ADHD In Teenagers: Managing Symptoms Of Attention-Deficit/Hyperactivity Disorder
Attention-deficit/hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder that can impact various facets of an individual’s life. In teenagers, symptoms of ADHD may exacerbate common challenges of adolescence, like trouble focusing and impulsivity. Understanding how ADHD often manifests in teenagers—and how to manage its symptoms—can be helpful for both young people and their parents, caregivers, and teachers. Here, we’ll discuss ADHD in teens, including a brief overview of the condition, common symptoms in young people, and options for treatment.
What is attention-deficit/hyperactivity disorder?
Attention-deficit/hyperactivity disorder (ADHD) is a developmental disorder characterized by inattentiveness, impulsivity, and/or hyperactivity, depending on the predominant presentation. ADHD can impact an individual’s mental and physical health, social life, family dynamics, and academic performance. Additionally, ADHD is commonly comorbid with various mental health conditions, such as depression, anxiety, and substance use disorder. Despite these challenges, ADHD can typically be managed with the right treatment.
While the exact cause of ADHD is unknown, several potential contributing factors have been identified. ADHD is thought to be primarily caused by genetics, with a heritability of up to 88%, according to some estimates. There are also thought to be various environmental risk factors—such as economic hardship, smoking during pregnancy, exposure to toxins, and components of early nutrition—that may increase one’s likelihood of developing the disorder.
ADHD typically manifests during childhood, before the age of 12; however, in some cases symptoms present later. For many people, childhood ADHD persists into adulthood. It can affect a person of any gender, but there is a significant gap in the rates at which different genders are diagnosed. According to estimates, 15% of boys in the US have been diagnosed with ADHD compared to 8% of girls. This disparity may be partly attributed to the fact that hyperactivity symptoms—which can be easier to spot than inattentive symptoms—tend to be more common in those socialized as boys than those socialized as girls.
If you believe you or your teen may be living with ADHD, consider consulting with a qualified healthcare provider. A mental health or medical professional can provide you with screenings and determine whether further testing, a diagnosis, and treatment may be necessary.
Symptoms of ADHD
There are three possible presentations of ADHD: predominantly inattentive, predominantly hyperactive/impulsive, and a combined type. Hyperactivity is often associated with ADHD in young people, but not all children or adolescents with ADHD display hyperactive symptoms. In fact, research suggests that inattentive ADHD is the most common subtype in this age group.
To be diagnosed with ADHD based on the DSM-5 guidelines, an individual must experience at least six of the outlined symptoms of inattentiveness or impulsivity/hyperactivity for six months or more. Additionally, the symptoms must negatively affect social and academic or professional functioning. (For adolescents aged 17 and over, only five symptoms must be present.)
The primarily inattentive presentation
The primarily inattentive presentation is marked by trouble focusing, distractibility, and difficulty completing tasks. The following are common signs of inattentive ADHD:
- Trouble focusing on tasks
- Inattention to detail
- Difficulty listening
- Trouble completing projects or assignments
- Disorganization
- Dislike or avoidance of tasks that require uninterrupted concentration
- Difficulty finding or holding onto possessions
- Forgetfulness
The primarily hyperactive/impulsive presentation
The primarily hyperactive/impulsive presentation is characterized by spontaneous behaviors and overactivity. The following are common signs of impulsive/hyperactive ADHD:
- Frequent fidgeting
- Trouble staying seated
- Overactive behavior during inappropriate moments
- Trouble quietly participating in leisure activities
- Seeming like they’re “driven by a motor”
- Excessive talking
- Frequent interrupting
- Impatience when waiting their turn
- Interjecting in conversations or activities uninvited
The combined presentation
The combined presentation is as the name suggests. It means that individuals exhibit symptoms of both inattentive and impulsive/hyperactive ADHD.
Exploring ADHD in teenagers
Teenagers tend to undergo significant changes and experience various challenges as they transition to adulthood. Teens are faced with changing bodies, social pressures, academic stress, and a range of other concerns that can affect their mental health. These challenges can be exacerbated when a teen is living with symptoms of ADHD.
How attention-deficit/hyperactivity disorder can affect teens
The symptoms of ADHD can further complicate the lives of adolescents by interfering with their ability to interact socially, pursue academic objectives, and maintain mental and physical wellness. It’s estimated that over 11% of children and adolescents live with ADHD. The number of diagnoses has increased significantly over the past two decades—likely due to more widespread education on the topic and improved diagnostic tools—and is expected to continue to rise in the coming years. According to the Substance Abuse and Mental Health Services Administration, ADHD is currently the most prevalent childhood behavioral disorder.
In terms of effects, ADHD can contribute to various social challenges in adolescents. Teens with the disorder may struggle to focus during conversations, interrupt frequently, misread nonverbal cues, and otherwise struggle to communicate effectively. These effects can make developing and sustaining friendships even more difficult. Social challenges can also affect a teen’s family life, performance in school, and self-esteem.
Adolescents may also experience negative academic outcomes due to ADHD symptoms. Research suggests that students with ADHD score lower on standardized tests, carry lower GPAs, and repeat grades more frequently than those without ADHD. Young people with ADHD may struggle to focus on certain subjects, sit still during lessons, organize their class materials, or turn assignments in on time due to ADHD—and because classes and homework may not always be not designed with diverse learning styles and needs in mind. Additionally, learning disabilities are common comorbidities in teenagers with ADHD, potentially compounding difficulties in various subjects.
Additionally, ADHD can cause teens to develop behavioral challenges as well. According to the National Institute of Mental Health, teenagers with ADHD are “more likely to engage in impulsive, risky behaviors, such as substance use and unsafe sexual activity.” Further, ADHD frequently co-occurs with substance use disorder. Behavioral challenges like these may also impact social and academic functioning, family relationships, and mental health in turn.
Treatment options for teens with ADHD
ADHD treatment typically involves medication, psychotherapy, or a combination of both. Additionally, certain lifestyle changes may be a part of treating teens with ADHD to help alleviate some symptoms.
Medication
When treating ADHD in teens, professionals may prescribe either stimulant or non-stimulant medication. These medications—often prescribed in combination with talk therapy—may help some teenagers focus, better regulate their emotions, and control their behaviors. Always consult with a healthcare professional prior to starting, changing, or stopping any medication.
Mental health therapy
Behavior therapy, cognitive behavioral therapy, and other forms of psychotherapy are commonly recommended for teens with ADHD. Mental health professionals can provide teenagers with emotional support, help them develop healthy coping strategies, and address potential comorbid conditions.
Lifestyle changes
Incorporating healthy practices into the daily routine of a teen with ADHD may also help reduce some of the cognitive and emotional challenges of the disorder. Physical activity, for instance, may help adolescents limit mood swings, focus on tasks, and reduce executive dysfunction. Mindfulness meditation and relaxation exercises may lead to enhanced cognitive function and emotional regulation.
In addition to concerns related to mental health, challenges associated with physical health can arise out of ADHD. For example, sleep disruptions, asthma, and weight changes have been linked to ADHD in young people. Lifestyle changes like developing a healthy nutrition plan and maintaining a regular sleep schedule could be useful in coping with these effects.
Tips for addressing teen ADHD symptoms
Learning how to stay organized, manage time, communicate effectively, and develop other important life skills can help teens with ADHD as they become young adults. The following are some key tips that may be helpful for teenagers with ADHD in addition to their professional treatment.
Remove distractions
Teens with ADHD tend to lose focus when they are distracted, so limiting distractions may help adolescents who may otherwise struggle to pay attention for long periods. Consider removing visual clutter—such as unnecessary papers, folders, or school supplies—from their workspace. You may also want to limit the teen’s ability to navigate to certain websites or use their phone when they’re attempting to complete schoolwork. Noise-canceling headphones could also be helpful while studying. When they’re in class, sitting in the front row might help them remain engaged without being distracted by others.
Develop a regular routine
In teens, ADHD can significantly impair executive functioning, which is the ability to set goals and engage in actions to achieve them. Creating a routine may help individuals with ADHD limit the effects of executive dysfunction.
One potentially helpful strategy when developing routines is the time blocking method. This involves organizing your day into blocks of time during which you focus on one task at a time. Time blocking can not only help a teen with ADHD develop a regular schedule, but it may also help them limit distractions, as they won’t have to worry about when to work on various assignments.
Managing adolescent ADHD with the support of an online therapist
If you’re seeking support as you navigate teen ADHD or a related challenge, online therapy may be helpful. Since online therapy doesn’t require commuting to and from in-person appointments and is often more cost-effective than face-to-face sessions, it can represent a more convenient alternative for many.
How online therapy can help address ADHD in teenagers
With an online therapy platform like BetterHelp for adults or TeenCounseling for adolescents aged 13–19, you can get matched with a licensed therapist according to the needs and preferences that you’ll outline in a brief onboarding questionnaire. Clients can also switch providers at any time for no additional cost, which may make it easier to find a therapist who feels like the right fit.
You can then work with your therapist to develop healthy coping mechanisms and positive habits and find personalized ways to address key ADHD symptoms. Or, if your child is living with ADHD, meeting with a therapist might offer you emotional support and help you develop new ways to support your child as well.
The efficacy of online mental health care
Research suggests that online therapy may lead to positive mental health outcomes for many participants with ADHD. In a meta-analysis and systematic review of six studies, for example, the researchers indicate that online interventions may lead to improved focus and social functioning in adults, children, and adolescents with ADHD. The study also notes the convenience online therapy platforms can offer, mentioning that it can be particularly beneficial for “patients who have difficulties in accepting face-to-face treatment.”
Takeaway
How do I know if my 15-year-old has ADHD?
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria, developmental disorders like attention-deficit hyperactivity disorder (ADHD) show symptoms in younger children early in life. If you can recall your teen’s specific symptoms having occurred before the teen years and having impacted daily functioning, they may be a sign of a developmental disorder. Often, these core symptoms of ADHD must have shown up in two or more settings. For example, they may have impacted social skills, extracurricular activities, and home life.
The best way to know for sure that a child is experiencing ADHD in their teenage years is by working with school support and a licensed psychologist or psychiatrist to get an official diagnosis. A diagnosis may improve a teen’s life by allowing them to access accommodations and support tools for those with disabilities at their school. These accommodations can shift academic expectations and help a child focus less on poor concentration and more on building positive peer relationships and receiving support.
At what age does ADHD start to show?
Research shows that ADHD is a lifelong developmental condition. Symptoms can appear anytime but are often most apparent in early childhood, around four to six years of age. Symptoms may shift and change with hormonal changes, puberty, and life transitions. However, ADHD does not have a cure and will continue to cause symptoms throughout someone’s life, especially without positive reinforcement, support, and treatment.
What does an ADHD tantrum look like?
Children with ADHD may be emotionally sensitive and highly attuned to their senses. They may have emotional breakdowns more easily and become overstimulated if unable to move, explore, or work out their mental challenges. They may make careless mistakes or seem to have an “emotional rollercoaster,” struggling to regulate their emotions due to racing thoughts and difficulty slowing down their movements. This “tantrum” might look like crying, running away, throwing items, or becoming unconsolable over a situation others might consider “small.” Therapy, psychiatry, accommodations, education plans, case management, occupational treatment, parental support, and psychoeducation are all tools to help a child work through these moments. For example, children who become overly stimulated when they wake up may benefit from a later wake-up time. A child who starts screaming when their parents try to explain rules or equations to them may benefit from a different learning method or using an assistive technology device.
What age is hardest for ADHD?
Every child with ADHD is different; what one child struggles with, another may excel in. ADHD symptoms continue to impact people throughout their lives, though they may get worse at some points, especially due to hormonal changes, transitions, and traumatic events. In times of life when children are more likely to experience pressure and academic stress, like middle school and high school, they may struggle more academically and socially than in the past.
What are the five levels of ADHD?
There are three subtypes of ADHD in the DSM-5, including primarily inattentive ADHD, primarily hyperactive/impulsive ADHD, and combined type. Primarily inattentive ADHD only involves symptoms like difficulty focusing, inattention, memory loss, and cognitive challenges. Hyperactive/impulsive ADHD involves symptoms like risky decision-making, difficulty staying still, difficulty with volume perception, interrupting others, etc. The combined type of ADHD involves symptoms of both subtypes and is the most common type.
How does yelling affect ADHD?
Yelling can be overwhelming for a child with ADHD, causing overstimulation and potentially making behavioral issues worse. Instead, parents can react by emotionally regulating themselves and addressing the situation. If you have to act quickly, try to remain calm by keeping your voice level. Talking to a therapist can be a helpful way to learn techniques to support your child that work for your unique situation.
What should you not do with a child with ADHD?
When supporting a child with ADHD, avoid reacting with anger or yelling. Try to remain regulated when supporting their emotions and avoid blaming them for their behavior or calling them names like “a bad kid.” These labels can stick with someone, causing them future pain.
What parenting style is best for ADHD kids?
Authoritative parenting is the most effective parenting style for many children. In this style, parents are warm and empathetic but offer structure, routine, and support as adults. Studies show that children raised by authoritative parents have higher self-esteem and a greater quality of life.
How do you discipline a child with ADHD?
Discipline for a child with ADHD may not be effective, as punishment can cause rejection sensitivity and behavioral outlashes. Instead, parents of children with ADHD may try to meet their children where they’re at by providing empathy, accommodations, and frequent support. In addition, working with a mental health professional can help children with ADHD learn to regulate their own urges and emotions.
What causes ADHD to worsen?
ADHD symptoms may worsen in situations where a child is overly stressed, exposed to significant stimuli, or traumatized. In addition, ADHD symptoms can worsen with certain substances or foods. Certain environments may also cause symptoms, especially if the child is distressed. For this reason, accommodations in daily environments may reduce symptoms by providing the child with what they require to function optimally.
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