Have a Teen with ADHD? Here’s What Else Might Be Going On

This post: Have a Teen with ADHD? Here’s What Else Might Be Going On

Written by: Marybeth Bock

If you’re the parent of a teen with ADHD, you’re likely well aware of how your child’s diagnosis affects your entire family. Whether they were diagnosed a year ago or perhaps recently, chances are you’re constantly on the lookout for ways that you and your child can better manage their symptoms.

It’s easy for teens and parents alike to become frustrated when therapies and medications don’t seem to be proving helpful or it seems as though they may be triggering a new behavior challenge. But it could be that there’s something else going on that you may not be aware of.

According to the organization known as CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder), more than two-thirds of people with ADHD have at least one other coexisting condition. While any disorder can coexist with ADHD, certain disorders tend to occur more commonly with ADHD.

In fact, roughly 80 percent of those with ADHD are diagnosed with at least one other psychiatric disorder sometime during their life.

According to CHADD, here are some of the most common coexisting conditions linked with ADHD:

Behavior or Conduct Problems

All kids and teens get angry or become defiant occasionally when they’re upset. It’s perfectly normal.

But when these behaviors continue over time or become severe, they can be a sign of a behavior disorder. Teens with ADHD are more likely than others to also be diagnosed with a behavior disorder such as Oppositional Defiant Disorder or Conduct Disorder.

Oppositional Defiant Disorder (ODD) is one of the most common disorders occurring with ADHD. It usually begins before age eight but can also initially appear in adolescence. Teens with ODD may be most likely to act oppositional or defiant around people they know well, like family members, teachers, or coaches. 

According to the CDC, examples of ODD behaviors include:

• Often losing their temper
• Arguing with adults or refusing to comply with adults’ rules or requests
• Often getting angry, being resentful, or wanting to hurt someone who they feel has hurt them or caused problems for them
• Deliberately annoying others; easily becoming annoyed with others
• Often blaming other people for their own mistakes or misbehavior

Conduct Disorder (CD) is diagnosed when kids or teens show a pattern of aggression toward others, and often break rules and social norms at home, in school, and with their peers. 

Examples of CD behaviors include:

• Running away, staying out at night when told not to, or skipping school
• Being aggressive in a way that causes harm, such as bullying, fighting, or being cruel to animals
• Lying and stealing, or damaging other people’s property intentionally

Learning Disorders

Learning Disorders (LD) are also common among kids and teens who have been diagnosed with ADHD. Although intelligence is not affected by a LD, a child may have difficulty in one or more areas of learning, such as dyslexia which affects reading, dyscalculia which affects math, and dysgraphia which affects writing.

These learning disorders, when coupled with the signature symptoms of ADHD like difficulty paying attention or being organized, can hinder a teen from reaching their full potential academically.

Anxiety and Depression

Rates of both anxiety and depression are higher in people with ADHD. When a teen’s occasional worries and fears become persistent and interfere with their daily activities, it may be a sign of an anxiety disorder. This may play out as separation anxiety if they seem afraid when away from family; social anxiety if they become afraid of going to school or other places where they have to interact with others; or generalized anxiety if they’re extraordinarily afraid of the future or of bad things happening.

Similarly, it’s normal for all teens to occasionally feel sad or hopeless, but if these feelings become persistent, it could be a sign of a problem. Teens may be more likely to feel hopeless and sad when they can’t control their ADHD symptoms and that may interfere with their ability to do well in school or get along with friends and family.

Teens who suffer from depression may also lose interest in doing things they used to find fun, like playing a sport or an instrument, and they can end up feeling worthless.

Some ADHD medications can cause side effects like changes in eating and sleeping habits, which are also symptoms of depression. And, some signs of depression, like having a hard time focusing, are also signs of ADHD. For these reasons, it’s important to have your teen fully evaluated by a mental health professional to see if they may have one condition or both.

Difficult Peer Relationships

As we know, peer relationships are extremely important to teens and play a big part in their social development. Although some ADHD teenagers may not have any trouble getting along with their peers, others might struggle with making close friends or may even be rejected by peers. 

While it’s not fully understood how ADHD contributes to social challenges, kids and teens can come across as shy or withdrawn, they can be intrusive and intense, and at other times become aggressive. 

Autism Spectrum Disorder

ADHD and Autism Spectrum Disorder are common co-occurring conditions. Though they are distinct, people with diagnoses of either autism or ADHD often struggle in similar situations. In addition, autism can influence the presentation of ADHD symptoms and vice versa.

Unfortunately, there’s not a lot of research on how these conditions interact beyond childhood, so it’s important to seek out experts for evaluation, treatment and support.

Rejection Sensitive Dysphoria

Perhaps you’ve never heard of Rejection Sensitive Dysphoria (RSD), but it’s an “intense vulnerability to the perception – not necessarily the reality – of being rejected, teased, or criticized by important people in your life,” according to Dr. William Dodson, M.D., an ADHD specialist.

He explains that “98-99% of adolescents and adults with ADHD acknowledge experiencing RSD. For 30%, RSD is the most impairing aspect of their ADHD, in part because it does not respond to therapy.”

It’s likely that a teen with RSD is hiding their intense emotions from everyone around them. They may not like to talk about it because they feel shame over a lack of emotional control, and they don’t want people to know about their extreme feelings of vulnerability. 

What to do if you suspect your ADHD teen has a co-existing condition

Because a co-existing condition could be part of your teen’s challenges with ADHD, it’s important for them to have a comprehensive evaluation by a mental health professional to see if any additional treatment might be necessary. The challenge for health care professionals is to figure out whether a symptom belongs to ADHD, a different disorder, or to both disorders at the same time. 

As a parent, it’s essential to be your teen’s ally and strongest advocate so that they can get an individually tailored and comprehensive treatment plan. These plans should be ongoing and reviewed annually to make sure your teen’s treatment options are working or if they need to be adjusted. 

The one thing that every ADHD expert will agree on is that any behavioral therapies and medications that your teen utilizes should be combined with regular exercise, healthy sleep, and stress management practices. 

For more helpful information, visit these websites:

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Marybeth Bock, MPH, is Mom to two young adults and one delightful hound dog. She has logged time as a military spouse, childbirth educator, college instructor, and freelance writer. She lives in Arizona and thoroughly enjoys research and writing – as long as iced coffee is involved. Her work can be found on numerous websites and in two books. Follow her on Facebook and Instagram.

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