By Cathy Cassata
Traumatic events can happen to anyone. Sexual assault, physical abuse, natural disasters, witnessing or being a victim of violence, or the tragic death of a loved one are just a few examples of traumatic occurrences.
When people experience these events, they may be left with physical, mental and emotional symptoms immediately afterwards that manifest as shock and denial. They may also experience long-term effects of trauma that occur down the line, such as unpredictable emotions, flashbacks, strained relationships, and headaches or nausea, according to the American Psychological Association.
“All of us can have overwhelming experiences in life, but when we talk about trauma, we are talking about those overwhelming experiences not getting resolution and not getting worked through on the nervous system level,” explains Tonya L. Miles, PsyD, a psychologist practicing in Overland Park, Kan.
The effect of trauma is mitigated based on the age and developmental level of a person at the time it occurred, she adds. “Certainly, it’s going to affect children in a very different way than adults because their brains and nervous systems are developing,” Miles says.
Trauma and ADHD also have some very specific associations.
First, having ADHD can be a contributing factor to being exposed to trauma.
“One of the big complicating factors is that people who have ADHD … tend to die at an earlier age, and tend to get into more auto accidents, and tend to have more injuries related to the ADHD (due to) their inattention and impulsivity,” says Miles. “Kids with ADHD that is primarily untreated, tend to use drugs at an earlier age, tend to have higher rates of premarital sex. All this can set the stage for more potential traumatic events to happen.”
Higher trauma scores associated with ADHD
A 2017 study in Academic Pediatrics found that kids with ADHD had more adverse childhood experiences, or ACEs, compared to children without ADHD.
ACEs are potentially traumatic events that occur in childhood, such as abuse, neglect and witnessing violence. The researchers found a significant association between ACE score, and moderate to severe ADHD. The study looked at children whose parents indicated presence and severity of ADHD, and their child’s exposure to nine ACEs. It found that children with ADHD had a higher prevalence of each ACE compared with children without ADHD.
“It is well known that those who have experienced trauma are more likely to experience more significant symptoms of ADHD,” says Dr. Ami Baxi, a psychiatrist at Lenox Hill Hospital in New York City. “One should assess for a history of trauma as it can often be a predisposition to ADHD.”
She adds that traumatic experiences can also exacerbate ADHD symptoms.
And symptoms of trauma can often be confused with symptoms of ADHD, Baxi says. For instance, symptoms of both conditions include:
- Trouble with concentration
- Memory issues
- Emotional dysregulation
- Sleep disturbances
- Impulsivity and/or restlessness
- Difficulty establishing and maintaining relationships
- Substance abuse
A mental health professional can help you determine why you’re experiencing these symptoms and how to best manage them.
Four Tips for Dealing with Trauma
If you are experiencing symptoms of trauma, with or without ADHD, consider the following tips:
Know that trauma is treatable
You shouldn’t view trauma symptoms as uncurable and something you’ll have to deal with for the rest of your life. Miles stresses that symptoms of trauma are treatable.
“An important part of treating trauma is nervous system regulation and managing our activation levels so that we’re not in high-anxiety states,” she says. “Nervous system regulation sounds trite, but things like deep breathing turn on a relaxation response in the body, so learning strategies that help you feel more calm, safe, and comfortable can help.”
Engage in movement
While movement is helpful for people who have hyperactivity, Miles says it can also help the brain process more effectively when your nervous system is activated.
“If people are in a car accident, they might start shaking and people will say: ‘Oh, they’re cold,'” Miles says. “But it’s not the cold; it’s the nervous system trying to release the activation in the body. So it’s the body saying: ‘I need to get rid of all that adrenaline that is pumping.'”
Moving your body stimulates your vagus nerve, which regulates internal organ functions, such as heart and respiratory rates.
Connect with others
Because humans are wired for connection with other people to feel a sense of belonging and safety, Miles says, building relationships can ease the effects of trauma.
“However, it’s necessary to be comfortable and not overwhelmed by connection because trauma is often at the hands of other people. And so you might not feel safe with other people,” she says.
And relationships can be difficult, of course, for those with ADHD.
“Sitting still long enough to connect and engage can be hard,” Miles says. “Also, difficulty managing emotions, which is an ADHD symptom, can often create complications in relationships.”
Building relationships and connection in small amounts as you build trust is a healthy approach, Miles says.
Get help from a mental health professional
People who have ADHD often have other mental health issues, including anxiety and depression. For that reason, it’s important that people get a proper assessment of their mental health, Miles says.
“Some people may not realize that they are experiencing symptoms of trauma,” she says. “They may think it’s anxiety or it’s just part of the ADHD because it can be hard to differentiate between the two.”
Gaining an understanding can help adjust expectations and treatment goals.
Baxi says the first-line treatment for ADHD is most often medications, including stimulants. But, she says, psychotherapy can also be effective.
“Psychotherapy can play a role in addressing the role of trauma in ADHD symptom presentation,” she says. She cites cognitive behavioral therapy — which helps people identify and change negative thought patterns that influence their behavior — and somatic therapy — which treats mental health issues through a focus on the mind-body connection.
“Specifically, trauma-focused cognitive behavioral therapy and somatic psychotherapy have been found to be helpful in addressing a history of trauma,” Baxi says.
Academic Pediatrics: Associations Between Adverse Childhood Experiences and ADHD Diagnosis and Severity
The Jed Foundation: Understanding Emotional Trauma