Attention deficit hyperactivity disorder (or ADHD) is a neurodevelopmental disorder that is diagnosed especially during childhood, with most of the scientific literature on the subject focusing on this period of age.
Despite this, 85% of children with ADHD continue to maintain symptoms in adolescence, and 60% persist in adult life (times when certified cases increase in the female population, with the ratio between the sexes being equal).
Because childhood and adolescence are periods with specific evolutionary particularities, due to the maturational milestones that are inherent in them, it is of great interest to know the expression of ADHD in adolescence .
In this article we will talk about what ADHD is and we will address the way it manifests itself at the clinical level, showing its evolution in the process that leads from childhood to adolescence (as well as the implications that may arise).
- Related article: ” Types of ADHD (characteristics, causes and symptoms)“
What is ADHD
ADHD is a neurodevelopmental disorder that is expressed in the form of inattention and / or hyperactivity . People who suffer from it can meet only one of the two symptoms, or satisfy the diagnostic criteria established for both. Then we proceed to describe the way in which both are manifested in childhood, going on to expose the face that they usually adopt when crossing the threshold of adolescence.
Inattention is usually easily detected when the child enters school. The teachers, and also the parents themselves, may notice that the child is not concentrating long enough to successfully complete their school activities, neglecting necessary details or expressing boredom during their performance. Likewise, when his attention is demanded, he responds in such a way that he does not seem to be listening to what is being said to him, as if what he thinks about absorbs all his cognitive resources.
There is also a peculiar difficulty in following instructions and maintaining interest in those activities that require projecting the focus of attention in a sustained manner . Attention is easily dispersed in the face of external stimuli that are not related to the task at hand, assuming frequent interruptions that lengthen obligations and reduce leisure time. It can also behave in a forgetful or absent-minded way, neglecting its properties or losing them.
Hyperactivity is shown as excessive behavioral activation in contrast to what would be expected in the objective situation in which the child participates. For example, you can tinker during the time you should be sitting, moving your arms or feet restlessly. You can also get up from your seat at inappropriate times or resort to annoying activities like running around, humming or even climbing; to satisfy an apparent need for movement.
In addition to motor activity, the child with ADHD can speak in a talkative way, interrupting the turn of others and emitting words at a rate so accelerated that it affects their ability to communicate . Play behavior is also substantially affected, making it difficult for him to engage in shared activities while remaining calm. This circumstance can be one of the first experiences of interpersonal rejection in childhood.
Diagnostic manuals (such as the DSM itself in its fifth edition) suggest that, in order to diagnose ADHD, the symptoms must be presented before 12 years of age. Likewise, it must be extended to at least two contexts (home, school, etc.) and ostensibly interfere in the normal development of family or academic activities. It is also key to rule out the diagnosis of another possible mental health problem (such as childhood schizophrenia).
ADHD in adolescence
Despite the relevance of the question, there are relatively few studies that have focused their interest on the clinical expression of ADHD in adolescence . This stage of development is extremely important to strengthen extra-family social ties, make decisions about the future, shape identity, discover sexuality and ultimately build the foundation on which the person will be built for years to come.
For this reason, it is essential to know how ADHD could limit, or perhaps hinder, the successful acquisition of such relevant evolutionary milestones. Especially due to the fact that there is ample empirical evidence on the possible permanence of symptoms in this transition between both life periods, although subject to “transformation” as a result of the interaction between life experience, the demands of the environment and the effervescent maturation. of the central nervous system.
Access to information and communication technologies, managing the (sometimes contradictory) expectations of family and friends and even the beginning of the first intimate relationships, can be compromised by the challenges that ADHD imposes on those who suffers from it. It is also not uncommon for additional difficulties to occur in the area of mental health , such as mood and anxiety disorders, which require specialized and independent care.
In the following lines we will delve into the specific way in which ADHD is expressed in adolescence. We will focus only on the most important complications that may arise, although it is necessary to emphasize that they do not have to occur at all, and that we currently have effective therapeutic strategies aimed at alleviating their effects . This text serves to guide detection and stimulate the search for effective solutions.
- You may be interested: ” Learning difficulties: definition and warning signs
One of the most important obstacles to confirming the diagnosis of ADHD in adolescence is the fact that hyperactivity, the symptom that most easily allows us to infer the presence of the disorder during childhood, tends to soften when entering this period. Thus, it can be replaced by impulsive behaviors, which are confused or camouflaged in the accumulation of expectations that society places on adolescents.
The prefrontal cortex is a relatively recent anatomical region of the brain in evolutionary and phylogenetic terms. One of its most relevant functions is associated with impulse inhibition, as well as frustration tolerance. This area of the nervous system ends its maturation in the second decade of life, which is why many adolescents have deficits in these executive functions. The effect, however, may be even more pronounced in those diagnosed with ADHD.
There is evidence that ADHD in adolescence can be expressed through a special difficulty in making decisions weighing the possible future consequences , which ends up translating into greater erratism when choosing curricular itineraries or work options. It is also very important to sharpen attention on other impulsive behaviors, due to the physical risk involved, such as substance use or participation in risky sexual activities.
2. Difficulties in planning
ADHD in adolescence can manifest itself cognitively, in addition to the impulsiveness referred to, through specific difficulties in planning for the future and outlining action plans that direct behavior purposefully towards a goal . In this sense, it is common that the own responsibilities are assumed bordering the time limit that was available for its realization, or that a sequence of steps is followed without sufficient logic for the optimal development of the intention.
3. Unstable social relations
Adolescents with ADHD can display interpersonal behavior that is plagued by instability , such that they easily abandon their relationships. They are also often very impatient, which can translate into constant interruptions to peers, parents, and teachers. All this, together with a possible tendency to “lose your temper”, contributes decisively to the appearance of conflicts in the family and academic context.
The rejection of social groups can occur with some frequency also in adolescence, prolonging a social problem whose germ could have sprouted in the same childhood, and consecutively threatening the way in which the person perceives himself. The ostracism of the reference group, as a further consequence of the lack of knowledge about essential mental health issues, facilitates the appearance of mood problems and anxiety in people with ADHD.
4. Difficulty maintaining attention
As academic demands increase, adolescents with ADHD may perceive their attentional abilities being overwhelmed and show difficulties in their performance. This fact is accentuated in the face of repetitive tasks that require excessive detail or that are valued as tedious or uninteresting. Therefore, they can make various mistakes during their preparation, reaching a point where an explicit preference for leaving them unfinished is evident.
This difficulty in maintaining attention focus is also extended to social relationships. During the communication process, the person with ADHD may feel distracted by thoughts alien to the ongoing conversation, so that they perceive deficiencies in capturing the content of the messages and responding consistently with them. On some occasions difficulties are observed in maintaining interest in a film, book, or other audiovisual work; especially when you don’t have options to interact.
5. Labor problems
Working life, like academic life, can also be compromised as a result of the diagnosis of ADHD , especially in cases in which it is maintained when reaching adulthood. There are studies that suggest a preference for jobs in which physical dimensions predominate, as opposed to those that require cognitive skills. In addition, they may need help managing time and organizing the schedule of their job responsibilities.
As in social relationships, there may also be a tendency to leave jobs when they exceed coping resources, or when they are considered as not very gratifying.
6. Mental health comorbidities
Teenagers with ADHD may have other mental health problems that add to the effects of their neurodevelopmental disorder; and that they stand as a consequence of both its core symptoms and its consequences on social relations, academic development, family life and self-image. The most common are anxiety disorders, major depression, and substance abuse or dependence .
It is important to assume that ADHD can last into adolescence, in a way that often goes unnoticed, but can seriously undermine options for building a meaningful life. Therefore, it is always advisable to consult with a mental health professional in case of doubts about the presence of this condition and / or the comorbidities that may accompany it.