ADHD in Teens

Reviewed by Smitha Bhandari, MD on June 20, 2019

Most children who are diagnosed with ADHD still have it as teens. Symptoms of ADHD in teens are similar to those of ADHD in children. They include:

  • Distractibility
  • Disorganization
  • Poor concentration
  • Hyperactivity
  • Impulsivity

During teen years, especially as the hormonal changes of adolescence are going on and the demands of school and extracurricular activities are increasing, ADHD symptoms may get worse.

How Does ADHD Affect a Teen's Life?

Because of problems with getting distracted and poor concentration, many teens with ADHD have problems in school. Grades may fall, especially if the teen is not getting ADHD treatment.

It's not uncommon for teens with ADHD to forget assignments, lose textbooks, and become bored with their daily class work. Teens may become inattentive or excessively attentive, not waiting for their turn before blurting out answers. They may interrupt their teacher and classmates, and they may rush through assignments. Teens with ADHD may also be fidgety and find it tough to sit still in class.

Often, teens with ADHD are so busy focusing on other things they forget about the task at hand. This can be seen especially with homework and athletic skills and in relationships with peers. This lack of attention to what they're doing often leads to bad grades on tests and being passed over for sports teams, after-school activities, and peer groups.

Does ADHD Raise the Risk of Car Accidents and Problem Drinking?

Yes. Driving poses special risks for teens with ADHD. Teens with ADHD are two to four times more likely to have a car accident than teens without ADHD.

Teens with ADHD may be impulsive, risk-taking, immature in judgment, and thrill seeking. All of these traits make accidents and serious injury more likely.

Still, studies show that teen drivers with ADHD who take their medication are less likely to have accidents.

Teens with ADHD are more likely to be heavy drinkers than teens without ADHD. They are also more likely to have problems from drinking.

In studies, teens with ADHD were twice as likely as other teens to have abused alcohol within the past 6 months and three times as likely to abuse drugs other than marijuana.

Getting the right treatment for ADHD may help lower the risk of later alcohol and drug abuse.

Discuss driving privileges with your teen in relation to their overall ADHD treatment plan. It’s your responsibility to establish rules and expectations for safe driving behaviors. Be sure to include a discussion about the risks of texting and talking on the phone while driving.

Kids With ADHD and Relationships

Not all children with ADHD have trouble getting along with others. If your child does, you can take steps to help improve their social skills and relationships. The earlier your child's troubles with peers are addressed, the more successful such steps can be. It helps for you to:

  • Recognize the importance of healthy peer relationships
  • Involve your child in activities with their peers; choosing an activity your child is particularly good at or enjoys will help them have the confidence to focus on engaging more with peers.
  • Set up social behavior goals with your child and a reward program
  • Encourage social interactions if your child is withdrawn or excessively shy
  • Before your child goes to an event, talk about what they should expect there and what others might expect from them
  • Don’t try to do too much at once. Pick one or two habits to work on at a time.
  • Don't go overboard. Your child doesn't need to be part of the most popular group at school or have lots of friends. One or two close friendships may be all they need.
  • Ask your child's teachers how class is going for them. Work with them and the guidance counselor to clear up any conflicts that could get in the way of friendships.

Kids with ADHD can be targets for bullying, too. Be prepared. Talk with your child about what to do if they get teased or picked on. Make sure they know it's OK to tell you if they are bullied.

What's the Recommended Treatment for Teens With ADHD?

There are many opinions when it comes to treating ADHD in teens. Some experts believe that behavior therapy alone may work for teenagers. But according to the National Institute of Mental Health, about 80% of those who needed medication for ADHD as children still need medication in their teen years.

Usually, a combination of medication and behavior therapy is best in treating teens with ADHD. The American Academy of Pediatrics, the American Medical Association, and the American Academy of Child and Adolescent Psychiatry all recommend behavior therapy to improve behavior problems that are a part of ADHD.

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Stimulant medications are commonly prescribed to treat teens with ADHD. These drugs may make teens more alert and help them do better at school. Examples of stimulant medications include dexmethylphenidate (Focalin, Focalin XR), dextroamphetamine (Adderall, Adderall XR), lisdexamfetamine (Vyvanse), methylphenidate (Concerta, Quillivant XR, Ritalin), and mixed salts of a single-entity amphetamine product (Mydayis). 

Non-stimulant medications such as atomoxetine (Strattera), clonidine (Kapvay), and guanfacine (Intuniv) are also used to treat teens with ADHD. Non-stimulant medications for ADHD  have different side effects from stimulant drugs. For instance, they don't often lead to anxiety, irritability, and insomnia as the stimulant drugs may. They also are not habit-forming and have less likelihood of being abused than stimulant drugs, which may make them a more appropriate option for teens with ADHD who also have alcohol or drug misuse problems.

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Overmedicating doesn't help and can lead to thoughts of suicide, mood swings, and drug misuse.

Alternative treatments include elimination diets, the use of supplements, parent training, memory training, and neurofeedback. These treatments are sometimes used along with prescribed medications.

Omega-3 fatty acids have also shown to be of benefit.  Recently, a small device to help stimulate the part of the brain believed to be responsible for ADHD was approved by the FDA. This device, called the Monarch External Trigeminal Nerve Stimulation (eTNS) System, can be prescribed for patients 7 to 12 years old who are not taking medication for ADHD.

How Can Parents Help a Teen With ADHD?

ADHD affects all parts of a teenager's life. As a parent, your first goal should be to talk openly with your teen. Be supportive and accepting at all times. You can also enlist your child's pediatrician for help in discussing ADHD and its treatment.

By taking the following actions, you can help your teen manage ADHD:

  • Provide clear, consistent expectations, directions, and limits.
  • Set a daily schedule and keep distractions to a minimum.
  • Support activities where your teen can have personal success (sports, hobbies, or music lessons, for example).
  • Build your teen's self-esteem by affirming positive behavior.
  • Reward positive behavior.
  • Set consequences for bad behavior.
  • Help your teen with scheduling and organization.
  • Keep a structured routine for your family with the same wake-up time, mealtime, and bedtime.
  • Set up a reminder system at home to help your teen stay on schedule and remember projects that are due. Be sure to include homework and playtime in the schedule. Kids may benefit from a visual representation of their schedule, such as a calendar or list. Review this with them often.
  • Work with your teen's teachers to make sure your teen is on task at school.
  • Stay calm when disciplining your teen.
  • Set a good example. Teens don't always show it, but the adults in their lives are very influential and important to them.
  • Make sure your teen gets plenty of sleep. Set firm rules for the TV, computers, phones, video games, and other devices. Make sure all of these are turned off well before bedtime.
  • Organize everyday items. Your child should have a place for everything and keep everything in its place. This includes clothing, backpacks, and school supplies.
  • Use homework and notebook organizers. Stress the importance of having your child write down assignments and bring home the needed books. A checklist can be helpful to make sure items like schoolbooks, lunch boxes, and jackets are brought home each day.

When Your Child Is Older

Living well with ADHD means sticking with your treatment. When they’re adults, encourage your child to meet with the person who treats their ADHD. Together, they should talk about how they can manage their meds on their own. If they go to talk therapy, they should have a plan for continuing that, too.

Discuss how they can make sure to order new medication before it runs out. If they are moving away or leaving for college, make sure they have another doctor or ADHD professional near their new home so they can get help when they need it.

Your child needs to know that it's important to take their medication as their doctor prescribed. Otherwise, their symptoms will get worse. That can make it hard to study or to do well at work. It even raises the odds they could engage in risky behavior, like alcohol abuse.

Make sure they know that they should never share medication with someone else.

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You’ll also want to talk to your child about the daily responsibilities they'll face when they are on their own. For example, how will they manage meals and do laundry? Which bills can they expect to pay, and how will they pay them?

Set boundaries

Part of helping your child become an independent adult is treating them like one, regardless of their ADHD. Don't nag about what they should be doing, and respect their privacy and wishes when they don't want help. You may also want to do things that show them you’re treating them like an adult. For example, you could invite them out to dinner instead of surprising them by dropping by their apartment.

Helping your child plan is good. Make it clear to them that you’re available when they need you. For example, they may ask you to remind them their rent is due each month. But make sure your child is making the requests.

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Let the pros step in

You may be used to helping your child with many aspects of their life, like managing money and dealing with tough social situations. Just because they are an adult doesn’t mean you should stop being loving and supportive. But one way to help them make the leap to adulthood is to encourage them to seek help from others. For example, a life coach who specializes in ADHD can help them develop good study skills. A therapist can help them find positive ways to communicate when dealing with conflict, too.

WebMD Medical Reference

Sources

SOURCES:

CHADD: "Children and Adults with Attention Deficit Hyperactivity Disorder," "Social Skills in Adults with ADHD," "Teens and Young Adults," "Treatment of Teens with ADHD," "Successfully Launching Your Teen or Young Adult With ADHD into the World," "Psychosocial Treatment for Children and Adolescents with ADHD."

National Resource Center on ADHD: "Symptoms and Diagnostic Criteria."

CDC: "ADHD and Risk of Injury," "Other Concerns & Conditions."

National Institutes of Health: "Severe Childhood ADHD May Predict Alcohol, Substance Use Problems in Teen Years."

FDA.

National Institute of Mental Health: "Could I Have Attention-Deficit/Hyperactivity Disorder?"

American Academy of Child & Adolescent Psychiatry and American Psychiatric Association: "ADHD: Parents Medication Guide."

Proceedings of the National Academy of Sciences of the United States of America: "Lag in maturation of the brain's intrinsic functional architecture in attention-deficit/hyperactivity disorder."

Labour Economics: "Sex, drugs, and ADHD: The effects of ADHD pharmacological treatment on teens' risky behaviors."

Attention Deficit Disorder Association.

National Resource Center on ADHD.

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Bagwell, C.L. Journal of the American Academy of Child & Adolescent Psychiatry, November 2001.

Davidson Institute: “Tips for Parents: Improving Skills in Children with ADHD.”

Hoza, B. Journal of Pediatric Psychology, July 2007.

Unnever, J.D. Journal of Interpersonal Violence, February 2003.

Understood: "FAQs About Social Skills Groups."

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