Why It’s Important to Know The Similarity (and Differences) Between ADHD and Trauma

I recently read this article from The Child Mind Institute addressing two common conditions that often get mistaken for each other: attention-deficit/hyperactivity disorder (ADHD) and trauma. As someone who has been diagnosed with both, I found it quite validating to see how similar the two are, and reflected on how they both manifest differently and similarly in my life.

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The article initially discusses how clinicians in a hurry might be quick to diagnose ADHD when seeing children that are fidgety, lack focus, and are jumpy, and in doing so may overlook that the child could be experiencing trauma, and not ADHD. While trauma and ADHD can have similar symptoms, it’s important to identify the root cause because the ways in which each condition are treated is different.

This is a question I always have to ask myself; is it ADHD or trauma? I wasn’t diagnosed with ADHD until I was 24, so I spent most of my life thinking something was “wrong” with me and that I failed in numerous ways, rather than understanding I had a condition that I didn’t have the tools to cope with. Just a couple of years prior to being diagnosed with ADHD, I started realizing I also had trauma and began working on that with my therapist. Growing up with both undiagnosed, I still find it murky and muddy to determine what is my trauma being triggered, and what is a manifestation of my ADHD.

For example, the hardest part of my ADHD is rejection sensitive dysphoria (RSD), which is an extreme awareness or perception of rejection, whether it exists or not. At the same time, I have a lot of trauma around being rejected, because I’ve had traumatic experiences throughout my life where I faced intense rejection and was abandoned by the people closest to me. In these moments, I have to ask myself whether it’s a trauma wound, or a part of my ADHD, because the way I cope with it will be different. If it’s ADHD-related, I may need to be distracted, or take a deep breath and tell myself it will pass quickly. If it’s a trauma trigger, I may need to sit with it for a moment and think about what part of me is being activated — I may need to spend more time in that moment tending to the rejected parts of myself that feel triggered.

In order to identify if something is trauma or ADHD, I get curious with myself to find the root cause. When I experience an ADHD or trauma symptom, or series of symptoms, I’ll look for clues to find the cause.

Did I recently have a social interaction that might be triggering? If so, it’s probably trauma.

Did I have a bad sleep last night for no reason? If so, it’s probably ADHD.

Can I identify any potential triggers? If not, it might be ADHD.

Is there a trauma anniversary coming up, or did one just pass? Probably trauma, and not ADHD.

Asking myself these questions not only helps me figure out what’s causing the experience, and therefore helps find the best coping mechanism, but it also helps me get better at anticipating what makes my ADHD or trauma worse, so I can better prepare myself to deal with it, or prevent it altogether.

Since I went so long not knowing I had trauma and ADHD, I often wonder what came first. Did I have trauma first, which then led to me dealing with ADHD-like symptoms such as a lack of focus, hypersensitivity, and impulsive emotional expressions? Or did I always have ADHD, which made me more prone to trauma because having undiagnosed ADHD is traumatic in and of itself? It’s a bit of a “chicken or the egg” scenario, where I’m not really sure what came first. That being said, I’m not sure it matters what came first because, at the end of the day, I still deal with both. I also know that they both fuel each other — the more my trauma is activated, the more I experience ADHD symptoms. On the flip side, on days where my ADHD feels worse, I find myself more easily triggered and my trauma feels rawer. According to the article, children with ADHD who experience a traumatic event are four times more likely to develop post-traumatic stress disorder (PTSD) versus neurotypical children so it’s quite possible that my complex trauma stemmed from ADHD. At the same time, I can also pinpoint certain traumatic moments in my life, and identify how those experiences made me more prone to hyperarousal or executive functioning difficulties, both hallmarks of ADHD.

While I don’t know what came first, I still try to identify whether the cause of a particular difficulty like focusing or feeling rejected, stems from ADHD or trauma so I can address it accordingly. In the moments that I can’t separate it out and determine the cause (which is more often than not), I try to treat both conditions at the same time. This can be difficult when the coping mechanisms for each condition contradict each other, such as in the example above, but sometimes taking a holistic approach and addressing it from all possible angles helps.

For example, if I’m feeling really rejected and I don’t know if it’s from being triggered or RSD acting up, I try to first offer myself grace; I tell myself that it’s OK that I feel that way, and it’s not my fault. I remind myself that these experiences aren’t necessarily based in truth but are a manifestation of the conditions I deal with, and that feels very real. I then try to reach out for support to counteract the parts of my brain that are activated. If that still doesn’t help, I try to disengage from the experience and take some space to redirect my energy by focusing it on something like listening to music or watching something captivating. This helps take my mind off the experience so that I can come back to it when I’m calmer and feeling more in control of my emotional processing. By treating it as both ADHD and trauma, I cover all my bases and have the best shot at feeling OK sooner.

I may not always know what is ADHD and what is trauma, but I do know that after years of therapy and working on it, I have a good toolbox for either or both, and that makes it a lot more manageable. It helps to be able to share my experiences and work it through with a loved one because trauma and ADHD can make my mind feel all jumbled, so having help with sorting all the puzzle pieces helps me put it all together. I don’t always know why I react in the ways I do, and can’t always make sense of things, but the more I allow myself to take it slow and figure it out, the easier it gets.