PTSD vs. ADHD: What's the Difference?

Many mental health conditions share symptoms with ADHD, including post-traumatic stress disorder (PTSD). In some instances, children who have been through traumatic events get misdiagnosed with ADHD or vice versa. Although PTSD and ADHD share some similar symptoms, they have different origins and are treated differently, so it's vital that they're identified correctly.

So, what sets the two conditions apart? How can you tell which your child's symptoms are attributed to, and is it possible for someone to have both PTSD and ADHD? In this article, we'll go over the similarities and differences between ADHD and PTSD, as well as their symptoms, treatment, and diagnosis. Then, we'll discuss whether someone can have both.

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PTSD vs. ADHD

PTSD and ADHD share some similarities, but they are not the same. Acknowledging the similarities and differences between PTSD and ADHD can help you get the right support for yourself or a child sooner. 

Understanding post-traumatic stress disorder

If you're reading this, you most likely have a good understanding of ADHD. What about post-traumatic stress disorder? Let's go over the basics first. Post-traumatic stress disorder (PTSD) is a mental health condition that some individuals develop after they experience or witness a traumatic event. When discussing PTSD, it's crucial to state that PTSD and trauma are not interchangeable terms. Not everyone who experiences a traumatic event will meet the criteria for PTSD. In fact, most people who face or witness a traumatic event do not develop PTSD. A specific set of criteria must be met for a person to get a PTSD diagnosis, which we will go over later on in this article.

Differences

Here are some key differences between ADHD and PTSD:

• ADHD symptoms must have started by the age of 12 (even if someone is diagnosed long after the age of 12) and PTSD can begin at any age
• ADHD is a neurodevelopmental condition, whereas PTSD is a mental health condition.
• PTSD is only experienced by those who have witnessed or endured a traumatic event, ADHD has a strong hereditary link.

Similarities

Commonalities between PTSD and ADHD include but aren't limited to:

• Executive functioning challenges
• Elevated risk of insomnia/trouble sleeping
• Elevated risk of depression and anxiety
• Difficulty with emotion regulation
• Trouble concentrating
• Impulsive behavior
• Memory issues
• Restlessness

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Symptoms

Even though some symptoms of PTSD and ADHD can look similar from the outside, the criteria for diagnosis to occur are not the same. To understand how ADHD and PTSD are diagnosed, it's important to first go over the symptoms of each.

PTSD

PTSD symptoms are broken down into multiple categories. An individual must experience symptoms in each category for a diagnosis to take place. These include:

Exposure to a traumatic event marked by at least one of the following:

• Directly experiencing the traumatic event.
• Witnessing a traumatic event as it occurred to other people.
• Learning about a traumatic event a close family member or a close friend experienced. In circumstances of threatened or actual death of a loved one, events must have been accidental or violent.
• Experiencing repetitive or extreme exposure to details of a traumatic event* (e.g., first responders who arrive at the scene of a crime).
• *Does not apply to exposure through media (e.g., movies, online videos) unless the exposure relates to a person's occupation.

One or more of the following intrusion symptoms connected to the traumatic event, starting after the event occurred:

• Involuntary, recurring, and intrusive memories of the traumatic event.
• Recurrent distressing dreams where the content or effect of the dream is related to traumatic experiences.
• Dissociative reactions, like flashbacks, where an individual feels or acts as if the traumatic event was happening again.
• Intense or ongoing psychological distress at exposure to internal or external stimuli or cues that symbolize or resemble aspects of a traumatic event.
• Physiological reactions to stimuli or cues that symbolize or resemble aspects of a traumatic event.

Ongoing avoidance of stimuli associated with the traumatic event, starting after the traumatic event occurred, marked by one or both of the following:

• Avoidance of, or making efforts to avoid, distressing memories, thoughts, or feelings related to or connected to the traumatic event.
• Avoidance of (or efforts to avoid) reminders such as people, places, activities, objects, or situations that provoke distressing memories, thoughts, or feelings about or associated with the traumatic event.

Changes in cognition and mood associated with the traumatic event, marked by two or more of the following:

• Inability to recall important details of a traumatic event, generally due to dissociative amnesia and not to factors like substance use or brain injury.
• Continuous and exaggerated negative beliefs or expectations about others, oneself, or the world (e.g., "I deserve what happened," "I am bad," "I am ruined forever," or "I can't trust anyone.")
• Persistent, distorted thoughts that lead one to feel as though they "brought on" or "caused" the event.
• Persistent negative emotional state (e.g., anger, guilt, or shame).
• Lowered interest or participation in activities that are usually significant to the individual.
• Feeling detached or estranged from other people.
• Persistent trouble experiencing positive feelings, like happiness, affection from others, or satisfaction.

Changes in arousal and reactivity connected to the traumatic event, marked by two or more of the following:

• Angry outbursts or irritable behavior with little-to-no provocation, often expressed through verbal or physical aggression toward people or objects.
• Sleep disturbances such as trouble falling asleep, staying asleep, or restless sleep.
• An exaggerated startle response.
• Problems focusing or concentrating.
• Self-destructive behavior or recklessness.
• Hypervigilance.

Kids younger than 6 may experience some symptoms of PTSD that differ from what we see in adults. For example, young children may be extra clingy toward other caregivers, act out scary events during play, or wet the bed even though they are potty trained. Childhood trauma can have a serious impact on a person's life and mental health, and it's essential to address the effects of trauma, whether someone does or does not meet the criteria for post-traumatic stress disorder.

ADHD

ADHD symptoms are broken down into two categories: Inattention symptoms and hyperactivity or impulsivity symptoms. One person with an ADHD diagnosis might experience primarily inattentive symptoms, whereas others may experience primarily hyperactive/impulsive symptoms or a combination of the two.

Inattention symptoms:

• Failure to pay close attention to details or making what looks like careless mistakes in school, at work, or during other activities.
• Failure to follow through on instructions and finish schoolwork, chores, or other duties (e.g., becoming sidetracked at work).
• Avoiding, disliking, or reluctance to engage in tasks that require sustained mental effort, like school assignments or homework.
• Losing necessary items for tasks and activities, like school materials, keys, paperwork, eyeglasses, and cell phones, more often than others.
• Trouble holding attention during tasks or play activities.
• Frequent challenges with organizing tasks and activities.
• Often seeming as though one isn't listening when spoken to directly
• Forgetfulness that affects daily activities.
• Being more easily distracted than others.

Hyperactivity and impulsivity symptoms:

• Fidgeting, tapping hands or feet, or squirming in one's seat.
• Leaving one's seat in situations when it's expected that one will remain seated.
• Running about or climbing in inappropriate situations (can be limited to restlessness in adolescents or adults).
• Interrupting or intruding on others during play, conversations, and other activities.
• Often appears "on the go," acting as though one's "driven by a motor".
• Blurting out answers to questions before others (e.g., parents, teachers) are finished talking. 
• Trouble playing or taking part in leisure activities quietly.
• Frequent difficulty waiting for one's turn.
• Excessive talking.

Diagnosis

A number of different professionals can diagnose conditions such as ADHD or PTSD. For example, a neurologist, pediatrician, or psychiatrist might diagnose ADHD. As for what the diagnostic process looks like, here’s what to expect:

PTSD 

For PTSD to be diagnosed, clinically significant symptoms of the disorder must occur for more than one month. Additionally, disturbances must cause notable distress or impairment in one or more relevant areas of functioning, such as social situations, school, or work. PTSD can be diagnosed in individuals of any age group, including children, preteens, teens or young adults, and adults. A professional able to diagnose mental disorders like PTSD will understand what to look for in individuals of different age groups. Remember that some symptoms can manifest differently in toddlers or young children and may be less obvious.

ADHD

For ADHD to be diagnosed in those ages 17 or younger, one must experience at least 6 symptoms of either inattention, hyperactivity/impulsivity, or both. In those ages 18+, 5 symptoms in either or both categories must be present. Again, regardless of age, symptoms must have started before the age of 12 and must not be better attributed to another cause, including mental health conditions like PTSD.

Treatment Options

A wide variety of treatments are available for both ADHD and PTSD. While it's not an extensive list, especially when it comes to add-on and/or alternative treatments, here are some common treatment options you might see used or recommended for each condition.

PTSD 

Therapy is usually the first line of treatment for PTSD. Working with a trauma-informed therapist who specializes in PTSD is ideal for those with the condition. Therapies used to address PTSD symptoms include but aren't limited to trauma-focused cognitive behavioral therapy and EMDR. For younger kids, play therapy can be valuable. Medications, such as antidepressants, can be prescribed to help people with PTSD navigate concerns such as feelings of depression, anxiety, and trouble sleeping.

ADHD

Most people with ADHD benefit from stimulant medications like Adderall and Ritalin. However, there are non-stimulant medication options for ADHD, too. Like with PTSD, therapy can be helpful for those with ADHD and is often recommended alongside medication. However, what an individual focuses on in therapy for ADHD will differ from therapy for PTSD. Treatment goals will usually vary, too, though some may be similar depending on the person.

Can PTSD Be Mistaken For ADHD?

PTSD can be mistaken for ADHD in some instances. To avoid misdiagnosis, a provider should ask about your child's history and when their symptoms started. If your child only started exhibiting symptoms like trouble concentrating after a traumatic event, make sure to tell the provider they see for an evaluation.

Can Someone Have Both?

It's possible to have both ADHD and PTSD. In fact, research shows that the lifetime prevalence of PTSD is higher in adults with ADHD. Children with or without ADHD can have PTSD, too. Post-traumatic stress disorder and ADHD are both very common, and it's relevant to note that PTSD has the potential to exacerbate ADHD symptoms. If you or your child started to experience ADHD symptoms prior to the trauma history and started to experience PTSD symptoms after a traumatic event, it's possible that you or they could have both.

Takeaway

Post-traumatic stress disorder (PTSD) and attention deficit hyperactivity disorder (ADHD) share some traits. While it's possible for the two conditions to co-occur, it's crucial to take note of when symptoms began so that a medical or mental health professional can provide the proper diagnosis. Even though some symptoms of ADHD and PTSD overlap, treating ADHD and PTSD can look quite different. Getting the right form of support can help people with ADHD, PTSD, or both disorders, get to a better place.