People with ADHD often face unique challenges. One of these challenges is that, for a variety of reasons, ADHD often co-occurs with trauma and traumatic stress. Traumatic experiences can take many forms, from a one-time event, such as an accident or an assault, or a traumatic situation that is sustained over time, such as living in an abusive household. While anyone can experience traumatic events, ADHDers experience higher frequency of traumatic experiences and related mental health concerns than their neurotypical peers.
What is trauma?
Trauma can be generally defined as a psychological and emotional response to experiencing an event that is highly distressing or disturbing. These events can include experiencing an accident, having an illness, losing a loved one, experiencing a natural disaster, or encountering violence such as sexual assault or torture. Some trauma is considered "complex" when the distressing event happens repeatedly or is ongoing for a lengthy period of time.
How can trauma look like ADHD?
Symptoms of trauma can include difficulty concentrating, poor memory, emotional dysregulation, disrupted sleep, impulsivity, restlessness, and difficulty connecting with others, all of which can be associated with ADHD as well. However the cause and experience is different. For example, poor memory associated with trauma may be connected to the avoidance of painful and distressing memories, whereas the poor working memory that ADHDers experience is more connected to their neurocognitive functioning.
It is important to note that trauma does not cause ADHD. However, trauma can exacerbate the symptoms of ADHD.
When an individual experiences traumatic events or daily traumatic stress, their body and mind can become consistently on guard as a way to attempt to protect themselves from future pain. They may develop a kind of hypervigilance, watching for potential danger and learning how to get ahead of any risks that may come their way. When these postures become automatic, the individual's nervous system is basically in a state of constant dysregulation.
Individuals with ADHD Tend to Experience More Traumatic Events Than Neurotypical People
Research has shown that there is a greater likelihood of individuals with ADHD experiencing trauma when compared to their neurotypical peers. One study found that children with ADHD experienced significantly higher rates of socio-economic hardships, familial mental illness, divorce, and incarceration in the family. Additionally, children with higher scores on the Adverse Childhood Experiences Questionnaire (ACE) were significantly more likely to have moderate to severe ADHD.
Growing up with ADHD, whether it is diagnosed or not, is typically a traumatic experience in and of itself. Children with ADHD may grow up not knowing why they feel different. Their caregivers and teachers may have difficulty understanding their differences and challenges as well, leading to increased criticism, frustration, or punishment directed toward the child. ADHDers can easily internalize a deep sense of shame, self-loathing, or feeling of defectiveness when they and those around them do not understand why they operate the way they do.
Additionally, individuals with ADHD have been shown to process and experience emotion with higher intensity than neurotypical peers. While this ability to feel emotions so deeply can allow for great empathy, creativity, and joy, it can also make painful experiences feel all-consuming and overwhelming when a flood of emotion takes over.
Addressing Trauma and ADHD Symptoms in Therapy
When an individual has both ADHD and a history of trauma, it can be difficult to tease apart what exactly is impacting their nervous system and executive functioning. So, what do you bring up in therapy? Trauma or the ADHD symptoms? The answer is…both.
The experiences you have had have shaped you, whether related to your ADHD directly or not and whether difficult events feel significant or mundane. Clients and clinicians should both consider potential experiences of trauma in treatment.
As you work to heal your trauma, you may expect that your symptoms will decrease or fade. However, change and healing aren't linear. Something to keep in mind is that healing trauma involves self-acceptance and learning to know and love yourself. This often leads to masking less, which means that your ADHD traits will seem far more present and apparent than they might have been before. Your trauma symptoms may alleviate, but your ADHD symptoms might feel stronger than ever.
In Closing
If you are experiencing difficulties and wonder if they are related to past trauma and ADHD, know that you are not alone. There is help available and talking to a therapist about your experiences can be an important part of understanding yourself in the context of your full history and finding healing and acceptance.
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