The Deepest Well: Healing the Long-Term Effects of Childhood Trauma and Adversity—A Transformative Guide to Understanding Childhood Trauma and Health

by Nadine Burke Harris

In the previous chapter, I mentioned that a graph of the response of the prefrontal cortex to adrenaline and noradrenaline looks like an inverted U. Well, for kids with impaired impulse control and inattentiveness due to toxic stress, PFC function is likely to be on the downslope of the inverted U (kind of like if you drink way too much coffee, you can’t focus to save your life). In those cases, our clinical team tends not to use stimulants like methylphenidate (Ritalin) or drugs derived from amphetamines. Instead, we often use guanfacine, a nonstimulant that was originally developed to treat high blood pressure but has also been used to treat ADHD. Guanfacine targets specific circuits in the prefrontal cortex where adrenaline and noradrenaline exert their action, improving impulsiveness and concentration, even in situations of high stress.