Does Trauma Cause ADHD? And Vice Versa?

Could experiencing traumatic stress cause ADHD in me or my child? What is the ADHD-PTSD link? What does effective treatment look like? Is it ever too late to be treated? Answers to these and more in this expert Q&A.

The connection between trauma and ADHD is fascinating, if not fully understood. As research continues to fill in the blanks, Nicole Brown, M.D., MPH, MHS, recently answered questions from ADDitude readers about whether trauma begets attention deficit hyperactivity disorder (ADHD or ADD), what treatment options help children with ADHD who have experienced trauma, and what constitutes “trauma” in a diagnostic sense.

Q: Can trauma cause ADHD?

Research doesn’t support the idea that trauma causes ADHD. Research does tell us that ADHD is a condition that’s largely genetic and inherited, and that it causes specific areas of the brain to be underdeveloped or otherwise impacted. Because trauma affects those same areas of the brain, it exacerbates ADHD symptoms. The science, however, is still out on what actually causes ADHD.

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Q: What “counts” as trauma?

Researchers use the term ACEs, which stands for “adverse childhood experiences,” to describe potentially traumatic events that occur before age 18. ACEs traditionally include incidents like physical and emotional abuse, neglect, and household dysfunction. Our conception of ACEs, however, is continuously broadening, and there’s an explosion of science around it.

Death of a caregiver has traditionally been thought of as an ACEs type, for example. But the experience of almost losing someone close to you can be just as traumatic. Some children are also more at risk for certain unique traumatic stressors, as is the case with children of color experiencing stressors like systemic racism and concentrated poverty. Another important element to consider is that trauma is experienced, lived, and internalized very differently among people.

It is possible for “smaller” events to add up to trauma. Many studies on ACEs are limited in that they only look at the incidents in a “snapshot” form, not a cumulative form. The timing and accumulation of adverse events aren’t considered, nor is how they may impact the health trajectory of an individual. But we absolutely know that the more ACEs experienced, the more negative outcomes that are predicted.

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Q: With trauma and adverse experiences in childhood, can there be delayed responses that manifest only in adulthood?

Absolutely. In fact, it seems like most of the literature on ACEs has actually been done in adult populations, and pediatric literature is catching up. What we’re gleaning from the science is that ACEs cause changes in the brain and changes in different organ systems that begin in childhood and that translate to heightened risk for mood disorders and other chronic health conditions in later adulthood.

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You can read all Q&As on Additudemag.com