ADHDers and the Fear Response

ADHD and trauma is linked. That is indubitable. This does not necessarily mean that, as Gabor Mate postulates, that trauma causes ADHD, but there is no getting away from the fact that ADHDers are more likely to get PTSD and that ADHD symptoms are worse in people who have also experienced trauma. So why is that? Recent research shows an interesting possibility.

We have all heard of Pavlov, who experimented on animals and discovered conditioned responses: learned, automatic, and involuntary responses to arbitrary signals. Pavlovian fear conditioning is how we all learn to predict a negative event. For example if we have been in a car accident at the moment a specific song plays on the radio, the next time the song plays we will automatically think of the accident. If another car accident happens again at that moment, the next time we hear the song our body may automatically ready itself for an accident, no matter how we tell ourselves that this is illogical. This is fear conditioning. Fear conditioning is what keeps us safe in life threatening circumstances. It allows us to react before we consciously can decide to do so. It may be a smell that warns our body of danger, or a sound, or an image. Animals often sense a thunderstorm before it arrives. Soldiers in a war respond instantly to a threat. Fear conditioning happens across all species and offers a clear survival benefit.

Going back to that car accident that happened when a certain song was played, if we kept driving and the song was played again but no accident happened, our fear response would lessen. The more times the song was played and no accident happened, the less we would feel fear. That is fear extinction as Pavlov named it in 1927.

It is the interactions between fear learning and fear extinction that shape our behaviour during our development. Remember that 95% of our thoughts are not conscious thoughts but the result of automatic patterns. We learn about fear and safety through our upbringing and those responses stay with us.

In PTSD these conditioned responses are maladaptive. The traumatic experience is relived over and over according to diverse stimuli, some of which will be related to the trauma, but others may be unrelated or internal. The ability to distinguish between threats and safety is impaired.

The fear response and extinction circuitry uses dopamine and serotonin, neurotransmitters that are part of our reward and motivational aspects of human behaviour. Alterations in the fear learning system are associated with depression and anxiety and these two conditions often co-occur with ADHD.

Recent research found that ADHDers have differences in their fear circuitry compared to non-ADHDers and that it is in particular the fear extinction circuit that differs. The responses of ADHDers are similar to those of PTSDers. This means that it takes us longer to stop automatic fear responses. In evolutionary terms this may have made us excellent protectors and guards, but in modern day life it causes difficulties. It explains why there seems to be such a strong link between ADHD and trauma. It may explain some of our difficulties with emotion regulation and our tendency to build up trauma over our lifetime.

What does that mean for ADHD coaches? It means that being trauma informed is extremely important. It means that before anything else, we need to look at the trauma responses and determine whether this client needs coaching or therapy. It means we need to discuss triggers and glimmers, sympathetic and parasympathetic nervous systems, and the need for inner child work.

I provide training for ADHDers, professionals, teachers, and anyone else who is interested in ADHD and emotions. For more information on this August programme and to book follow this link https://www.scatterbraincoaching.co.uk/offers/cy7bwD4B

Bibliography:

Spencer, A. E., Marin, M. F., Milad, M. R., Spencer, T. J., Bogucki, O. E., Pope, A. L., Plasencia, N., Hughes, B., Pace-Schott, E. F., Fitzgerald, M., Uchida, M., & Biederman, J. (2017). Abnormal fear circuitry in Attention Deficit Hyperactivity Disorder: A controlled magnetic resonance imaging study. Psychiatry Research - Neuroimaging, 262, 55–62. https://doi.org/10.1016/j.pscychresns.2016.12.015

Tortora, F., Hadipour, A. L., Battaglia, S., Falzone, A., Avenanti, A., & Vicario, C. M. (2023). The Role of Serotonin in Fear Learning and Memory: A Systematic Review of Human Studies. In Brain Sciences (Vol. 13, Issue 8). Multidisciplinary Digital Publishing Institute (MDPI). https://doi.org/10.3390/brainsci13081197