Does your teenager have undiagnosed ADHD?

It’s normal for parents to feel like they’re a little disconnected from their teenage offspring. It might even seem like a completely different person has moved into the bedroom down the passageway. They’re slamming doors, moping about with eyes glued to their cellphone screen and respond to most questions with a monosyllabic “fine”.

There’s nothing unusual about a tempestuous teenager – but if a combination of factors are leading you to believe there might be something more complex at play, it might be undiagnosed Attention Deficit Hyperactivity Disorder (ADHD). Know the tell-tale signs of ADHD, so you can step in if you need to – diagnosing the condition and putting them on an effective and holistic treatment plan might just be the first step in making their future a whole lot brighter.

Persistent problems
Child psychiatrist and author of the book What’s the Fuss About ADHD? Dr Brendan Belsham says it’s a fallacy that ADHD is something you grow out of in childhood. In reality, says Belsham, the condition often becomes more problematic in the teenage years, when there’s a greater demand on the executive functioning of the individual.

“If the brain is an orchestra, executive function is the conductor,” explains Belsham. “All the individual players can be highly skilled in their own right, but if there’s no one controlling the group, it means nothing. In teens with ADHD, this is often the case. All the individual aspects of brain functioning are perfectly adequate, but there’s no cohesive output.”

According to Belsham, until the teenage years, executive function is largely controlled by someone else – a parent or caregiver – so there are built-in safety nets in place. However, this is unsustainable in adolescents, who suddenly have to be responsible for their own time management and productivity – and this is when the symptoms of untreated ADHD often come to the fore.

“This is also the time when sexual indiscretions and substance abuse become a reality, and when adolescents get behind the wheel of a car,” says Belsham. “This makes untreated ADHD symptoms even more dangerous.”

Resisting diagnosis
Belsham describes his teenage patients as generally falling into one of two camps: they’re either clued-up on ADHD and are comfortable with working towards a conclusive diagnosis; or they’re afraid of the stigma attached to the condition, and resist a diagnosis, even though it’s entirely warranted.

“Teenagers these days are so wired, they know how to research everything and anything, which makes it a lot easier for them to understand ADHD,” says Belsham. “The trouble is with adolescents who are already struggling to assert themselves, and simply don’t want to be labelled with ADHD because they’re afraid of what their peers might think.”

Another common problem Belsham encounters in undiagnosed ADHD teens is propaganda from the media and input from their teachers, who often don’t understand the severity of the condition and may offer their own misinformed solutions. This results in a confused adolescent, in denial of their own condition.

Be aware
Belsham advises parents to be on the lookout for symptoms of undiagnosed ADHD – and to be aware of the fact that although hyperactivity may have been present in childhood, it doesn’t always persist into adolescence.

“A key symptom to look out for is inattentiveness, which might present as procrastination, careless mistakes and not persisting with tasks,” says Belsham. “Also be aware of impulsivity, which often manifests as tactlessness, constantly getting into trouble, or speaking inappropriately and out of turn.”

Tackle the issue
In terms of approaching the issue with your teenager, Belsham explains the best way to do this is to wait for a trigger from the teen themselves – poor results on a test or working hard with no results – and then raise the issue.

“Don’t approach the situation with any value judgment and don’t try to apply any labels,” says Belsham. “Rather use phrases like ‘I’ve noticed you’ve been working really hard, but you always seem disappointed with your results’ and then suggest finding a specialist to try and understand the problem. It’s all about avoiding criticism and being sensitive.”

Belsham warns parents of the dangers of untreated ADHD for an adolescent going into adulthood – everything from self-esteem to finding and maintaining employment, or establishing relationships.

“It might seem a difficult task to raise these issues with your teenager when you’re already struggling to communicate with them, but leaving the problems unsolved could have seriously negative ramifications later in life,” concludes Belsham.