Attention deficit hyperactivity disorder in adolescence

While Attention Deficit Hyperactivity Disorder or ADHD is relatively well recognized in children, when it comes to older age groups it is in a way more difficult to recognize. Many adolescents struggle with this issue and are likely to benefit from some form of help. Not identifying their difficulties often leads to people labeling them as “lazy”. Individuals with this condition also don’t perform up to expectations.

The difficulties in identifying this condition are many fold. Firstly, for a diagnosis of ADHD to be made, symptoms must have been present prior to age 12. This may be difficult to recall for the teenager as well as the parents. Secondly, obtaining reliable information for third parties will be difficult as teenagers spend their day with a variety of teachers and other adults with little time and direct contact with only a few people, mostly their peers. Parents too may also not have the opportunity to spend a lot of time with them, other than during day-to-day tasks. The third issue is that symptoms can be varied and greatly influenced by contextual factors, requiring a careful unraveling of them.  

For a diagnosis of ADHD to be made, symptoms must have been present prior to age 12. This may be difficult to recall for the teenager as well as the parents

In adolescence this may show a trajectory towards more severe and even antisocial activities towards adolescents. It is described that treating ADHD in these adolescents can go a long way in ameliorating these behaviours as well

While the hyperactivity component is marked in most children with ADHD, adolescents with this issue rather than being hyperactive tend to be very impulsive and inattentive. The main reason for this change in presentation is the trajectory of the disorder itself. It is well described that the hyperactivity component of children with this issue declines with age, towards adolescents. This overt hyperactivity in some changed in to a internal sense of restlessness. They are left with attention regulation and impulsivity regulation issues, which tend to decline at a much slower rate with age. To confuse matters even more, adolescences itself is a period of heightened difficulties with emotions and impulses.  

Again issues with attention are likely to crop up at times of heightened demand for attention ( e.g in close proximity to exams, when there are many things to concentrate on at the same time). Adolescents are also likely to have built up their own ways of coping with difficulties. It is when all of these cannot compensate that their difficulties with attention begin to show.  

Another factor that contributes to the difficulties that adolescents have with ADHD is related to the finding that around 70% of those with this issue also have difficulties with what are called executive functions. These are the higher or skills such as planning impulse control, working memory ect.These functions become more needed as children grow older. The education system in its current form also puts a severe strain on these functions, so that some adolescents find that their coping strategies are inadequate. These deficits also become more prominent in adolescence. When they were children their parents may have compensated for these issues by helping them (e.g constant reminders, packing their bags, planning activities and helping in academic tasks). However, as they grow older, they will be expected to perform more and more independent tasks which require these executive functions.  

One of the main secondary issues for adolescents with ADHD is depression. With failing grades, and impulsivity getting in the way of relationships, they are vulnerable to develop depression. The entity we describe as hyperkinetic conduct disorder, more commonly described in adolescence can also be an issue. These children are more likely to violate age appropriate norms and engage in activities such as stealing lying, hurting other etc… In adolescence this may show a trajectory towards more severe and even antisocial activities towards adolescents. It is described that treating ADHD in these adolescents can go a long way in ameliorating these behaviours as well.   

While currently ADHD is considered a disorder that can persist into adulthood causing the same kind of issues described above, but in different contexts (E.g in work rather than in academic work.), diagnosing ADHD in adolescents and even adulthood isn’t an easy task. Many other conditions and circumstances have to be carefully considered before hand. As such these kind of diagnoses are best made by professions with training and experience in these areas.  

However that being said correct diagnosis and treatment of ADHD in adolescent’s as in children can make a significant positive difference to their lives.