Is it ADHD?

Or Could it be Trauma

We see kids all over the place that act wild, hyperactive, and excessively
energetic, and we often assume they have ADHD. We need to realize, with great
compassion, that the symptoms of ADHD and trauma look very similar.

Problems with concentration, angry outbursts, sleep disturbances, and socially

withdrawn behaviors are all examples of symptoms of children who have
experienced a significant event, or trauma. The symptoms for ADHD include
difficulty sustaining attention, difficulty organizing tasks, hyperactivity,
impulsivity, and difficulty following through with instructions. They sound
pretty similar, right?

When a child has experienced domestic violence, drug addicted parents,

neglect, and an unstable home environment we would expect them to struggle.
What about if they had a surgery (or surgeries) at an early age when they did
not comprehend what was happening? What if a child felt helpless as he
watched his family fall apart and he blamed himself while his parent’s
divorced? What if there was unknown sexual abuse that a child feels unwilling
(or unable) to talk about? Are we as parents, physicians, and mental health
providers missing the possibility that our children may have been traumatized,
and treating it as ADHD?

The treatments for Trauma and ADHD are very different. If a clinician, teacher,
or parent observes a child’s hyperactive behavior, or distractibility, they might
conclude that the child has ADHD without realizing that the real problem could
be unresolved trauma. Giving a child who has been traumatized stimulant
medication can wreak havoc on their nervous systems. Teaching them coping
skills for their inattention is pointless if they need to process a traumatic event
(or events.)

Taking a thorough history is the first step for proper treatment. Exploring
events such as surgeries, difficult dental procedures, sudden changes in
behavior (which might signal sexual/physical abuse or bullying), and
significant life changes (such as moving to a new school) is essential in teasing
out the differences between ADHD and trauma.

The brain stores traumatic events that are unresolved in the mid brain. When a
child is triggered by a similar event later on, or is excessively stressed, his
behavior can mimic ADHD. Picture it like someone who is carrying a backpack
of experiences. For most of us, the “backpack” has a few things that were
challenging in it, but we trudge on because it’s not overly significant. When a
child has traumatic experiences his “backpack” is “fuller and heavier” than
other kids, and his brain is working overtime to manage the load.

Normally, when everything is working well, we use our prefrontal cortex (PFC,)
which is in the front of the brain, to help us make important decisions. When
trauma is present, or is triggered, the child is often flooded with the survival
skills he was born with and may not have access to his prefrontal cortex. The
memories in the midbrain (the backpack of traumatic experiences) sabotage
the brain’s ability to use the “thinking” part of the brain, or the PFC. Instead the
need for “fight or flight” shows up due to the trauma history, and the child can
act like he is distracted, hypervigilant, and inattentive. He is not a behavior
problem, he needs help.

One solution to this challenge is allowing a safe place for the child to process
any significant events to rule out trauma. There are treatments available today
to release trauma such as EMDR, somatic experiencing, and brainspotting.

Often with traditional talk therapy, a child processes using the “thinking” part
of their brain. This can be very difficult and cause the child to not want to
continue with therapy. With brain-body trauma therapy using the above-
mentioned methods, the child processes in the mid-portion of the brain and it
releases the “stuck” event which causes the ADHD-like symptoms to release. Commented [JCDN1]: Por eso es tan importante una
intervención que no este dirigida directamente a los niños.
Debe ser estratégica y dirigida al fortalecimiento del
Using Brainspotting and bilateral sound with a simple headset, the therapist sistema!
can guide the child to remember a “medium sized” event so they can feel what
it is like to release it. Rapport is important for a child to feel safe enough to
revisit the trauma. The difference in this type of therapy is that the child isn’t
just remembering the event, he is releasing it from the “stuck” part of his
midbrain. After the release, it is easier for the child to learn new skills that
improve his behaviors.

I have seen children reduce their anxious behaviors, improve concentration,

and change how they look at past events that previously overwhelmed them
using brain-body trauma processing. The treatment is often much shorter than
traditional treatments because it’s solving the underlying problem before
introducing Cognitive Behavioral Treatment interventions. As parents,
teachers, and health care professionals, let us be aware of the similarities of
ADHD and trauma, and find out what will truly help our kids get better… and
allow them to thrive.