ADHD Symptoms in Teens

Introduction

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects individuals of all ages, including teenagers. While it's commonly associated with young children, the symptoms and challenges of ADHD persist into adolescence and adulthood. Recognizing ADHD symptoms in teenagers is crucial for early intervention and providing the necessary support. 

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ADHD is a complex disorder characterised by patterns of impulsivity, hyperactivity, and inattention. No particular cause has been identified for ADHD, and is mostly a combination of factors. It's important to understand that ADHD is not due to laziness or a lack of discipline but is a neurobiological disorder that affects the brain's executive functions, which are responsible for planning, organising, and managing tasks.

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ADHD can also be diagnosed in teenagers, while it might be a little less obvious than to make this diagnosis in children. The adolescent will have to meet with a clinical psychologist or psychiatrist to have a clinical assessment taken. This will involve history taking, use of questionnaires and rating scales, and a physical examination. The process will also involve the parents or teachers of the adolescent to gain a more holistic understanding of their symptomatology. Depending on the country of practice, the healthcare provider will make the diagnosis based on the diagnostic manuals in use. 

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Symptoms of ADHD in teens

While ADHD can manifest differently in teenagers than in younger children, there are common signs and symptoms that are noticed. Some teenagers shed the symptoms of ADHD that were present in their childhood, whereas some can have more persistent, and worse symptoms.

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Inattention

• Inability to pay attention and making careless mistakes
• Difficulty following instructions and completing tasks.
• Seeming forgetful.
• Difficulty with organising tasks such as doing them in order, keeping materials in check, meeting deadlines, and time management.
• Frequently losing important items or personal belongings.
• Unable to persist in tasks that can take a lot of time.
• Constantly changing tasks or activities.
• Difficulty in following a conversation by leaving mid-conversation or appearing as if they are not listening.
• Procrastinating on tasks that have to be done. 
• Being easily distracted by unrelated things or thoughts.

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Hyperactivity

• Being restless and finding it difficult to sit still, especially in situations that require focus or concentration.
• Interrupting others during activities or conversations.
• Talking excessively, often inappropriately given the situation.
• Fidgeting and excessive physical movement.
• Being always on the go.
• Trouble with working quietly.

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Impulsivity

• Engaging in risky behaviours, with no consideration of the consequences.
• Interrupting or intruding on others.
• Difficulty in waiting for one’s turn.
• Perceiving little to no danger. 

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These symptoms also manifest in various ways in teenagers like:

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• Emotional dysregulation: Teens might have frequent mood swings, emotional outbursts, and irritability. This can also be seen as an inability to manage anger, frustration, and disappointment.

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• Academic struggles: Due to inattention, poor time management, and disorganisation, teens might procrastinate a lot. This leads to unorganised tasks, materials, and incomplete assignments. They might receive lower grades and underperform compared to their true potential. The concerns with fidgeting in class, interrupting, and not paying attention can also be difficult to cope with.

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• Social challenges: Teenagers might have difficulty in making and maintaining friendships due to their impulsive or forgetful behaviours. They might also struggle with taking turns in conversations or activities, and in being an active listener. There might also be a tendency for blurting out things out of turn, and acting without consideration of social cues. 

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• Social isolation: Due to the social challenges associated with this disorder and difficulty in regulating impulses, teenagers can find it extremely complicated to make friends. This can lead to them having fewer reciprocal friendships. They can also be victims of bullying.

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• Low self-esteem: Teens with ADHD might also experience low self-esteem and self-worth due to the academic, social, and emotional challenges associated with the disorder. This can manifest as internalisation of their symptoms to lead them to believe they are inadequate or incapable. 

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• Risk taking behaviours: Engaging in dangerous activities with no consideration of the consequences can also be something teenagers with ADHD struggle with. This includes substance abuse, reckless driving, rule breaking, or unprotected sexual activity. 

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• Strained family relationships: Parents and sib;ings of teenagers with ADHD might not understand or cope with the teen’s behaviours, leading to difficult family relationships. 

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• Personal hygiene issues: Some teenagers with ADHD can also find it hard to keep up with their personal hygiene. This can be linked to concerns related to procrastination and disorganisation. 

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There is a gender gap in the diagnosis of ADHD in teenagers, due to the difference in clinical presentation. Research has suggested girls with ADHD have fewer symptoms of hyperactivity and impulsivity compared to boys with ADHD. Boys to girls ratio of meeting diagnosis of ADHD is in the ratio of 3:1. The reason could be because of the more obvious symptoms of ADHD in boys, and the fact that they are referred more frequently for ADHD treatment than the girls are. 

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Treatment of ADHD in teens

After identification of ADHD symptoms and diagnosis, a combination of treatments can be devised to suit the teenager’s needs. These include:

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• Medication: Stimulant medication such as methylphenidate or amphetamine-based medication can be provided to help with symptoms associated with executive control. Non-stimulant medication such as atomoxetine and antidepressants can also be prescribed.

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• Behavioural therapy: Interventions using behaviour modification and cognitive-behavioural therapy can help with the management of impulsivity, disorganisation, and self-control.

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• Psychotherapy: This form of therapy can help teens cope with negative emotions, emotional dysfunction, self-esteem, and isolation in a healthy manner. 

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• Parent training: Parents can be psycho-educated and trained to understand ADHD in a better manner and learn strategies to manage their teenager’s behaviours. 

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• Educational support: Education plans and classroom accommodations can be made to extend support to teenager’s with ADHD. They can be provided individual extra study sessions, extra test-taking time, and quiet spaces for studying.

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• Lifestyle changes: Balanced diets, better sleep, and regular exercise can help to manage symptoms of ADHD in teens.

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Providing support to teens with ADHD

In addition to the treatment interventions, parents, teachers, and communities can help teenages with ADHD thrive. Some effective ways to provide support include:

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• Maintaining open and non-judgemental communication with them. This allows teenagers to share their experiences and their feelings. It also encourages them to reach out when they need help.

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• Setting realistic expectations based on the teen’s limitations and abilities can help in goal-setting. It is also important to celebrate their successes, in order to provide them motivation. 

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• Parents can also help ensure teens have access to accommodations in school for learning and testing. They can also hire tutors if their child is struggling with syllabus or to aid self-discipline. 

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• It is important for parents to establish routines that are consistent and structured rules to help teens manage their daily lives in an effective manner. This also ensures that parents are a part of their child’s treatment.

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• Encourage teens to participate in extracurricular activities, so they can receive social opportunities in a structured manner. Teens can also be taught social skills if they are struggling. 

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• Open and honest conversations about substance use and sexual activity must be had to help teens understand the risks and consequences. It also opens dialogue for them to come to parents or teachers if they are in a tough situation.

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Thus, early recognition of signs and symptoms of ADHD in teenagers is essential to help them navigate the unique challenges. Providing appropriate support and interventions is crucial for their well-being and coping. Through a combination of medication, therapy, educational support, and understanding from family and peers, teenagers with ADHD can learn to manage their symptoms and thrive in various aspects of their lives.

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The team of expert psychologists and psychiatrists at Rocket Health foster a supportive and empathetic environment, to help teenagers with ADHD reach their full potential and lead fulfilling lives.

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References

Attention-Deficit/Hyperactivity Disorder in children and teens: What you need to know. (2021). National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-in-children-and-teens-what-you-need-to-know.

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Hinshaw, S. P. et al. (2006). Prospective follow-up of girls with attention-deficit/hyperactivity disorder into adolescence: Evidence for continuing cross-domain impairment. Journal of Consulting and Clinical Psychology, 74(3), 489-499. https://psycnet.apa.org/record/2006-08433-009.

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Novik, T. S. et al. (2006). Influence of gender on attention-deficit/hyperactivity disorder in Europe- ADORE. European Child and Adolescent Psychiatry, 15(1), 15-24. https://pubmed.ncbi.nlm.nih.gov/17177011/.

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Pederson, S. L. et al. (2021). Real-world changes in adolescents’ ADHD symptoms throughout the day and across school and non-school days. Journal of Abnormal Child Psychology, 48(12), 1543-1553. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7805014/#R17. 

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Pietrangelo, A. (2021, May 1). “What are the symptoms of ADHD in teenagers?” Healthline. https://www.healthline.com/health/adhd/adhd-symptoms-in-teens.

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Rooney, M. (2023, May 2). “ADHD in teenagers.” Child Mind Institute. https://childmind.org/article/adhd-in-teenagers/. 

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Rossi, P. D. et al. (2023). Age-related clinical characteristics of children and adolescents with ADHD. Frontiers in Psychiatry, 14. https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1069934/full.

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Shaw, P., & Sudre, G. (2022). Adolescent attention deficit hyperactivity disorder: Understanding teenage symptom trajectories. Biological Psychiatry,  89(2), 152-161. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7736482/.

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Symptoms of attention deficit hyperactivity disorder (ADHD). (2021, December 24). NHS. https://www.nhs.uk/conditions/attention-deficit-hyperactivity-disorder-adhd/symptoms/.

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Wilcutt, E. G. (2012). The prevalence of DSM-IV attention-deficit/hyperactivity disorder: A meta-analytic review. Neurotherapeutics, 9(3), 490-499. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3441936/.