ADHD (attention deficit hyperactivity disorder) is a neurobiological condition characterised by inattention, hyperactivity and impulsivity. For an analysis of the clinical causes of this neurodiversity, please see our previous article in XQ the News. .
The disorder is commonly associated with children, but in reality, it is a condition that manifests itself in childhood and persists into adulthood. And from a diagnostic point of view, ADHD is easier to detect in the early years of schooling, whereas in adolescence it is sometimes overlooked or misinterpreted, with significant consequences for the quality of life of those affected.
Difficulties in identifying ADHD in adolescents
In adolescents, the symptoms of the disorder are mixed with typical adolescent behaviour: restlessness, lack of attention and disorganisation, desire for independence leading to rebelliousness, mood swings ranging from euphoria to despair, efforts to adapt to physical and emotional changes, difficulties with self-regulation.
The overlap of ADHD symptoms with the typical changes experienced by homo sapiens between the ages of 13 and 17 makes adolescent ADHD difficult to identify. In any case, online tests are useless: a clinical diagnosis requires a visit to a qualified psychiatrist or psychologist.
There is also an additional difficulty in diagnosis that depends on the ‘masking’ effect that the adolescent with ADHD learns to put into practice from childhood.
What is masking in ADHD?
Like people with autism spectrum disorders, people with ADHD use ‘masking’ a lot more than neurotypical people. But what is masking? We can define it as public behaviour that is contrary to their authentic self, as if they were putting on a mask.
However, these are not malicious or harmful behaviours. All people suppress some of their impulses because of social convention. For example, in Europe, burping in public is not acceptable behaviour and avoiding this natural impulse is a form of masking.
Compared to ADHD, these coping strategies are much more common and cause great fatigue and stress because putting them into practice takes more energy in ADHD. They are defence strategies and compensatory behaviours that the person chooses to use to mask a behaviour and meet social expectations, hiding aspects of their impulsive or hyperactive nature. This can be done consciously, as when we make an effort not to speak impulsively, or unconsciously by developing adaptive habits from childhood. For example, a hyperactive child who is constantly criticised may try to prove his worth by standing out or, on the contrary, suppress his liveliness so as not to be a nuisance. At a later age, this can lead to difficulties in identifying one’s own needs, inhibition of spontaneous expression and even a form of social phobia. Society often judges some of the typical behaviours of ADHD, such as distractibility or difficulty with organisation, in a negative light, leading many people to internalise a sense of inadequacy and sacrifice their authenticity in order to feel accepted. And the frustration becomes dangerous (as shown by the data on psychiatric admissions in Spain) when this effort to pretend is able to avoid social or educational disasters.
The educational and social impact of ADHD
ADHD has a significant impact on both the educational environment and social relationships, affecting a young person’s performance and emotional balance. At school, difficulties with concentration, disorganisation and procrastination affect the ability to complete tasks and meet deadlines. Even students with high intellectual potential may achieve lower than expected academic results due to a lack of planning and difficulty in carrying out long-term projects. This can lead to frustration for young people, parents and teachers, creating a cycle of failure that undermines motivation.
At a social level, young people with ADHD can appear impulsive and unpredictable, with difficulties in following rules and moderating their reactions. The tendency to interrupt others or carry out actions without thinking can jeopardise friendships and lead to isolation or lack of understanding. The accumulation of difficulties at school and in relationships can also feed anxiety and stress, making the disorder appear to be an anxiety problem rather than an attention deficit. The resulting low self-esteem can lead to deep sadness and, in some cases, increase the risk of alcohol or drug abuse as an attempt to cope with emotional distress.
Recognising and properly treating ADHD in adolescents is essential to prevent its impact on a young person’s general wellbeing and to prevent changes in their school career, relationships and emotional development.
Treating ADHD in adolescents
Again, there are no simple solutions to diagnosing ADHD. It is necessary to consult specialists. Finding the best treatment for adolescents is a complex process involving both pharmacological and psychotherapeutic aspects. In the brain, ADHD is characterised by low levels of dopamine and reduced activity in the prefrontal cortex compared to neurotypical people, which affects planning and self-control.
Medications such as methylphenidate (Ritalin and Medikinet) and other amphetamine derivatives are commonly prescribed to treat ADHD. There are also non-stimulant medications, such as atomoxetine, which can be used as an alternative if stimulant medications are not suitable or cause side effects.
Medication should be accompanied by cognitive behavioural therapy (CBT), which is particularly effective for young people with ADHD, helping them to develop strategies to improve self-control, time management, problem solving and emotional regulation. CBT can also be useful in improving self-esteem and reducing negative behaviours such as impulsivity.
At school, young people with ADHD are entitled to an individual education plan, which may include support in the classroom, extra time for homework, the possibility of scheduling exams to reduce anxiety, and digital tools to help them improve the organisation and management of their work.
Conclusions
ADHD in adolescence is a disorder that can seriously affect the academic, social and emotional development of young people. However, with early diagnosis and appropriate treatment, it is possible to control symptoms and significantly improve the adolescent’s quality of life. It is important that society, educators and mental health professionals are better informed about ADHD so that young people can get the support and help they need to cope with everyday challenges. Early treatment and a comprehensive approach can make a difference in the lives of young people with ADHD, enabling them to fulfil their potential.
