ADHD can appear differently in teens than in younger children. Adolescents may be less likely to show hyperactivity, although symptoms of inattentiveness and impulsivity often continue.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting about 1 in 9 U.S. children ages 3 to 17.

Symptoms typically appear during childhood, with the average age of diagnosis between 5 and 9 years old. But symptoms can continue into adolescence and adulthood and may change throughout life.

In this article, we’ll explore ADHD in teenagers and what the symptoms may look like.

No one has all the signs and symptoms of ADHD. And even if your teen has a few, it doesn’t mean they have it. Here are 15 ways that ADHD can show itself in a teenager:

Lack of focus

A teen with ADHD might have trouble staying on task. They may start on a project only to end up starting another before finishing. Being easily distracted can lead to careless mistakes at school, work, or home.

Disorganization

Everyone misplaces their keys on occasion, but this can be a common occurrence in teens with ADHD. They may spend a lot of time searching for their possessions. Time mismanagement can lead to missed appointments and deadlines.

Self-focused behavior

It can be difficult for a teen with ADHD to recognize what other people want or need. They can have a hard time waiting for others or taking turns.

Fidgeting

Restlessness is a common sign of ADHD. Hyperactivity in adolescents may present as fidgeting. A teen with ADHD might find it difficult to sit still without squirming or getting up.

Fear of rejection

Some people with neurodevelopmental disorders such as ADHD report experiencing rejection sensitive dysphoria, though this is not a defined mental health condition. Rejection, teasing, or criticism can trigger high emotions.

Daydreaming

A person with ADHD may find themselves lost in daydreams for long periods.

Impulsivity

Teens, in general, tend to be more impulsive than adults. For a teen with ADHD, resisting temptation may be particularly difficult, potentially leading to dangerous decisions.

Difficulty following a conversation

ADHD can interfere with conversational skills in the following ways:

  • appearing not to listen, even when someone is speaking directly to them
  • interrupting
  • talking too much
  • leaving mid-conversation
  • butting into others’ conversations

Procrastination

Procrastination is a byproduct of lack of focus. It’s especially noticeable in things that take a long time. Your teen might put off homework or other duties so long that they completely miss deadlines.

Trouble working quietly

Quiet activities are generally not easy for teens with ADHD. They may find it difficult to sit and read or work on a project by themselves.

Always ‘on the go’

Teens tend to have fewer hyperactive symptoms than younger children with ADHD. But some are a flurry of activity. They may be set on playing their favorite video game one minute and going to a friend’s house the next.

Trouble reading social cues

They may not realize it when they’ve interrupted or annoyed someone. It may be difficult to make or keep friends.

Trouble compromising with others

Lack of focus, difficulty following a conversation, and trouble with social cues can make it hard to compromise with others.

Personal hygiene issues

It’s not true of every teen with ADHD, but some have a problem keeping up with personal hygiene. It may have to do with disorganization and procrastination.

Difficulty following directions

Lack of focus, restlessness, and mind wandering can make detailed instructions nearly impossible to follow.

What can worsen ADHD symptoms in teens?

Lifestyle and environmental factors, like stress, changes in routine, and lack of sleep, can all contribute to ADHD symptoms in teenagers. Hormonal shifts may also play a role.

A small 2020 study found that ADHD symptoms in teens worsened through the school day and peaked in the late afternoon before easing in the evening. Symptoms did not change significantly on days the participants did not have school.

Boys under age 18 are more likely to receive an ADHD diagnosis than girls. However, there’s no significant gender gap in adult diagnoses, suggesting symptoms may be overlooked in girls.

Symptoms in boys and girls can differ. Girls may lean more toward less noticeable inattentive symptoms than to obvious hyperactive symptoms.

A 2021 study also notes that ADHD symptoms may peak later in girls. Researchers found that boys were more likely to enter adolescence with elevated symptoms, while girls were more likely to experience escalation during adolescence.

Puberty and emerging independence are a part of any teen’s life. Navigating these issues with ADHD may be more challenging. Research suggests that teens with ADHD may have higher rates of:

Lower self-esteem and social functioning can lead to trouble with:

  • relationships with peers
  • getting along with family
  • academic performance

Comorbidities like anxiety and depression are common.

Doctors typically diagnose ADHD during childhood. When a diagnosis occurs in teenagers, it’s usually because the condition went undiagnosed in younger years. For an ADHD diagnosis, symptoms must have occurred before age 12.

It’s more challenging to diagnose in teens because hyperactive symptoms are less obvious. Because of overlapping symptoms, it’s also important to distinguish ADHD from disorders like:

  • anxiety
  • depression
  • sleep disorders
  • hearing and vision problems
  • learning disabilities
  • mood or personality disorders
  • substance use disorder

There’s no single test for ADHD. The process includes a physical exam and hearing and vision tests. It usually involves filling out questionnaires and getting input from parents and teachers.

ADHD is not something you can diagnose on your own. It takes a trained health professional to evaluate specific symptoms.

Recent research suggests that about 43% of children with ADHD carry the condition into adolescence and adulthood. That’s higher than earlier estimates.

Treatment for ADHD depends on the severity of symptoms. For adolescents, experts typically recommend a combination of medication and behavioral therapy.

Many teens with ADHD respond to stimulant medication, like:

A 2018 study found that methylphenidate was the most appropriate first-choice option for this age group.

Behavioral therapy can help teens and their parents learn how to cope with emotions and navigate the world with ADHD. This may include training for:

  • social skills
  • problem-solving
  • organizational skills

Managing symptoms of any coexisting conditions, such as anxiety or depression, must also be part of the treatment plan.

Are ADHD medications safe for teenagers?

A 2020 research review concluded that ADHD medications were effective in reducing symptoms with little short-term risk. Still, parents should be aware of the potential side effects of ADHD medications and the risk of misuse or diversion (transferring prescribed medications to other people).

Teens naturally strive for independence but still need support and guidance. Here are some ways you can help your teen cope with ADHD:

  • Be patient with their struggles. Harsh reminders aren’t helpful.
  • Create a daily structure for sleep, including wind-down time, bedtime, and wake-up time.
  • Use a calendar to help them organize their schedule.
  • Organize the home so there’s a dedicated landing zone for frequently used items, such as keys.
  • Help them organize their spaces, including rooms, desks, and backpacks.
  • Be specific when giving instructions and provide directions one at a time.
  • Set up reminders or help them set up their own reminders for important tasks.
  • Help them break down complicated tasks into manageable pieces.
  • Provide academic support through homework buddies or tutors.
  • Set up a chore chart to help them keep track of tasks.
  • Get to know their friends.
  • Encourage conversation about relationships, sexuality, and drug use.
  • Make room for them to vent frustration without repercussion.
  • Help them understand the dangers of distracted driving and drug use.
  • Make it clear that coming to you for help is a mature and responsible thing to do.
  • Don’t scold or punish them for things they can’t control.
  • They’re on their way to adulthood, so let them have a say in things that affect their health and well-being.
  • Praise all small progress.

Many people with ADHD have at least some symptoms that continue into adolescence and adulthood. That’s why it’s important to address ADHD and help your teen manage symptoms.

You’re not alone. Many families are meeting the challenges of life with ADHD. Look into ADHD resources and ask your teen’s doctor or school counselor for information about local resources.