When I moved out of home at the age of 19, I often described that period in my life as being like almost feral, huh, I kind of joke about it. I was very traumatized, not in my body. I hadn't started any therapy work yet, and I had really just left my family of origin under some really crazy and sad circumstance. And I was pretty much a mess, which was actually—I would later find out—that mess was very appropriate for what my life had been like up until that point. And at that time I just thought I wasn't good at keeping it together, and functioning as well as other people could. And when I think back to that time in my life, I would struggle with any of the following issues: being socially anxious most days, very preoccupied on a body level about what people thought about me, and it didn't matter who it was—a stranger, the bus driver, coworker, didn't matter. Socially I might have been a very interruptive talker, or very... an unconscious talker, not being present and grounded around others. If I made it to a dentist appointment or a doctor's appointment, if you saw me in the waiting room, you'd see me nervously bouncing my leg, or kind of chewing on something, wondering if the receptionist hated me because I was 25 minutes late. I was late to everything, and I had this internal anxious motor going on all the time. I also had functioning issues like remembering appointments, paying rent on time. If I asked directions, like “where's the laundromat?” I couldn't listen and take in the steps; I could ask, but then I would probably become really self-conscious, and consumed with what the person thought about me asking, and I would mildly dissociate, and not take in where the laundromat was. Laundry and dishes were very difficult to get done. Days off or open days were a total mess for me, like spending the day being anxious about what to do with my time, or what to do with myself, and then only leave the apartment at 7pm, just to go to a coffee shop, just to go somewhere. And I had issues with the time-space continuum. I had magical thinking that I could use public transit, and get from one side of town to the other side of town in five minutes, when it actually takes 40. Probably why I was late to everything. I was impulsive with money, with credit cards, and paying them on time was a mess, or paying them was a mess. When it came down to practicing my musical instrument, at that time I was always like: “today's the day!” and I would never make the time or I could never hold the attention. And I often had mood dependent behaviors going on, and what that means is thoughts like, I'll quit smoking when I'm in the right place, I'll do the laundry when I have more energy later in the day, I'll get it together when I quit smoking weed. And those are all mood dependent behaviors. Something has to happen in order for me to get something done.
And at that time I worked evenings, and usually got to bed around 1 or 2am, and I'd often have to get up at 9 or be at work at 10. That was a total mess. This was when I worked in restaurants, and I'd have to really rally to get stuff done. I'd dread doing adulting tasks for a week, like just paying a bill or something like that. And then I would have to super focus for a day, and to get anything done, like bills, errands, or laundry. And just a year or so prior to that time in my life, I almost didn't graduate high school for the same problems in functioning, like not being prepared, not showing up. Not graduating was a lot about my absences, as well as barely passing grades, and lifelong until therapy, I never had the focus to do well in school or be consistent with assignments.
It really wouldn't take much to emotionally crash me, it wouldn't take much at all to trigger me to intense shame, or I'd dissociate, or I'd become reactive, depending on the person or the situation. And I was extremely sensitive, which was always exhausting. I could be reactive, I could be irritable, and I could be in an anger-based trigger that could take over, and I might be in that for a couple of days. Not like dangerous, but just really upset. And I was both consistently anxious and depressed, but I wasn't in my body enough to know that. And I had no frame of reference, meaning I was like that probably since mid-grammar school, up until that point in my life. However, I was able to get to my band rehearsals and gigs, sort of in a good enough way, and work in a good enough way, although I did lose jobs, and I did lose gigs for lateness or general messiness, either emotionally or function-wise. Complicating all of this, I was pretty much almost a daily pot smoker, quasi-drinker, but even after sobriety, these things continuously needed to be worked on.
Most of my ongoing thoughts around that time was like an obsession: like, when am I going to get it together? When am I going to really rally and get my life together? That was perpetual around that time. And let's talk about maybe some potential diagnoses for everything that I just told you. You could hear all that and say, well, you were 19. It sounds right, that could be valid. Or you could say it was probably the drugs and the alcohol, also valid. Or worse, you could be like psychologically lazy and say I needed a swift kick in the pants, and I just needed to “stop screwing around!” Or if I had gone to a different therapist than the one that I started seeing back then. I wonder what they would make of all that, clinically. Like what might a different therapist make of all that, maybe now? ADHD? GAD? (Generalized Anxiety Disorder), Substance Use Disorder, run of the mill depression, run of the mill anxiety, mood disorder. Like the person saying, you say you rally but then you crash. It's often really subjective to the clinician. And all of these questions would depend on the therapist, I think, as well as just taking a lot of assessments with a psychologist.
I'm not trying to criticize therapists here. I'm more pointing out the confusion in overlapping symptoms, over a variety of issues. However, if they asked me about growing up, like the therapist I actually got did at that time, it creates more of an in-depth picture about why those struggles and those symptoms were there. My therapist just focused on my story, what happened to me, and related that story to those struggles, and gave me tools to work on them, and processed the abuse with me in session, as well as group. The focus was on growing up with a father who was both alcoholic and probably had narcissistic personality disorder, a mother who was also alcoholic and probably had something else going on, something cluster B, the chaos, the stress, the domestic abuse, the domestic violence, poverty, neglect, manipulation, several moves, medical trauma, emotional abuse, both verbal and psychological, and sexually off behaviors in the adults. And spending most of my childhood was spent in bars waiting to go home. So that's what we focused on. And in the model of therapy that I do, the client's story is way more important than the client's symptoms. Symptoms are important, but they're not the sole thing that is talked about in the room.
Here are some things about adult ADHD, which is the focus of this video, and discerning adult ADHD from adults who have grown up in childhood trauma. I'm not focusing on ADHD in children in this video at all. So there is some research that links ADHD to our genetics. There's an 80% parental correlation, meaning if your parents had it, it's highly likely that you'll have it. There was research that links to smoking and drinking during pregnancy, like in the womb. There is also research that links it to exposure to lead, which was really used in the US between the 1920s all the way through 1986, and we were all exposed to lead via gas emissions at the time. Four percent of Americans over the age of 18 struggle with ADHD. It used to be known as ADD, which is no longer used. And ADHD addresses the attention and hyperactivity, but you could struggle with both of those or just one separately. In no way am I saying that all kids who have ADHD symptoms or carry the diagnosis are traumatized. I repeat, this is not a video about saying it's all about trauma. ADHD can very much just happen on its own for kids in all kinds of families and all kinds of severity of symptoms. In this video, we'll be looking at adult-based ADHD and contrasting with adults who grew up in childhood trauma.
And here is some more about ADHD. Let's see what it looks like. So I've divided the symptoms between the hyperactivity as well as the attention, with the attention being difficulty focusing, forgetfulness, poor planning, poor time management. You can also include difficulty in making decisions under that. Problems with task completion, hyperfocus—such as with games or hobbies or something of strong interest to the person. In the middle, I've included sensitivity and low self-esteem, for not really falling in either of the two categories of attention and hyperactivity in my mind. For hyperactivity, we have low frustration tolerance, interrupted sleep like busy consciousness or busy brain during sleeping hours, the tendency to have that going on. Hyperactivity, which can be described as like having an internal motor going all the time, impulsivity, poor mood regulation, verbal communication problems, which is also something that we're going to come back to later in the video.
Adult ADHD can be exhausting. Clients can describe it as always feeling like they're on edge, because they are forgetting something and they could be fired for it, or forgetting something could be dangerous to themselves and to their family. It's very shaming as well to not be organized or forgetting major things like a work project, or remembering something important that our partner just said to us. I can think of a lot of adults with ADHD who have at some point pretended like they heard the directions or the thing or the questions, but they were really somewhere else in their head when the questions were asked and they kind of have to fake it. So it's disconnecting and it sucks to also feel constantly behind the eight ball or just treading water with our functioning.
Now let's bring in some childhood trauma symptoms for adults and compare with what we were just looking at. And I struggled with this diagram. The struggle was that these two issues have way more in common than they do in what they have in difference. Initially, it wasn't a Venn diagram, it was more like a single blob of symptomology. This diagram and video is my clinical opinion. My expertise is in childhood trauma and abusive family systems, not ADHD, but here I'm going to try to do my best. The arrows in this diagram are to emphasize the extremes of differences. ADHD, on the left in my mind, doesn't have the extreme symptom differences to childhood trauma. However, I think childhood trauma does display some major differences to ADHD, and that's what you see on the far right of the infographic.
So let's get into the gray area. I've listed the overlapping symptoms, as others have in other diagrams, such as difficulty focusing, low frustration tolerance, interrupted sleep, disorganization, dissociation, verbal communication problems, low self-esteem related to the symptomology, forgetfulness, impulsivity, shame, and guilt, and as well as sensitivity. I have the remaining ADHD symptoms such as poor planning and hyperactivity to orbit the gray area, meaning they are also kind of pulled into the commonality of childhood trauma. I've also done this with the childhood trauma symptoms of emotional dysregulation, hypervigilance, emotional reactivity, and isolation, meaning I think those symptoms orbit strongly in the gray area overlap as well.
The differences—I think the major differences between these two issues is the etiology of the symptoms that I've listed, such as attachment issues, body memories, or flashbacks if you like, relational control of self or others, or you could also list that as codependency if you like, numbness—like not celebrating graduations, weddings, promotions, or being extremely disconnected from our feelings. And that last one: belief-based self-sabotage or harm. These are what I see as childhood trauma symptoms here. You could also look at the far-right childhood trauma symptoms as CPTSD. Perhaps the whole point of this video in discerning ADHD from childhood trauma is the presence of an abuse story, which for some is tricky to figure out or feel like you qualify for having that abuse story.
Here are some recommendations. Given the commonality, types of ADHD therapy are probably helpful anyway about the symptoms, regardless of whether it's trauma or not. However, if there is that abuse story, good childhood trauma work with a trauma therapist would be the thing that I would explore if the person feels ready. As a side note, you can do different types of therapies at different stages in your life, and that's a really great way to do it. For trauma, treatments like EMDR process the story and work on new beliefs, and I describe good trauma work as something that releases and drains all that noise that causes the ADHD-like symptoms.
At the age of 19, I started doing individual and group work for my childhood trauma. And I'm not saying everyone will have this experience, but I went from being that somewhat feral mess in daily struggling and treading water, to starting college around that time, and getting a 4.0 GPA in my first semester, having almost not graduated from high school two or three years earlier. That's what childhood trauma work... that's how it affected me... really good, safe childhood trauma work. While I still struggled, I had such a greater capacity to show up and function and complete things, because I was actively processing my childhood with really good, safe people, and I was also sober.
And I have a recommendation for therapists, not only to be more trauma informed, but to also be trained in better honoring someone's story. I think the worst thing that we can do as therapists is to just treat symptoms in a vacuum, without knowing what fully happened to the person, or explore that in context of their symptoms. Too many people also hear: “but that's the parents you got—whadaya going to do?” And I think that that's just coming from the therapist not knowing how to work with childhood trauma, or worse, that they believe in the old “you got to get over it” standpoint. So I hope this video was helpful to you and provided some thoughts about where these symptoms might come from. And as always, may you be filled with loving kindness, may you be well, may you be peaceful and at ease, and may you be joyous. I will see you next time.
