Is it ADHD or trauma? For many adults, this question has defined years of misdiagnosis, ineffective treatment, and deepening shame. The answer is often both — and understanding why changes everything. Popular trauma-informed voices have claimed that ADHD arises from childhood adversity rather than neurodevelopmental wiring — a compelling narrative that contradicts decades of genetic research. At the same time, dismissing the trauma connection entirely leaves clinicians and clients without a framework for understanding why ADHD and trauma so frequently co-occur, look so similar, and compound each other so powerfully. This session offers a third path. Drawing on polyvagal theory and ADHD genetics research, this presenter offers a nervous system framework for understanding how ADHD and trauma dysregulate the autonomic nervous system through overlapping but distinct pathways — and how to tell them apart. When the ADHD nervous system is structurally more vulnerable to traumatic imprinting, shame and Rejection Sensitive Dysphoria emerge as social trauma responses and nervous system regulation becomes foundational to treatment. This session moves beyond the either/or argument to offer clinicians and clients a more accurate, more compassionate, and more clinically useful framework for understanding what's happening in the nervous system and what to do about it.