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Teens, ADHD, and Risky Behavior

WebMD Feature
Reviewed by Kimball Johnson, MD

When teens with ADHD take reckless risks, their parents are understandably upset. But grounding the teen or yanking his driver's license can backfire.

"The challenge is not to prevent a kid with ADD from doing anything else that any other adolescent would do," says UCLA pyschiatry professor Mark DeAntonio, MD.

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Instead, the parents' task is to keep their teen safe, without nipping their development in the bud.

"You don't want to make the person a child," says Harold Robert Meyer, founder and executive director of the ADD Resource Center in New York.

The Allure of Risk

It's no secret that some teens don't always show good judgment when it comes risk. But risk may be particularly attractive to teens with ADHD.

Why? "In general, they're more impulsive. They do things without thinking," DeAntonio says. "Another thing is that they often have complaints of being easily bored. Often, what gets their attention are things that are more risky or exciting… and they often don't fully consider the consequences of their acts."

Almost all of his teen patients with ADHD struggle with impulsivity. But only about one-third engage in truly dangerous behaviors, he says. "Some of these behaviors are things that other teens [without ADHD] do, but they're willing to push it to the limits."

For example, teens with ADHD will skateboard, surf, or rock-climb, he says, but "they tend to have more broken bones or they blow their knees out when they're playing sports."

Some also "do things like reckless driving, drug behaviors, sexual behaviors," he says.

Meyer has seen some teens who steal, taunt people, or provoke fights "to produce an adrenaline rush," he says. 

Their risky behavior may also happen online. "Many of the kids, especially the girls with ADD, seem to be more trusting of people on the Internet," he says.

For those with low self-esteem, doing risky things can give them a warped form of bragging rights. "They're able to do something that other people can't or won't do," Meyer says.  

DeAntonio helps his teen patients to identify the activities that put them in harm's way and to "to help them appreciate the risks that they're taking."

Peer pressure, in good relationships, can help. Since teens value their friends' opinions, DeAntonio tells teens with ADHD: "Listen when your peers say, ‘You really scare me. You do things that you shouldn't be doing.'"

As teens grow into their 20s, a serious relationship can have a calming effect, Meyer says. For example, if a young woman tells her boyfriend who has ADHD that she doesn't like his high-risk activities, Meyers says, "It can quiet them down... They want to behave a little bit better, and to hear it from a girlfriend has more of an impact."

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