Mental Health Report: Trauma Haunts 82% of Adults with ADHD
Roughly 8 in 10 adults with ADHD have experienced trauma, and more than 70% also have anxiety and/or depression, according to an ADDitude reader survey. This comorbidity is fueling a mental health perfect storm.
October 6, 2022
The mental health of adults with attention deficit hyperactivity disorder (ADHD) garners a passing grade — but barely.
In an exclusive ADDitude survey, 1,542 adults assigned their mental health status a rating of 2.27 out of 4 — a C-minus average. One contributing factor: Nearly three-quarters of respondents with ADHD also reported diagnoses of anxiety, depression, or both. This sky-high level of comorbidity is four to eight times greater than the national average.
This self-rating reflects the fact that, over the last 2 and a half years, ADDitude survey respondents said they have…
- …felt depressed (68%)
- …suffered with sleep problems (67%)
- …felt unmotivated (62%)
- …experienced mood changes (61%)
- …worried excessively (55%)
- …lost friendships or other relationships (54%) over the last three years.
More than half blamed the pandemic, and the issues it raised, for these and other mental health struggles.
“I worked face-to-face with customers who refused to wear masks,” said a mother of two in North Carolina. “This led to thoughts and feelings of anger, depression, and worthlessness because I didn’t understand why someone would think that my health wasn’t worth protecting by simply wearing a mask.”
In the survey, only about 7% called their mental health “very good” and fewer than 4% said they had no mood changes in the last three years.
The Burden of Anxiety
More than three-quarters of people reported feeling debilitating anxiety that impaired their daily living. The top reasons they cited were as follows:
- finances and money (61%)
- access to health care (38%)
- the pandemic (37%)
- political violence (33%)
Social isolation, once a pandemic requirement and now a complicated choice for many, has led to feelings of apathy, irritability, withdrawal, and sadness for more than half of respondents with ADHD. A whopping 86% said they used social media, though 60% of those individuals said it harms their mental health and even contributes to addiction issues, headaches, and eating issues for up to 24%.
The Scars of Trauma
An astounding 82% of ADDitude survey respondents said they have experienced trauma, a rate that is significantly higher than the national average compiled by the U.S. Department of Veteran Affairs: 50% for women and 60% for men. Sexual assault, the death of a loved one, car accidents, and bullying were among the traumatic incidents cited by ADDitude readers.
“I endured childhood emotional neglect and traumatic events (car accident, parents separating, violence, and bullying),” said a women diagnosed with ADHD and autism. “As an adult, I experienced sudden bereavements (my best friend and mother), and trauma based on supporting my bereaved father.”
The ADDitude survey captured many stories like these, suggesting that trauma is the rule rather than the exception for people with ADHD. The primary treatment for trauma is psychotherapy, namely, cognitive behavioral therapy (CBT), and other approaches. Yet only 25% of survey respondents said they were receiving CBT for trauma and only 57% reported receiving therapy of any kind. Almost 82% said they were taking medication, which most deemed “helpful” or “very helpful.”
“Finding a therapist who fit my schedule, was in my insurance network, and was seeing new patients was nearly impossible,” said a woman in Washington with ADHD, anxiety, and an eating disorder. “My health insurance does not cover my therapy, so I pay out of pocket. It’s been a nightmare.”
Strategies for Adults Living with Anxiety, Depression, or Trauma
A combination of ADHD medication and therapy has been found to be the most beneficial for adults with ADHD and anxiety, according to J. Russell Ramsay, Ph.D. He also offers the following daily coping mechanisms for ADHD and anxiety:
- Develop strict routines with space blocked out for downtime
- Exercise daily for at least 30 minutes, ideally outdoors
- Sleep at least 7 hours each night
- Fill your calendar with task- or time-based items that are clearly defined
- Maintain consistent treatment for ADHD
- Accept negative thoughts for what they are: just thoughts
“Sometimes we’re so caught up in our daily routines that we fail to step back and analyze sources of stress,” adds Kathleen Nadeau, Ph.D. “Whenever it starts to affect your moods, get out paper and pen and list the biggest stresses in your day. Then look for ways to reduce or eliminate them.”
She also recommends combatting anxiety and depression by cutting down on carbohydrates, which offer a quick energy hit but also a long crash and, often, weight gain. She urges adults with ADHD to create a chart where they can track progress against sleep, exercise, nutrition, green time, and stress reduction every day.
Edward Hallowell, M.D. recommends reaching out to friends, family, or a support group to avoid worrying alone.
For patients who have experienced trauma, Kerry J. Heckman, LICSW, uses somatic therapy, which “increases awareness of the sensations in the body to give the patient a roadmap to understand what they mean,” she says. “Focusing on the body’s response to the trauma — instead of the trauma itself — reduces the possibility of re-traumatizing the individual and starts the healing process. Through the body, we have more access to the traumatic residue, which may not be available in memories.”
Somatic therapy is a long-term treatment (lasting a year or more) that requires a licensed mental health practitioner trained in somatic therapy who also has experience treating people with ADHD. Since somatic therapy is a modality used by licensed therapists, most insurance policies that cover traditional talk therapy will cover somatic therapy as well.
5 Ways to Practice Somatic Therapy at Home
Though working with a trained therapist is the best treatment, Heckman says patients with trauma and ADHD can follow these simple rules to increase awareness of the nervous system.
#1. Note body sensations throughout the day. Noting and amplifying good experiences can be especially helpful when treating both ADHD and trauma, both of which carry a history of negative experiences.
#2. Find safety in structure. Structure — knowing consistently what to expect — can foster a sense of safety and decrease chronic stress-related activation or vigilance.
#3. Build a strong foundation. Diet, exercise, and sleep are the foundations of a healthy nervous system function.
#4. Notice agency. Paying attention to the areas of life where there are choices brings awareness to what can be controlled, rather than what feels uncertain.
#5. Communicate with the nervous system to calm it down. One way to quiet activation in the body is the gentle reminder that this is not a survival situation. To do this, slow down your movement and speech; check for muscle tension; and check in periodically with your body to see what movement it craves.
Trauma, Mental Health, & Adult ADHD: Next Steps
- Get 5 Daily Rituals to Reduce Stress
- Free Download: Make Mindfulness Work for You
- Read: The Relationship Between PTSD and ADHD
- Read: Treating Traumatic Stress Alongside ADHD
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