ADHD as a Chronic Emergency Response: Oscillation Between Hyperarousal and Depletion in Neurodevelopmental and Trauma Contexts Charles J. Wolf

Attention-Deficit/Hyperactivity Disorder (ADHD) is traditionally conceptualized as a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. However, emerging perspectives suggest that ADHD may also be understood as a chronic emergency response system, oscillating between states of hyperarousal (“emergency mode”) and subsequent depletion (“recovery mode”). This paper explores the neurobiological and psychological underpinnings of this oscillation, drawing parallels with trauma responses observed in Post-Traumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). We examine the roles of dopamine dysregulation, executive function impairments, and the impact of adverse childhood experiences (ACEs) in shaping these states. Furthermore, we discuss the implications for treatment, advocating for integrative approaches that address both neurochemical imbalances and trauma-informed care.