IS IT ADHD/ADD OR REALLY DEVELOPMENTAL TRAUMA DISORDER/COMPLEX TRAUMA (CHILDHOOD VERSION OF PTSD)?

This can be an unnerving question.  Especially if you have a child who has been diagnosed with ADHD/ADD…like I have. I first came across this possibility when I was reading a book by the world famous Dr. Bessel Van Der Kolk, “The Body Keeps The Score;  Brain , Mind, and Body in the Healing of Trauma”, which I will refer to often as it is a big source for me, but not the only source. 

What I learned in this book really rocked me to my core, to say the least! I had more of those “light bulbs going off in my head” moments as well! The kind where I say to myself “OMG this makes total sense” which is immediately followed by “OMG I have to spread the word so other people can know this too!”  It made me think about my child and the poor children whom I had taught at a middle school who grew up in a chaotic, volatile, abusive or neglectful home environment, where most students came from abusive, neglectful and emotionally absent and un-supportive homes, that had also been diagnosed with ADHD and for which stimulant medication did not help.  After much research, I now believe the majority were misdiagnosed with this elusive disorder, which has no seemingly real point of origin and should have been diagnosed with a trauma-based disorder such as Developmental Trauma Disorder (also known as Complex Trauma (or Adverse Childhood Experiences), instead. This is a child’s version of PTSD., as a result of chronically enduring abuse and trauma from their primary caregiver, (intentional or not).  NOW I KNOW WHY AND I’M SHARING THIS INFORMATION WITH THE PUBLIC BECAUSE IT IS VERY VERY IMPORTANT TO HAVE A CORRECT DIAGNOSIS!  ADHD/ADD and Developmental Trauma Disorder/ Complex trauma/ACE”s require very different treatment protocols-most ADHD/ADD treatments focus on organizational and time management skills, while the trauma based disorders require treatments designed to dig deeper and treat the psychological and emotional turmoil and ongoing visceral sensations that accompany such traumatized individuals.

Let’s first take a look at what these disorders are exactly …According to the Center for Disease Control website, ADHD/ADD is a common neurodevelopmental disorder that favors boys by a ratio of 3:1 and includes symptoms such as poor impulse control, difficulty paying attention, being overly active (as if driven by a motor), talking out of turn (known as blurting), constantly losing and forgetting things, daydreaming, squirmy, fidgety, making careless mistakes, difficulty in resisting temptation and trouble getting along with others.  According to the CDC website, there are several “possible” (meaning they don’t know for sure) causes such as premature birth and low birth weight, brain injury, exposure to environmental metals or toxins such as lead, drug/alcohol/tobacco use by the mother during pregnancy, but no known cause has yet to be found. Earlier assertions that sugar and too much television/video games as a cause has NOT been supported by research. 

The statistics for ADHD are staggering, according to the CDC website, the cases of ADHD/ADD have increased dramatically over the last 20 years. In 2019, 9.4% (I’ve also seen as much as 11% on other credible websites) of 2-17 year olds had this diagnosis in the U.S. That’s 3.1 MILLION children and a 43% increase in diagnosis since 2003!  This meteoric rise in cases of ADHD/ADD, can largely be attributed to not only the media blitz of advertisements about ADHD medications and doctors being quick to diagnose those who have even the slightest of symptoms for no other reason than to “have a diagnosis” or to enhance a normal student’s academic performance and the pressure put on teachers and schools to deliver high achievement scores.  The typical traditional treatments for this disorder namely include stimulant medications and behavioral therapy, talk type therapies. Diagnosis is a multi-step process because there is no single test for diagnosis and includes a physical exam (to rule out other causes) and an ADHD/ADD checklist which is filled out by teachers and parents regarding the history of the child. Comorbid disorders that appear to go along with this diagnosis might include, OCD, Oppositional-Defiant disorder/Conduct Disorder, Anxiety, Depression, Borderline Personality Disorder, Tourette”s Syndrome, Bi-polar and learning disabilities, Impulse Control Disorder and more. 

Now let’s look at “Developmental Trauma Disorder” also known as “Adverse Childhood Experience” or “Complex Trauma”, which share almost identical symptoms of ADHD/ADD but have very different origin/cause and treatment protocols and is very similar to PTSD in adults but according to Dr. Bessel Van Der Kolk, “PTSD does not fully capture the developmental impact of childhood trauma because a child’s early experiences occur in the context of a developing brain, the social interaction and neural development are inextricably intertwined.” This means that basically, a child’s brain develops based on the internalization of both affective and cognitive characteristics of their primary caregiving relationships. Unfortunately, trauma at the hands of a loved one produces the most damaging and toxic type of stress and trauma. It causes deep tumultuous emotions that the victim may not be able to handle or process within their psyche or have words to express their pain. This is known as “ALEXITHYMIA” and can make the situation and therefore the psychological and physiological damage even worse, This very  “special” type of trauma that abusers save especially for their loved ones, starts at home with the abusers being primary caregivers such as parents and causes what’s known as “TOXIC STRESS.” This type of stress and consequential physiological and psychological cascade of problems it causes is because the child who instinctively relies on and loves their caregiver, is fighting a tormenting internal battle and impulse of needing and wanting their caregiver but they also know that this caregiver is the source of their pain, suffering and neglect. (This is also true for victims of domestic violence.) They want and need love but they also want and need to escape and get away from the pain and suffering, after all…where there is terror, there is no safety. TERROR AND SAFETY CANNOT EXIST TOGETHER, as they are contradictory.  This epic internal clash of conflicting and opposing forces causes a destabilization in the child’s homeostasis which then sets the stage for further problems across all developmental domains including a nervous system that is chronically ramped- up and ready to fight or go numb and collapse even though the trauma is over. Common symptoms include the exact same symptoms as ADHD/ADD and all the other disorders I listed above in the ADHD paragraph. Why is this?

During an act of abuse, a child has the ability to blank out (dissociate and depersonalize themselves), even when merely being yelled at. This is a way they can make themselves “disappear”, so that their mind is not in the present and therefore not having to “endure”.  These dissociation states can also be MISTAKEN for the “daydreaming” and “checked out” symptoms of ADHD/ADD. According to Dr. Van der Kolk, the thalamus (also known as a filter of incoming information and gatekeeper), of an abused child also breaks down and causes a “sensory overload” where the floodgates of incoming information (sensory and environmental) is wide open so the child’s brain gets overwhelmed and over- stimulated and compensates by closing it all down and so they begin to “hyperfocus” as a coping mechanism.  When this breakdown happens, the cost to the child includes the ability to feel alive, feel as “one” with their own bodies and filtering out various sources which would bring the child pleasure, excitement and happiness. The broken down thalamus also causes problems with attention, concentration and learning new things…JUST LIKE ADHD/ADD! The ramped up central nervous system of an abused child will cause them to act out without much control over their emotions or impulses because they’ve lost their innate ability to sooth and modulate themselves and their behavior and tend to see everyone as a potential threat.  Their emotions become dysregulated and difficult to control. They will constantly misjudge social cues from those around them and act as if they have a “chip on their shoulder.” Poor impulse control is a hallmark symptom of ADHD/ADD but it could also be seen as a traumatized child acting out and/or re-enacting the trauma, or their failed attempts to escape. This also fills the victim with shame, which unfortunately is a cornerstone of addiction. It’s also important to point out that Dr. Van Der Kolk, in New York Times best selling book, which also contain the latest works from Dr. Stephen Porge’s (the Polyvegal Theory), Dr Dan Siegel (Developmental Psychopathology) and others at the forefront of this newer research, explains that, other “pseudo-diagnoses” symptoms such as the ones listed above in the ADHD/ADD paragraph could also be caused by trauma and abuse, which has shown to be a lifelong ordeal and causes many problems such as developing auto-immune diseases (yes, the toxic stress from being abused can cause auto-immune diseases and many other PHYSICAL ailments), later on in life, unless there is intervention with a PROPER diagnosis and proper therapy based on that diagnosis. You can also find more information on this topic by taking a look at articles on the “ACE Studies”, which confirms this as well.

Diagnosis cannot happen in a 15 minute doctor’s appointment or 2 or 3.  WE need to do our own due diligence as parents in research and fact finding the right answers, which takes time, but it’s a hell of a lot better than continuing to give a traumatized and abused child, who has an already hyper-aroused and over- stimulated Central Nervous System, stimulants and INCORRECT TYPES of therapy because of a hastily made ADHD diagnosis. This can have disastrous results! Traumatized and abused children have very different treatment protocols than ADHD/ADD. I hope this information has helped to shed a little light on this new possibility! Thank you for reading!🌺🌺🌺

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