ADHD Information for Teens
“I have ADHD…..so what?” In many ways, so what is right. Mostly, you are just a regular teen, with all the ups and downs that come with being a teenager. In other ways, growing up and heading towards adulthood with attention-deficit/hyperactivity disorder may present some unique challenges. People used to think that only young kids had ADHD and that children grew out of it as they got older. Now we know differently. Today’s research has shown that most kids do not outgrow ADHD when they reach adolescence, and most teens don’t outgrow ADHD when they become young adults. So what does being a teen with ADHD really mean?
First, you should know that having ADHD doesn’t have to get in the way of living the life you want. Many teens just like you have grown up to follow their passions, live happy lives, have families and be successful in their work. They’ve found this success because they’ve taken the time to learn how ADHD affects them and taken charge of a treatment plan that works for them and their own situation.
“I’m not a kid anymore!”―ADHD in the teen years
The main symptoms of ADHD—inattention, impulsivity and sometimes hyperactivity—are the same for teens as they are for children. However, you may notice some differences. For example, you may struggle less with symptoms of hyperactivity, such as fidgeting or staying seated, now than you did when you were younger. On the other hand, you may notice greater challenges with staying on top of your schoolwork and other responsibilities. This is because there are more demands on your time, your schoolwork is probably more difficult and there are higher expectations for you to be independent now that you are a teen. This can all feel overwhelming, but don’t worry; these challenges are not that different from what your friends are going through, even those without ADHD. Just remember that proper treatment can help you as you grow into yourself and adjust to the changes in your life.
Another thing associated with ADHD in adolescence is difficulty with executive functioning, the brain’s ability to prioritize and manage thoughts and actions. In other words, executive function allows you to think about goals and consequences for your actions, plan accordingly, evaluate your progress and shift plans as necessary. When you’re a child, your parents and teachers may have taken care of some of the executive function chores by reminding you to do your assignments, nagging you about organizing your schoolwork and letting you know about upcoming appointments. However, in adolescence, your parents and teachers expect you to start doing these things yourself, and sometimes that transition can be tough on you and those around you.
You may wonder why you have ADHD. Some teens feel guilty for having ADHD. Others feel that it is something that they should be able to be cured of or control on their own. Having ADHD is not your fault. Research has clearly shown that ADHD runs in families (is due to genetics). ADHD is a brain-based disorder, and the symptoms shown in ADHD are linked to many specific brain areas. There is no known cure for ADHD, but we know many things that can reduce the impact that ADHD has on your everyday life.
“Is it just ADHD?”—Other conditions in the teen years
Some teens with ADHD also have the challenge of other conditions that commonly occur with ADHD. These conditions may have been present since you were much younger or may start during adolescence. Up to 60% of children and teens with ADHD have at least one other condition; so don’t think you’re alone.
Some of the other conditions commonly experienced by teens with ADHD may affect how you act. Specific ones include oppositional defiant disorder (ODD) and conduct disorder (CD). ODD means you may have difficulty following rules and may lose your temper often or argue with adults. CD is more severe and involves having difficulty following rules, but may also include dangerous and illegal behaviors such as fighting, stealing or trespassing.
Other conditions that affect how you feel (called mood disorders) can also be common in teens with ADHD. Depression is the most common mood disorder. If you have depression, you may often feel sad or irritable and may not be interested in activities you once enjoyed. You may also have trouble sleeping, feel hopeless about the future, and sometimes think about death or suicide.
Anxiety disorders may be present in as many as 10%–40% of teens with ADHD. If you have an anxiety disorder, you might have excessive worry, difficulty controlling your worries, and physical symptoms including headaches or upset stomach. You might also get anxiety attacks and often try to avoid situations that make you anxious.
Substance use and abuse is a significant concern of many parents and teens. The risk for later substance use among children with ADHD ranges from 12%–24%. Some substances, such as alcohol, may be illegal for you based on your age. Other substances, such as marijuana or other drugs, may be illegal, period! For these reasons alone, you should avoid using them. If you choose to use such substances and find you have difficulty controlling yourself, if others have expressed concerns to you about your use, if you need the substance to “get going” or “slow down” or if you feel guilty about your use, you may have a substance problem. You should get professional help from a licensed mental health professional or addiction specialist.
Learning and communication problems can also be common and may become apparent with the added demands of middle school and high school. If you are concerned about your ability to learn in the classroom, your ability to understand what others say to you or your ability to express yourself the way you want to, then you should tell your parent(s). You may need an evaluation by a professional to determine how you learn, think or communicate.
Sleep problems are also common in teens with ADHD. Changes in sleep cycles are normal for all teens. You may prefer to stay up later at night, sleep later in the morning and need more sleep overall. As a teen with ADHD, you may have difficulty sleeping well. This may be a side effect of your medication, but can also occur on its own.
At this time, it is not possible to predict who will experience these additional difficulties. It is likely that genetics play a role. The additional stresses experienced by some teens with ADHD, such as social criticism or internal frustration, may also make you more vulnerable to these difficulties. For more information on these conditions (which are called co-existing or co-occurring), please see ADHD and Co-existing Conditions.
What should you do if you suspect that you may have any of these additional conditions? Talk to your parent(s) about getting an evaluation by a psychologist, psychiatrist or other trained mental health professional.
My life with ADHD
What does it feel like to have ADHD? You may be embarrassed about your diagnosis. You may wish to deny that you have ADHD. Having ADHD may make you feel different from your friends, and you may want to believe that your symptoms have lessened or even disappeared. It is important for you to understand that you are not responsible for having ADHD. Having ADHD is not due to any mistake you made and is not a punishment. ADHD is just like other medical conditions, such as asthma or poor eyesight. You can’t control the fact that you have ADHD, but you can control the way you manage it. Following your treatment plan is a key to meeting your goals and achieving success.
You may feel bad about yourself, or you may feel that you are not as good as your friends or other students at your school. Research shows that teens with ADHD and learning disabilities report feeling very stressed when going to school and sitting in class, feeling tired, having frequent arguments with close friends, feeling different from other classmates, having low self-esteem and feeling that their parents don’t understand them. If you feel this way, remember, you are not alone and you can feel better. Talk with a parent, another trusted adult or health professional about how you feel. Participate in activities you enjoy and recognize that everyone has different strengths and weaknesses.
Many teens are concerned about talking with their friends about their ADHD. You may feel that your friends don’t understand your difficulties or may make fun of you. You can choose the friends with whom to discuss your ADHD and what details you want to share. However, explaining ADHD to your trusted friends may surprise you—they may be a great source of support or even have ADHD themselves. Although the exact number of children and adolescents with ADHD is unclear, somewhere between 1.4 million and 2.3 million youths have ADHD (about 1 out of every 10 kids), so you are far from alone in facing the challenges that come with it.
ADHD can affect many aspects of your life. Teens in general can face academic challenges, social difficulties and problems at home, however, having ADHD may make these issues more difficult to deal with or more severe.
Academic Performance: As a high school student, your life can be more hectic, with more demands to juggle and less supervision than when you were younger. Academically, the workload and difficulty of the material increases, and long-term projects are assigned more often. These factors all present challenges to teens with ADHD. You can benefit from assistance and training on note taking, study skills and organization/time management. As you develop these skills, you will come to rely less on parents or teachers and be more confident about your own ability to structure your time and perform at your potential. Students who have a diagnosis of ADHD and whose ADHD symptoms impair their academic functioning may qualify for classroom accommodations. These accommodations are based on your particular needs but can include extra time on tests, taking tests in a separate location where there are fewer distractions or additional organizational support. Work with your parents and your school if you think you might need or want this kind of help.
Social Functioning: In adolescence, your relationships with others your age can become increasingly important to you. But these relationships are not always easy to navigate. During these years, your friendships are changing; you probably become interested in dating; and you may encounter more significant peer pressure. You may be more easily frustrated or more emotionally sensitive than others your age. Some teens with ADHD have no difficulty establishing and maintaining relationships, while others find dealing with different personalities, expectations and desires quite challenging. Participating in structured social activities, such as sports, clubs or youth groups, can give you a built-in social group and shared positive experiences.
Home Life: Nearly every teenager has conflict with his or her parents over rules, privileges, household chores, friends…you name it. However, on average, households of teens with ADHD have higher levels of parent-teen conflict than households with teens who do not have ADHD. Why is this the case? One source of conflict in the home is that teens want more freedom and independence. However, the difficulties with organization, forgetfulness and thinking before acting that commonly go along with ADHD may make your parent(s) reluctant to give you the freedom you desire. In addition, many teens with ADHD have more difficulty completing homework and chores on time or following rules due to inattention, distractibility, lack of interest or lack of organization. These difficulties can lead to a frustrating cycle of negative interactions for both teens and parents, as parents feel they need to lecture, yell or punish and teens respond with anger or in other ways that aren’t very helpful. When this occurs repeatedly, the parents may feel they need to nag even more to be heard and the teens get more resentful and belligerent; tensions can escalate and tempers can flare. What can be done to interrupt this cycle? Discussing issues in the heat of the moment when everyone is angry doesn’t work. Instead, set aside a time when all parties are calm to discuss any areas of disagreement or conflict. Clear communication is important. If family conflict is taking a large toll on the family, consider seeking help from a qualified mental health professional.
Treatment of ADHD
Although no cure currently exists for ADHD, this doesn’t mean that there’s nothing you can do about it. Successful treatment generally involves a combination of education, behavioral therapy and medication. Although the symptoms of ADHD may change with age, you may still require treatment to target these symptoms and even may need treatment into adulthood.
Education is a necessary component to any effective treatment plan and provides you with the tools to understand your disorder and how to manage it. If you were diagnosed with ADHD when you were very young, it is likely that this education was directed to your parent(s). It is important that you receive this education as well, ask your doctors and treatment providers questions and express concerns if you have them.
It is a myth that medication becomes less effective in the teen years. In fact, medications should be as effective, but co-occurring conditions may require changes to the treatment regimen. You and your parent(s) may also consider a change to a long-acting ADHD medication to help manage your symptoms better throughout the day, as you may have activities after the school day has ended and into the evening hours. For more information, see Managing Medication for Children and Adolescents with ADHD.
Behavioral treatment is another common treatment approach for teens with ADHD. Proven psychosocial treatments include parent-teen training in problem-solving and communication skills, parent training in behavioral management methods and teacher training in classroom management. For more information, please see Psychosocial Treatment for Children and Adolescents with ADHD.
There are many alternative and complementary treatments that claim to help with ADHD symptoms. Many such as elimination diets, nutritional supplements and play therapy lack scientific research to show their effectiveness as ADHD treatments. The section on Complementary and Other Intervetions can provide strategies for evaluating different treatments. It’s important to avoid products that claim to cure ADHD. Being a smart consumer and carefully looking at products is key.
Additional issues for teens with ADHD
As a teen with ADHD, you are facing the same issues that prove challenging for your peers: developing your identity, establishing your independence, understanding your emerging sexuality, making choices regarding drugs and alcohol and setting goals for your future. However, you may also face some unique difficulties, as described below.
Driving: Getting your driver’s license is an exciting event and one that results in increased freedom and independence. However, inattention and impulsivity can lead to difficulties with driving. Drivers with ADHD have more tickets, are involved in more accidents, make more impulsive errors, and have slower and more variable reaction times. The use of stimulant medications when prescribed has been found to have positive effects on driving performance. Always follow safe driving habits, such as using a seat-belt, observing the speed limit, and minimizing distractions such as texting or eating while driving.
Adherence to medication regimen: Nearly half of children don’t take their medications as prescribed, and the use of ADHD medications decreases over the teenage years. This decrease occurs for a multitude of reasons: teens may have negative attitudes toward medication use; they may feel that their ADHD symptoms are not impairing their functioning; they may dislike the side effects of the medication; or they may simply want to take a vacation from their medications to see what happens. If you and your parents decide to stop your use of medication, you should consult with your doctor and designate a trial period for doing so. During this period, you should specify your goals and develop a plan to achieve those goals. Your plan may include tutors or frequent check-ins with a teacher or counselor. Make sure to specify what indicators might signal the need for restarting the medication, such as declining grades or increasing conflict at home. After a time, evaluate your progress with your parent(s) and your doctor and determine whether or not medication is effective for you.
Diversion of medications: Use or abuse of ADHD stimulant medications, such as Adderall or Ritalin, among individuals for whom these medications are not prescribed is an increasing problem. Individuals who use stimulants without a prescription may do so for either academic reasons (improving their ability to study or succeed on tests) or for recreational reasons (to get a high or a buzz). At some point in your life, friends or acquaintances may ask you to give or sell your medications to them for these purposes. The use of medications by individuals for whom they were not prescribed is illegal and could have serious legal consequences. In addition, your ADHD medications are safe and effective when taken as directed, but can be dangerous if used without medical supervision. You should never give or sell medications that are prescribed to you to anyone else. Take some time to think about how you might respond if someone asks you for these medications. Some strategies include changing the subject, simply refusing and walking away, explaining the dangers of non-prescription medication use, or telling them that your parents monitor your pills and would notice if some were missing. Practice your responses; it is likely that you will face this situation and being prepared is important.
Building your self-esteem: Living with ADHD can be challenging. Many teens with ADHD find that the school environment does not suit their personality or maximize their natural talents. It is important for you to find your place in life and identify your strengths: Are you athletic? A good artist? Do you have musical talent? Are you good with computers? Find environments and activities that remind you of your strengths and allow you to experience success. Remind yourself that everyone has strengths and weaknesses. The important thing is to do your best to work through difficulties and spend plenty of time on activities in which you shine.
“What about my future?”
Only you can determine what lies in store for you and your future. The fact that you are taking the time to read this website and educate yourself about your diagnosis shows that you are reflecting on your strengths and weaknesses and taking steps to prepare yourself for your future. We know that teens with ADHD are at risk for potentially serious problems as they transition into adulthood. We also know that as many as two-thirds of teens with ADHD continue to experience significant symptoms of ADHD in adulthood. In addition, as they become adults, teens with ADHD are at higher risk for difficulties in education, occupation and social relationships. However, these are only risks, they are not guarantees. Most teens with ADHD become successful, productive adults and so can you! Continued awareness and treatment is crucial so that you can avoid the risks and meet the goals you set for yourself, whatever they are.