ADHD is usually diagnosed in childhood. However, in some cases, the child might have transitioned to their teen years but would not have gotten a formal diagnosis of their condition. As they grow up and face the ever-increasing demands of adolescence and the changing world, they might struggle to cope with the symptoms presented by their condition.
Parents, guardians and teachers of such teenagers might feel that they are struggling because of the symptoms of ADHD. However, obtaining a diagnosis in the teenage years might pose several problems.
In this article, we explore the issues related to the diagnosis of ADHD in teenagers, tests used for diagnosis, co-occurring conditions, the best strategy to move forward and more.
Why does diagnosing ADHD in the teenage years seem challenging?
There are numerous reasons behind this which are as follows:
To begin with, symptoms must have been present in some form before the age of 12 to qualify for a diagnosis of ADHD; however, recalling earlier symptoms might be difficult.
Second, a lot of the symptoms described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria are often created with younger children in mind (for example: "runs about or climbs excessively") and may not apply to teenagers.
Third, getting trustworthy accounts of a teen's symptoms from outside observers—like parents or teachers—is more challenging. This is so because teenagers sometimes have several teachers, each of whom only has contact with them for a limited period of the day. Additionally, parents probably have less direct contact with teens now than they did when they were younger.
Fourthly, as was already said, teens may exhibit subtler forms of some of ADHD's most obvious symptoms, such as severe hyperactivity.
Finally, the diagnosis of ADHD may be hampered by the presence of other disorders.
It is crucial to seek a thorough evaluation that includes an in-depth history, a clinical assessment of academic, social, and emotional functioning, as well as reports from parents, teen's teachers, and other important adults (like coaches) if anyone has a solid reason to believe that the teen may be suffering from undiagnosed ADHD.
A physical examination should be part of this evaluation to rule out any other potential explanations for the symptoms being seen. Rocket Health provides a comprehensive online consultation with India’s leading RCI registered Clinical Psychologist to test for ADHD. Click here to learn more.
What tests are used to diagnose ADHD in teenagers?
Numerous medical specialists, including psychiatrists, psychologists, psychiatric nurses, licensed counsellors, and social workers may assist in the diagnosis and treatment of people with ADHD.
Teenagers who are suspected to have ADHD will likely go through a thorough medical evaluation and physical assessment. The teen may be asked a series of questions from a standardised questionnaire or self-test as part of this assessment to determine the likelihood of ADHD.
Teenagers can be requested to go into detail about topics like:
- How frequently do you give up on an endeavour before it's finished?
- How frequently do you lose things?
- How frequently do you forget key dates or events?
- Do you have difficulty staying seated?
- Do you have trouble unwinding?
- How frequently are you distracted by your surroundings?
A typical assessment usually lasts between one and three hours. Apart from the standardised assessment, insights from parents, teachers and other important people in the teen’s life are gathered by conducting interviews.
Gender differences between ADHD symptoms in teenage boys and girls
As per the Centre for Disease Control and Prevention, boys are three times more likely than girls to be diagnosed with ADHD. It's not always the case that girls are less likely to get the disorder than boys. Instead, it's probably because girls exhibit ADHD symptoms differently. The signs are more subtle and challenging to spot.
Boys with ADHD frequently exhibit externalised symptoms, such as running and impulsivity. Girls with ADHD, however, frequently have internalised symptoms. These symptoms include inattention and low self-esteem. In addition, boys are more likely to be physically hostile whereas girls are more likely to be verbally confrontational.
Girls with ADHD experience difficulties that are sometimes disregarded because they frequently exhibit fewer behavioural issues and less obvious signs. This results in them not being given a referral for an examination or medical care which could lead to future complications.
Co-occurring conditions during adolescence
Along with ADHD, other disorders can often be present. These disorders may have existed from childhood or may just become apparent as a result of the added stress of puberty.
Studies have well documented the fact that up to 60% of adolescents and children with ADHD also have one or more other disorders. These disorders can make parenting more difficult, and many parents feel that getting professional treatment helps give their teens guidance and resources.
Adolescents with ADHD often deal with oppositional defiant disorder (ODD) and conduct disorder (CD), two of the most prevalent disorders. ODD is characterised by a pattern of angry outbursts, impatience, and defiance of requests and directives from adults. It involves traits like hurting people or animals, stealing, trespassing, and absenteeism. The CD is a more extreme kind of non-compliant and defiant behaviour. According to data, between 25% and 75% of adolescents with ADHD are thought to suffer from one of these disruptive behavioural problems.
It has also been demonstrated that up to one-third of children with ADHD may have learning difficulties, which can cause serious communication and learning issues. Parents should be aware of their teen's academic achievement and closely monitor any changes or dips in performance as middle school and high school demands throw greater burdens on teenagers.
Speaking difficulties, such as stuttering, as well as issues with language comprehension and clarity of speech are all examples of communication disorders. If parents are worried about their teen's communication, they should speak with the school or get an examination from a speech-language pathologist.
Teens with ADHD also frequently experience sleep disturbances. All teenagers experience changes in their sleep patterns as they start to stay up later at night and prefer to sleep in later in the morning. Sleep disturbance may be more severe in adolescents with ADHD and is not always a negative effect of medication. Given this danger, it is important to properly evaluate sleep before beginning medication to see if there is already a sleep disorder.
Therapy for teenagers diagnosed with ADHD
In addition to medication for ADHD, therapy is quite helpful for teenagers with ADHD to cope with their problems and live a more fulfilling and successful life. There are two main approaches which are used which are as follows:
Cognitive Behavioural Therapy
Cognitive behavioural therapy (CBT) is a type of psychotherapy that is used to treat ADHD. It can be administered individually or in groups and aims to assist persons who have the condition in identifying and reducing the irrational ideas and behaviours that reinforce maladaptive behaviours. In particular for adolescents who also experience anxiety or depression, CBT has been demonstrated to be beneficial. CBT assists individuals with ADHD to lessen their tendency to pay excessive attention to potential risks.
Behavioural therapy has numerous techniques that are frequently used to reduce ADHD. These entail parents, teachers, and other adult carers knowing the circumstances underlying both positive and negative behaviours, as well as how each type of behaviour is promoted and discouraged.
Knowing just when and where these behaviours occur will help you understand how to either promote positive behaviours to occur again or put an end to undesirable behaviours. Teenagers with ADHD are more likely to have a positive effect on their behaviour if they are aware of how other people's reactions affect whether a behaviour continues or not.
You might experience a wave of emotions after receiving an ADHD diagnosis which is completely normal. If you have a reason for your symptoms, you might feel relieved. Or, you can feel overwhelmed and unsure of what comes next.
Don't feel pressured to decide on a course of therapy right away. Give yourself some time to consider the new information before taking the next action.
When you're prepared, Rocket Health is here to help you take the next step. Schedule a consultation with our doctors from the comfort of your home to discuss your treatment options, which may involve therapy, medication, and/or lifestyle modifications.
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