Hyper or Hurting: Is It PTSD or ADHD?

Attention Deficit Hyperactivity Disorder (ADHD) and Post Traumatic Stress Disorder (PTSD) share many overlapping symptoms but stem from very different causes. However, they share a significant overlap in behavioral symptoms, including difficulty concentrating, impulsivity, and emotional outbursts. The neurobiological effects of trauma on children can mimic ADHD symptoms (Perry, 2009)¹. Both conditions can lead to challenges in academic settings and social interactions.

Distinguishing Features of PTSD and ADHD in Children

Children may develop PTSD in response to witnessing or experiencing a traumatic event. Children with PTSD might re-experience the trauma through nightmares or flashbacks, show a marked avoidance of reminders of the trauma, and exhibit increased arousal symptoms such as being easily startled or having difficulty sleeping (American Psychiatric Association, 2013)². These symptoms can be mistaken for inattention or hyperactivity but are rooted in trauma. Thus, through addressing the trauma in therapy, children can find relief from these symptoms. This is a stark contrast from ADHD, which is a neurodevelopmental disability that persists across the lifespan.

ADHD is characterized by patterns of inattention, hyperactivity, and impulsivity that are not typical for the child’s developmental level. The key distinction is that these behaviors are consistent across various settings and situations and are not triggered by specific events or situations. ADHD symptoms typically manifest before the age of 12 and can be observed over a long time period (American Psychiatric Association, 2013)2.

Tips for Parents: Identifying the Difference and Seeking Support

1. Observation Across Contexts: Notice if your child’s behaviors are consistent across different settings (home, school, with peers) or if they seem to worsen in response to specific reminders or situations. ADHD-related behaviors are usually pervasive, whereas PTSD symptoms may be situational or triggered by specific trauma reminders.
2. Listen and Validate: Children might wish to share their feelings or experiences related to the trauma they’ve encountered. This can be a challenging and emotional experience for parents and caregivers. Children learn best through watching the behaviors of the adults in their lives, so be sure to model healthy communication and emotional expression. By listening to your child and refraining from advice or judgements, you are communicating that you can handle it and their feelings are valid.
3. Seek Professional Help: A thorough psychological assessment can help distinguish between the nuanced behaviors of PTSD and ADHD, and outline appropriate recommendations based on your child’s individual diagnosis and needs. Psychologists use various testing measures and interviews to differentiate between diagnoses such as ADHD, PTSD, and other emotional or behavioral concerns.
4. Advocate for Your Child: Whether it’s obtaining accommodations at school or finding the right therapist, advocating for your child’s needs is crucial. Collaboration with teachers, school counselors, and mental health professionals can ensure your child receives comprehensive support and coordination of care.

Conclusion

Disentangling the symptoms of ADHD and PTSD in children requires keen observation, patience, and professional guidance. The overlapping symptoms pose challenges, but accurate and comprehensive assessment can help you better understand your child’s needs. Early diagnosis and intervention can mitigate the adverse effects of childhood PTSD and ADHD.

Footnotes

1. Perry, B.D. (2009). Childhood trauma, the neurobiology of adaptation, and “use-dependent” development of the brain: How “states” become “traits.” Infant Mental Health Journal, 16(4), 271-291.
2. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.