Recently, someone who I have treated for several years was in my office and as he described some stress that he had experienced when he was training a new employee and it seemed to me that his level of stress was much higher than it needed to be considering his coping skills and ability to manage training his employees. I then explored with him his baseline stress level when he has nothing happening that he feels stressed about. As we discussed this it became clear to me that he was having flashback type reactions and being triggered by events to recall past stresses. These are centered around stressful events related to his struggles with concentration and attention. I concluded that he was experiencing PTSD symptoms because of events connected to his problems with concentration and attention span.
I had previously diagnosed PTSD for people with ADD/ADHD but they all had other traumatic experiences that were enough to cause the PTSD. This time the traumatic events were directly related to the ADHD. Importantly, I had not recognized this earlier and I believe that this kept my patient from making more progress letting go of his stress reactions.
After recognizing my patient's PTSD symptoms I helped him to commit himself to protecting himself from stress and working on calming himself with mindfulness type skills. I also discussed trying a stronger antianxiety medication to help reduce the number of times that his brain reacts [instantly] to triggers related to past traumatic experiences. For him I recommended a low dose of aripiprazole. I have found this type of medication superior to antidepressants, benzodiazepines, propranolol, etc.