiety
Shame and guilt
Sleep difficulties
Misdiagnosis can impair treatment in a remarkable way. Whilst ADHD is primarily treated with a combination of psychological therapy to improve executive functioning and interpersonal relationships, trauma is treated by processing the traumatic events in safe ways and hyperarousal management techniques.
As the two share certain symptoms, it is important to know how to distinguish ADHD and trauma:
〰 Cause: ADHD is a neurological developmental disorder, meaning it is present from birth. Trauma only occurs after a traumatic event, which can cause significant changes to the neurological and limbic systems. Hence, it is important to look at the timeline and identify when the symptoms started.
〰 Hyperactivity: Hyperactivity in ADHD (fidgeting and excessive movement), which is caused by a need for stimulation and dopamine, can often look like hyperarousal or hypervigilance in trauma (being on high alert to look for danger in the environment) - a natural response to the body’s overactive fight or flight system.
〰 Memory and concentration: ADHD results in poor memory because the less focus one is able to maintain, the less content they can hold in their working memory. Trauma results in poor memory because their limbic system (vital in working memory) has been affected, and their cognitive load is filled with hypervigilance towards the threats in their environment.
〰 Anxiety: People with ADHD often experience anxiety about maintaining their relationships, work, and life responsibilities knowing that their ability to manage these commitments is weaker than others. Those with a trauma history that have endured highly stressful and disturbing experiences may present with anxiety as a result of the impact on the limbic system - which should, naturally, be able to reassure you with feelings of safety and security.
〰 Shame: Shame is an epidemic in those with ADHD, arising from frequent failures to meet the expectations of others (it’s estimated that those with ADHD receive 20,000 more negative messages than neurotypical counterparts by the age of 10 🥺). Certain types of trauma are particularly vulnerable to shame, such as domestic violence, sexual abuse, and childhood abuse, which are dehumanising and humiliating in nature, and often can cause questions about how they responded to the situation — the perfect recipe for shame to form.
〰 Sleep: ADHD sleep difficulties are a side effect of impaired motor and emotional arousal, alertness, and regulation circuits in the brain. Trauma causes sleep difficulties by affecting the body’s overall stress response, which can be hard to calm when consistently hypervigilant to potential danger. Nightmares are also frequent in those who have experienced trauma — often caused by the mind’s attempt at integrating a traumatic experience.
That said, both ADHD and trauma can coexist — but in order to differentiate the two and get accurate treatment, ensure your psychologist/psychiatrist conducts a thorough biopsychosocial assessment, including family history and screening for any potentially traumatic experiences.
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