When Trauma Looks Like ADHD
Updated: Jan 6
Childhood trauma, or developmental trauma, leaves impacts that are often not obvious or expected. It shapes how you perceive, react to, and navigate the world. For many, they go through years of medications, therapies, diagnoses, medical professionals, etc. and end up feeling hopeless by the end because nothing has "fixed" it. Commonly, we see clients who share that they've been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Sometimes that shoe fits - and sometimes it doesn't. While ADHD and childhood trauma are distinct and separate, their overlap can lead to misdiagnoses and missed opportunities for healing. What might look like ADHD on the service can be impacts of developmental trauma - meaning that traditional ADHD treatment and education might not be the fix-all.
What Is Developmental Trauma?
Developmental trauma stems from adverse experiences in early childhood, such as neglect, abuse, or inconsistent caregiving. These experiences can disrupt the development of a child’s nervous system, sense of safety, ability to regulate emotions, and create challenges in developing and maintaining relationships. Over time, these disruptions can lead to patterns of behavior and coping mechanisms that persist into adulthood.
How Trauma Affects the Brain
Trauma impacts the brain's development, particularly in parts of the brain that are responsible for memory, attention, and emotional regulation. The brain becomes wired to prioritize survival, often leading to:
Hypervigilance: Constantly scanning for threats, making it hard to focus on tasks.
Dysregulation: Difficulty managing emotions or calming down after stress.
Impulsivity: Acting quickly without considering consequences, a byproduct of a fight-or-flight response (trauma response.)
These are all also hallmark traits and symptoms of ADHD.
ADHD or Trauma? Spotting the Differences
While both ADHD and trauma can result in attention difficulties, impulsivity, and emotional dysregulation, the root causes differ:
ADHD is a neurodevelopmental condition present from birth or early childhood, not caused by external events.
Trauma-related symptoms often arise after specific adverse experiences and are tied to unresolved emotional or physical stress.
Key distinctions include:
Triggers: Trauma-related symptoms often worsen in response to specific triggers, while ADHD symptoms are typically consistent across the board. Sometimes these triggers aren't easily identifiable, especially if we're talking about developmental trauma/childhood trauma. For instance, if typically you're a fairly focused person but you find yourself spacing out every time you talk about money with your partner or spouse, that is good indicator that something about money is a trigger point for you.
Memory: Trauma can lead to intrusive memories or dissociation, which are not typical of ADHD. Dissociation can look like spacing out and "inattention," however, which is typical of ADHD characteristics.
Focus Patterns: ADHD-related focus difficulties may improve when engaging with interesting tasks (hyperfocus), while trauma-related focus challenges often persist even during something that is more engaging.
When Trauma Looks Like ADHD
Inattention: Trauma can pull attention away from the present moment due to hypervigilance or dissociation, resembling ADHD’s hallmark inattentiveness, as stated above. The "zoning out" that happens for many with ADHD could be an act of dissociation for someone with a history of developmental trauma.
Impulsivity: A survival response to perceived threats can look like ADHD impulsivity. Someone who seemingly routinely makes decisions that are risky in nature or not thought out thoroughly may appear to have ADHD or ADHD traits. However, this can sometimes be a result of the impact of childhood trauma. A developing child's brain that is enduring routine stress will find it hard to develop the part of the brain that is responsible for rational decision making and impulse control. As a result, they struggle with this as an adult.
Restlessness/Hyperactivity: An inability to relax or sit still may stem from underlying anxiety or an activated nervous system. Hyperactivity is a well-known symptom of ADHD. A child's brain isn't hardwired to regulate on it's own. A regulated caregiver has to model and teach this to a child in order for them to develop the parts of the brain that are responsible for healthily regulating. In those with developmental trauma histories, we find that caregivers most often hadn't modeled this and so in adulthood, their baseline is hyperactivity and difficulty "shutting off."
Forgetfulness: Trauma impacts working memory, causing difficulties that mimic ADHD forgetfulness. The parts of the brain that are responsible for retaining information are the last parts of the brain to develop. They really struggle to develop when someone is persistently stressed.
Why Proper Diagnosis Matters
A misdiagnosis can lead to treatments that address symptoms but not the underlying cause. For example, ADHD medications may not address trauma’s root impacts, leaving individuals struggling despite following all recommendations for ADHD. A thorough evaluation by a professional trained in both trauma and ADHD can be crucial. If you are someone who has had an ADHD diagnosis but nothing seems to help, it might be time to talk with someone who specializes in developmental trauma/childhood trauma.
Healing Trauma to Address “ADHD-like” Symptoms
For individuals whose ADHD-like symptoms are rooted in trauma, healing requires addressing the underlying experiences - not just the behaviors on the surface. Strategies include:
Therapy: Modalities like EMDR, brainspotting, or somatic experiencing can help process trauma and regulate the nervous system.
Mindfulness Practices: Grounding techniques, meditation, and yoga can help individuals stay present and reduce hypervigilance.
Building Safety: Creating safe, predictable routines can calm a dysregulated system.
If you’ve been diagnosed with ADHD but feel unresolved pain from childhood experiences, it’s worth exploring how trauma might be playing a role. A therapist specializing in developmental trauma/childhood trauma can help unravel the similarities and differences between the two and get you closer to where you want to be.
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