ADHD and Puberty
Many parents of children with ADHD will tell you that their child’s behavior began to change for the worse during puberty. Hormones can be one of the culprits for girls, the changing levels of estrogen and progesterone can make ADHD symptoms worsen. For boys, while hormones may be a secondary cause of behavioral problems, they don’t necessarily contribute directly. Whether male or female, your child is bound to feel the changes during puberty and ADHD symptoms may make this difficult time even more difficult.
According to Dr. Larry Silver, “Fortunately, boys with attention deficit disorder don’t seem to have more difficulty coping with puberty than others.”  He explains that boys with ADHD, however, may still have some problems related to their ADHD and puberty.
Boys, as with girls, desperately want to fit in with their classmates and gain independence from their parents. They want to feel they are “one of the gang.” Taking medication, especially if they need to leave class or stop at the nurse’s office on the way to lunch, may make them feel alienated. Parents may suddenly be faced with a teen who refuses to take medication, believing that they no longer need it. Today’s longer-lasting medication can help. If your teen isn’t taking a medication that lasts throughout the school day, talk with your doctor about your choices. For some teens, taking some time off the medication can help them understand how the medication works and how it helps them both in school and social situations.
Emotional maturity can also be a problem. Teens with ADHD can be as much as 30% less mature than their non-ADHD peers. That means a teen who is 13 or 14 chronologically may have the emotional maturity of a 9 or 10 year old. Body changes can be hard to accept and understand because of this difference in maturity level. In addition, your child may feel left behind socially. While their peers are interested in girls and dating or simply changing the way they relate to each other, your teen may not be emotionally ready.
A combination of feeling left out and impulsivity can lead to risky behaviors, including substance abuse. Sometimes teens will become friends with the “wrong crowd” because this crowd accepts them – especially if your teen is willing to experiment with drugs and alcohol.
Just as with the boys, girls experience many body changes during puberty. And just as with boys, girls with ADHD can have a large difference between chronological age and emotional maturity. All of the changes in her body can be confusing and overwhelming.
In a previous post, Hormones and ADHD, we discussed how girls who once excelled in school suddenly struggle, forgetting homework or barely passing their classes. Fluctuating levels of estrogen and progesterone might be one of the causes. During a woman’s cycle, estrogen levels are higher during the first two weeks and then lower with progesterone levels raising during the last two weeks.
Low estrogen levels have been linked with memory and cognitive difficulties as well as depression. ADHD symptoms may seem even more prevalent during this time. For some girls, ADHD medications may not be as effective during the last two weeks of the cycle, even more so during the last few days before your daughter gets her daughter. Parents can help by using a calendar to keep track of monthly cycles and rating the severity of ADHD symptoms. This can help your teen learn to know what to expect. If your daughter is experiencing severe PMS symptoms, make sure to talk to your doctor about treatment options. Making sure your daughter knows you understand, accept her and are working to help her be the best she can be also helps.
 “ADHD Teens and Puberty,” Date Unknown, Larry Silver M.D., ADDitude Magazine
“Understanding Girls with ADHD,” 1999, Patricia O. Quinn, M.D., Kathleen G. Nadeau, Ph.D., National Center for Gender Issues and AD/HD