What’s the relationship between ADHD and trauma? Here are the similarities and differences.

Everything we go through in life impacts how we function daily. And sometimes, it can be challenging to tell what’s causing us to act, think, and feel how we do.

For example, those affected by attention deficit hyperactivity disorder (ADHD) and trauma can present similar symptoms. Learning how to tell the difference between them can help you get the appropriate care and support.

ADHD is a mental health condition typically characterized by inattentive, hyperactive, or impulsive behavior.

On the other hand, trauma is a mental, emotional, or physical response to a shocking or distressing event or series of stressful events.

Both have common symptoms, yet they tend to impact every person differently.

“In considering links between any two psychiatric disorders, it’s important to remember that there’s no such thing as black and white,” says James M. Greenblatt, MD, medical director at Psychiatry Redefined and author of the ADHD book “Finally Focused.”

Our health is constantly impacted by genetic, environmental, and psychosocial factors, among others, he says. And no two people are exactly alike.

So, although ADHD and trauma can overlap in presentation, their relationship — and our relationships with each of them — is nuanced.

“At this time, it’s unclear whether there’s a causal relationship between ADHD and trauma, though there’s growing evidence to suggest this connection,” says Kate Hanselman, a psychiatric mental health nurse practitioner who specializes in working with folks with ADHD at Thriveworks in Stamford, Connecticut, and lives with ADHD herself.

“We’re still discovering [the] causes [of ADHD], but it’s clear that it’s influenced by genetics and in utero and early life exposures to a variety of stress and trauma,” she adds.

For example, she explains that potential bullying from peers over social difficulties resulting from ADHD symptoms increases the risk of:

  • abusive behaviors
  • substance use
  • risky behaviors
  • being in potentially traumatic situations

There seems to be a relationship between childhood and trauma and ADHD symptoms.

A 2017 study suggests that stressful life events, including childhood trauma, can predict ADHD symptoms.

Another 2017 study indicates a significant association between adverse childhood experiences (ACEs) and moderate to severe expression of ADHD.

Hanselman explains that the brain changes from childhood trauma can be linked to ADHD symptoms. But timing plays a key role here — because ADHD is a neurodevelopmental condition, trauma that occurs later in life is unlikely to cause ADHD.

Early childhood trauma can intensify ADHD symptoms, though.

“Depending on the nature of the trauma, this can lead to children and adults with ADHD to withdraw or have a harder time socially, or to have a harder time with work or schoolwork, which can lead to further worsening of existing ADHD-related symptoms,” adds Hanselman.

Research suggests a relationship between ADHD and post-traumatic stress disorder (PTSD).

Kids with ADHD may be at risk for increased trauma due to their condition as well.

“The child [with ADHD] is often aware that [they’re] ‘different,’ which may exacerbate [their] sense of alienation and erode self-esteem. Worse, [they] may not understand why this is so and become trapped in a cycle of self-blame,” says Greenblatt.

“This can all be intensely [stressful], particularly for young children who can’t properly verbalize their lack of control over symptoms and may not understand why they are ‘different’ at all,” he adds.

A 2013 study shows that the lifetime prevalence of PTSD was much higher among adults with ADHD, compared with those without the condition.

PTSD symptoms can include:

  • memory issues
  • nightmares
  • flashbacks
  • irritability
  • difficulty concentrating
  • sudden bursts of anger
  • difficulty with emotional regulation
  • increased stress response
  • reduced interest in activities
  • sleep disturbances
  • feelings of shame or guilt

Some of these can present within people with ADHD, too. “Because of this, PTSD can contribute to and worsen underlying symptoms of ADHD,” says Hanselman.

The short answer is yes, it can.

“Any brain that’s already wired for increased difficulty with sustaining attention, regulating behavior, and impulsivity will most certainly have a harder time when under stress or trauma in the present,” says Hanselman.

“Past trauma, especially childhood trauma, has been linked to a possible increased risk for ADHD development and severity of symptoms,” she adds. “Especially with such an overlap of post-trauma symptoms and ADHD symptoms, we can see how easily the effects of trauma would make existing ADHD worse.”

Greenblatt adds that there’s a high potential for either condition to worsen the other.

For example, he says severe trauma can worsen preexisting aggressive or impulsive behaviors in children with hyperactive-impulsive ADHD. It can also lead to further problems with sleep, which people diagnosed with ADHD (or misdiagnosed with ADHD) already experience.

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“The lasting effects of trauma, especially trauma in childhood, can include inattention, impulsivity, and hyperactivity — the core symptoms of ADHD. So, trauma-related symptoms can be similar to ADHD symptoms, and vice versa,” Hanselman says.

Both experts suggest that trauma and ADHD have the following symptoms in common:

  • agitation and irritability
  • heightened impulsivity and risk-taking
  • disorganization
  • poor self-esteem
  • inattention
  • distractions
  • problems concentrating
  • difficulty with work, school, sleep, chores, etc.

Meanwhile, symptoms generally unique to ADHD include:

On the other hand, symptoms usually unique to trauma are:

If ADHD and trauma share so many symptoms in common, how can you distinguish between them?

Greenblatt notes that it can be difficult based on appearance or behaviors. This is because their presentations can be so similar yet different.

“There’s also tremendous variability in the presentation of both disorders, which can further challenge a diagnosis,” he adds.

Hanselman recommends reaching out for mental health support with a qualified professional if you or a loved one starts to experience concerning signs of either ADHD or trauma.

“Trying to differentiate or manage ADHD or trauma-related signs on your own can lead to delays in care, which can lead to worsening symptoms,” she explains. “There’s effective, safe, and life-improving care available, and it’s now more accessible than ever before.

“To prevent the cumulative effects of trauma that unmanaged ADHD symptoms can cause, it’s essential to implement a multifactorial treatment approach that targets the brain-related deficits and disruptions to neurotransmitter pathways that give rise to symptoms,” Greenblatt says.

Treatment may include:

ADHD and trauma have many similarities. But they also have their differences. No matter what you’re experiencing, help is available.

If you’re experiencing challenges navigating your daily life, and you think ADHD or trauma could be the underlying cause, consider speaking with a mental health professional about your symptoms. They’ll be able to provide you with a personalized treatment plan that can offer relief.