I am struggling a lot lately. That’s the cleanest way to put it.
Not in any obvious way. Just quietly, persistently, in a way that sits behind the eyes and won’t bugger off.
And I don’t fully know why.
Last August, in the middle of what I thought was a routine conversation, a GP looked at me and said, “Have you ever been assessed for ADHD?” I said no. I said I’d asked. More than once.
She checked my notes. Saw the conversations with the mental health clinician. Saw that they’d gone nowhere. And she looked… irritated. Not at me. At the system. Or at least that’s how it felt.
But it still went nowhere.
Because I couldn’t “demonstrate characteristics before the age of 12“, I wasn’t eligible for assessment. That was that. Months of anticipation quietly flattened. No assessment. No answer. Just a polite version of “computer says no”.
So I’m left in this strange middle ground. Not diagnosed. Not ruled out. Just… suspended.
And that suspension messes with your head.
Trauma Doesn’t Ask for Permission
Recently someone started talking to me about childhood trauma. Not in a dramatic way. Just matter-of-fact. And I paid attention.
Because the first twenty years of my life were not exactly gentle. Trauma leaves marks. It rewires things. The research backs that up. The 1998 ACE study by Felitti and colleagues showed a clear link between early adverse experiences and adult mental and physical health problems.
The higher the ACE score, the higher the risk of depression, anxiety, heart disease, addiction. The brain adapts to survive, and those adaptations don’t always age well.
That would explain the emotional sensitivity. The anxiety. The way I can be fine one minute and close to tears the next. The catastrophic thinking. The expectation that something will go wrong even when nothing has.
Trauma explains a lot.
But it doesn’t quite explain the executive dysfunction. The hours that disappear. The days where I’m flat out busy but not with the thing I’m meant to be doing. The fact that I can work like a machine on the wrong task and completely ignore the right one.
That feels different.
Executive Dysfunction Is Not Laziness
Executive dysfunction is a clunky term for something simple. Your brain struggles to plan, prioritise, initiate, or finish tasks. It’s heavily associated with ADHD, but it can also show up in trauma, depression, anxiety, even chronic stress.
Russell Barkley’s work over the last twenty years has framed ADHD less as a problem of attention and more as a problem of self-regulation. Not knowing what to do isn’t the issue. Doing it at the right time is.
That hits home.
I can know exactly what needs doing. I can even want to do it. But I’ll end up researching something random for six hours instead. Or tweaking something that didn’t need tweaking. Or reorganising a folder system that was perfectly fine.
Productive.
But not productive.
And that’s the maddening bit. It looks like effort from the outside. It feels like effort. But it’s misdirected effort.
Exhaustion That Makes No Sense
Then there’s the fatigue.
I can fall asleep at my desk. I’ve nodded off mid-meal. That’s not poetic exaggeration. It’s embarrassing. It’s baffling.
Trauma research shows chronic hypervigilance keeps the nervous system in a heightened state. Over time, that burns energy. ADHD research also links dopamine dysregulation with energy crashes and what some call “ADHD paralysis“. Depression flattens everything.
So which is it?
Maybe it’s all of it.
Add in working too hard. Overdelivering. Struggling to charge what I’m worth. People-pleasing like it’s an Olympic sport. That constant low-level pressure to prove I’m not a fraud. Of course I’m tired. I’d be surprised if I wasn’t.
But knowing that doesn’t fix it.
The System Is Good at Blood Tests
Here’s what gets me. They’ll throw tablets at your blood pressure or cholesterol in a heartbeat but leave you hanging for years (decades, even) when it’s your head.
If you do a blood test, they’ll spot everything. Uric acid slightly up? We can medicate that. Blood pressure a few points high? Let’s talk tablets. Cholesterol a bit off? Here’s a leaflet.
They’ll have you on statins before you’ve left the car park. The physical stuff gets fast-tracked because it’s measurable. Numbers on a screen. Tick the box, write the script, next patient please.
And don’t get me wrong, that stuff matters.
But the head? That’s murkier. Slower. Harder to pin down.
- If you don’t tick the exact childhood criteria, you’re out.
- If you can hold a conversation and run a business, you’re “coping”.
- If you’re not actively self-destructing, you’re probably fine.
Except you’re not fine.
You’re sat at your desk at two in the afternoon wondering why your eyes are stinging and you’re close to tears for no clear reason. You’re watching weeks disappear. You’re constantly behind on the thing that actually matters.
And you start to doubt yourself.
Maybe I’m just weak. Maybe I’m lazy. Maybe everyone feels like this and just gets on with it.
But I don’t think that’s true.
When There’s No Label
Part of me wants a label. Not for drama. Not to join a club. Just for clarity.
If someone said, “Yes, this is ADHD,” at least I’d know what lane I’m in. If someone said, “No, this is complex trauma,” then fine, I can work with that. Therapy. Nervous system work. Boundaries. Practical steps.
But this grey area is exhausting.
You can’t fully commit to ADHD strategies because you’re not officially ADHD. You can’t fully commit to trauma recovery because you’re not sure that’s the core issue.
You’re lost. You hover.
And hovering drains you. You end up Googling symptoms at midnight like you’re trying to diagnose a second-hand car.
Maybe this applies to more people than we realise. Maybe there’s a whole group of adults who function just well enough to avoid help but badly enough to feel like they’re constantly failing.
I don’t have a neat answer. I don’t have a diagnosis to wrap this up with a bow.
I just know that something isn’t right. And being told my blood pressure is a little bit shy of acceptable doesn’t touch the sides of that.
Questions You Might Be Asking Too
What is executive dysfunction and how is it different from laziness?
Executive dysfunction means your brain struggles to plan, start, or finish tasks, even when you know exactly what needs doing. It’s not about motivation or willpower. It’s a problem with self-regulation, often linked to ADHD, trauma, depression, or chronic stress. The difference is that someone with executive dysfunction is often busy and putting in effort, just not on the right thing.
Can childhood trauma cause ADHD-like symptoms in adults?
Yes. Childhood trauma can mimic many ADHD symptoms, including difficulty concentrating, emotional dysregulation, and fatigue. The 1998 ACE study showed a strong link between early adverse experiences and long-term mental health problems. Trauma rewires the brain’s stress response, which can look very similar to ADHD from the outside, making diagnosis tricky.
Why is adult ADHD so hard to get diagnosed in the UK?
NHS criteria typically require evidence of symptoms before the age of 12, which many adults can’t provide. If you grew up in an environment where symptoms were masked, dismissed, or attributed to something else, you may not meet the threshold for assessment. Long waiting lists and limited specialist resources make it even harder to get answers.
What does ADHD paralysis feel like?
ADHD paralysis is when you know what you need to do but physically and mentally cannot start. It’s not about being lazy or not caring. It often comes with overwhelming fatigue, brain fog, and a frustrating awareness that you’re stuck. Many people describe it as watching yourself not do the thing while feeling powerless to change it.
Is it possible to have both ADHD and complex trauma?
Absolutely. ADHD and complex trauma can coexist, and their symptoms often overlap. Executive dysfunction, emotional sensitivity, fatigue, and difficulty with self-regulation are common to both. This overlap makes it difficult to untangle which condition is driving what, especially without a formal assessment. Many adults live in a grey area without clear answers.