ADHD in adolescents: Diagnosis, treatments, and how to support your teenager

ADHD (attention deficit hyperactivity disorder) is a neurodevelopmental condition that impacts behaviour. While ADHD is generally diagnosed in childhood, some people may not receive a diagnosis until adolescence, when symptoms become more pronounced. Professor Debora Elijah, highly esteemed cognitive neuropsychologist, explains more.

What are the signs of ADHD in adolescents?

While the core symptoms of ADHD - hyperactivity, inattention, impulsivity - remain consistent throughout life, the way they appear in adolescents can differ.

Inattention

Adolescents with ADHD often have difficulty focusing on tasks for extended periods. They may frequently forget assignments, struggle to follow instructions, or leave tasks incomplete. They may also have trouble staying organised and lose things like their keys or phone regularly.

Impulsivity

Impulsivity in adolescents with ADHD can manifest as interrupting others or speaking out of turn in social interactions. They may also act without considering the consequences or make hasty decision-making, which can sometimes result in risky behaviours, such as substance misuse.

Hyperactivity

Hyperactivity may decrease or it might not involve physical movement as much as it did in childhood. Instead, it may appear as difficulty staying seated for long periods, fidgeting, or feeling an inner sense of restlessness. They may become easily bored or anxious in situations that require sustained attention.

In addition, adolescents with ADHD may also have difficulty regulating their emotions, which can lead to mood swings, irritability, and even outbursts, particularly during stressful situations. They may also have difficulty coping with failure, which can affect their self-esteem.

How is ADHD in adolescents diagnosed?

Diagnosing ADHD in adolescents requires a comprehensive evaluation by a healthcare professional. There is no single test for ADHD, so the diagnostic process involves several steps.

First, the clinician will conduct a detailed interview with the adolescent and their family to understand their medical history, behaviour patterns, and emotional wellbeing. This interview may also include questions about the teenager’s development and whether there is a history of ADHD in the family.

To gather more objective information, parents and teachers may also be asked to provide feedback through standardised questionnaires and observations that assess symptoms of inattention, hyperactivity, and impulsivity. This will help to identify patterns of behaviour in various settings.

In some cases, cognitive testing will also be recommended to assess executive function, including attention, memory, and problem-solving. These assessments will help to determine whether the adolescent’s symptoms are consistent with ADHD or if other co-occurring conditions, such as anxiety or depression, could be contributing.

The symptoms of ADHD should be present for at least six months and cause significant functional impairment in multiple areas of life to meet the diagnostic criteria for ADHD.

What are the most effective treatments for ADHD in adolescents?

Treatment plans for ADHD in adolescents typically involve a combination of behavioural therapy, educational support, and medication. Each adolescent may require a different approach depending on their symptoms and individual needs.

Medication

Medication is commonly prescribed to help manage the primary symptoms of ADHD. Stimulants, such as methylphenidate, are the most commonly used drugs for ADHD. These medications work by increasing the levels of certain neurotransmitters in the brain, which helps improve attention, focus, and impulse control.

Non-stimulant medications, such as atomoxetine, may be prescribed if stimulants aren’t effective or cause significant side effects. Medication can be highly effective, but it’s important to communicate regularly with the prescribing healthcare professional to ensure its efficacy and safety.

Behavioural therapy

Behavioural therapy involves reinforcing positive behaviours and discouraging negative ones, which can help improve focus and attention. In addition, therapy can also help adolescents understand ADHD better and build self-esteem, which is important for overall wellbeing.

Within behavioural therapy, cognitive behavioural therapy (CBT) is an important treatment option that focuses on teaching skills for better time management, organisation, and emotional regulation. Over time, therapy can help adolescents to develop coping strategies for managing impulsivity and inattention.

Educational support

Adolescents with ADHD can benefit from educational accommodations that address their specific learning needs. Schools can provide extra time on tests, modify assignments, or offer a quiet space for studying to help students stay focused and organised. Teachers can also offer regular check-ins to ensure the adolescent is on track.

Lastly, parents play a crucial role in supporting their adolescent’s treatment for ADHD. At home, it’s important to create a structured environment with consistent routines, encouraging time management, offering reminders, and setting clear expectations. Parents should maintain open communication, allowing their adolescent the opportunity to share their feelings and challenges. Recognising their strengths and celebrating accomplishments is important, while also showing patience and understanding in areas where they may struggle.

If you would like to reach out to Professor Debora Elijah, head on over to her Top Doctors profile today.