The American Psychiatric Association defines ADHD (previously known as Attention Deficit Disorder or ADD) in its Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as characterized by symptoms including difficulty sustaining attention, being easily distracted, making careless mistakes, difficulty waiting or taking turns, being in constant motion, and/or hyperactive-impulsive symptoms. According to ADHD statistics, ADHD often occurs with other mental disorders, such as anxiety, depression, or oppositional defiant disorder. Low self-esteem may result from the symptoms associated with ADHD, creating a vicious cycle of behavioral problems.
Given the disorder’s prevalence and potential longevity, it can help to understand the different signs of ADHD at various ages. This article will cover the common signs and symptoms of ADHD in children, teens, and adults to help you better recognize its often-varied manifestations.
What Causes ADHD?
The exact cause of ADHD remains unknown, but the National Institute of Mental Health (NIMH) suggests that genetics and environment may both be involved. Research has found that certain areas of the brain related to attention have been shown to be smaller in children with ADHD. In addition, certain chemical messengers (called neurotransmitters), such as dopamine, are thought to be at lower levels in people with ADHD.
Brain development is a complex process and requires the efficient functioning of many different systems within the body. An imbalance or disruption in any of these systems, such as the central nervous system, can cause significant changes to brain development and result in an increased risk for learning disabilities and mental disorders.
ADHD In Toddlers
Although most do not meet the minimum age requirement to be officially diagnosed with ADHD, toddlers can display some symptoms of the disorder of ADHD. In toddlers, these symptoms can include difficulty staying seated, impatience, overly bold behavior, joining in play without being invited, and problems waiting for their turn. However, these early indicators of ADHD may not necessarily signal the presence of the disorder since they are already common among this age group. While such behaviors often predict a diagnosis later in childhood, it is usually only in extreme cases that ADHD will be diagnosed in toddlers. Many professionals recommend waiting to see if these symptoms persist into childhood. It is important to consider the child's environment, including environmental toxins and family life, as these factors can also contribute to a toddler's behavior.
ADHD In Children
Because ADHD is usually diagnosed during childhood, knowing how its symptoms can show up in children can be vital. According to the Centers for Disease Control and Prevention (CDC), it is estimated that there are over 2.5 million children aged 3-11 in the United States who are living with ADHD.
There are three different types of ADHD that an individual can develop: inattentive type, impulsive/hyperactive type, and combined type. To meet an official diagnosis, children usually must display six of the symptoms from the hyperactivity/impulsivity category or six from the inattentive category.
This group of symptoms involves being easily distracted, not completing tasks, being disorganized, and having difficulty concentrating. Usually, teachers more easily observe these symptoms while children are at school due to the mental effort required for classwork.
One of the most noticeable symptoms of ADHD is a child's energy level, which can look like difficulty sitting still, excessive fidgeting, and talking for extended periods. This symptom class often also manifests in impulsive behavior, such as blurting out answers before questions have been completed, interrupting conversations, or not waiting their turn when speaking. These behaviors can be disruptive to both the child and those around them.
As children age into their teenage years and adulthood, hyperactivity and impulsivity symptoms may decline while inattentive symptoms persist. For this reason, signs of ADHD in teens may look more similar to those in adults than those in children. Teens with ADHD may have trouble staying focused on a task even when there are no distractions present. They may also have trouble organizing tasks, completing assignments on time, and managing time.
The symptoms of ADHD can be further classified based on whether they affect the child’s behavior, mood, or cognitive function:
Hyperactive and impulsive symptoms of ADHD often fit into this category. Behavioral symptoms include irritability, aggression, and repetitive word use.
These symptoms include inattentiveness, difficulty focusing for extended periods, and trouble prioritizing tasks. Cognitive symptoms are not always obvious in children since they may not know how to describe these concerns to an adult.
Children with ADHD can have mood swings that shift rapidly from excitability to aggression to sadness. Other children may not have severe mood swings but may be excitable, aggressive, anxious, or easily bored. Mood symptoms can be exacerbated when other mood disorders, such as depression, develop alongside ADHD. These symptoms are sometimes hard to identify in children since mood is an internal process that can manifest itself in certain behaviors.
Because ADHD can often look like numerous other disorders, experts suggest observing your child in different settings (they may behave a certain way specifically at home or school) or asking teachers, nannies, friends' parents, or anyone else who spends time around your child whether they have insights into behaviors that could signal the presence of ADHD. For a diagnosis, however, it is necessary to have the child tested by a healthcare professional, who can assess them, determine whether they’re living with ADHD, and answer questions.
Treatment for ADHD often differs depending on the age of the child. For instance, in children aged four to five, treatment is usually focused on behavioral therapy facilitated by a teacher or parent, and medication is used only in cases where children have severe symptoms and behavioral therapy has been unsuccessful. The AAP has recommended that behavioral therapy should come first and that medication should only be offered as a last resort. Speaking with a mental health professional can provide more guidance for treatment options, as well as assistance in helping parents engage in behavioral therapy with their child.
ADHD In Teens And Adults
The National Resource Center on ADHD estimates that at least 10 million adults are living with ADHD in the US. To be diagnosed, adults normally must have had signs of ADHD before age 12 but need to have fewer symptoms currently present than children to be diagnosed. The signs of ADHD in women and men are usually noticeable when the individual is performing tasks at work, completing college classes, or trying to finish projects. However, unlike children, adults with ADHD usually do not have the same energy and therefore may not display many of the hyperactive symptoms. Therefore, the symptoms of ADHD can become more internal during adulthood and may manifest more in cognitive difficulties.
An adult with ADHD may or may not have been diagnosed as a child, but they usually report struggling with completing tasks or staying focused. For many people with ADHD, the symptoms may change over time or be better controlled through behavioral therapy, but they do not go away. Others, however, will show improvement or even a lack of symptoms over time. Adults tend to report experiencing the following:
- Mind that races and produces disordered thoughts
- Anxiety from environmental overstimulation
- Feeling like they have brain fog
- Difficulty completing tasks because of distractibility
- Trouble organizing their space
- Time blindness makes punctuality difficult
For teens, the symptoms of hyperactivity and impulsivity may decline over time from childhood as symptoms of attentiveness persist; but this is not always the case. As teens are faced with greater academic demands, and potentially begin working, signs of ADHD may differ from those seen in children. If a teen is finding that focusing on tasks is difficult, and their mind is racing, they may want to speak with someone about the potential of having ADHD. As college is a time that is difficult for many individuals with ADHD, seeking treatment before attending school can help teens have a more pleasant experience.
As with children, treatment options for teens and adults with ADHD include behavioral therapy and medication. During therapy, teens and adults may learn skills that can help them organize, focus, and sustain productivity. Also, therapy can be offered in a group format for those who would like an aspect of social support and useful insights into managing ADHD from other people who are experiencing symptoms. A medical or mental health professional will usually create a plan that includes treatment options that are appropriate given the specific symptoms present.
Online Therapy For ADHD
There is an increasingly large amount of research suggesting that online therapy can help address the symptoms of ADHD. In a meta-analysis of six studies that included over 250 participants, researchers found that online therapy could effectively treat ADHD symptoms and facilitate care for those who may be hesitant to meet with a therapist face to face. In addition to finding a decrease in symptoms of ADHD, the analysis points to the convenience of online therapy as an advantage compared to in-person treatment.
If you’re living with symptoms of ADHD or a similar mental health-related challenge, online therapy can be a convenient and available method of care. If you're living with ADHD, you may not want to have to schedule additional time for commuting to a therapist’s office. With an online therapy platform like BetterHelp, you can connect with a therapist remotely, through video calls, voice calls, or in-app messaging. You can also go back and read messages with your therapist that are kept in a journal format, which may help you remember important points or reinforce specific concepts.
What does ADHD look like in a teenager?
In teenagers, ADHD symptoms can manifest as difficulty in executive functioning, disruptive behaviors, challenges in peer relationships, poor self-control, and issues with social skills. ADHD symptoms in teens might also include risky behaviors and potentially, substance abuse. That being said, ADHD presents itself differently in different individuals.
Can ADHD symptoms start at 14?
While ADHD is a developmental disorder typically identified in childhood, it is possible for symptoms to become more apparent or exacerbated during adolescence, possibly due to increased academic and social pressures.
At what age does ADHD peak?
ADHD does not have a specific age at which it peaks; instead, the presentation of symptoms can change throughout development. In some individuals, hyperactivity may decrease, but difficulties with executive functioning and self-control can continue into adulthood.
Does ADHD get worse in high school?
For some teenagers, ADHD symptoms may seem to worsen in high school due to increased academic demands, social pressures, and the need for greater independence and self-management. Implementing stress management techniques can be particularly beneficial during this time.
Can ADHD get worse with age?
ADHD symptoms can change with age. While hyperactivity may decrease, issues with attention, organization, and impulsivity may continue. Additionally, adults with ADHD may experience co-occurring conditions such as sleep disorders or anxiety.
How do I know if my 16 year old daughter has ADHD?
Observing consistent patterns of inattention, impulsivity, and/or hyperactivity in two or more settings (e.g., home, school) may indicate ADHD. Consulting a clinical psychologist or healthcare professional for a comprehensive evaluation, including psychological tests, is essential for an accurate ADHD diagnosis.
How do doctors test for ADHD?
Doctors and clinical psychologists typically use a combination of clinical interviews, observer reports, psychological tests, and a review of the individual’s developmental, medical, academic, and behavioral history to diagnose ADHD.
What are the 3 main symptoms of ADHD?
The three main symptoms of ADHD are inattention, hyperactivity, and impulsivity. These symptoms can affect academic performance, social interactions, and various aspects of an individual’s life.
Can ADHD be triggered by puberty?
While ADHD is a developmental disorder present from childhood, the hormonal changes and brain development occurring during puberty can exacerbate symptoms or make them more noticeable.
How do you get tested for ADHD at 14?
A 14-year-old showing signs of ADHD should undergo a comprehensive evaluation by a healthcare professional or clinical psychologist, involving psychological tests, clinical interviews, and a review of developmental and behavioral history.
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