As a parent, nothing is more scary than our kids being in some kind of danger. As many other parents can tell you a diagnosis of ADHD usually happens in a predictable way. It begins with a trip to your child's general practitioner. You carefully describe your child's symptoms. "My child can't sit still, they can't remember anything, they can't behave, they have difficulty completing projects, they struggle to pay attention, they have frequent outbursts of anger, they lose EVERYTHING, and the problems seem to be getting worse.". It's not uncommon, then, for your child's doctor to make a diagnosis of ADHD and prescribe a stimulant to help with the hyperactivity and/or inattention.
NOTE: I AM NOT A MEDICAL DOCTOR AND DO NOT PRESCRIBE, RECOMMEND, OR DISCOURAGE THE USE OF PRESCRIPTION DRUGS YOUR DOCTOR HAS PRESCRIBED.
That said, I have studied psychotropic drugs as a professional counselor and am not completely uninformed as to the dispensing and use of these drugs, the diagnoses, and how they are prescribed. That said I normally advocate for professional therapy in lieu of, or as an adjunctive component of total therapy.
ADHD: A Disorder or Symptomology?
When considering whether to diagnose, or how to diagnose, clinicians turn to the Diagnostic and Statistical Manual of Mental Disorders. The DSM-5, or the new DSM-5 TR is the tool used to diagnose mental disorders, often for the purpose of reimbursement by insurance. In comparing the symptomology of ADHD with that of trauma disorders, we really need to look at the individual disorders and the symptoms associated with each, in the context of a complete assessment.
In order to compare ADHD and trauma disorders, please see the table below describing symptoms ADHD and ways traumatic stress / PTSD can be misdiagnosed as ADHD. Obviously, this is a VERY CONDENSED explanation, and should not be used to self-diagnose, or to provide any diagnosis, but can be used for informational purposes and a base for additional research.
ADHD | Comments |
Has difficulty with attention and makes "careless mistakes". | Victims of traumatic stress / PTSD often re-experience traumatic events. When this happens, attention to details or events is diminished or occasionally lost altogether, resulting in what may appear as careless mistakes. |
Inability to maintain attention / focus | When experiencing flashbacks or intrusive memories, clients often find it hard or sometimes impossible to maintain attention, their minds going back into the trauma. |
Does not seem to listen | Again, when re-experiencing the traumatic event, it often seems that the client / child is simply not listening or not paying attention. |
Inability to complete tasks or finish work. | Distractions, often caused by flashbacks or other re-experiencing symptoms, make completing tasks difficult at times. |
Appears "messy" or disorganized | An anxious person often presents as messy or disorganized. It is wise to find out "why" the person is so disorganized when making a firm diagnosis. |
Loses things | Disorganization, loss of focus, and lack of attention often result in the client losing things. This is often a source of frustration for the client and their family. |
Easily distracted | Uh, Oh! Did you say something??? Trauma clients often get "sucked into" flashbacks, intrusive memories, causing dissociation that often looks like "zoning out" or distraction. |
Forgetful | All of the above symptoms often result in trauma clients being forgetful, as their minds are distracted by trauma symptoms. |
Fidgets | Fidgeting is often a sign of anxiety. This anxiety can be situational or can be an indication of trauma. |
Hyperactive | Again, same as above. Symptoms should be taken as a cluster and part of a total picture, rather than merely comparing individual symptoms. |
It's easy to see from the above table that symptoms of PTSD and ADHD can easily overlap. This overlap can be confusing and make an accurate diagnosis difficult. When attempting to diagnose symptoms of ADHD, it is critical to look at the "total person" and all aspects of symptoms the client is experiencing. A "quick and dirty" 5 minute interview is most likely inadequate in making an accurate diagnosis of ADHD and prescribing medication. A thorough assessment can help insure a proper diagnosis, resulting in proper and adequate treatment. Why is this so important? A person suffering from PTSD / trauma may exhibit many of the same symptoms as a person who suffers from ADHD but medication may well act differently depending on the reason behind the symptoms. Imagine a person suffering from traumatic stress or PTSD receiving stimulants. The anxiety they already feel may be multiplied rather than ameliorated. A person with an already heightened startle response and hyperarousal should be helped to regulate and calm rather than stimulated. An incorrect diagnosis, resulting in incorrect treatment can make an already bad situation worse.
If you or someone you love has been diagnosed with ADHD and has not shown improvement, please consider seeing a competent psychotherapist specifically trained to recognize signs and symptoms of traumatic stress and PTSD. A correct diagnosis can make all the difference in the world!
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