Trauma & Autism/ADHD/AuDHD

I believe there is vast and often misunderstood prevalence and overlap of trauma and PTSD in those with Autistic Spectrum Disorder (ASD) or ADHD or both AuDHD.

Living with autism and/or ADHD (or AuDHD) presents some unique and individual challenges. Both can involve difficulties with attention, impulse control, hyperactivity - either externally seen in behaviours or within the mind - and as well challenges with social interaction, communication, executive functioning, not to mention a whole array of adopted maladaptive coping strategies and masking behaviours. 

Whilst there are challenges, many people come to experience and channel aspects of their neurodiversity as a superpower. This can also mean a person may:

• Be highly creative in their abilities or thinking

• Be able to channel a great amount of energy and passion in their interests

• Be very open and honest in relationships

• Be flexible and open-minded

• Ability to hyper-focus

• Make important contributions in their areas of interest

  
  

In my experience it can be incredibly helpful to get to know yourself and your struggles to then be able to work with what you’ve got as best you can. You can learn to make the most of some traits and learn what is best to delegate or find ways to manage. It's also important to recognise your emotional needs and know how you best rest and recharge.

Exercise, mindfulness meditation and nutrition can all be especially supportive to your wellbeing too. As well as a whole range of psychological tools like CBT Therapy and DBT emotional skills training. Finding your tribe and joining support groups and forums can be a lifeline to meet and chat to people who understand and have shared experiences. 

What is Trauma and PTSD?

Symptoms of Trauma and PTSD are responses that usually occur following a difficult, frightening, shocking or overwhelming experience. 

Basically what happens with an experience that is traumatic, shocking or too confusing or in other ways... too much... is that what you are experiencing is all just too overwhelming in that moment… the brain is simply unable to process all of your experience at that time.

You cannot process all the information, make sense of all that is happening and how you feel about it all, all in one go. 

You can think of trauma being like emotional plumbing. If you think of a pipe that flows clearly, the water is able to run through it easily. This is what it’s like when we are feeling at ease… we are more able to process what is happening. The information flows in and through. However, when there is too much coming down the pipe at once, or if there is a blockage in the pipe, then the information and the processing is just not able to get through. It gets blocked. When there is too much to process, and the younger we are when we experience trauma, the more easily overwhelmed we will be, the more likely it is that the pipe gets blocked.

With trauma, we are then left with unprocessed… shock, overwhelm or whatever else it might be from our experience. That blocked, unprocessed experience/moment/memory then presents as symptoms of trauma and PTSD until we are able to process this all more fully.

Symptoms of trauma and PTSD include:

• experiencing flashbacks

• bad dreams / night terrors

• ruminating thoughts

• experiencing intrusive thoughts or images

• physical sensations such as pain, tingling, nausea, etc.

• feeling easily overwhelmed

• irritability / anger

• sleep problems 

• difficulty concentrating

• being triggered. Any kind of reminder of the traumatic memory can bring back a whole load of thoughts, feelings, physical sensations and urges that you may have had at the time

• unable to focus

• anxiety/panic

• depression/hopelessness

We might find ourselves in a hyper or hypo-aroused state outside of our window of tolerance. We can feel quickly overwhelmed, highly activated or fatigued and in need of deep rest.

Some of the symptoms of ADHD/Autism/AuDHD can be mistaken for trauma and vice versa. 

The overlap of Autistic Spectrum, ADHD and AuDHD and trauma…

Many people living with neurodiversity will have at some point, struggled with challenges before they received an accurate diagnosis. For a lot of people, this does not come until much later in adulthood. Although the Autism/ADHD/AuDHD will have been present from young. 

The trauma and relational trauma often comes from moments (that can be significant, stand-out events, or many micro-moments) along the way when neurodiverse struggles have been met (either from a parent, family member, teacher, friend, colleagues etc) with some negative or punishing response, like:

• misunderstanding

• impatience

• shaming

• annoyance/irritation

• frustration

• mocking/teasing

• name - calling

• punishment

• criticism / harsh judgement

• rejection

  
  

We may have experienced very negative or punishing feedback or even devastating consequences in response to what are, and always were, genuine struggles.. that are not your fault.

Many adults diagnosed later on in life recall being told as a child that they were:

• lazy

• stupid

• not trying hard enough

• have a bad attitude

• are doing it on purpose

• are bad

And of course, none of the things are actually true. You were experiencing executive functioning shut down, cognitive and emotional overload... all the time being confused about why.

Needless to say, these sorts of experiences do not support the development of positive self-esteem or confidence. It's where alot of relational trauma stems from.

Many adults I've worked with have experienced difficult times relating to their neurodiversity having been met with negative feedback (or worse) before they themselves have been able to understand the actual nature of their struggles with the right diagnosis.

In the meantime, growing up with, or living with autism or ADHD can leave you feeling confused about why you can’t seem to do things that other people seemingly can.

Autism and ADHD is not trauma. The trauma comes from how this has been received, responded to and managed - this is usually before a diagnosis has been made and properly understood.

As a result of negative experiences or trauma, it’s not uncommon at all to be left thinking and feeling like:

“Why do I find this so difficult?” 

“What’s wrong with me?”

“I can’t cope”

“Maybe I’m stupid”

“There’s something wrong with me”

“I’m not good enough”

“I can’t do it”

“It’s my fault”

“I’m worthless”

“I’m useless”

These sorts of thoughts and feelings can understandably leave a person feeling helpless, hopeless, depressed, confused, anxious and further isolated.

One of the reasons it’s so important to get the right diagnosis is so you can get the right understanding and perspective on yourself and your unique skills and struggles. Receiving the right diagnosis can bring a huge relief and help make a huge amount about your life, your experiences, school, friendships and relationships all suddenly make so much more sense.

There can also be a process of grief and anger at the same time. 

Additional factors relating to autism and trauma:

Usually there is Autism and ADHD or other forms of neurodiversity across the family as there is a genetic component, and so often we’ve grown up with and around family members who have also had their own cognitive and emotional regulation struggles.

They may or may not have been diagnosed (it’s typically less likely in past generations - the understanding just wasn’t there). Understanding about these conditions are still currently evolving. It may have meant that relationships within the family were unhealthy or unsupportive or damaging in some way. There may have been abuse or neglect.

Much of what we’ve grown up with neurodiversity-wise may have been normalised. We don’t know any different if we don’t know!

Some people may have experienced harsh parenting growing up, with parents or family where there is a lack of empathy. Some may have had narcissistic parents or family members. I believe this is common amongst the neurodiverse community.

Having autism and ADHD can mean having difficulty processing information and emotions so this can also contribute to the likelihood of being more easily overwhelmed and therefore impacted by trauma or finding it harder to process and work through it.

Having AuDHD can be a very confusing and conflicting thing to navigate.

Related experiences may include:

• childhood experiences / parenting styles / early life experiences because of other neurodiversity or mental health issues in the family 

• A narcissistic parent or caregiver

• A lack of understanding or compassion of your struggles from others

• Difficulty processing and regulating your emotions

• Feeling different and isolated

• RSD rejection sensitive dysphoria

• Misdiagnoses and misunderstanding from health professionals

• Negative or punishing responses from others

Trauma Treatment for ADHD/Autism/AuDHD

Getting the right neurodiverse diagnosis can be life-changing.

It can help you get the right understanding and treatment.

This may include medication but also lifestyle changes, psychological tools and emotional support are important. 

Many people receive multi incorrect mental health diagnosis before arriving at the most fitting. Getting the right diagnosis can really leave you feeling like everything finally makes sense. Whilst that can be a relief, there can also be a mix of feelings, including possibly trauma from past experiences.

Neurodiverse conditions can often be mistaken for trauma or PTSD or related mental health conditions like Borderline Personality Disorder or Emotionally-Unstable PD, eating disorders or anxiety disorders. Often Autism, ADHD or AuDHD absolutely co-exists with varyings degrees of trauma and PTSD and there can be an overlap of symptoms. It can be very difficult to try to work through which is which. However, with the right kind of guidance and support you can start to identify and process any trauma and as you do this, you can become clearer about what difficulties or reactions are or were trauma-related and what is your baseline.

Trauma Therapy can also be a huge transformative help .

EMDR Therapy for Autism/ADHD/AuDHD

EMDR Therapy is a great approach for the trauma related to negative feedback and misunderstanding relating to Autism and ADHD/AuDHD.

EMDR Therapy is a specific trauma treatment approach that is powerful, gentle and effective. It helps you to be able to process trauma, grief and anger from experiences or moments in your life that you were not able to process fully at the time.

Thinking back to the ‘emotional plumbing’ metaphor… EMDR is a technique that helps you to be able to 'unblock the pipes' and process, unprocessed experiences/shock/trauma/grief and as a result alleviate the symptoms of trauma and PTSD and feel a lot less triggered and more settled.

It can help you to feel more emotionally regulated. Many people experience feeling calmer and more settled and find it easier to manage their emotions after EMDR.

It can also help you to be clearer in yourself in terms of cognitive or emotional challenges and symptoms - about what is related to trauma and what is AuDHD related.

Whilst it won't change a diagnosis of autism or ADHD, some people find it helps ease some symptoms and they feel happier, more positive, confident and more at ease.

You can find out more about EMDR Therapy HERE

nb: It is always recommended if you are seeking EMDR Therapy to find a suitably qualified and experienced, registered healthcare professional.

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Dr. Sarah Davies is a Chartered Counselling Psychologist and is highly experienced in working with neurodiversity and trauma. She is also an author having written practical self-help guides on dealing with narcissistic and abusive relationships.