The Link Between Trauma & ADHD, According to Experts

Are you a childhood trauma survivor who now experiences ADHD symptoms? You might be wondering if trauma could be the cause. Read on to learn more.

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For many people, being a survivor of childhood trauma is an unfortunate reality. Most Americans experience at least one traumatic event by the time they’re 16 years old. Childhood trauma has far-reaching effects, impacting survivors long after the traumatic incident (or incidents) occurred. 

While some survivors don’t develop significant mental health effects, some go on to develop post-traumatic stress disorder (PTSD), and others may go on to experience other mental health challenges, like attention-deficit/hyperactivity disorder (ADHD) related symptoms. 

It’s common for ADHD and trauma to co-occur, with a comorbidity rate of about 28% to 36%, and research shows that people with both disorders experience more severe symptoms. But an important question remains: Can trauma cause ADHD? The answer isn’t so straightforward. Keep reading to understand the link between trauma and ADHD.

Does trauma cause ADHD?

In short, researchers have not identified a single known cause for ADHD. Rather, various factors come into play and act as risk factors for developing this disorder. Trauma is a potential risk factor, based on the research we have, although it is not considered one of the main primary contributing factors. While the connection isn’t linear, understanding how trauma may mimic or influence ADHD symptoms can lead to better care and fewer misdiagnoses.

What are the main risk factors for ADHD?

Researchers have determined a few contributing factors for ADHD, including the following: 

1. Genetics

Research shows that ADHD is very heritable (74%, to be exact), which means most people with ADHD are genetically predisposed to it. If you have a parent or sibling with ADHD, you’re more likely to have it, too.

2. Maternal smoking or drinking

If your mom smoked cigarettes and/or drank alcohol while she was pregnant with you, this can increase your chances of having ADHD. The risk is higher if she was a heavy smoker. 

3. Low birth weight

Studies suggest a link between low and very low birth weight and the development of ADHD.

4. Lead exposure

Being exposed to lead pollution early in life can increase the risk of ADHD — particularly hyperactivity and impulsivity symptoms.

5. Brain injury

Children who experienced a traumatic brain injury are more likely to develop ADHD than those who haven’t.  

How does trauma influence the development of ADHD?

On top of the above risk factors, research points to trauma influencing ADHD symptom development. However, it’s important to keep in mind that trauma in and of itself likely isn’t a direct cause of ADHD. 

“Trauma can alter brain development and contribute to ADHD-like symptoms,” says Na’Keora Bryant, LPC, a Charlie Health Group Facilitator. “This can be behavioral adaptation, dysregulation from the stress hormone, or neurobiological changes.”

This is especially the case with trauma in childhood and ACEs, or adverse childhood experiences, Bryant says. Common ACEs include traumatic incidents such as:

• Physical, sexual, verbal, and emotional abuse
• Emotional or physical neglect
• Losing a parent (whether through divorce, incarceration, or death)
• Witnessing violence
• Living in a household where people are struggling with substance abuse and/or mental health conditions
  

Trauma can literally change the brain, and these effects may be more profound during childhood when the brain is still developing. Research shows that traumatic adverse childhood experiences can result in significant changes to important brain regions, including the amygdala and the hippocampus. 

Trauma also impacts the prefrontal cortex, the area of the brain associated with executive functioning, such as memory, paying attention, decision-making, and other cognitive processes. Research shows that some people with PTSD have impaired executive functioning, which could be related to the impacts of trauma on this brain region. 

Additionally, a phenomenon called negative memory bias is common in people with post-traumatic stress disorder. Negative memory bias means you’re more likely to remember negative experiences rather than positive or neutral ones. Research shows a link between negative memory bias from childhood trauma and ADHD-like symptoms, such as inattention, hyperactivity, and impulsivity. Basically, trauma can mimic ADHD symptoms without someone having ADHD.

To sum it up, while trauma isn’t currently considered a primary cause of ADHD, research over the years has suggested that it may influence brain development and behavior in ways that increase the likelihood or expression of ADHD symptoms. However, further research is needed to determine the extent of the direct link. Plus, we need more research that distinctly looks at trauma and formal ADHD diagnoses, not just ADHD-like symptoms. 

Is there a link between ADHD and trauma symptoms?

There’s a direct overlap between some PTSD and ADHD symptoms, Bryant says. Because of these similarities, it’s possible for trauma symptoms to be misdiagnosed as ADHD — and vice versa. “Misdiagnosis is common, but it simply emphasizes the correlation of trauma and ADHD,” she says. 

Here’s a breakdown of some common ADHD symptoms, PTSD symptoms, and the symptoms they share: 

ADHD symptoms 

• Inattention
• Trouble finishing tasks
• Being forgetful and easily distracted
• Hyperactivity, high energy levels, and fidgeting

PTSD symptoms

• Flashbacks and distressing, intrusive memories
• Avoiding memories or situations related to the traumatic event
• Hypervigilance and feeling on edge
• Experiencing negative emotions and negative views about yourself and/or the world

Shared symptoms

• Trouble concentrating
• Emotional dysregulation
• Restlessness 
• Sleep troubles 

Each disorder has its own clear diagnostic criteria. Only a comprehensive psychiatric evaluation from a mental health professional can uncover the root cause of your symptoms. Is it ADHD? Trauma? Or is it both? Getting the right diagnosis is the first step toward effective treatment.

How do you treat ADHD and trauma?

If you deal with both ADHD and the effects of trauma, it’s important to address both to best improve your mental well-being. Bryant recommends an integrative, multi-model approach to treating symptoms. Treatment doesn’t have to follow a strict order—ADHD and trauma can often be addressed simultaneously or separately, depending on your provider’s guidance.

What is the treatment for ADHD?

ADHD treatment depends on your individual circumstances. Some people benefit substantially from therapy and lifestyle changes, while others greatly benefit from medications.

Therapy for ADHD

Behavioral therapy for ADHD can help manage symptoms and improve executive functioning. Here are two common approaches:

• Cognitive behavioral therapy (CBT): CBT helps you learn to create healthier thought patterns and behaviors. A therapist can teach you coping skills to manage symptoms and provide tips to improve executive functioning, helping you combat struggles such as procrastination, disorganization, and impulsivity.
• Dialectical behavior therapy (DBT): DBT helps target emotional dysregulation that’s common with ADHD. You’ll learn to cope with difficult emotions and manage distress. You can also build mindfulness skills that can help you stay in the moment, improve your focus, and reduce impulsivity. Interpersonal effectiveness skills can also help you maintain healthier relationships.

Medications for ADHD

If your mental health provider decides you can benefit from ADHD medication, there are a few options, including:

• Stimulants: Stimulant medications work rapidly to improve ADHD symptoms by increasing levels of specific brain chemicals (AKA neurotransmitters) called norepinephrine and dopamine. These neurotransmitters affect how well you can pay attention, stay focused, and remain motivated. 
• Non-stimulants: Providers prescribe non-stimulants in cases where stimulants aren’t the best fit, such as if someone with ADHD has co-occurring anxiety or if they have a history of substance abuse. These medications also increase levels of the neurotransmitters linked to executive functioning, but take more time to work than stimulants.
• Antidepressants: In some cases, a provider might recommend an antidepressant such as Wellbutrin (bupropion) or a tricyclic antidepressant. These meds may help with ADHD symptoms. Sometimes, they’re prescribed alongside a stimulant. 

What is the treatment for trauma?

When addressing your trauma, it’s crucial to seek trauma-informed therapy. Medication can also be helpful. 

Therapy for trauma and PTSD

Various therapy modalities can help you unpack trauma and address post-traumatic stress disorder  symptoms, including:

• Trauma-focused cognitive behavioral therapy (TF-CBT): This form of CBT is specifically designed to help trauma survivors process and reframe traumatic experiences, allowing them to create healthier thought patterns and behaviors. TF-CBT is most commonly used in kids and teens. It’s also helpful for people with complex PTSD (C-PTSD) who have endured repeated, chronic trauma. 
• Eye movement desensitization and reprocessing (EMDR): This therapy, designed specifically to treat PTSD, helps you process traumatic memories, typically through guided eye movements. EMDR helps your brain store these memories differently, making their emotional impact lessened.
• Prolonged exposure therapy (PE): Many trauma survivors avoid any and all reminders of their trauma, but this can further fuel the cycle of trauma and worsen symptoms.  Prolonged exposure is a structured form of exposure therapy that involves gradually confronting trauma-related memories and situations to reduce fear and avoidance, thereby improving PTSD symptoms. 

Medications for PTSD

Alongside therapy, some people with post-traumatic stress disorder might benefit from medication. Two antidepressants are FDA-approved to treat PTSD symptoms:

• Zoloft (sertraline)
• Paxil (paroxetine)

A psychiatrist or psychiatric nurse practitioner might prescribe other medications off-label. 

How Charlie Health can help

If you’re a trauma survivor who also struggles with ADHD, Charlie Health can help. Our virtual Intensive Outpatient Program (IOP) offers more than once-weekly mental health treatment for people dealing with serious mental health conditions.
Our compassionate clinicians provide trauma-informed care, incorporating evidence-based therapies like CBT, DBT, and exposure therapy into individual counseling, family therapy, and group sessions. We also offer medication management if your provider believes you can benefit from medications in addition to your therapy.

With this kind of support, you can heal from your trauma, better manage ADHD symptoms, and improve your overall mental health. Fill out the form below or give us a call to start your healing journey today.