Why Trauma Often Gets Misdiagnosed As ADHD
Imagine a child with the following symptoms:
Difficulty concentrating and learning in school
Distractibility
Disorganization
Insomnia or restlessness
Hyperactivity
To many parents, teachers, and pediatricians, these traits often seem like first-class indicators of ADHD. While ADHD might be a legitimate diagnosis, these traits are also often seen in children who have suffered trauma. Since the approaches for ADHD and childhood trauma are very different, it is important to be able to distinguish the two, and look beyond similar symptoms to give an accurate diagnosis. Determining why a child is exhibiting symptoms like hyperactivity is all about making sure they get the help they need and the proper treatment for whatever their condition may be.
What Is Trauma?
Children (and adults) that have been exposed to stressful or traumatic events often exhibit signs of trauma through symptoms like those listed above. Trauma can occur as the result of something an individual has witnessed, experienced, or even heard about. Like adults, no two children process trauma the same way, and the specific symptoms exhibited by traumatized children vary.
What Causes Trauma?
Childhood trauma is often discussed in terms of ACEs: Adverse Childhood Experiences. These events tend to be recurring or long-term, and can be physical, emotional, or mental. Some traumatic events might be easily identifiable like witnessing ongoing household violence, experiencing the death of a loved one, or spending weeks in the hospital. Other types of trauma are less overt and more difficult to identify, like narcissistic abuse, early exposure to inappropriate messaging, and more.
What Is ADHD?
Attention deficit hyperactivity disorder (ADHD) is a common disorder that is characterized by impulsivity, inattention, and/or hyperactivity. Some patients are primarily inattentive; some are primarily hyperactive. Some display a combination of symptom types. While ADHD is often thought of as a childhood disorder, the majority of childhood ADHD patients’ symptoms continue into adolescence, and symptoms persist to adulthood in about 65% of patients.
What Causes ADHD?
Researchers have yet to determine the exact causes of ADHD, though there is thought to be a genetic component.
ADHD and Childhood Trauma Have Overlapping Symptoms
The most obvious reason that trauma gets misdiagnosed as ADHD is that many of the symptoms overlap. Children who have been through trauma often have feelings of fear and helplessness, unusually reckless or aggressive behavior, feelings of guilt or shame, and exhibit other trauma avoidance behaviors. Children with ADHD have difficulty sustaining attention, challenges with focusing on instructions and organization, and issues with mood and verbal control. Overlapping symptoms include easy distraction, restlessness, hyperactivity, sleep issues, and difficulties in social settings like school– which is often the first place either of these conditions are noticed.
ADHD Is A “Go-To” Diagnosis
Many teachers and childhood professionals are familiar with ADHD as a diagnosis. Because children are often unwilling or unable to put their trauma into words, it is easy to assume that restless behavior or difficulty in the classroom is due to ADHD. Because ADHD has become a go-to, and because there are many well-established treatment options, some teachers, doctors, and parents are quick to jump to ADHD as the answer.
ADHD And Trauma Exacerbate Each Other
As neuroscientist Dr. Gabor Maté points out, the human brain is a “social organ,” and doesn’t just develop based on biological signals. The human brain relies on its environment, including its social environment, to develop, which means traumatic events may change the way the brain develops. Trauma impacts regions of the brain that cause social difficulties, learning difficulties, inattention, mood dysregulation, and other ADHD criteria.
ADHD Symptoms May Be Caused By Trauma
While trauma and ADHD are distinctly different, some behavioral symptoms of ADHD may be caused by underlying trauma, and some studies show that experiencing trauma increases a child’s chances of being diagnosed with ADHD. To understand what is going on with a child who’s having behavioral problems, you must look at the origin of the symptoms. For example, a distractible child might not have an ADHD-related reason for their focusing difficulties. Instead, they might be exhibiting hypervigilance or a dysregulated nervous system that comes from trauma.
Getting The Right Treatment For The Right Diagnosis
If your child is exhibiting signs of trauma or ADHD, it is important to find a treatment plan that works for them and addresses the root of their issues. At Whole Self Therapy, our therapists are well-versed in childhood trauma and developmental issues like ADHD. We understand that you want more than just coping strategies: you want answers. Our practitioners focus on getting to the bottom of your child’s problems and helping them be their best, happiest, and healthiest selves.