Have you noticed symptoms in your teen that you suspect to be ADHD? Perhaps they seem particularly hyperactive, impulsive, or inattentive compared to their peers?
This article will help you to understand more about ADHD symptoms in teens, along with treatment options and strategies. I also explore other reasons your teen might be displaying ADHD symptoms.
What is ADHD?
ADHD (attention deficit hyperactivity disorder) is considered to be a neurodevelopmental disorder. Despite this being called a ‘disorder,’ psychologists prefer to describe it as a neurodevelopmental difference. A difference in the way the brain is ‘wired.’
ADHD is a medical condition which causes people to have differences in brain development and brain activity. It affects attention, self-control, hyperactivity, and impulsivity.
You may have also heard the term ADD (attention deficit disorder). This term is used for people who have excessive difficulties with concentration without the presence of other ADHD symptoms such as excessive hyperactivity or impulsiveness. However, ADD is now considered an outdated term. It is no longer classified as a diagnosis according to the diagnostic statistics manual. People who would previously have been diagnosed with ADD are now described as having ADHD – inattentive type. I will explain in more detail below.
Who Is At Risk of Having ADHD?
Some risk factors for having ADHD include:
- Premature birth.
- Blood relatives such as a parent or sibling with ADHD or a mental health disorder.
- Maternal substance abuse during pregnancy.
- Having epilepsy.
- Younger children who have been exposed to certain toxins may also be at higher risk of ADHD.
But you must remember, it is not your fault if your child has ADHD. There are often a combination of causes and most of these are beyond your control.
Challenges in the Teen Years
The teen years can be a challenging and confusing time to go through, with added academic pressures coupled with emotional and physical changes. Young people with ADHD face an extra set of challenges. Puberty can intensify teens’ symptoms, which can cause extra stress at the same time as they are facing big changes and milestones.
ADHD Symptoms in Teens
Your teen probably won’t display all of the signs of ADHD.
ADHD can present differently from person to person, with a combination of factors such as age, gender, individual personalities and ethnicity all contributing to the way ADHD looks in your teen. This can make it harder to recognise, diagnose and treat.
There are three major types of ADHD, which are:
- Combined ADHD type. This is the most common type of ADHD. It’s characterised by impulsive and hyperactive behaviours as well as inattention and distractibility.
- The impulsive/hyperactive ADHD type.
- The inattentive and distractible ADHD type.
Key Inattentive-Type Symptoms
Getting Easily Distracted
A teen with ADHD may have a short attention span. They might find it difficult to stay on task. They may start other tasks before finishing their first ones or fail to follow through directions. This can lead to careless mistakes.
Disorganisation may include forgetfulness and losing personal items. Whilst this might seem like a symptom that everyone displays on occasion, for a teen with ADHD it is a regular occurrence. This includes: trouble staying organised, losing items necessary for activities and forgetfulness in daily activities. Lack of organisation can often has a big impact on a child’s life. It can affect academic, social and family life, appointments and deadlines.
Reluctant to do Tasks Which Require Mental Effort
Does your child procrastinate? Do they avoid certain tasks which seem daunting or overwhelming to them? This may be especially noticeable in tasks which take a long time or require mental effort. Your child may complain about how bored they are during high school or other activities and might put off homework for as long as possible.
Symptoms of Hyperactivity/Impulsivity in Teens With ADHD
Your child may fidget, talk excessively or have problems with “executive functioning” (planning ahead, thinking things through, making good decisions). They may struggle to take part in a calm, quiet activity.
Restlessness is a common ADHD symptom in teens. Your teen may find it difficult to sit still. This may interfere with many areas of life, such as conversational skills. It may appear that your child is not listening, even if they are. On top of this, impulsivity may cause them to interrupt, talk too much, or leave mid-conversation.
Hyperactivity and/or Very High Energy
This is another hallmark ADHD symptom in teens. It is also strongly associated with ADHD in young children. Hyperactivity in your teen might be less obvious than in younger children, and can present itself as general restlessness and inattention.
Hyperactivity and impulsivity particularly affects teens socially. Their impulsive behaviour can sometimes be perceived as rude. Teens with ADHD may make poor, ill-thought-out choices, which can lead to others not wanting to be influenced by them. All this can make forming relationships with others more challenging.
Lesser Celebrated Positive ADHD Symptoms For Your ADHD Symptom Checklist
Teens with ADHD can have a high level of creative energy. Living with ADHD can give them a different perspective on life, leading to creative thinking. This should be seen as a strength of ADHD. When their creativity shines through it can lead to satisfaction and higher self-esteem.
We can reframe impulsivity and instead think about its more popular cousin, spontaneity. Teens with ADHD might be more likely to try something new or break away from social norms.
The Ability to Hyperfocus
Hyperfocus involves tuning out everything around you to focus on a particular task. For example you might notice that your child can spend hours playing Apex Legends even though they struggle to stay seated for five minutes at the dinner table!
The ability to hyperfocus is a gift, if channeled in a positive way. A child can use this “superpower” to become an exert in a certain physical, mental or musical area. It can also be invaluable in adult life for many careers.
Other ADHD Symptoms
Sleep Pattern Changes
Teens with ADHD can find it difficult to fall asleep. Winding down and giving their body the appropriate “sleep cues” is often difficult. They can also find it difficult to stay asleep. A lack of sleep can lead to more severe ADHD symptoms. This creates a vicious cycle.
Sometimes families find that a prescription for melatonin (a synthetic version of our natural sleep hormone) helps their child’s sleep. This can be prescribed by a paediatrician.
Escalation in Risk-Taking
Risky behaviours are common ADHD symptoms in teens. Studies have shown that ADHD can be related to higher risk for dangerous driving, substance abuse, aggressive and criminal behaviour, unsafe sexual practices, gambling, and unhealthy eating. However, everyone is different. Just because your child has ADHD, doesn’t mean they will engage in any of these risky behaviours.
There are some underlying factors which can explain the connection between these risk-taking behaviours and ADHD. These include:
- Sensation-seeking tendencies;
- Decision-making difficulties;
- Peer pressure;
- Reluctance to invest effort in challenging tasks.
Mood and Self-Esteem Difficulties, Including Heightened Emotions
Diagnoses of anxiety, depression, conduct disorder and sleep disorders are common in people with ADHD. This is not surprising given that the main features of ADHD impact a child’s behaviour, thinking, academic performance, social interaction and more. In a worst case scenario ADHD can leave a teen feeling out of control and confused, isolated or depressed.
Owing to the high levels of overlap with other conditions, ADHD is sometimes misdiagnosed as mental health issues.
Academic Ups and Downs
This will be discussed in more detail below. Academic highs and lows may be linked to the inattentive and hyperactive symptoms which can cause a lack of focus. They may struggle to tune into instructions and process them, or they may forget them when distracted.
Trouble Reading Social Cues
Teens with ADHD sometimes have a hard time when entering social settings. They can become distracted or bored whilst having a conversation, or struggle to tune in to important social cues. Teens with ADHD can also have a hard time managing their emotions when interacting with others.
Why Might ADHD Only Become Apparent in the Teenage Years?
Whilst ADHD often begins in childhood, most of these symptoms are common features of childhood. Your child may have had difficulties but these didn’t particularly stand out compared to their peers.
When you look back, you might be able to track or remember certain symptoms in hindsight.
Changes in their environment or hormonal changes in teens will often make ADHD symptoms stand out more. For example, what seemed like excess energy in childhood could be troublesome for an adolescent. People are less forgiving with teenagers, and this excess energy may present as anger due to hormones.
Do you think that your teen has at least seven of the symptoms above? Do you also think that these symptoms are interfering with their quality of social life or schoolwork?
If the answer to both of these is yes, and the symptoms are present in two or more settings (e.g. home and school), your teen might be diagnosed with ADHD.
If the answer to both of these questions is no, it may not be ADHD which is causing the symptoms.
Conditions Which Have Similar Symptoms to ADHD
The following are other conditions/issues which have overlapping symptoms with ADHD. Might any of these explain your teen’s difficulties?
- Mood disorders such as bipolar disorder and major depressive disorder
- Obsessive compulsive disorder (OCD)
- Specific learning difficulties such as dyslexia, dyscalculia, dysgraphia or dyspraxia (DCD).
- Oppositional defiant disorder
- Poor sleep
- Poor diet which can cause iron deficiencies
- Low blood sugar levels
- Hearing problems
It is also important to remember that children who have ADHD may also experience these other conditions/issues as well as their ADHD symptoms. This is called “comorbidity”.
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Differences in ADHD in Boys and Girls
Typically, girls are often diagnosed later than boys and sometimes they are misdiagnosed or even undiagnosed until adulthood. This is because ADHD symptoms (in general terms) differ between girls and boys. Girls appear to be more likely to display the inattentive type symptoms of ADHD. These can more subtle and easily mistaken for other issues such as hormonal changes.
ADHD in Boys
Boys often have the combination ADHD type of inattentive and hyperactive symptoms. Therefore, boys are more likely to display disruptive behaviours. This type of ADHD can be associated with poorer school grades, given the challenges it presents in a structured educational setting.
This predisposition towards disruptive behaviors in boys with ADHD often stems from their hyperactive symptoms. They may have difficulty sitting still, tend to interrupt conversations, act without thinking, and exhibit a higher degree of impulsivity. It’s no surprise that these behaviors can often lead to difficulties in the classroom, where concentration and adherence to rules are key to academic success.
The inattentiveness that often accompanies the hyperactivity in boys with combined-type ADHD can further exacerbate these academic challenges. Boys may struggle with organizational skills, maintaining focus on tasks, or following through on assignments. As a result, they may underperform academically, not necessarily due to a lack of understanding or ability, but primarily due to the behavioural aspects of their ADHD.
ADHD in Girls
Girls often present with the inattentive-type ADHD symptoms, and some common differences for girls with ADHD include:
- A higher risk of having other conditions alongside their ADHD including: anxiety, depression and low self-esteem. These concurrent issues can complicate diagnosis and treatment, making it essential to provide a comprehensive and nuanced approach to their care.
- A lower rate of aggressive or impulsive behaviours, with the exception of higher rates of verbal aggression towards others. This difference can sometimes lead to girls with ADHD being misunderstood or overlooked in traditional diagnostic processes.
- Daydreaming, shyness and mood swings are more common for girls. These behaviors don’t align with the stereotypical hyperactive and disruptive ADHD behaviors often seen in boys.
It’s important to understand these gender-specific differences as they often result in girls being underdiagnosed or diagnosed later in life compared to their male counterparts. The inattentive symptoms predominant in girls, such as trouble focusing, being easily distracted, or forgetfulness, can be perceived as merely a lack of motivation or academic ability.
When girls with ADHD are underdiagnosed and undertreated, they can struggle with low self-esteem, academic difficulties, and social problems. Early identification and tailored interventions are crucial in helping them manage their symptoms and lead fulfilling lives.
Getting a Diagnosis
If you think your child may have ADHD, the best and first step to take is speaking to your healthcare provider. You may then be referred to a paediatrician or another mental health professional such as a child psychiatrist or clinical psychologist. The process of ADHD assessment varies depending on what country you live in. Even within the UK, the assessment process can vary massively between services.
You may be asked to complete some screening questionnaires. Your mental health professional will also take a developmental history, and may do other specific structured assessments.
Often, the professionals assessing your child will observe your child in school. At minimum, they will seek the views of your child’s teachers. Both teachers and parents should be involved in the process of assessment for ADHD.
The ADHD Process at Our Clinic: Everlief Child Psychology
At Everlief, ADHD assessments are extremely thorough. A psychiatrist, clinical psychologist and assistant psychologist are part of the team who conduct the assessments. Our assessments involve:
- A meeting with a child and adolescent psychiatrist.
- Conners screening questionnaires.
- Young DIVA parent and child interviews conducted by our assistant psychologist.
- The QB test.
- A school observation.
- A cognitive assessment with a clinical psychologist – the WISC-V (the Wechsler Intelligence scale for Children, Version 5)
This thorough process ensures that we can make the correct diagnostic decision as a team. It allows us to develop a comprehensive understanding of each child’s strengths and needs, so that we can help the family and school make a strategic plan to support the child.
What Happens Next?
You might find it difficult knowing what to do next following a diagnosis of ADHD.
Psychologists would say that the best and most effective treatment for teens with ADHD is managing their everyday environment. Managing a teen’s environment means practising strategies which aim to reduce symptoms and aid the smooth running of their everyday life.
Below are some strategy ideas which can be used at home and school to help your teen to manage their environment and improve their quality of life whilst living with ADHD. Not all of these strategies will be effective for your teen. It starts as a trial-and-error process. As time goes on, you will be able to create your own list of strategies.
Strategies at Home
ADHD can affect all aspects of a teen’s life. Coupled with the added pressures and changes from puberty, it can be extremely challenging. As family members, there is a lot you can do to help a teen manage their ADHD:
- Help your teen with scheduling and organisation. For example: using whiteboards to plan activities for the week and make lists of things to remember, such as homework assignments and deadlines, appointments etc. You may find the book Smart But Scattered Teens helpful, to discover strategies that work for your child.
- Keep a structured routine for your family, with predictable bedtimes, mealtimes and wake-up times where possible and a structured evening wind-down routine.
- Be clear and specific when talking to your teen, with brief directions when they need to do something.
- Help your child manage distractions. For example, help them create a clear workspace when they are doing homework.
- Try to provide a healthy lifestyle. A nutritious diet, sufficient sleep and lots of physical activity are important and can help symptoms from getting worse. Read more about child brain health, mental health and the lifestyle connection in our article about lifestyle and mental health here
- Begin to incorporate stress management techniques into your teen’s life.
- It is important to remember that having ADHD is just one aspect of your child’s identity. There are so many more amazing and wonderful aspects to who they are. Your teen may feel like they’re letting others down or can’t do anything right. Help your teen to discover their strengths can boost their self-esteem, resilience and success.
Strategies at School
ADHD can cause significant problems at school, especially if it is not well understood by staff.
Getting organised and prepared for lessons can be a struggle. The following are classroom strategies which you can suggest:
- Offer one-on-one help to get started with tasks, and to check your child is on track.
- Allow them to have extra time to finish tasks, especially tests.
- Use visual planners. Encouraging the child to write down their homework deadlines.
- Break up long concentration tasks such as reading. Movement breaks can provide the feedback the body is craving and allow them to re-focus efficiently. A movement break can be as simple as a brisk walk around the playground.
- Allow them to sit at the front of the class to limit distractions
- Allow use of fiddle toys such as fidget spinners and stress balls. They provide sensory feedback which can calm nervous energy and help a child stay focused.
- Write down important information where it can be easily found. Remind the child where this information is written.
- Have clear and concise rules and expectations for the class. Display these visually on a wall.
- Remind the child how much time is left for a task. Help them manage their time. For example, if they are writing an essay, support them to allocate equal amounts of time for the beginning, middle and end.
- Provide access to study and revision technique classes where possible. Each child needs to find a system of learning that works efficiently for them.
ADHD doesn’t always need “treatment”. Many children can thrive with ADHD. Some see it as a strength or even a super power. However, consider the following interventions and whether they would be helpful for your child.
Therapeutic sessions with a clinical psychologist or another mental health professional can help with ADHD in teens. ADHD is not considered a mental health disorder, but clinical psychologists can provide “psychoeducation” to help ADHD teens manage their condition and thrive. For example, they can learn about improving sleep hygiene and managing their energy levels.
Therapy sessions may be beneficial for additional problems which may occur alongside ADHD, such as anxiety. Therapies which may be used, include:
- Psychotherapy can help your teen to open up about the feelings of coping with ADHD. Psychotherapy can help your teen to understand how ADHD affects their identity as a person.
- Psychoeducation will allow you and your child to discuss and understand ADHD, its symptoms and its effects.
- Behavioural therapy is about helping your child adapt their behaviour to get out of negative cycles that do not serve them.
- Social skills training teaches skills and confidence in social situations.
- Cognitive behavioural therapy (CBT) this is a talking therapy which can help manage problems by identifying and adapting unhelpful thinking patterns and behaviours.
If your child isn’t thriving despite trying some of the methods above, you could talk through the pros and cons of medication with their doctor. In the UK, medication is usually first prescribed by your child’s paediatrician or psychiatrist. Once the dose has been stabilised, it can then usually be prescribed by your child’s GP.
ADHD medication aims to relieve symptoms and make the condition manageable in day-to-day life. Some medications used to treat ADHD belong to the stimulant medication group. These medicines increase activity in the brain, particularly in areas that play a part in controlling attention and behaviour.
The NHS lists 5 types of medicine licensed for the treatment of ADHD:
Medications are not a permanent cure for ADHD but may help to better manage the symptoms. They are usually given in small doses and gradually increased. Regular medication reviews (at least every 6 months) are vital to monitor the effectiveness of the treatment and check for any problems. It is important to remember that these medications may come with their own side effects.
Summary: ADHD Symptoms in Teens
ADHD is a neurodevelopmental difference which commonly affects attention, hyperactivity, impulsivity and self-control. The word ‘disorder’ is an unfortunate term and psychologists believe it should be described as a difference, a difference in the way the brain is ‘wired.’
If you believe your teen has ADHD, it is important to seek a proper diagnosis. Following an ADHD diagnosis, the first step is to manage your teen’s environment. In some cases, a combination of medication and therapy can provide relief and help your child begin to thrive.
ADHD is a topic we regularly discuss through live workshops in our online membership community called Everlief Parent Club. You can find out more about the Parent Club here: https://courses.theyarethefuture.co.uk/epc-enrolment
Stephanie Soza is currently studying for an MSc in Theory and Practice in Clinical Psychology at the University of Reading. She hopes to become a Clinical Psychologist in the future. She is also currently on clinical placement at Everlief with Dr Lucy Russell (Founder of They Are The Future). Stephanie has a specialist interest in the mental health and well-being of teenagers, particularly surrounding negative body image and eating disorders.
Dr Lucy Russell is a clinical psychologist and clinical director of Everlief Child Psychology. She is the Founder of They Are The Future.
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