There has been a lot of research and discussion around trauma, development and attachment being connected to the diagnosis of ADHD specifically but in my personal opinion, this discussion could be relevant to most neurodivergent diagnoses. 

I would like to point of this podcast episode is a lot of my personal opinion and observation of myself, my history, and my observation of both personal and professional relationships with others who are diagnosed, as neurodivergent humans. I have also done my research and combined research papers and facts from evidence-based communities. I will try to be clear to specify which is which. 

I would like to emphasise the connection between the diagnosis of ADHD to childhood trauma, environment during upbringing and how parents’ attachment styles are connected. 

So before we get into those let’s outline a few important facts about ADHD… firstly, for a long time ADHD was known primarily as a childhood-specific disorder but as research now knows children don’t just grow out of their ADHD but they do often mask and sometimes shift symptoms. In contrast to the difficulties with hyperactivity and impulsivity that children with ADHD tend to encounter, adults with the condition are more prone to a lack of mental focus, memory problems, and restlessness. It’s also important to realise that boys and girls show equally, BUT ADHD displays a little more differently between genders and hence it is often many women have missed diagnosis in childhood and a lot of them struggle through life and are often diagnosed later in life or not at all. Through social media, people are more likely to realise they have these symptoms and seek help themselves more often nowadays. Which is an awesome and positive side of social media. This is both very helpful and empowering to get the diagnosis, BUT also can come with a lot of grief, knowing life could have been very different if they were diagnosed and got the help they needed as children or teenagers. 

Let’s look at childhood trauma first, 

Childhood trauma is linked to ADHD, and vice versa. Trauma and adversity can alter the brain’s architecture, especially in children, which may partly explain their link to the development of ADHD. ADHD and trauma can also present similar symptoms, which may complicate assessment. Trauma, if present with ADHD, can exacerbate ADHD symptoms. At the same time, ADHD may also increase the risk of exposure to trauma.

Traumatic stress, and other factors, like premature birth, environmental toxins, and genetics, are associated with risk for ADHD. The connection is likely rooted in toxic stress – the result of prolonged activation of the body’s stress management system.

When confronted with an acute adverse stressor, the body releases adrenaline, triggering the fight or flight response. Cortisol, a stress hormone, is also released, helping to mobilize the body’s energy stores, activate the immune system, and even briefly enhance memory.

When this stress response is activated in children in the context of supportive adult relationships, these physiological effects are buffered. However, when these buffering relationships are unavailable, and when the stress response is long-lasting, toxic stress may be the outcome.

Studies indicate that toxic stress can have an adverse impact on brain development in children. Regions of the brain involved in fear, anxiety, and impulsivity may overproduce neural connections, while areas dedicated to reasoning, planning, and behavioural control may produce fewer neural connections. This may lead to what we term maladaptive behavioural responses – they include ADHD and other conditions like anxiety and mood disorders.

Toxic levels of stress hormones can even cause neuronal cell death, especially in the prefrontal cortex (a region associated with executive function, self-regulation, and attention) and the limbic systems (associated with learning, memory, emotional regulation, and reactivity).

Comparing ADHD and Trauma

Traumatic stress and ADHD affect the same areas of the brain, which can complicate ADHD symptom assessments in children. Areas of overlap include:

• Difficulty      concentrating and learning in school
• Distractibility
• Disorganization
• Often      doesn’t seem to listen
• Difficulty      sleeping
• Restlessness
• Hyperactivity

Trauma can make children feel agitated, troubled, nervous, and on high alert — symptoms that can be mistaken for ADHD. Inattention in children with trauma may also make them disassociate, which can look like a lack of focus — another hallmark symptom of ADHD. The fact that ADHD and child traumatic stress frequently co-occur with other conditions like mood disorders, anxiety, and learning disabilities makes it all much harder to tease apart.

Moving on, let’s touch on attunement, 

So ADHD is long been thought to be a genetic condition. From my thinking (and I couldn’t find anything firm to support this but my logic does support this). Say you have a mum and dad and they BOTH have ADHD. A child is born and needs attunement, protection and to CO-REGULATE with their caregivers… But if both parents had ADHD/possibly trauma, their nervous system is likely not to be regulated and likely will struggle to co-regulate with their baby.

If a baby is unable to safely co-regulate with their caregivers this is where we see attachment issues come in. See where this is all connected? Genes or nurturing?

Lastly, Attachment Theory and how that is linked to ADHD, 

Of course, I’m not suggesting that everyone with ADHD will have an insecure attachment style or attachment wounds. Still, there is a connection. 

Attachment theory proposes that caregivers who are attentive and responsive to their child’s needs allow them to form a sense of security. From the child’s perspective, this means that they feel safe enough to explore their world with confidence because they see their caregivers as sensitive and protective. 

ADHD and Attachment Theory start to connect based on ADHD’s links to hyperexcitability, difficulty focusing, and impulsivity.

All of these traits can be challenging for a caregiver to manage in everyday scenarios and could potentially interrupt the quality of the bond that the caregiver and child form. Furthermore, caregivers’ sensitivity regarding how they manage their children’s behaviours forms the basis of a secure attachment bond. Yet, the needs of children with ADHD are greater than those without. This can affect how well caregivers can meet their child’s needs. Perhaps for these reasons, the findings of many different studies have found that many people with ADHD tend to display behaviours that resemble those of insecure attachment styles. 

So, the question now is whether attachment issues cause ADHD, or is it the presence of ADHD that leads to an insecure attachment.

The secure attachment style typically goes together with a positive outlook, healthy levels of self-esteem, and the ability to focus for long periods. What’s more, secure attachers are typically willing and enthusiastic to persevere with difficult tasks. In contrast, the insecure attachment style links to lower levels of positivity and self-esteem, inattentiveness, hasty behaviours, and a lack of drive to persevere with difficult tasks.

Fascinatingly, attachment theory may have implications for whether or not someone develops ADHD before they are even born. In a review of twenty-nine different studies that examined how attachment may affect ADHD, results showed that if a primary caregiver had an insecure attachment style, then it was more likely that their child would develop ADHD.

This can mostly be linked with studies identifying that babies are both with the same or similar nervous system as their mothers. Interesting right? And makes sense, PLUS links back to the toxic stress theory we mentioned earlier. 

How somatic therapy would help with trauma and attachment wounds, environment and attunement? 

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