This article: (http://acestoohigh.com/2014/07/07/how-childhood-trauma-could-be-mistaken-for-adhd/) was sent to me by a GTRI student (Thanks Charity!). Worth the read to consider how we may mistake hyperactivity as evidence of ADHD vs. evidence of hypervigilance and PTSD. Given the high prevelance of ADHD diagnoses in areas where there is also much trauma (urban and impoverished settings), it stands to reason that there could be significant misdiagnoses. I began to understand this problem some 17 years ago during my pre and post doc experience in small town Concord, New Hampshire. We saw all sorts of boys first diagnosed with ADHD, then diagnosed (and heavily drugged) with bipolar disorder. Back then we called them emotionally-dysregulated. Nearly all had been subject to domestic violence and had witnessed their mothers abused by boyfriends. A large number had seen their mothers had guns held to their heads. Such experiences shape a child and so it stands to reason that a brain bathed in the hormones released during terror and horror would have an impact. It is also true that in this same population there was a high incidence of tobacco use, also known to be highly correlated with ADHD diagnosed children.
My suspicion is that one day we will find syndromes that encompass both diagnoses but that will not be until we have better understanding and technology to assess what is happening in the brain during an episode of “hyperactivity.”
Check out the above article and if you are a clinician, consider alternative explanations for ADHD diagnosed children. Do you see signs of emotion dysregulation? And if so, how might that be more central feature of the treatment plan?