We can begin this discussion by acknowledging the link being studied between attention-deficit hyperactivity disorder (ADHD) and childhood trauma. It’s been observed that children who endure adverse childhood experiences (ACEs) seem to be at a higher risk of ADHD. Since pediatric clinicians don’t always use screening tools for trauma when evaluating for ADHD, the association is being studied.
One of the reasons for the confusion is that the symptoms of ADHD and post-traumatic stress disorder (PTSD) often overlap (more on that soon). Since the comorbidity of the two disorders can run as high as 37 percent, it can be hard to untangle cause and effect.
What Do We Mean by ACEs?
An adverse childhood experience is a traumatic event that impacts anyone under 18 years of age. Some examples are:
- Loss of a loved one via death, divorce, incarceration, etc.
- Domestic violence
- Emotional, physical, or sexual abuse
- Neglect or abandonment
- Illness, injury, or disability
- Experiencing a crime, a natural disaster, a war zone, and more
- Ongoing crises like trafficking, kidnapping, etc.
Not every child in situations like this is traumatized, but if they are, the more ACEs they deal with, the higher the risk of PTSD or complex post-traumatic stress disorder (C-PTSD). Either condition has been found to possibly cause serious problems like strokes or heart disease. More recently, ADHD is being considered a possible offshoot of ACEs.
A Closer Look at ADHD and Childhood Trauma
One reason a child is diagnosed with ADHD could be the observation of particular changes in their brain. However, the same parts of the brain that are involved with ADHD are impacted by ACEs, trauma, and PTSD. Thus, as mentioned above, children with either or both conditions may present with symptoms that noticeably overlap. Such symptoms may include:
- Hyperactivity
- Social struggles that lead to withdrawal and self-isolation
- Sleep disturbances
- Lack of emotional regulation
- Being easily distracted
- Low self-esteem and a negative self-image
- Hyper-vigilance
- Learning issues
- Agitation and restlessness
- Inability to concentrate and/or maintain effective executive functioning
At least 20 percent of children who experience traumatic events also check all the clinical boxes for ADHD. This presents a major challenge for any and all practitioners.
Is Traumatic Stress a Risk Factor for ADHD, or Could It Be the Other Way Around?
This is exactly what’s being researched. There is evidence that ADHD increases the likelihood of trauma, partly because ADHD frequently co-exists with other mental health disorders. However, children with ADHD are more commonly targeted for negative events like bullying and abuse. Of course, such treatment can be the cause of trauma. In other words, the evidence of an association between ADHD and PTSD is growing. As to what comes first, that may simply be a case-by-case scenario.
Where Does This Leave Someone Who May Be Impacted by Either or Both Disorders?
You’ll not want to jump to conclusions. You’ll also want to have a game plan. Both ADHD and PTSD are serious. If their common symptoms are observed in yourself or your child, initially, it doesn’t matter what came first. The top initial priority is getting a professional evaluation from a team of medical specialists.
Many assessments and tests exist. These can be used to commence a process of elimination. As your history and current symptoms are reviewed and observed, trends and patterns become more obvious. Even so, it requires patience and flexibility to discern precisely what is going on. But this does not prevent a therapist from beginning treatment in the name of symptom relief.
All that said, the symptoms listed above must not be downplayed or ignored. The earlier you connect with an experienced professional, the sooner you can start moving toward clarity. I’m here to help you on this tricky but necessary journey.
