ADHD in Teenagers: Symptoms, Diagnosis, and Treatment

Adolescence is a time of great change for teenagers, from learning more about their identities and navigating relationships to doing well in school and balancing extracurriculars. No wonder their attention will sometimes be divided between one thing and another. However, ADHD in teenagers is quite common. What may seem like inattention or normal fidgeting may actually be a sign of this condition.

ADHD (attention-deficit/hyperactive disorder) can affect social relationships and school performance in teenagers. This is why it is crucial to understand the symptoms, causes, and treatment for this disorder. In this article, we’ll cover just that.

What is ADHD in Teenagers?

ADHD is a type of neurodevelopmental disorder that is characterized by patterns of inattention, hyperactivity, and/or impulsivity. It can occur at any age but often begins in childhood and adolescence. The symptoms of this condition often interfere with relationships and daily activities.

What are the Symptoms of ADHD in Teens?

You may have heard of ADD vs. ADHD and wondered what the difference is. There are three types of ADHD based on which symptoms are most apparent: ADHD-inattentive (formerly known as ADD), ADHD-hyperactive/impulsive, and ADHD-combined.

Symptoms can also vary between genders. In fact, more boys than girls are diagnosed with ADHD at 12.9% versus 5.6% [*].

Young adolescent women tend to show symptoms of inattentive ADHD. They often take on adaptive behaviors and coping strategies that mask these symptoms. Inattentive ADHD is characterized by the following:

• Lack of focus
• Disorganization
• Daydreaming
• Mental paralysis
• Difficulty listening or following conversations
• Easily distracted
• Short attention span
• Making careless mistakes
• Often losing things

Young adolescent men, on the other hand, display more symptoms that fall under hyperactive/impulsive ADHD. This type of ADHD has the following characteristics:

• Constant fidgeting
• Inability to sit still
• Excessive physical movement
• Excessive talking
• Inability to wait for their turn
• Interrupting conversations
• Acting without thinking
• Little to no sense of danger

Then we have the combination ADHD type. This means that male and female teenagers may exhibit six or more symptoms of inattentive ADHD and hyperactive/impulsive ADHD.

What Causes ADHD in Teenagers?

More research is still being done to find the exact causes of ADHD. However, many studies suggest that genes play a large role [*]. Similar to many disorders, ADHD results from a combination of factors. Aside from genetics, researchers are also looking at environmental factors that might raise the risk of developing the condition, such as exposure to lead and brain injury.

What Risks Do Teenagers with ADHD Face?

Teens with ADHD face challenges when navigating puberty and their emerging independence. They may face certain risks, some of which are more prevalent in certain genders than others.

Studies have found that engagement in risky behaviors is more prevalent in males than females, a trend that increases as teens mature into adulthood [*]. Teenage boys are more likely to be at risk for substance abuse, risky driving, and conduct problems [*]. On the other hand, teenage girls are more likely to be at risk for unwanted pregnancies, eating disorders, and sleep disorders [*].

Teenagers with ADHD may also struggle with low self-esteem and social functioning. This can lead to trouble with relationships and academic performance.

How is ADHD Diagnosed in Teenagers?

If parents or caregivers suspect ADHD symptoms in teens, then they should see their healthcare provider, particularly their child’s pediatrician. These primary care providers will rule out any other conditions that may cause similar symptoms to ADHD, like sleep disorders, anxiety, stress, or physical conditions and illnesses. In many cases, your child’s pediatrician will refer you to a mental health professional, such as a clinical psychologist or a psychiatrist, who will conduct a more thorough evaluation to diagnose ADHD.

During the evaluation, your teenager’s pediatrician or mental health professional might:

• Examine your child’s medical and mental health history
• Ask for permission to speak with family members, teachers, or adults who know your child, especially in different settings
• Used standardized behavior rating scales or ADHD symptom checklists
• Administer psychological tests that examine executive functioning, working memory, and reasoning skills to rule out learning disabilities

Specific diagnostic criteria must be met for a teenager to be diagnosed with ADHD. Teens up to age 16 can be diagnosed with ADHD if they have at least six symptoms of inattention and/or six symptoms of hyperactivity/impulsivity for at least six months. The symptoms must be present in two or more settings (e.g., at school, at home, with friends, with relatives) and interfere with social or school functioning.

What are the Treatments for ADHD in Teenagers?

Treatment for teenagers with ADHD depends on the severity of symptoms. In many cases, a combination of therapy and medicine is recommended by mental health professionals. Co-existing conditions, like anxiety or depression, must also be part of the ADHD treatment plan.

Medications

Stimulants are common medications that are prescribed for the treatment of ADHD in teens. Many adolescents respond well to stimulant medications [*], including:

• Methylphenidate (Ritalin, Focalin)
• Dextroamphetamine-amphetamine (Adderall XR, Mydayis)
• Dextroamphetamine (Dexedrine)
• Lisdexamfetamine (Vyvanse)

Medicine ADHD treatment for teens usually starts with the lowest possible dose. Your doctor will adjust this as needed and communicate potential benefits and side effects with your teen.

Therapy

Behavior therapy can be highly beneficial for teenagers with ADHD. Cognitive behavioral therapy (CBT), in particular, is considered the gold standard for ADHD psychotherapy. Several subtypes of CBT, such as mindfulness-based CBT and dialectical behavior therapy (a branch of CBT), may also be useful for ADHD treatment.

Studies have shown that behavioral therapies are most effective when combined with medication [*]. These therapeutic techniques can also help teens and their parents navigate the challenges of ADHD as they learn social skills, problem-solving skills, and organizational skills. They can also help with daily life struggles that come with ADHD, such as time management, procrastination, and poor planning.

Non-Medication Interventions

There are many natural treatments for ADHD that can be used as a supplement to therapy and/or medication interventions. Natural treatments incorporate foods and activities that counteract one or more of the brain differences found in ADHD. For example, sunlight and exercise help to increase blood flow to the brain, certain foods help to combat protein deficiency, while neurofeedback and meditation help to increase brainwave activity in the frontal lobe.

How Can Parents Help a Teen with ADHD?

Typical teen ADHD behavior is characterized by impulsive, fearless, and sometimes chaotic actions that can make daily life challenging. It is undoubtedly difficult, but remember it is not your child’s fault, as they cannot help their behavior. Fortunately, there are effective ways to manage. Here are some tips for you to help your teen with ADHD:

Learn more about ADHD

Learn all you can about ADHD. Whether you are studying symptoms like ADHD paralysis or looking to understand impulsivity related to the condition, learning about it will help you feel more patient and less frustrated. Learning about executive function deficits and coping skills to manage these deficits can support teens in better managing some symptoms of ADHD.

Set clear boundaries

Establishing clear behavioral boundaries is one way to manage ADHD behavior more effectively. Communicate what behavior is expected of everybody at home. Reinforce positive behavior with immediate praise or rewards. If boundaries are overstepped, you may also use consistent enforceable consequences, such as taking away a privilege.

Have a routine

Having a routine can make a huge difference in how a teen with ADHD copes with daily life. A routine ensures that they know what to expect, and it can minimize the stress that comes with ADHD symptoms like choice paralysis. For instance, if your child is getting ready for school, break it down into clear, actionable, predictable steps so they know exactly what needs to be done.

Maintain a positive relationship

Teenagers with ADHD are often more sensitive to criticism. This is understandable, considering they often get too much criticism without receiving any help to change their behavior. Rather than nagging, criticizing, or lecturing, highlight your teen’s strengths and reinforce the behavior that you want to see. Their positive attributes might include quick thinking, creativity, and playfulness. When teens take advantage of their strengths, it can boost their self-esteem, success, and resilience.

Get enough exercise

Getting enough physical activity is essential to maintain a teenager’s well-being. You can walk together or play a sport — anything that will help your teen expend energy. This will also improve their quality of sleep. Just make sure they aren’t doing anything too strenuous or exciting close to bedtime.

The Bottom Line

ADHD can be difficult for both teenagers and their parents or caregivers. But with the right treatment plan — whether with medications, therapy, or both — it is possible to live a happy and fulfilled adolescent life even with the condition. Consulting a licensed therapist who specializes in ADHD will help tremendously. And with a little bit of guided effort every day, your teen will go on to enjoy life despite their condition.

Explore our collection of ADHD handouts for psychoeducation and coping skills to support teenagers in managing symptoms of ADHD.

References:

1. Centers for Disease Control and Prevention. Data and Statistics About ADHD. 16 October 2023.
2. Faraone S & Larsson H. Genetics of attention deficit hyperactivity disorder. 11 June 2018.
3. Rodríguez-Planas N, Sanz-de-Galdeano A, Terskaya A. Gender norms in high school: Impacts on risky behaviors from adolescence to adulthood. April 2022.
4. Institute of Medicine (US) and National Research Council (US) Committee on the Science of Adolescence. The Science of Adolescent Risk-Taking: Workshop Report. 2011.
5. Littman E & Wagenberg B. Gender Differences in ADHD and Their Clinical Implications. 26 July 2023.
6. Brahambhatt K, Hilty D, Hah M, et al. Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder During Adolescence in the Primary Care Setting: A Concise Review. 18 May 2016.
7. Muacevic A & Adler J. Efficacy of Cognitive Behavioral Therapy and Methylphenidate in the Treatment of Attention Deficit Hyperactivity Disorder in Children and Adolescents: A Systematic Review. 17 December 2022.