Welcome! In this blog post, I invite you to explore the symptoms of both Attention-Deficit/Hyperactivity Disorder (ADHD) and trauma, highlighting its complexity and the crossover. There is an increasing body of research showing a close association between ADHD and trauma. Trauma may exacerbate pre-existing ADHD symptoms in children. Traumatic events can cause behaviour that mimics ADHD symptoms (e.g., constant emotional arousal resembling impulsivity and hyperactivity). While the information suggests that trauma does not directly cause ADHD, the two conditions can be linked, leading to a growing movement for trauma-informed care interventions in managing ADHD.

Although for now there is no causal relationship, ADHD and trauma can co-occur. Both conditions may affect similar brain areas. Trauma can contribute to the emergence, persistence, and severity of ADHD symptoms.

Throughout my career, I have worked with individuals facing the challenging comorbidity of ADHD and trauma, often compounded by childhood abuse and self-medication through substances like cannabis. Individuals who turned to cannabis as a form of self-medication for their ADHD symptoms. Unfortunately, this path sometimes leads to unexpected consequences, psychosis triggered by cannabis use (click the link for a definition of psychosis) .

One case that stands out involves a young man whose unresolved trauma was overlooked by the mental health system. While he identified his struggles as ADHD, his severe childhood trauma had gone unaddressed. His symptoms, which he believed were solely related to ADHD, closely mirrored those of trauma. For example:

– Hyper-vigilance and attention difficulties 

– Emotional dysregulation 

– Impaired executive function 

– Difficulty concentrating 

– Restlessness or agitation 

– Impulsivity 

– Emotional outbursts 

In our discussion, I emphasized to him that the situation was far from straightforward. While he appeared to acknowledge his ADHD symptoms, his trauma was going untreated, which it was clear to me that his childhood trauma played a significant role in amplifying or even mimicking these symptoms, which I believed required an investigation. However, solution-focused hypnotherapists (SFH) do not diagnose.

Childhood trauma, particularly severe abuse, profoundly affects brain development, resulting in behavioural patterns closely resembling ADHD. This case exemplifies the intricate relationship between trauma and ADHD, emphasizing the need for trauma assessment. Combining ADHD with trauma complicates diagnosis. It’s essential to remember that there is no definitive blood test or visible brain abnormality confirming ADHD. Diagnosis relies on behavioural observations, self-reporting, and comprehensive assessments.

While ADHD is primarily a neurodevelopmental disorder with strong genetic and biological roots, trauma-related behaviours are adaptive responses to past stress or danger. When both exist, trauma often amplifies or mimics ADHD symptoms, making diagnosis more difficult. When trauma-induced responses coexist with ADHD, they exacerbate symptoms, blur diagnostic boundaries, and complicate treatment. Trauma significantly impacts brain regions like the amygdala, hippocampus, and prefrontal cortex, leading to symptom overlap, including impulsivity, hyperactivity, and emotional dysregulation.

Research shows that childhood trauma disrupts brain development, particularly in regions that control emotion, memory, and executive function:

Amygdala: Trauma over-activates the amygdala, the brain’s fear-processing center, leading to hyper-vigilance and emotional outbursts.

Hippocampus: Traumatic experiences shrink the hippocampus, affecting memory and creating difficulties in distinguishing between past and present threats.

Prefrontal Cortex: Trauma weakens the prefrontal cortex, impairing decision-making, emotional regulation, and impulse control, areas also impacted by ADHD.

Both ADHD and trauma can manifest in similar ways, hyperactivity, impulsivity, and emotional dysregulation. However, their origins differ. ADHD has a genetic and neuro-developmental basis, whereas trauma-induced hyper-vigilance is an adaptive response to repeated exposure to danger.

Therefore, careful assessment is crucial when trauma and ADHD overlap. Misdiagnosing ADHD without considering trauma can lead to ineffective treatments. The best approach is a dual focus on trauma-informed therapy and ADHD management, ensuring both conditions are addressed simultaneously for comprehensive recovery.

Trauma also alters the body’s stress response system, specifically the Hypothalamic-Pituitary-Adrenal Axis, leading to chronic cortisol elevation. This overactive stress response weakens the immune system and heightens the risk of physical conditions like heart disease and hypertension. People with trauma and ADHD live with stress on a daily basis, triggering them to spend more time in their emotional mind filling their metaphoric stress bucket.

Consequently, there is emerging evidence which suggests that trauma promotes chronic inflammation, disrupting the immune system. This can lead to increased vulnerability to autoimmune disorders, cardiovascular diseases, and gastrointestinal issues. Trauma survivors often face not just psychological but physical health challenges, which further complicate their long-term well-being.

Beyond neuro-biological changes, childhood trauma profoundly affects emotional and psychological functioning:

Emotional Instability: Trauma survivors often experience chronic anxiety, depression, and mood swings, sometimes misdiagnosed as generalized anxiety disorder or other mood conditions.

Attachment Issues: Trauma disrupts healthy emotional bonds, causing attachment disorders in adulthood. Survivors often struggle with trust and intimacy, leading to unhealthy relationships or emotional detachment.

Cognitive Distortions: Trauma frequently leads to distorted self-perceptions, feelings of unworthiness, guilt, or a pervasive belief that the world is unsafe. These beliefs contribute to impaired learning, concentration, and long-term academic or professional difficulties.

Through my nursing career, I’ve witnessed firsthand the significant risk childhood trauma poses for the development of mental health conditions such as:

Post-Traumatic Stress Disorder (PTSD): Flashbacks, nightmares, and hyper-vigilance often arise in trauma survivors.

Mood Disorders: Depression is significantly more common in those with unresolved trauma. Exposure to trauma (such as childhood abuse, neglect, or other adverse experiences) can increase the risk of developing bipolar disorder.

Anxiety Disorders: Generalized anxiety disorder (GAD), panic disorder, and social anxiety disorder may all have roots in unresolved trauma.

Personality Disorders: Trauma can contribute to the development of Borderline Personality Disorder (BPD) or Dissociative Identity Disorder (DID).

For many individuals, cannabis is used as a form of self-medication to manage ADHD symptoms such as agitation and anxiety. However, cannabis can also increase the risk of psychiatric conditions like psychosis, particularly for those with underlying trauma. This underscores the importance of professional guidance in managing these conditions rather than turning to self-medication.

Risk Factors: The appeal of cannabis as a potential remedy for managing ADHD symptoms often leads to self-medication. However, individuals with ADHD may inadvertently exacerbate their symptoms by using cannabis. Additionally, as mentioned by the young man in this post, cannabis use is associated with an increased risk of psychosis. He reported needing to escalate his cannabis use to alleviate symptoms. These risk factors highlight the complexities of using cannabis to address mental health.

Approach: CBT helps individuals reframe negative thoughts and behaviors. Trauma-focused CBT addresses trauma symptoms, while traditional CBT targets ADHD-related challenges.

Benefits: CBT is widely effective for both trauma and ADHD, promoting structured techniques for symptom management.

Limitations: Individuals with severe trauma or ADHD may find it challenging to engage fully in CBT due to difficulty focusing or emotional overwhelm.

Approach: Medications are often used to manage ADHD symptoms, such as stimulants (e.g., Methylphenidate, amphetamines) or non-stimulants (e.g., Atomoxetine). For trauma-related conditions, medications such as antidepressants or anti-anxiety medications may be prescribed to manage associated mood disorders.

Benefits: Medication can provide quick symptom relief for ADHD, improving attention, impulsivity, and hyperactivity. In trauma cases, it can help stabilize mood, reduce anxiety, and treat comorbid conditions like depression or PTSD.

Limitations: Medication doesn’t address the underlying causes of trauma and may not resolve emotional dysregulation stemming from traumatic experiences. Additionally, some individuals may misuse medications or experience side effects.

Approach: Eye Movement Desensitization and Reprocessing (EMDR) is a specialized therapy designed to help trauma survivors process distressing memories. It uses guided eye movements to help patients reduce the emotional impact of traumatic experiences.

Benefits: EMDR is highly effective for trauma and can help reduce PTSD symptoms, allowing patients to move forward without being hindered by past traumas. It works well in conjunction with other therapies or medication.

Limitations: EMDR is not designed to treat ADHD directly, so it must be combined with ADHD-specific interventions for individuals with both conditions.

Approach: Mindfulness techniques, such as Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT), focus on increasing awareness and acceptance of present experiences. These therapies help reduce stress, improve emotional regulation, and develop coping strategies.

Benefits: Mindfulness has been shown to improve attention, reduce anxiety, and help individuals manage stress, important aspects for both trauma and ADHD management.

Limitations: Mindfulness requires consistent practice and may not offer immediate symptom relief, particularly for individuals with severe ADHD-related inattention or trauma-related hypervigilance.

Approach: SFH combines hypnosis, positive psychology, and solution-focused techniques, helping individuals set and visualize future goals. SFH fosters relaxation and emotional regulation, particularly beneficial for trauma-related hyperarousal and ADHD’s impulsivity.

Benefits: SFH empowers individuals by focusing on solutions rather than revisiting past trauma, promoting relaxation, stress reduction, and positive thinking.

Limitations: SFH is not a first-line treatment for ADHD’s neurodevelopmental challenges and works best alongside ADHD-specific interventions like medication.

By combining these approaches, clinicians can offer a holistic and personalized treatment plan for individuals managing the dual challenges of trauma and ADHD. All these therapies have a role to play, however I am promoting SFH because this is my area.

SFH stands out as a powerful approach for addressing both trauma and ADHD. It seamlessly integrates principles from positive psychology, hypnosis, and solution-focused techniques. This holistic blend allows individuals to tap into their innate strengths and move toward their desired outcomes. The Initial Consultation plays a pivotal role in SFH. During this phase, individuals receive education about how the brain responds to trauma and ADHD. This deeper understanding of their symptoms becomes the bedrock for subsequent interventions. SFH not only enhances effectiveness but also empowers the individual. By focusing on solutions and positive change, it provides a pathway for growth and healing. While SFH does not directly target the neuro-developmental origins of ADHD, it significantly alleviates symptoms that often overlap with trauma. Emotional dysregulation, stress, and negative thinking patterns find relief through SFH.

Below is a brief breakdown of how SFH can benefit individuals dealing with ADHD and trauma.

SFH places a strong emphasis on forward momentum and the establishment of positive goals, rather than dwelling on past traumas. This approach is particularly empowering for trauma survivors. As its focus is on moving forward, SFH allows individuals to break free from the chains of painful memories. Survivors can envision a future less burdened by past trauma, which is both empowering and liberating.

During SFH sessions, individuals enter a deeply relaxed mental state. In this receptive condition, stress and anxiety responses diminish significantly. Clients become more open to positive suggestions, creating fertile ground for transformation. SFH helps clients process emotions and release negative thought patterns. By cultivating healthier ways of thinking, individuals gradually alleviate emotional distress and hyper-arousal commonly associated with trauma.

SFH empowers individuals by tapping into the “intellectual brain,” specifically the prefrontal cortex. This brain region plays a crucial role in rational thinking and emotional regulation.  People with ADHD often struggle with emotional regulation. When trauma is also in the picture, these challenges can become even more pronounced. Through the calming and focused state of hypnosis, SFH reduces anxiety and stress. By helping individuals manage their emotions more effectively, SFH can lead to improvements in both ADHD symptoms (such as impulsivity) and trauma-related issues (like hyper-vigilance or emotional overwhelm).

 ADHD symptoms such as inattention and distractibility can be addressed indirectly through SFH. By helping clients focus on solutions and future goals, the therapy encourages them to engage their problem-solving and organizational skills. The trance state in SFH induces a calm, focused mind, allowing individuals with ADHD to experience improved concentration and mental clarity, even after the session ends. Regular sessions can help strengthen the brain’s ability to focus and sustain attention.

Both trauma and ADHD can lead to heightened stress and anxiety, and these conditions often feed into each other. SFH helps clients reduce the activation of the amygdala, the brain’s emotional centre, which is responsible for fear and anxiety responses. In the relaxed state achieved through hypnotherapy, stress hormone levels like cortisol decrease, while levels of feel-good neurotransmitters (e.g., serotonin and dopamine) rise. This neuro-chemical shift helps calm the nervous system, reducing ADHD-related restlessness and trauma-induced anxiety.

SFH places a strong emphasis on positive visualization and goal-setting. Clients are guided to imagine their desired outcomes and the steps they need to take to achieve them. This approach is particularly helpful for both trauma and ADHD, as it shifts the focus away from problems (e.g., traumatic memories or struggles with attention) and toward actionable solutions. Over time, this builds resilience, improves self-esteem, and helps individuals develop more effective coping strategies.

SFH encourages individuals to think differently and develop a more flexible mindset, which is particularly beneficial for both trauma survivors and those with ADHD. Trauma can lock individuals into rigid patterns of fear or avoidance, while ADHD can lead to repetitive, unproductive thought cycles. By exploring new perspectives and practicing solution-focused thinking, individuals become more adaptable in their responses to challenges, both emotional and cognitive.

SFH taps into the brain’s ability to change and adapt, neuroplasticity, which means the brain heal. Our brains are not fixed; they have the capacity to rewire themselves. Neuroplasticity refers to the brain’s ability to form new neural connections, reorganize existing ones, and adapt in response to experiences, learning, and environmental changes.

Through positive visualization and solution-focused questioning, clients begin to form new neural pathways that support positive behaviour and thinking patterns. Repeated reinforcement of these pathways during hypnotherapy sessions can help individuals with ADHD develop better attention control and reduce impulsivity, while also helping trauma survivors break free from negative emotional patterns.

In SFH, rewind and reframe are key techniques used to help clients process past experiences and shift their perspective toward positive outcomes. This cannot be undertaken until the stress bucket has been significantly reduced.

Rewind:

The rewind technique helps clients reduce the emotional intensity of distressing memories or past trauma without needing to re-experience them in detail. In a relaxed, trance-like state, the client is guided to mentally “rewind” and view the event from a detached, safe perspective. This process helps dissociate the emotional response from the memory, making it less distressing over time. The aim is to allow clients to acknowledge the memory without being overwhelmed by it.

Reframe:

Reframing involves shifting the client’s perspective on their situation, focusing on positive outcomes and future possibilities rather than the negative aspects of past experiences. During hypnosis, the therapist introduces suggestions that help the client view their challenges in a new light, emphasizing strengths and solutions rather than problems. This technique empowers the client to see how they can move forward, encouraging a mindset of growth and positive change.

Both ADHD and trauma can severely disrupt sleep patterns, leading to further issues with focus, mood, and emotional regulation. SFH promotes deep relaxation, which can help reset the body’s sleep-wake cycles and reduce insomnia. Improved sleep can lead to better cognitive functioning during the day, helping individuals manage both ADHD symptoms and trauma-related anxiety more effectively.

In Summary, when managing trauma and ADHD, we must adopt a personalized and comprehensive approach. This is because ADHD and trauma shared symptoms. Trauma symptoms often overlap with those of ADHD. Since there’s no definitive blood test or brain scan for either condition, accurate diagnosis relies heavily on thorough assessment. Therefore, it is crucially, that mental health clinicians assess trauma as part of their diagnostic process. As trauma-informed care ensures that we address underlying emotional wounds alongside ADHD symptoms. Initially, clinicians commonly use medication to treat ADHD. While medication can alleviate some symptoms, it does not directly target trauma’s root causes. SFH is a comprehensive approach to complement medications. SFH emerges as a powerful tool for emotional regulation, stress reduction, and fostering positive thought patterns. Its unique advantage lies in techniques like “rewind” and “reframe,” which prove particularly effective in trauma healing. By integrating SFH with other ADHD-specific treatments, clinicians offer a holistic approach. This combination supports patients in managing emotional responses to trauma or stress while promoting a forward-looking mindset.