Areas › Focus, starting, and ADHD › Getting assessed and diagnosed
Hypervigilance after trauma and ADHD scanning look much alike from outside. Often the honest answer is that both are present, and the real question is how much of each.
Watching that comes from threat is aimed at something and tends to switch on in particular situations. ADHD distraction is not fussy about where it is or what is happening. Trauma exposure is more common in this group than in the general population, so the two frequently sit together, and treating one as if it ruled the other out leaves a person half helped. Ask what the watching is for, and when it started.
Qur’an and Sunnah
If a troublemaker brings you news, check it first (Quran 49:6). The instruction is to look before concluding, which is also the kindest thing to do with someone's history.
يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُوٓاْ إِن جَآءَكُمۡ فَاسِقُۢ بِنَبَإࣲ فَتَبَيَّنُوٓاْ أَن تُصِيبُواْ قَوۡمَۢا بِجَهَٰلَةࣲ فَتُصۡبِحُواْ عَلَىٰ مَا فَعَلۡتُمۡ نَٰدِمِينَ
Believers, if a troublemaker brings you news, check it first, in case you wrong others unwittingly and later regret what you have done
Qur’an 49:6read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
A national survey of children with a parent reported ADHD diagnosis found most also had at least one other mental health or developmental condition. Co-occurrence is the ordinary case rather than a complication. The survey covers parent report in one country and did not look at trauma specifically, so read it as a general caution against the single-label assessment.
Larson K, Russ SA, Kahn RS, Halfon N. (2011). Patterns of comorbidity, functioning, and service use for US children with ADHD, 2007.. Pediatrics doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Two things can be true at once, and which to treat first is a different question from which is real.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
Ask for the most frightening moment of their life, then the next one down, then the next, until there is a scale running from one to a hundred. You get the ladder you needed, and they get something they did not expect: fear comes in sizes.
Disruptive mood dysregulation disorder was built partly to keep the bipolar label off children whose future nobody can yet see. Worth remembering when that word lands on a family's paperwork: it describes now, and it does not settle later.
Alongside diagnoses, ask how relatives died. Falls from roofs, crashes, deaths with the safety gear left on the ground: these recur in some family lines and they say something a list of diagnoses cannot.