Advice Column, Child, Education, Health, Parenting, Tween & Teen

ADD And ADHD In Adolescence

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Adolescence is the period in a child’s life which is filled with much turmoil and changes. Not only are there physical changes (including hormonal) but an emotional shift where the youngster has to grapple with several of the following:

  1. Acquiring a feeling of identity (self-identity such as “who am I”; social identity such as “which group/s do I belong” and certainty about his/her own values and ideals “where am I going with my life”).
  2. In establishing an identity for themselves, the adolescent phase is characterised by experimentation and rebelliousness, which leads to conflict with parents mostly about authority and decision-making.
  3. Being acknowledged by peers as well as being accepted by them (fitting in).
  4. Concerns and worries about school, exams and careers after school.
  5. Foray into romantic relationships with accompanying insecurities etc.

During a youngster’s development from childhood to adolescence it becomes common for the symptom pattern of ADD/ADHD to change, most notably by a decrease in hyperactivity. Nevertheless, difficulties with attention and impulsivity remain. It was thought that ADHD tends to “burn out” by the time children reach adolescence and rarely continues into adulthood, however research suggests that this is not the case. Other difficulties that can appear for an adolescent suffering from ADD/ADHD over and above the usual teen concerns are:

Adolescents with ADHD often feel “different” from others and they may become socially isolated, especially if they are impulsive and act before they think without due consideration for the feelings of others.

They may also still carry the remnants of a lowered self-esteem developed in childhood as a consequence of ADHD. Remember that children and adolescents that have been diagnosed with ADD/ADHD would have experienced the gamut of difficulties on an academic, social and personal front. Low self-esteem may lead to a teenager refusing medication, avoiding educational or other activities and be more vulnerable to peer pressure in order to fit in. They may also lack motivation as they could have internalised that they are not as competent as their peers.

Difficulties with focusing, organizing and long-term planning usually pose a difficulty for the ADHD adolescent as the workload at school increases and becomes more complex. As a result adolescents may have difficulty completing tasks, taking good notes, being able to prioritize important tasks and apply adequate study methods for tests and examinations.

Adolescents with ADD/ADHD are to some extent more likely to experiment with undesirable behaviours at an earlier age because of their impulsivity and not considering the consequences of their actions. Usually teenagers tend to develop new strengths that help them with decision making, consequently, their ability to think long term, resist instant gratification and regulate their own behaviour does improve. The teenagers with ADHD, however, are simply likely to lag behind in these areas. Therefore, teenagers with ADHD have much more of a harder time regulating their impulses, even when they know their behaviour is destructive. As such, impulsiveness can potentially lead to substance abuse, aggressive acting out, unprotected sex, promiscuity, reckless driving or any other high-risk activity.

Like all teenagers, the need for acceptance and to “fit in” is substantial. Some teenagers with ADHD will be more at risk of becoming the “class clown” or becoming the “most rebellious” or the “outrageous” one to get some attention and acknowledgement from their peers.

On the whole, ADD/ADHD is a complex disorder and usually there are accompanying conditions such as depression, learning difficulties, anger and anxiety which can affect adolescents with ADD/ADHD in widely contrasting ways.

Sandton Psychology Centre has psychologists that work with adolescent difficulties and issues. It may become necessary for a parent to seek professional assistance for their teenager during this period. Adolescents will likely benefit from psychological intervention that will teach them how to deal with impulsive behaviour, difficulty with remaining focused and/or organisational skills, long-term planning and low self-esteem which are all aspects related to ADHD

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