Attention deficit hyperactivity disorder or ADHD in teens can lead to behavioral problems, low concentration, and forgetfulness. It may also increase the risk of anxiety and depression in teens. According to the American Academy of Pediatrics (AAP), nearly 9.4 children between ages two and 17 are affected by ADHD in the US.
Some teens may exhibit the first signs of ADHD in early childhood. However, most children are diagnosed with ADHD between ages six and 12. Further, this condition can progress into adulthood. However, appropriate management may help lessen the symptoms and improve the quality of life (1) (2).
Read on to learn about the causes, types, symptoms, and effective ways to manage ADHD in teens.
What Are The Types Of ADHD in Teens?
- Predominantly inattentive type:
- The teen has a short attention span and cannot focus on details.
- It makes the organization and management of tasks difficult.
- Following instructions or conversations becomes challenging due to frequent distractions.
- Forgetting details of daily routines and losing essential items is a common occurrence. However, hyperactivity is usually absent.
- Predominantly hyperactive-impulsive type:
- The teen talks a lot and finds it challenging to stay still even during essential tasks, such as eating meals or doing homework.
- They fidget a lot and tend to remain restless.
- Due to high impulsivity, they may interrupt a conversation frequently or speak at inappropriate times.
- They usually find it difficult to wait for their turn.
- Combined type: It is the most common type of ADHD wherein the teen exhibits inattentive and hyperactive-impulsive symptoms.
Children with ADHD may also have other disorders, such as a learning disorder, anxiety, or depression. The occurrence may vary from one teen to another. ADHD tends to be more common among boys than girls (5).
What Are The Symptoms Of ADHD In Teens?
The symptoms of ADHD in teenagers could vary based on the type of ADHD, its intensity, and its frequency (6). Teenagers with ADHD may display subtler signs of hyperactivity than inattentiveness and impulsivity.
Inattentive ADHD symptoms in teens
- Short attention span and easy distraction cause difficulty concentrating, thus affecting the teen’s academic performance.
- Following instructions, such as driving or following a map, becomes challenging due to loss of focus and easy distraction.
- Unwillingness to involve in tasks and activities, such as school projects and assignments that require concentration, focus, and mental effort
- Frequent forgetfulness, leading to the loss of personal items and belongings, such as notebooks, scarves, and caps
Hyperactive-impulsive ADHD symptoms in teens
- Difficulty staying still or being seated, even in places where sitting is necessary, such as the classroom
- Restlessness, causing the inability to concentrate or focus. It affects the academic and non-academic performance of the teen.
- Talking too much and often interrupting others while they are still talking. Such teens answer a question without listening to it properly.
- Trouble waiting for their turn due to which a teen may frequently interrupt others while playing, talking, or doing a group task
A display of these symptoms does not necessarily mean the teen has ADHD. Most of these symptoms may even appear in other mental health conditions and learning disabilities.
What Are The Causes Of ADHD?
- Genetic factors: Research shows that a teen has a two- to eight-fold increased risk of developing ADHD if they have a parent or sibling with the same condition (10). The risk is higher when one of the identical twins has ADHD. Researchers have noted that those with ADHD have genes linked to low dopamine levels, causing inattention, mood instability, and low motivation (11). Dopamine is a neurotransmitter that passes nerve impulses between nerves and regulates body functions.
- Environmental factors: Maternal smoking, alcohol use, or substance abuse during pregnancy may increase the risk of ADHD in the unborn baby. Early childhood exposure to lead and low zinc levels are some other risk factors (12). Head trauma or injuries and premature birth may heighten the risk of ADHD. Other environmental factors that may increase the risk of ADHD are stressful or violent environment at home, harsh parenting, and poor parental support in early childhood
The research on ADHD is advancing, and several new risk factors are being discovered. There’s no evidence that ADHD can develop due to immunizations, allergies, excess sugar intake, and food additives.
How Is ADHD Diagnosed In Teens?
The Centers for Disease Control and Prevention (CDC) recommends screening children between four and 18 years for ADHD in case they show related symptoms. A trained healthcare provider is likely to perform the following diagnostic procedures to determine ADHD (13).
- Getting a detailed history of the teen’s academic and socio-emotional functioning from the teen, parents, and teachers
- Observing the teen’s behavior to rule out the possibility of other mental health problems that mimic ADHD symptoms
- Rating the teen’s symptoms as per the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition (DSM-5) criteria. For the successful diagnosis of ADHD, the symptoms must be present in a child or teen for at least six months. Children up to 16 years must have six or more symptoms of either ADHD type, while teens older than 17 years should have five or more symptoms.
- Determining if the teen has any co-existing concerns, such as emotional or behavioral disorders, developmental disorders, and physical conditions
- Referring the teen to a specialist for co-existing conditions that the healthcare provider can’t diagnose clearly or treat
If a diagnosis is made, a treatment strategy is devised to manage ADHD symptoms.
How Is ADHD Treated In Teens?
ADHD does not have a specific cure, but treatment strategies can significantly reduce symptoms and improve the teen’s functions. The treatment course depends on the teen’s age, symptoms, overall health status, medical history, and preferences (14) (15) (16).
According to the CDC, the treatment of ADHD for children older than six years should include multiple therapies, such as:
- Behavior therapy: It helps a teen learn social behavior aspects, such as aggression control, improves problem-solving skills, and boosts self-esteem. It also helps the teen cope with their symptoms and improves their behavior in a social setting.
- Organizational skills training: It teaches organization, management, and planning skills to reduce distraction and enhance learning.
- Parent behavior management training and school intervention programs: These can help parents and teachers understand and manage ADHD and other co-existing conditions. These can also ensure that the home and school environment is friendly to a teen’s needs and can help them learn ways to overcome ADHD positively.
Along with therapies, a doctor may prescribe FDA-approved medicines to the teen after their consent. Medicines are generally used in cases where ADHD symptoms affect normal functioning. The medicines may include the following.
- Psychostimulants, such as methylphenidate, could reduce ADHD symptoms by boosting and balancing neurotransmitters. They are available in short and long-acting forms, and their dose needs adjustment as the teen grows and shows any side effects. If a teen experiences severe side effects or the stimulant is ineffective, the doctor may consider non-stimulants.
- Non-stimulants, such as atomoxetine and guanfacine, take longer to show effect than stimulants. However, they alleviate ADHD symptoms and also improve focus and attention. Antidepressants do not specially treat ADHD but may be prescribed when depression co-exists with ADHD.
Medications could have side effects based on their dosage and concentration. Stimulants are more likely to cause side effects than non-stimulants (17). The following are the potential side effects of ADHD medications (18).
- Sleep problems, such as insomnia
- Reduced appetite
- Growth delays
- Tics and jitteriness
- Stomachache and headache
- Cardiovascular issues, such as an increase in heart rate and blood pressure
- Nausea and vomiting
- Mood swings and irritability
Provide the teen with the prescribed dosage of stimulants to reduce the risk of substance abuse. Consult a doctor for a repeat prescription and never self-medicate. Some teens may experience a rebound effect where the symptoms of ADHD reemerge as the effects of the medicine wear off. However, the rebound effect lasts for a short duration.
The healthcare provider would closely monitor the treatment of ADHD. Medicines could be reviewed and updated periodically based on the prognosis of the disorder.
What Are The Possible Complications Of ADHD?
If ADHD is left untreated, it may lead to the following complications (19).
- Poor academic performance and low grades are common occurrences among teens with untreated ADHD. It is often the result of inadequate concentration in the classroom and while studying at home.
- Impulsiveness could cause frequent loss of temper and arguments with teachers, parents, and peers. It could make it difficult for the teen to observe relevant rules in a setting.
- Hyperactivity could make the teen come across as socially intrusive and impolite. The teen could find it difficult to forge social alliances and relationships with peers.
- Inattentiveness could affect the daily activities of the teen and also impact their safety. The teen may not fully understand crucial information, such as safety information at certain places.
- The teen could have an increased risk of accidents, especially while driving. According to the CDC, teens with ADHD are more susceptible to injuries due to accidents. Hyperactivity and impulsiveness could be the reasons. For instance, a teen with ADHD is more likely to jump a signal due to hyperactivity and impulsiveness, increasing the risk of an accident.
- Older teens with untreated ADHD could find it difficult to retain jobs for a long time.
- Hyperactivity and impulsiveness may affect the teen’s self-restraint ability. It could make them susceptible to take miscalculated and fatal risks.
- The symptoms of ADHD combined with poor social relationships may increase the risk of depression or anxiety. It could even make a teen prone to alcohol and substance abuse.
A combination of medicines and behavior therapy can help in the long-term management of ADHD, thus reducing the risk of complications. Parents can also play their part by helping the teen manage their daily tasks.
Tips To Help Manage ADHD In Teens
- Accept that your teen has ADHD and explain to them their condition in a reassuring way. Help your teen identify their strengths and tackle weaknesses. Show support and in still faith so that they can achieve their aspirations. Help your teen identify their strengths and tackle weaknesses.
- Involve your teen in rules setting and work together to decide the rules that work the best for your teen. Help them understand and accept each rule and take responsibility.
- Set age-appropriate rules and consequences. Remember, your teen is going through a lot, so abstain from being too harsh. Instead, set impactful consequences, such as helping a parent or family member with a chore.
- Praise positive behavior and provide additional privileges to make your teen feel appreciated. Encourage them to stay on track by following rules. Be a role model that your teen may look up to in times they feel lost.
- Set a timetable for daily activities, such as homework and bedtime. It can help establish a routine, which the teen can observe without forgetting their tasks.
- Train your teen to cope with challenging situations. Do role-play activities to teach them the right ways to behave socially even when the situation may feel out of hand.
- Help your teen practice coping strategies to understand the process of “think and react.” Understanding the situation and managing emotions and behavior is a step further to being independent.
- Divide school work for easy understanding. A child or teen with ADHD may have academic issues. Therefore, divide their school work into smaller objectives that are easier for the teen to achieve. You can speak to your teen’s teachers and school staff to devise relevant classroom strategies for improved academic performance.
- Plan for breaks between activities. Teens and children with ADHD swing between hyperactivity and tiredness, affecting their behavioral, socio-emotional, and academic functioning. Encourage your children or teens to have breaks between their tasks.
- Motivate your child or teen to try activities that calm their body and the mind. Walking in nature and reading soothe the senses and offers relaxation. Your teen can try these activities or any other exercise of their choice that helps them cope with the symptoms of ADHD.
- Provide distraction-free study areas. It helps children and teens to concentrate and focus on their homework or assignment. Ensure their room has no electronic gadgets during study time to avoid distraction.
- Be sensitive to your teen and listen to them mindfully. Have frequent interactions to know about their feelings and any issues in school or with their peers. Guide and teach them ways to deal with issues, such as peer pressure.
- Involve your teen or child in group activities, such as dance, gymnastics, music, dance, or art. It will help your teen come out of isolation, build self-esteem, and develop confidence.
- Set age-appropriate rules and consequences. Explain to your child/teen clearly that these rules are for their betterment. If they break a rule or indulge in an unnecessary conflict, don’t yell. Instead, calmly enforce the consequences. Limit screen time to an hour a day. Screen time includes all forms of electronic entertainment, such as playing video games and the use of cell phones. Excessive screen time may overstimulate the teen. Also, screen time right before bedtime may make it difficult to fall asleep.
- Ensure your teen gets eight to ten hours of sleep at night. Sleep deprivation may worsen ADHD symptoms, such as irritability and impulsivity.
- Help your teen adhere to their medication and therapy regimen. It can help in better management of ADHD symptoms at home and school.
- Teach your teen safe driving habits to prevent accidents and injuries. You may speak to a driving trainer who specializes in teaching driving to teens with special needs, such as teens with ADHD.
- Keep a positive attitude at home. If your child is acting out, look for possible causes, such as schoolwork or bullying. Discuss and tackle the issue with your teen so that they feel better.
- Provide a well-balanced diet with plenty of seasonal vegetables and fruits. Teach your teen the importance of not skipping meals and how to concentrate on eating during a meal. It can help in cases where the teen is experiencing a loss of appetite due to inattentiveness or hyperactivity.
- Read food labels carefully. Some children and teens may become hyperactive on the consumption of certain preservatives and artificial food colorings. For instance, the preservative sodium benzoate may worsen hyperactivity symptoms in some children (1). The effects could vary among teens. Speak to the healthcare provider to know if there are any foods the teen must avoid.
Frequently Asked Questions
1. Can ADHD get worse in the teenage years?
Teens with ADHD show lower hyperactivity symptoms compared to younger children. However, as teenagers already experience many changes in physical and psychological aspects, the presence of ADHD could make their life challenging. They may have problems when making friends, being a part of conversations, and difficulty coping with frustration (21).
2. What does ADHD look like in a teenage girl?
Girls often have fewer of the typical symptoms of ADHD, making identifying them more difficult than boys. Easy distractibility, more quiet display of hyperactivity (e.g. doodling or fidgeting), talking out of turn, struggling with multiple tasks, and poor time management are more evident in girls with ADHD (22).
ADHD is a long-term condition that is manageable with the right combination of therapy, medication, and personal management measures. Early diagnosis and treatment could make it easier for the teen to cope with the ADHD symptoms as they turn into adults. Teens can successfully enter into productive adulthood and learn new coping strategies when provided the right support by parents, peers, and teachers. This is not about “fixing” the teen who has ADHD, rather it is encouraging and empowering the teen to take charge of his/her ADHD.
- If your teen has difficulty concentrating, seems forgetful of things, is disinterested in routine activities, is restless, or talks too much, they may have ADHD.
- ADHD is of three types, predominantly inattentive type, hyperactive-impulsive type, and a combined type.
- Set simple rules, motivate your teen to deal with challenges, appreciate their efforts, involve them in activities such as music, dance, or art.
- Talk to a doctor who will analyze your child’s condition to suggest a specific therapy such as medication or behavioral therapy to help your teen cope with the condition.
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