ADHD is a truly frustrating disorder. For teachers, parents, friends, classmates. The kid or teen with ADHD will test everyone’s patience. But it’s certainly not easy on them either.

Understanding some of the more emotionally-related aspects of ADHD and how many of these symptoms overlap with mental disorders, may not only help you have more empathy for your teen with ADHD, but can help you help them.

Don’t go anywhere – let’s talk about your teen’s ADHD and clarify a few of the issues you may be seeing in their behavior.

This is Speaking of Teens, the podcast that teaches you the science of parenting adolescents so you can be less stressed and more excited about having a teenager. I’m Ann Coleman, I’m an attorney turned parent educator and I’ve spent years studying the science of teen behavior and I want to help you learn how to parent your teens for the best possible outcome.

Today I want to talk to you about a few of the lesser-known aspects of ADHD – these are the things many parents either don’t know about or misunderstand.

First, let me just clarify what ADHD really is and how the disorder differs from the issues we see with the neurotypical teen.

I had Dr. Mark Bertin on the podcast back in episode 41. Dr. Burtin is a nationally renowned expert in ADHD and he explained ADHD as being a developmental delay in self-management skills – poor executive function – the thinking skills provided by the prefrontal cortex, which is, in fact, still being programmed in a neurotypical teen too.

So, where a typical teen has issues remembering or planning ahead or needs some reminding and prodding, a kid with ADHD will have a much harder time managing their time, their school projects, their emotions. They’re at least 2 or 3 years behind a typical teen in being able to do many of the things required of them in normal everyday life.

This is why so many kids with ADHD get labeled as unmotivated or lazy, which causes them to feel so bad about themselves because they don’t understand why they have such a hard time.

As Dr. Bertin reminded us, ADHD is a skills-based disorder, it’s not about whether or not they’re putting forth enough effort. Being frustrated with a kid with ADHD for not trying hard enough is like being mad at a deaf kid for not trying to hear harder.

ADHD is not caused by a lack of motivation or effort, it’s a disorder that creates a total lack of skills in certain areas – and no amount of insistence on trying harder will change a lack of skills. They need scaffolding and supports while they are still learning.

Dr. Bertin quoted Russell Barkley an internationally recognized authority on ADHD in saying that “ADHD is just not a disorder of not knowing what to, but a disorder of not doing what you know.” Feeling capable of doing things but just not quite being able to get there, as Dr. Bertin says, “can begin to undermine your mindset, undermine how you feel about yourself in ways that then do undermine your motivation.”

So, start with an understanding that your teen with ADHD is not simply “not trying” – there’s no way for someone to develop skills without patiently teaching them those skills.

And in the meantime, there are so many opportunities for your teen to feel like a complete and utter failure for not being able to do what kids around them can do.

Purely from this standpoint, teens with ADHD are going to be feeling “less than”, being super frustrated about their abilities, and likely not very motivated.

So, please remember the mantra, “they are doing the best they can with what they have” – this is true for all teens but especially true for those with ADHD.

And this applies to so many other areas of their life besides school. ADHD also impacts your teen’s ability to regulate their emotions. And teen’s already have a hard time with their emotions because the emotional center of the brain is super sensitive during adolescence, meaning they are much easier to get angry or nervous about things and the prefrontal cortex has a hard time helping them calm down.

Additionally, neurotypical teens are also prone to seeking out and doing risky things because the brain’s reward system is also super revved up and raring to go. And again, the prefrontal cortex, because it’s weak in executive function skills, has a hard time getting a teen to proceed with caution.

And all of these issues are magnified for About 75% of teens with ADHD. They are more likely to have outbursts, meltdowns, angry explosions, arguments and fights. They are more likely to become a bit unhinged or out of control over little or nothing. They are more likely to do ridiculously dangerous or risky things and all with little thought about what might happen or how you might feel about it.

Again, remember, this is a brain-based disorder where they are simply not equipped with the skills to manage these impulses – they have a lack of self-management skills.

Now, this may not be the case for your ADHD kid, but for around 75% or more, they’re going to have issues with their emotions.

So, your kid with ADHD may seem to react in anger or nervousness to something that makes no sense to you. They may seem completely irrational, might blame everyone but themselves, might throw things, punch holes in walls and seem completely out of control.

They also tend to take much longer than the neurotypical teen to calm down after getting angry or nervous. Learning emotion coaching is essential if your teen is ADHD – I’ll link to some episodes for you in the show notes.

Something else going on in the ADHD teen brain is that the neurotransmitter, GABA is extremely low.

GABA helps keep us from getting over-excited, afraid, anxious – it inhibits certain behaviors so we don’t do things we shouldn’t

But then add the fact that the ADHD teen also have very low levels of dopamine, so it causes them to be in an almost constant state of boredom – they are bored – All. The. Time.

This is why teens with ADHD are more likely to get in trouble. They seek out stimulation any way they can – they’ll do the typical teenage stuff but on a grander scale because of that lack of self-regulation and these low levels of GABA and dopamine.

And the kicker is, if they can’t get that stimulation from risky behavior, quite often their brain will say, “well, let’s just start an argument – that’ll liven things up a bit.”

Now remember, this is their brain – it’s neurochemical – it’s not them using the thinking part of the brain to decide that they need this sort of action – it just happens organically.

But this level of stimulation is what their brain craves – it’s what feels normal to them. What feels normal to a neurotypical teen is boring for them.

The other side of this is that positive emotions are often a bit much for ADHD teens as well. They are of course, more intense, and excitable and over the top and in your face and may simply just be too much for a lot of people – including friends. They also have a hard time understanding or reading other people’s emotions. So, they tend to have more social and friend issues.

So, it’s really important for you to recognize that if your teen has ADHD, they are under even more stress than a neurotypical teen. They’re under stress at school, friends, romantic relationships, and likely suffer from poor self-esteem…it’s really, really difficult for them and they didn’t bring any of this on themselves. They didn’t ask for this, but they have it and they need help dealing with it.

They also have more trouble with sleep than the average teen. Having ADHD is like walking into a television store where all the TVs are turned on – but they’re all playing different things. That’s what it feels like in our brain – yes, I have ADHD – I’m a daily Adderall taker and likely always will be.

And those TVs in our brain don’t shut themselves off just because we want to go to sleep at night. Sleepless nights are a major issue for teens (and adults) with ADHD. It’s harder for them to go to sleep because you just can’t shut your brain down – so much noise.

It’s so important to check in with your ADHD teen often to make sure they’re not having any major issues. Keep your connection strong so they will confide in you because something that can make life even more complicated for them is that at least half of kids with ADHD will also have other disorders or mental health issues – anxiety, depression, borderline personality disorder, disruptive behavior disorders, autism spectrum disorder, conduct disorder…

And something to be very aware of – anxiety disorder symptoms are almost indistinguishable from ADHD symptoms and often teens have both ADHD and anxiety (which is a really unfortunate combination).

Teens with an anxiety disorder can also be extremely irritable, moody, and grumpy (worse than a typical teen). They’re prone to meltdowns and flip-outs and are just overall really intense. They can be extremely irrational and can fly into rages at the drop of a hat.

Anxiety symptoms can also make it extremely difficult to concentrate on school and homework and like ADHD, kids with anxiety often engage in risky behaviors including using substances to relive their symptoms.

So, it’s not at all unusual for a kid with anxiety to be misdiagnosed with ADHD or a kid with ADHD to be misdiagnosed with anxiety – and also not unusual for a kid to have both at the same time.

So be very careful that you are using a psychologist – who specializes in teasing these issues out, when you see these symptoms. Have your child professionally evaluated. A pediatrician is not your first stop except to perhaps get a referral to a psychologist. I just can’t stress this enough.

Another symptom to watch out for in teens with ADHD is something called rejection sensitivity – or the more pronounced version of it is called Rejection Sensitive Dysphoria.

By the age of 12, kids with ADHD will have received somewhere around 20,000 more critical messages than neurotypical kids. Think of the internal messaging they’ve created for themselves.

Estimates are that almost everyone with ADHD has some level of rejection sensitivity.  It’s not really known if there’s an underlying pathology for the issue or if it’s caused by all of the criticism and negative messaging people with ADHD receive as a kid.

No matter, it’s very real thing and it’s super hard to live with.

Rejection sensitivity causes someone with ADHD to get really anxious or even extremely angry just imagining that they’re being criticized, judged, or disapproved of in some way. If someone truly rejects them – these emotions can go through the roof.

And when you consider the fact that teens in general have a hard time distinguishing between neutral and negative facial expressions, ADHD teens are going to jump to conclusions much quicker than their neurotypical counterparts. So, these teens are going to have huge overreactions - anger, rage, anxiety or extreme sadness.

Now the next level up from rejection sensitivity is RSD or rejection sensitive dysphoria – and it’s even worse.

People with RSD feel these emotions of anger, rage, sadness or anxiety to such an extent that they describe it as an intense or overwhelming emotional pain like nothing else. They often don’t even have the words to describe it – they just say it’s intense, horrible, awful.

In teens with RSD, when they feel they’ve failed somehow or are being criticized, or someone’s showing disapproval – all of this is like a rejection – and it’s almost impossible for them to control the anger or rage or the intense sadness or nervousness – so it’s an enormous lashing out or falling apart.

And so, these kids are often misdiagnosed with a sudden onset of severe depression or even bipolar disorder or borderline personality disorder. It’s also misdiagnosed as social phobia because people with RSD are terrified of being embarrassed in public, of people thinking bad of them.

So, people with ADHD typically learn to deal with RSD in a couple of different ways – maybe both.

1. They just become a people pleaser – they get so wrapped up in avoiding rejection that they basically mold themselves into whatever anyone else likes, and/or
2. They just avoid doing anything that they fear they won’t look good doing, a fear of failure – if it’s risky, they avoid it. That could be anything from going out for a sports team to applying for a certain college.

So, rejection sensitivity or RSD may explain a lot for you if you’ve seen this type of behavior in your ADHD teen.

My hope, by telling you all of this is that you will make sure to do your own research as well as take your teen to one or even more professionals to insure you get a proper diagnosis. Make sure this person understands how anxiety and ADHD and several other disorders overlap and that they work hard to tease those symptoms out.

Neurodevelopmental disorders or mental health disorders should not be diagnosed with a check sheet in your pediatrician’s office. Most pediatrician’s do not have the training necessary to make these difficult diagnoses.

Find the right experts, do your own research, get second opinions. The information is out there, you just have to look.

I’ll have a few related episodes linked in the show description right where you’re listening so be sure to check those out.

Thank you so much for joining me here today. I hope this episode may have opened your eyes to some of these ADHD issues. If you got something out of today’s show, I’d be every so grateful if you’d share it with a few friends who may also be able to benefit from it.

And if you’d like to join the conversation with other parents of teens, come join us in the Facebook Group – the link is at the very bottom of the episode description right where you’re listening.

And if  you’re listening to this before June 28^th 2024, join the Facebook group to see my Live presentation and Q & A – “How Our Behavior Can Make Our Teens’ Behavior Worse” that’s on June 28^th 2024 at 6 pm central time – and if you’re in New Zealand that’s Saturday, June 29^th at 11 am and for Australia, that’s Saturday, June 29^th at 9 am. You can use Time Buddy online and check your local time against 6 pm Chicago time US.

So, until I talk to you again, remember, a little change goes a long way.