Understanding the Overlap Between ADHD and PTSD
When someone is managing both ADHD and Trauma, it’s like trying to juggle two balls that are completely different shapes. One is a soft, bouncy ball (ADHD) that requires attention regulation and focus, while the other is a heavy, unpredictable one (PTSD) that often pulls you back to past trauma. This overlap can make everyday life feel like an obstacle course, but with the right tools and mindset, it's entirely possible to navigate these challenges with confidence.
ADHD and PTSD: Two Unique but Interconnected Struggles
Let’s break it down. ADHD, or Attention Regulation Difference (a neurodiversity-affirming term), is often classified as a “top-down” disorder. This means it primarily affects higher-level cognitive functions, like the ability to plan, organize, and regulate attention. In contrast, trauma, including PTSD (Post-Traumatic Stress Disorder) is typically classified as a “bottom-up” disorder, rooted in the body’s trauma responses, such as heightened stress reactions, hyperarousal, and intrusive memories.
When both conditions coexist, individuals may experience the combined effects of top-down and bottom-up challenges. This overlap means that the person is trying to manage difficulties that involve both the cognitive and physical realms—often simultaneously! So, you may find that you’re struggling to focus on tasks (ADHD) while also being overwhelmed by intense emotions or flashbacks tied to past trauma (PTSD). It’s no wonder that managing both can feel like a constant uphill battle.
How ADHD and PTSD Interact
ADHD’s symptoms, like distractibility, impulsivity, and difficulties with attention regulation, can make it harder for someone to stay grounded in the present moment. This can make it more challenging to engage in traditional coping strategies that would help someone with PTSD stay in control during moments of stress. On the flip side, the heightened emotional reactivity caused by PTSD—like feelings of panic, hyperarousal, or feeling "triggered" by seemingly unrelated stimuli—can make ADHD symptoms feel more intense or overwhelming.
Here’s the kicker: people with ADHD often struggle to control their attention, which can leave them more susceptible to PTSD symptoms, like intrusive thoughts and emotional flooding. In turn, the heightened emotional experiences associated with PTSD may make focusing on a task (or even staying present) feel nearly impossible for someone with ADHD.
Top-Down and Bottom-Up: The Double-Whammy
When we talk about "top-down" vs. "bottom-up" disorders, we’re referring to how different systems in the brain are affected.
Top-down refers to the brain's higher-order processes, like decision-making, organizing thoughts, and regulating emotions. Top-down functioning is your thinking brain—the part that tries to reason, plan, organize, and calm yourself down with logic. In ADHD, these functions often need extra support.
Bottom-up refers to the body's sensory and emotional responses—think fight-or-flight reactions and physical sensations tied to stress. Bottom-up functioning is the body reacting before the brain has time to process—like flinching before you realize someone was just joking, or feeling overwhelmed before knowing why. PTSD often triggers these automatic bodily responses when a person is exposed to reminders of past trauma.
With ADHD and trauma, the bottom-up responses (from your nervous system) can overpower the top-down control (your ability to think things through). So you might know what you should do (like focus, stay calm, or get started on a task), but your body and brain aren’t on the same page. You're not being “irrational” or “immature”—you’re simply experiencing a disconnect in the brain-body communication system. Yes, your brain or body might be reacting more intensely than the situation calls for—but that’s not the same as someone telling you you’re “overreacting.” This isn’t a choice or a flaw in character—it’s a nervous system doing its best to protect you based on past experiences. When trauma is involved, you're not being dramatic or difficult—you’re being hijacked by a survival system that learned to stay on high alert.
When both systems are impacted, it’s like having two opposing forces pulling you in different directions. Your body is in constant "fight or flight" mode because of trauma and nervous system dysregulation, while your brain is trying to plan and organize in a world that often feels like it’s moving too fast or too chaotic due to ADHD. This creates a cycle of confusion and frustration that can be tough to break and cope through (cue lashing out, melting down, or crashing out). Oftentimes, this exhausting dynamic can push the nervous system into a state of freeze or shutdown which can lead to a state of depression. How are you supposed to navigate life (go to work/school, be a friend/parent/sibling, etc) when your body is constantly overreacting to perceived threats of danger or even just on the lookout for danger and your brain is working overtime to sort through all the mental debris just to make sense of the world and what’s happening? Not easily! It’s exhausting and can be very painful mentally, emotionally and physically.
Breaking the Cycle
It’s important to recognize that ADHD and PTSD/Trauma are not mutually exclusive—many people have both, and they can learn how to thrive despite these challenges (I won’t lie—it took some work. But I genuinely see my ADHD and trauma as a superpower now. And getting to that point? Completely worth it.). Here are a few tips for managing the overlap:
Somatic Techniques: Because trauma often lives in the body, somatic techniques like grounding through breath, orienting to your environment, or tuning into physical sensations can help regulate your nervous system and bring you back to the present. These body-based practices can also support emotional regulation and focus, especially for those navigating ADHD. Nervous system regulation requires somatic release. Talking is great for mental processing, but somatic therapy is best for physical processing. Remember that finding the somatic technique that works for you can include a trial-and-error phase. Learning what helps and what doesn’t takes time—and while it’s not always fun, it is part of the process, and that’s okay.
Routine & Structure: ADHD thrives in environments with routine and structure. If you’re managing PTSD, having a predictable schedule can help reduce the likelihood of feeling overwhelmed or triggered. Small, achievable goals can help manage both ADHD and PTSD symptoms. This isn’t always realistic or possible so be okay with starting small. It’s also important to be mindful about flexibility. While mental flexibility may not come easily, being intentional can make it more accessible. Building up self-trust and reliability takes baby steps. One baby step I took was incorporating the 5 Minute Journal into my routine. (Click the link if you want 10% off your new journal)
Therapy: Therapies like Cognitive Behavioral Therapy (CBT) and Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Acceptance & Commitment Therapy (ACT), Internal Family Systems (IFS), and Dialectical Behavioral Therapy (DBT) can be extremely beneficial for people dealing with both ADHD and PTSD. These therapies are evidence-based and help individuals reframe negative thought patterns, regulate emotions, and develop healthier coping strategies. Finding the right therapist can feel overwhelming—and even exhausting. That’s why we offer free consultations with our providers, so you can get a sense of the fit before committing. I also recommend working with a therapist who understands the nervous system and incorporates that lens into the healing process. It can make a world of difference.
Medication: In some cases, medications can help address both ADHD and PTSD symptoms. Working closely with a healthcare provider to find the right balance is key to managing both conditions. Functional medicine doctors can help explore and identify any hormonal issues. Supplements are another helpful approach to symptom management. For example, Omega 3 Fatty Acids are great for heart health but also fuel your brain to improve executive functioning and nervous system regulation (1).
Key Takeaway
Living with both trauma and neurodivergence may feel challenging at times, but it’s essential to understand that you’re not broken. These conditions are simply two pieces of a puzzle that can be managed with the right support, strategies, and mindset. By embracing a holistic approach that acknowledges the interaction between your mind and body, you can begin to feel empowered. Empowerment means gaining the tools and awareness to take back control over your brain and body—so you can respond with intention instead of reacting on autopilot.
If you’re navigating ADHD and trauma and want to learn more or explore therapy options, don’t hesitate to reach out. Whether you’re looking for therapy or holistic support like somatic therapy, we’re here to help you take the first step toward healing and growth.
Sherzai, D., Moness, R., Sherzai, S., & Sherzai, A. (2023). A systematic review of omega‑3 fatty acid consumption and cognitive outcomes in neurodevelopment. American Journal of Lifestyle Medicine, 17(5), 649–685.https://journals.sagepub.com/doi/abs/10.1177/15598276221116052
