They are more connected and similar than you may think
Near the end of last year, I wrote an article outlining many of the ways in which we understand ADHD to be primarily caused by genetics. My writing was sparked by Gabor Maté’s insistence that ADHD is caused by trauma.
It’s not.
There’s no evidence of a causal link, but there is a correlation.
Dr. Maté is a well-respected expert in understanding the impacts of trauma but is not an expert on ADHD. Regardless, I am certain Dr. Maté’ took psychology 101 and knows full well correlation does not equal causation.
Having outlined evidence of a strong genetic component in the development of ADHD, and an estimated heritability rate between 75–80%, I now want to explain why someone might conflate ADHD, autism, and trauma.
Namely, I’ll explain why there are so many similarities, and how one can look like the other.
Difficulty concentrating
Both trauma and ADHD cause difficulty concentrating, but of course, the underlying mechanisms are significantly different.
In ADHD trouble focusing is caused by difficulty regulating our attention. If a group of people is gathered in a classroom for a lesson or conference room for a meeting, and a minor distraction occurs just outside the door, those with ADHD will have a greater challenge ignoring it.
Neurotypical people — those without ADHD — will more easily maintain their focus on the meeting or lesson, and are much less likely to be distracted.
After a person with ADHD has diverted their attention to something else, it’s also much more difficult for us to return our attention to the original task, especially if it’s not something we find terribly interesting.
With trauma difficulty concentrating is more often due to anxiety, intrusive thoughts, and distressing memories.
Trouble sleeping
Sleep issues are extremely common amongst Autistics and those with ADHD. This can be caused by multiple factors, including sensory modulation issues (i.e. heightened sensory sensitivities and SPD), circadian rhythm issues such as delayed sleep phase syndrome, and insomnia.
Sleep issues related to trauma are frequently caused by nightmares, flashbacks, anxiety, and intrusive thoughts or memories.
Impulsivity
This one is very interesting. Impulsivity in autism and ADHD is usually caused by a delayed maturation of the brain, in particular the Prefrontal Cortex (PFC).
Prolonged stress, or trauma, cause our amygdala to become overactive. The amygdala is the part of the brain which responds to perceived threats and is activated when we feel fear and anxiety.
Part of the role of the emotion centre of the brain (the amygdala and its colleagues in the limbic system) is to tell the PFC to temporarily stand down.
The PFC is responsible for mental tasks like logic, reasoning, and impulse control — tasks that are not needed if our life is thought to be in danger. Our brain reverts to something we often call “fight or flight” mode, where survival instincts kick in.
Understandably, when we experience our environment — or people in that environment — as unsafe we become hypervigilant, on alert for danger, so we can take action to keep ourselves safe.
If our amygdala is frequently (or constantly) on the field searching for signs of danger, then our PFC spends more time on the bench than getting to do its job.
In sum, a benched PFC means less mental energy exerted to control our impulses, and more brain power being spent reacting to perceived threats in the environment.
Emotional intensity
When we’ve experienced prolonged distress or trauma, our emotions tend to either become “blunted” (we put up emotional walls to protect ourselves from the painful experiences) or heightened.
Another form of impulsivity is emotional impulsivity. Heightened emotional responsiveness will cause our amygdala to run on overdrive, reacting to neutral or minor problems as though they were clear and present dangers.
When we encounter a potentially upsetting situation, but our PFC is online, we can often reason with ourselves, using logic to temper our emotions and prevent ourselves from reacting in a way we might later regret.
When our PFC is under-developed due to a neurodevelopmental disorder, or our PFC is on the bench due to trauma response, we are much more likely to experience intense emotions and respond impulsively.
The result is similar, but the causes are markedly different.
© Jillian Enright, Neurodiversity MB
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