SWISS MEDICAL EXPERTISE: ZURICH, MALLORCA, LONDON

10 Minutes

Edited & medically reviewed by COGNIFUL Team
Fact checked

It is common for mental health professionals to misread symptoms, mixing two similar diagnoses. The problem is particularly prevalent with diseases that involve more complex symptomatology, like attention deficit hyperactivity disorder (ADHD). For instance, many professionals have mixed the symptoms of anxiety with those of ADHD or misdiagnosed an underlying learning disability as ADHD. What makes the matter more complex is that ADHD can co-exist with almost every psychiatric disorder known to the world.

Posttraumatic stress disorder, or PTSD, is perhaps the most difficult differential diagnosis for mental health professionals to tell apart or treat alongside ADHD as a co-occurring issue. [1] The significant overlaps between the two conditions can confuse seasoned professionals, leaving them struggling to decipher the differences. On top of this complexity, misconceptions about both disorders further exacerbate the confusion.

When comparing ADHD vs PTSD or suspecting a combination of both, it is essential to approach every case with an open mind and a readiness to accept any possibility. Furthermore, raising awareness about the ADHD and PTSD overlap is crucial to raise concerns in time for more effective management.

While both ADHD and PTSD have many distinct symptoms, many of them can overlap. [2] Following are the six more common ADHD vs trauma symptoms in adults that can occur in both conditions, leading to a mix-up or a misdiagnosis:

Sleep-related issues

People with underlying attention deficit hyperactivity disorder often struggle to fall asleep or maintain it. Some of them may also have a difficult time waking up if they manage to fall asleep in the first place. The main issue triggering these sleep problems is their inability to wind down and relax their mind and body. The consequent lack of sleep can make ADHD symptoms significantly worse.

People struggling with PTSD also commonly report insomnia and other sleep disturbances, mainly due to symptoms like nightmares. As with ADHD, poor or inadequate sleep makes their symptoms worse.

Trouble with concentration

PTSD and ADHD can cause problems with concentration and focus, but the triggering reasons may be different. Problems with executive functions, such as poor focus, are a big part of ADHD symptomatology and can make such people struggle to concentrate on day-to-day activities. Sometimes, they may also have difficulty shifting their attention from one task to another.

Posttraumatic stress disorder, on the other hand, gives rise to intrusive thoughts and anxiety, both of which can reduce focus. Anything that reminds these people of their past traumas, including smells, sounds, and intense emotions, can bring on these symptoms.

Negative self-perception

Both complex PTSD and ADHD in adults can target self-esteem. The challenges associated with ADHD can be complex to navigate and create problems in different aspects of life. For instance, such people may frequently get in trouble at work or school, feeling like they do not fit in. The consistent struggle these people have to put in everything they know is more accessible to their peers, which may make them feel bad about themselves.

PTSD is also known to cause similar problems with self-esteem. The condition can make the trauma survivors create exaggerated negative self-perceptions about themselves that may make them believe that they deserve what they went through. PTSD may also make them feel as if they are damaged or the reason behind what they had to endure.

Recklessness or impulsivity

Individuals with ADHD often struggle with self-control. Their impulsive behaviors can land them into risky situations or force them to perform self-destructive practices. PTSD can also cause a person to act recklessly, making it similar to the impulsivity seen in ADHD. People with underlying trauma behave recklessly as they feel like they do not have enough time or are triggered by something. This creates a panicked situation, which makes it more challenging to control dangerous impulses. [3]

Emotional dysregulation

Individuals with ADHD can struggle to manage their feelings. Often, they may feel emotions more severely or for longer than others, which can get in the way of their lives. People with PTSD face similar problems with emotional regulation. As PTSD can cause episodes of sadness, anxiety, anger, and suicidal ideation, it may be hard to confuse it with emotional dysregulation due to ADHD.

Memory problems

Having problems with working memory means individuals with ADHD may have difficulty acquiring new information and keeping it long enough to utilize it effectively. These problems may also occur in people with PTSD, and the stress from their underlying trauma can negatively affect their working memory. Moreover, individuals with PTSD also have many intrusive memories and frequent flashbacks, scattering their sense of time and deteriorating their memory even more.

In addition to the possible symptomatologic overlap between ADHD and PTSD, both conditions have many distinctive differences that the professionals can use to tell them apart.

Differences in Onset and Development

The timing of symptoms to develop is a crucial difference that experts use to differentiate PTSD and ADHD symptoms.

  • ADHD: This condition typically kicks in during childhood, and the symptoms usually become noticeable before an individual turns 12. The disorder is long-term and persists into adulthood for many. [4]
  • PTSD: This disorder can develop at any age after exposure to trauma. The symptoms may not immediately become noticeable and sometimes may appear months or years after the initiating event.

Root Cause

The root causes for ADHD Vs PTSD can be fundamentally different.

  • ADHD: It is primarily a neurodevelopmental disorder that shares a vital genetic component. Research based on brain imaging has revealed significant differences in the function and structure of brain areas responsible for regulating impulse control, executive functioning, and attention.
  • PTSD: As a trauma-related disorder, PTSD is a combined result of genetic, environmental, and psychological factors. The condition also has associations with alteration in specific brain areas that process fear, such as the hippocampus and amygdala. [5]

Cluster of Symptoms

Apart from sharing many symptoms and presentations, the specific symptom clusters for ADHD and PTSD can considerably vary.

  • ADHD: This condition consists of a triad of impulsivity, hyperactivity, and inattention.
  • PTSD: This condition is characterized by avoidance, intrusion, altered reactivity and arousal, and adverse effects on mood and cognition.

The different clusters of symptoms due to ADHD and PTSD indicate different mechanisms and pathways that underlie each disorder.

Research has highlighted that ADHD and PTSD can occur together, especially in people exposed to high trauma levels. These people include those belonging to military personnel, survivors of abuse, and those involved in severe accidents. The co-occurrence of both issues together can severely complicate diagnosis and treatment.

ADHD Vs. PTSD: Shared Risk Factors

Many risk factors can increase the risk of acquiring both PTSD and ADHD together. These include:

  • Genetic predisposition: Evidence suggests that a family history of psychiatric disorders can increase a person’s risk of acquiring ADHD and PTSD together. Genetic studies have also confirmed many variations that make this co-occurrence likely.
  • Environmental Stressors: Early exposure to trauma, stress, or other adverse experiences in childhood can heighten the risk of developing PTSD and ADHD. These factors can affect the development and function of the brain, leading to the symptom onset.

CPTSD Vs ADHD: Clinical Implications

When ADHD and PTSD overlap, treatment is tailored to address both disorders together:

  • Diagnosis: An in-depth clinical assessment becomes essential to differentiate ADHD and PTSD. The process often involves taking history, using a symptom checklist, and opting for neuropsychological testing.
  • Integrated Treatment: Fortunately, many treatment strategies are available to manage challenges related to ADHD and PTSD. Some examples include eye movement desensitization and reprocessing (EMDR) and trauma-focused CBT. The goal is to manage the symptoms of both disorders while improving overall functioning and life quality.

Distinguishing between PTSD and ADHD can be highly challenging due to the considerable symptom overlap. However, the following pointers provide hints for professionals to get to the correct diagnosis:

  • Context and Timing: The symptoms of ADHD typically occur from an early age and remain consistent over time. PTSD, on the other hand, may begin at any time following exposure to a traumatic event. Therefore, underlying the timeline of the symptoms and their context can help clinicians make a diagnosis.
  • Comorbid Conditions: While making a diagnosis, it is essential to consider other comorbid conditions, such as depression, anxiety, and other trauma-associated disorders. These conditions may complicate the overall clinical picture, requiring integrated treatment programs.

When your ADHD hides behind complex PTSD, an appropriate treatment that addresses both issues becomes necessary.

Medication Management

Medications are necessary when it comes to managing ADHD, PTSD, and both together.

  • ADHD: Stimulant medications, such as amphetamines and methylphenidate, are commonly used to keep symptoms under control. Sometimes, non-stimulants, such as guanfacine and atomoxetine, may also be effective. [6]
  • PTSD: Selective serotonin reuptake inhibitors (SSRIs) such as paroxetine and sertraline are frequently helpful in managing anxiety and depression. Other medications, like prazosin, may sometimes be prescribed to manage nightmares and sleep issues.

Psychotherapy Interventions

Psychotherapy interventions form the mainstay of treatment and may include the following for both ADHD and PTSD:

  • Eye Movement Desensitization and Reprocessing: Abbreviated as EMDR, this therapy helps patients reduce the emotional impact of their traumatic memories through reprocessing. EMDR has been particularly effective for PTSD but can also support people with underlying ADHD symptoms. [7]
  • Trauma-Focused Cognitive Behavioral Therapy: TF-CBT has been designed to help individuals process their traumatic memories and control related symptoms. [8]
  • Skills Training & Behavioral Therapy: This includes parent training, CBT, and social skills training to manage ADHD. These therapies can be individualized to incorporate trauma-informed approaches to manage both disorders simultaneously.

Integrative Strategies

In addition to medication and therapy, experts recommend using integrative strategies as an adjunct to improve clinical outcomes. These may include:

  • Psychoeducation: Educating patients and their loved ones about PTSD and ADHD is crucial. Understanding these disorders can minimize stigma, foster a supportive environment, and improve coping strategies. Psychoeducation can also help individuals actively pursue their treatment with motivation.
  • Mindfulness & Stress Reduction: Mindfulness activities, such as yoga, meditation, and breathing exercises, can benefit the symptoms of PTSD and ADHD. These approaches can help people improve focus, enhance emotional regulation, and manage stress. For instance, mindfulness-based cognitive therapy and mindfulness-based stress reduction can be particularly helpful in managing depression and anxiety commonly seen in ADHD and PTSD.

ADHD and PTSD are chronic conditions requiring ongoing management. Following are some considerations to keep them in control for longer:

  • Regular Monitoring: Regular follow-up appointments with health professionals can help monitor symptoms, medication efficacy, and emerging issues, if any.
  • Building Resilience: Acquiring new coping skills, creating a support system, and improving problem-solving abilities are essential for managing both ADHD and PTSD effectively.
  • Adapting Treatment Plans: Treatment plans must be flexible and adaptable to changing needs. This is important because when individuals transition through various stages of life, their symptoms may change.
  • Promoting Well-Being: Encourage activities that boost wellbeing, such as hobbies, physical exercise, and social engagements, to improve mental health and quality of life.

Choosing a therapeutic community-based program is the best way to manage ADHD and PTSD acutely and in the long run. Our comprehensive programs can help people fighting both issues alone or in co-occurrence in the best possible way with long-term recovery.

Understanding the differences and similarities between ADHD and PTSD is critical for effectively diagnosing and managing both disorders. While both conditions share many symptoms, their symptom clusters and underlying causes are distinct. Nevertheless, the conditions can be easily mixed up, mainly due to their potential to co-occur. Effective treatment for individuals experiencing both PTSD and ADHD involves a combination of psychotherapy, medication, and other supportive interventions. Community support and family involvement are the cornerstones of recovery; hence, many individuals fighting these disorders choose therapeutic community-based programs for rehabilitation. Our programs embrace a compassionate and holistic approach to help users navigate the challenges of PTSD and ADHD, fostering recovery, resilience, and a fulfilling life.

[1] Spencer AE, Faraone SV, Bogucki OE, Pope AL, Uchida M, Milad MR, Spencer TJ, Woodworth KY, Biederman J. Examining the association between posttraumatic stress disorder and attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Th

[2] Daud A, Rydelius PA. Comorbidity/overlapping between ADHD and PTSD about IQ among children of traumatized/non-traumatized parents. Journal of Attention Disorders. 2009 Sep;13(2):188-96.

[3] Ford JD, Connor DF. ADHD and posttraumatic stress disorder. Current Attention Disorders Reports. 2009 Jun;1(2):60-6.

[4] Magnus W, Nazir S, Anilkumar AC, Shaban K. Continuing Education Activity.

[5] Bremner JD. Traumatic stress: effects on the brain. Dialogues in clinical neuroscience. 2006 Dec 31;8(4):445-61.

[6] Roh H, Kim B. A brief replication study comparing stimulants and non-stimulants for attention-deficit/hyperactivity disorder treatment with a focus on compliance, efficacy, and satisfaction. Journal of the Korean Academy of Child and Adolescent Psychi

[7] Guidetti C, Brogna P, Chieffo DP, Turrini I, Arcangeli V, Rausa A, Bianchetti M, Rolleri E, Santomassimo C, Di Cesare G, Ducci G. Eye Movement Desensitization and Reprocessing (EMDR) as a Possible Evidence-Based Rehabilitation Treatment Option for a Patie

[8] Scheeringa MS, Weems CF, Cohen JA, Amaya‐Jackson L, Guthrie D. Trauma‐focused cognitive‐behavioral therapy for posttraumatic stress disorder in three‐through six year‐old children: A randomized clinical trial. Journal of Child Psychology and Psychiatry. 2

FAQs

HOW COGNIFUL CAN HELP

COGNIFUL is a leading provider of luxury addiction and mental health treatment for affluent individuals and their families, offering a blend of innovative science and holistic methods with unparalleled individualised care.

UNIQUE METHOD

A SUCCESSFUL AND PROVEN CONCEPT FOCUSING ON UNDERLYING CAUSES
Therapeutic Community
Lasting Approach
MULTI-DISCIPLINARY & HOLISTIC
HEALING ENVIRONMENT
LUXURY FACILITY
TRAUMA INFORMED THERAPY

LASTING APPROACH

0 Before

Send Admission Request

0 Before

Define Treatment Goals

1 week

Assessments & Detox

1-4 week

Psychological & Holistic Therapy

4 week

Family Therapy

5-8 week

Aftercare

12+ week

Refresher Visit