Adult ADHD and PTSD

Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that can be very difficult to manage–especially for adults with ADHD.  As the name suggests, this cluster of symptoms is the result of experiencing a traumatic event.  A person with PTSD may be easily triggered by a smell, sound, sight or other sensation associated with a conscious or unconscious element of a traumatic incident, reactivating the psychological response.

Often people with PTSD are aware of their traumas and associated triggers. These people may recognize when they are reenacting the emotional response. This is the case with people who have been in car accidents and become unable to drive (or ride) in a car without distress; crime victims who are terrified to go near a bank or other scene of the crime; sexual abuse or rape victims who become physically sick when they smell certain cologne or try to eat certain foods, like hot dogs or sausage.

For people who don’t remember the trauma, these reactions are usually confusing and frightening.  People may spend years in therapy attempting to figure out why they have such extreme reactions to seemingly neutral objects.

What about those who have unnamed trauma?  Or, those who are unaware of their triggers and may not recognize what is happening when they slip into that ‘psychological space’ in their minds.  Below is a list of some more commonly reported PTSD reactions.

  • Often the symptoms begin as feeling a bit dazed and numb–things seem a bit hazy or unclear–that can continue for several days or weeks.  Disassociation is a common response to trauma, not unlike the times one’s mind just disappears with ADHD.
  • The confusion and dreaminess is usually followed by or accompanied with anxiety, often the generalized (free-floating) anxiety that feels like edginess, being easily startled and jumpy for no apparent reason.
  • People usually have problems sleeping or relaxing. Hyper-vigilance, that constant sense of urgency, being on guard or ‘waiting for the other shoe to drop’, ramps up the anxiety to the point of paranoia at times. This can lead to sleep deprivation, which amplifies the hyper-vigilance and many other problems.
  • Isolation is pretty common for people who are hyper-vigilant or paranoid.  In the extreme, people become afraid to go about their daily lives; in less extreme cases, they may avoid certain areas or trigger points and try to continue with their daily routine.  If left untreated, this can lead to problems at work or school, in relationships or other facets of daily living.
  • Symptoms of depression may also follow:  Frequent crying, feeling ‘flat’ (aka blah) or sad, lack of energy, loss of interest in things you usually enjoy, irritability or agitation, problems with concentration, changes in eating and sleep patterns, for some, thoughts of suicide or death and feeling guilty or worthless.

This is important for the thousands who are living with PTSD and unaware of this cycle.  Either PTSD or ADHD could be misdiagnosed for the other.  More often, they occur simultaneously, inflaming symptoms that look a lot alike. The pattern may be repeated at infrequent intervals, or happen very rarely.

Often PTSD goes undiagnosed, unless a medical or mental health professional takes an extensive personal history, asking the right questions in just the right way. Many times the reporter does not disclose this information.  Unfortunately, unless it is a fairly obvious trauma, people often forget to include the event when giving their history –or they withhold the information because they don’t want to talk about it.  More likely, it will surface in an on-going therapeutic relationship–often when one seeks therapy after being triggered.

People react differently to events.  Some people are traumatized by seemingly benign events that other people experience and shake off easily.  Others survive horrific events that seem traumatic without long-lasting psychological damage. If you haven’t read Man’s Search for Meaning, you should. It’s an amazing story of a concentration camp survivor.

Another good example of how PTSD affects people is war veterans.  Many come home scarred for life, reliving their experiences through nightmares, flashbacks and extreme psychological distress that impair every area of their lives.  Others who experienced the same event seem able to compartmentalize those atrocities and suffer few, if any, long-term problems.  There is no accounting for resilience.

In a study that compared girls with ADHD to girls not suffering from it, higher rates of abuse were found in the ADHD population. Of the girls with ADHD, 14.3 percent had been abused. Of the girls without ADHD, 4.5 percent had been abused. The study was published by Allison M. Briscoe-Smith and Stephen P. Hinshaw in a 2006 edition of Child Abuse and Neglect.

http://www.livestrong.com/article/221175-add-child-abuse/#ixzz1WRIaxgex

Attention Deficit Hyperactivity Disorder (ADHD) and Post-Traumatic Stress Disorder (PTSD) show a high degree of comorbidity in traumatized children. Two hypotheses may help explain this relationship: children with ADHD are at higher risk for trauma due to their impulsivity, dangerous behaviors, and parents who may have a genetic predisposition for impairment of their own impulse control; and hyperarousal induced by severe trauma and manifested by hypervigilance and poor concentration may impair attention to create an ADHD-like syndrome.  Co-morbidity of Attention Deficit Disorder and Post-traumatic Stress Disorder.

As you see, there is a lot of overlap in symptoms and a reported high incidence of abuse in kids with ADD/ADHD. PTSD can exacerbate your ADHD symptoms – and create anxiety with new symptoms EACH TIME THE EVENT IS TRIGGERED IN YOUR PRESENT LIFE.

The important thing to remember is that PTSD doesn’t just go away–it has to be managed, much like ADHD.  Learning more about your triggers and how to cope with the specific psychological symptoms you experience is the key to successfully living with PTSD.  Some people have success with EMDR treatment for PTSD, but many do not respond to it.  To date, there is no magic bullet that cures PTSD, to my knowledge.

My best advice–if you have periods of time when you experience any of the symptoms in the information above, talk to your medical or mental health provider. Be certain he/she is aware of any potential trauma history in your past, whether it is abuse, a car accident, witnessing domestic violence or being humiliated in first grade by a careless teacher. These events revisit you, but they don’t have to ruin your life.

Any thoughts about PTSD and ADHD?  Anyone want to share how you cope?