According to studies published and peer reviewed by Smitha Bhandari, MD, six million children have been diagnosed with ADHD in the United States alone. “Nearly two-thirds of those kids have another mental, emotional, or behavioral disorder as well. One of those conditions could be childhood traumatic stress.”
Doctors are beginning to pay attention to this connection, and a good doctor will dive deep into the case before labeling it ADHD because many of the symptoms of trauma and toxic stress (discussed in part 1 & 2) are the same as a true, clinical case of ADHD. These symptoms include:
- Trouble concentrating
- Difficulty learning
- Easily distracted
- Doesn’t listen well
- Doesn’t sleep well
Further explanation provided here, a study where children with trauma had an over-lapping diagnosis of ADHD:
Young children who experience trauma may have symptoms of hyperactivity and disruptive
behavior that resemble ADHD.
Trauma can make children feel agitated, troubled, nervous, and on alert. These behaviors
can be mistaken for hyperactivity.
What might seem like inattention in children who experience trauma might actually be
symptoms of dissociation (feelings of unreality or being outside of one’s body) or the result of
avoidance of trauma reminders.
Among children who experience trauma, intrusive thoughts or memories of trauma (e.g.,
feeling like it is happening all over again) may lead to confused or agitated behavior which
can resemble the impulsivity of ADHD
The age old question can certainly be asked here, which came first, the chicken or the egg? There is a proven overlap of symptoms, see image below:
Trauma & ADHD overlap of symptoms.
The reality is we don’t know if trauma is the causation of ADHD, but we do know there is a correlation. The question becomes of advocates, parents, teachers, and other caretakers is this: can we alleviate some of the symptoms of trauma and toxic stress by treating trauma accordingly? Are we misdiagnosing children all together, treating their symptoms and ignoring a probable causation of behaviors?
We know trauma in children is the causation of slowed or reversed development. For example:
“Children who suffer from child traumatic stress develop reactions to trauma that linger and affect their daily lives long after the traumatic event has ended. Symptoms can vary according to developmental stage. For instance, an infant or toddler may lose previously acquired skills, such as toileting or language skills, while a teen might exhibit unusually reckless, aggressive or self destructive behavior. The figure below provides a list of some of the common symptoms of child traumatic stress and ADHD. The overlapping area shows some symptoms that are common to both.”
The tendency for pediatricians at these points is to medicate children, and at times that may be appropriate, but we are then opening them up for addiction problems later in life. We are certainly challenged in this arena as we seek the best treatment for children. There is, however, great wisdom in investigating and treating trauma and toxic stress before we immediately label a child with ADHD and medicate them. If ADHD is, in fact, present, treatment of trauma and toxic stress will only help with symptoms.
Finally, studies continue to demonstrate that children with toxic stress and trauma often present with co-occurring disorders such as Bi-Polar, Borderline Personality Disorder, body issues and a host of others including anxiety and depression.
EARLY intervention for childhood trauma gives them the best shot at a healthy, productive life. Treat the trauma and you are treating the whole child.
There is never an excuse to harm a child, but unfortunately, children are traumatized and they may or may not also live with ADHD, but the best news ever is there is hope in treatment. So, parents, don’t just accept an ADHD diagnosis, investigate.
Here is a podcast episode where we discuss co-occurring disorders in children. Special thanks to Dr. Patrice Berry for this episode!