ADHD is a common neurodevelopmental disorder affecting millions of teen boys in the United States. According to the CDC, boys are more likely to receive a diagnosis of ADHD compared to girls.1 A teen boy with ADHD may struggle with many things in their life, from focusing in school to making and keeping friendships.
What is ADHD in Teens Boys?
Attention-deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed neurodevelopmental disorder in teen boys. When a teenage boy has ADHD, he is likely to find living life challenging at times. His body is changing due to increased testosterone production, which can worsen symptoms of ADHD in teen boys, like impulsivity and hyperactivity.
There are three types of ADHD; inattentive ADHD, hyperactive-impulsive ADHD, and combined ADHD. Each type is characterized by specific behavioral symptoms, with the combined type presenting with both inattentive and hyperactive-impulsive symptoms. It’s important to note that if a male adolescent has the combined type, it doesn’t mean their condition is far worse than others. Furthermore, ADHD is highly heritable, meaning that it runs in families.2
ADHD Symptoms in Teen Boys
Depending on the type of ADHD involved, symptoms of ADHD in teen boys can include difficulty paying attention to details or a conversation, restlessness or not being able to sit still for long periods when expected, and talking too much or interrupting others. Unfortunately, these symptoms may negatively affect their peer relationships and motivation to reach significant goals.
Common ADHD symptoms in teenage boys include:
- Chronic procrastination: Teens with ADHD struggle with chronic procrastination. They dislike boring activities, which can explain why starting a house chore or homework assignment takes too long. Any tasks that demand mental effort are also boring for them.
- Impulsivity: Impulsivity is an elemental symptom of the hyperactive-impulsive type. Butting into conversations, being unable to wait for their turn, and engaging in destructive behaviors like speeding, unsafe sex, and impulse spending.
- Making careless mistakes: Committing errors usually results from a lack of attention to detail and getting easily distracted. A teen could make mistakes in spelling and when filling in forms.
- Unable to sustain a time-consuming task: This can pose challenges in time management. You may have heard of the term time blindness, wherein a teen loses track of time and, as a result, they cannot stick to a schedule.
- Lack of organization: For example, they tend to place their things everywhere, miss their assignments, and may even neglect their hygiene and grooming. Difficulty organizing happens because they have executive dysfunction, a mental process involved in self-awareness and planning.
- Emotional dysregulation: Emotional dysregulation can sometimes manifest as irritability, anger, and defiance. Teens go through many struggles, which take an emotional toll on a teen boy with ADHD.
- Forgetfulness: This happens more frequently in ADHD due to executive functioning problems. Fortunately, there are ways to help them remember better.
- Unable to read social cues: When they’re in a social setting, they tend to misunderstand others — their facial expression, body language, and tone of voice.
ADHD in Teen Boys Vs. Girls
Between a male and a female adolescent with ADHD, it helps to remember that males have a more “external” presentation, while females have a more “internal” presentation.3 A teenage boy is likelier to break the rules and show aggressive behavior, whereas a teenage girl displays inattentiveness, shyness, daydreaming, and a lack of motivation.
When it comes to diagnosing ADHD in teen boys, there’s a higher chance for them receiving a hyperactive-impulsive or combined type diagnosis. On the other hand, girls with ADHD are more likely to be diagnosed as the inattentive type. ADHD is often underdiagnosed in females because their symptoms are not hyper, so they may not understand why they’re struggling and even blame themselves.
How Does ADHD Affect Teen Boys in Their Daily Life?
Testosterone increases by thirty-fold during puberty; thus, those with ADHD become more susceptible to getting involved in school misconduct. Research shows that this increase is linked to mood and behavior changes, particularly social aggression and risk-taking.4 While teens need healthy relationships, ADHD can make maintaining quality relationships with their friends and romantic partners hard.
Here are some of the ways ADHD affects teen boys daily:
- Increased risk of car accidents
- Higher levels of suicidal ideation
- Higher rates of failed exams and achievement tests
- More likely to get suspended for disruptive behavior
- Increased likelihood of getting bullied or bullying others
- Higher rates of substance abuse
- More likely to engage in unprotected sex
- Frequent outbursts of anger
Teens with ADHD & Relationships
Teens with ADHD might have trouble listening to conversations and feel bored, easily annoyed, and impatient. Moreover, they may need help remembering their commitments. When teen boys fall in love, they often develop intense feelings due to being overly sensitive. However, their difficulty focusing can lead to challenges in communication and maintaining trust. The same is true for friendships.
Because ADHD symptoms can strain their relationships, it’s essential for teen boys to be self-aware that what they’re doing may hurt the feelings of others. A knowledgeable parent, caregiver, or professional may teach them strategies, such as showing interest in others, being aware of their own emotions (especially when they receive criticism or feel ignored), and making others feel important.
How Is ADHD in Teen Boys Diagnosed?
According to the DSM-5 Criteria for ADHD, a typical diagnosis of ADHD in teen boys includes at least six symptoms of inattention and or hyperactivity–impulsivity that interferes with their functioning. Since ADHD is usually first diagnosed in children under 12 years old, an undiagnosed teenage boy’s symptoms might be mistaken for anxiety, depression, or another mental health condition that mimics ADHD.
Teen boys should have six or more symptoms at the age of 16 or five or more at the age of 17. These symptoms should be present for at least six months. In addition, the DSM-5 notes that there should be several of these inattentive or hyperactive-impulsive symptoms before the age of 12 and that these symptoms should show up in different settings, such as at home and in school.
To receive a diagnosis of inattentive ADHD, a teen boy must display at least six of the following symptoms:
- Doesn’t pay attention to details or makes careless mistakes in school and other activities.
- Has trouble holding their attention
- Doesn’t seem to listen when spoken to directly
- Doesn’t follow through on instructions and fails to complete tasks
- Has trouble organizing tasks
- Dislikes or is hesitant to do tasks that demand mental effort for long periods
- Loses things that are needed for important tasks, such as school materials
- Gets easily distracted
- Is always forgetful in daily activities
To receive a diagnosis of hyperactive-impulsive ADHD, a teen boy must display at least six of the following symptoms:
- Often fidgets or taps hands or feet, or squirms in seat
- Leaves seat in situations when staying seated is expected
- Unable to participate in leisure activities quietly
- Always on the go
- Often talks excessively
- Often says their answer before the question has been completed
- Often has trouble waiting for their turn
- Often interrupts the conversation or activity of others
Treatment for ADHD in Teen Boys
Stimulant and non-stimulant ADHD medications are considered the frontline treatment for ADHD. In many cases, a professional would combine medication and psychotherapy, such as cognitive behavioral therapy, to reduce ADHD symptoms in teen boys and improve their daily functioning.
Medications
As the first line of treatment for ADHD, medications come in different types. Stimulants and non-stimulants are commonly used, with stimulants as the better option for individuals with moderate to severe symptoms. Stimulants improve their attention and mood by increasing dopamine in the brain, while non-stimulants reduce hyperactivity. Non-stimulants are also an option for teens who cannot tolerate the side effects of stimulants.
Stimulant medications used to treat symptoms of ADHD in teen boys include:
- Adderall (amphetamine)
- Vyvanse (lisdexamfetamine)
- Ritalin (methylphenidate hydrochloride)
Non-stimulant medications used to treat symptoms of ADHD in teen boys include:
- Strattera (atomoxetine)
- Intuniv (guanfacine)
- Kapvay (clonidine hydrochloride)
Therapy
Therapy can further increase positive behaviors while managing ADHD symptoms in teen boys, such as difficulty organizing tasks and their environment. For instance, a therapist might offer tips to keep track of their school assignments, such as writing down their tasks on paper and setting up a workspace, and how not to feel overwhelmed by breaking down a long task into smaller chunks.6
Therapy options for ADHD symptoms in teen boys include:
- Cognitive behavioral therapy (CBT): CBT is an evidence-based treatment that helps with time management, task management, identifying inaccurate thought patterns, and replacing them with realistic ones.
- Dialectical behavioral therapy (DBT): DBT is effective for teenage boys struggling with impulsivity, low self-esteem, and emotional control. Although note that some teens do not experience these issues.
- Family therapy: Family therapy emphasizes family support in which parents are taught to set limits on their child, plan rules and routines, and use positive reinforcement.
- Contingency management (CM): CM is a behavioral treatment involving immediate rewards for good behavior. For example, allowing a teen to call their friend or watch television once they finish their homework.
How to Parent a Teen Boy With ADHD
Given the difficulties teen boys with ADHD face, including the common problems of adolescence, plus ADHD symptoms, parents play a huge role in helping them overcome their struggles and succeed. Educating yourself about the condition will enable you to come up with realistic strategies and, at the same time, care for yourself.
Here are six ways to support a teenage boy with ADHD:
- Set clear boundaries: Start with one boundary at a time, such as encouraging your teenager to voice their frustration, but firmly drawing a line when it comes to swearing or hitting things/people.
- Delve into psychoeducation: Psychoeducation improves adherence to treatment by providing your teenager with as much information as possible about their condition, thereby battling any internalized stigma they may be struggling with.
- Positively communicate rules: This focuses on the solution, not the problem. When telling them rules, such as fastening their seat belt while driving and sticking to a consistent bedtime, explain the benefits of following them.
- Set aside time to connect with them each day: Conversing with them can help you stay in the loop on what’s happening in their lives. Ask open-ended questions and let them discuss what they want to discuss.
- Encourage physical exercise: Unless your teenager has physical limitations, exercise can be a great addition to their treatment. Exercise has many mental health benefits, including feeling better, learning better in school, and being able to focus.
- Teach them healthy habits: This includes frequent breaks, eating nutritious foods, and getting enough sleep.
- Work with your child’s teacher: Collaborating with their teacher promotes an environment and routine that supports the teenager’s learning. Additionally, school accommodations are often provided through a Section 504 Plan.
- Keep your psychiatrist or family doctor updated: Teens with ADHD need to be checked regularly for any changes in their symptoms during treatment. Contact them immediately in case you notice worsening behavior.
When to Seek Professional Support
If your teenager consistently shows signs of inattention, hyperactivity, and impulsiveness affecting their daily life and relationships, reach out to a qualified mental health professional. It also helps to choose a neurodiversity-affirming therapist who can help with the teenager’s needs and strengths. A simple online search will show you a list of online directories and websites.
In My Experience
Teen boys who receive a multimodal treatment approach have the best outcomes. I find that combining medication and behavior therapy leads to significantly better outcomes than either medication or behavior therapy on their own. Furthermore, boys who enter therapy tend to do much better when they have external support from their parents and school. Some parents bring their ADHD teen to therapy wanting the therapist to “fix” their child. However, the child isn’t broken. They have a neurobiologic condition that usually can’t be improved with therapy alone, and the best outcomes typically involve therapy, contingency management plans, and school cooperation.
ADHD in Teen Boys Infographics
