Top 4 Mental Health Issues Facing Teens with ADHD in 2024

As we turn the new page on the calendar and welcome 2024, it’s common for many people to take stock of what happened in 2023 and what changes they would like to see for themselves, their families, their communities and even the world. One topic that many people are thinking and talking about is mental health, particularly for teens and emerging adults. In May 2023, the US Surgeon General published a study on the epidemic of social isolation and loneliness and its negative effects on both physical and emotional wellbeing. With increased rates of anxiety, depression and other conditions, parents, educators, health care providers, clinicians and coaches are not only concerned but also actively engaged in finding solutions and increasing the availability of resources.

In this blog, I want to look at the top 4 mental health issues facing young people with ADHD as well as strategies for how best to support them. As in anything else involving parenting somebody who is neurodivegent, collaborate with them and be an ally. It’s tough to face some of these demons alone and, yet, it can be even harder to accept help. Offer your compassion and your concern while creating a straightforward plan of action.

Depression

Depression involves recurrent, extended periods of negative moods and thinking. Teens and emerging adults battling depression along with ADHD often feel hopeless, misunderstood, and lack energy or motivation. They feel stuck and they can resist any supportive suggestions. A lot of research suggests that more screen time and social media during the pandemic and afterwards may have caused a rise in depression and suicide among American adolescents. One recent study showed that Millennials and teenagers have experienced the fastest climb in depression diagnosis rates, up 47 percent and 63 percent, respectively.

Common signs of depression include:

Hopelessness
Loss of energy and motivation
Spending increased periods of time alone
Lack of interest in activities/friendships
Changes in sleep or appetite
Difficulty concentrating
Physical aches and pains
Suicidal ideation

Depression can affect school attendance, work performance, and relationships with family and friends. Social withdrawal due to depression can lead to further isolation for teens with ADHD who may suffer from low self-worth and avoid activities or peers. These patterns make it difficult to break the cycle. If you think that your child, teen or young adult may be depressed, seek help. Start by contacting their primary care provider and get appropriate referrals. Depression can also lead to issues with substance abuse, suicidal ideation, and self-harm. Sadly, it rarely gets better on its own, and, if left untreated, can persist into adulthood.

Anxiety

Anxiety travels very often with ADHD and sometimes it’s hard for kids and their parents to distinguish between the two. It is characterized by persistent, excessive fears or worries about common and non-threatening everyday situations. Sometimes the fears may be rooted in actual events or threatening situations, but the reaction to these concerns is often exaggerated and distorted. In teens and emerging adults, anxiety is characterized by:

Constant feelings of worry, tension, unease or dread
Restlessness
Irritability
Negative expectations
Catastrophizing
Physical symptoms like racing heartbeat, shortness of breath, and upset stomach
Trouble sleeping

There are many mental health conditions under the umbrella of anxiety which include: specific phobias, panic, obsessive-compulsive disorder and social anxiety. External factors such as bullying, racism, homophobia and excessive social media usage are significant contributors to anxiety in teens and young adults. While ADHD and anxiety are two different conditions, they frequently coexist in kids and teens– around 30% of the time. Untreated anxiety often leads to depression so It’s really important to seek treatment for reducing anxiety. Again, start by consulting with your primary care provider.

Substance Abuse

Adolescence and early adulthood are often marked by increased risk-taking and sometimes rule-breaking. This is a period when many youth begin experimenting with illicit drugs and alcohol for the first time. Sometimes this experimentation can morph from experimentation to substance abuse for kids with ADHD. When something feels good, the reward centers in the brain–those fueled by dopamine-want more of it. The lack of impulse control makes it especially difficult to reign in these cravings.

The most common signs of substance abuse in teenagers can include:

Social withdrawal
Behavioral changes, volatility, and irritability
Engaging in risky behavior such as unsafe sex, drunk driving, and theft
Sneaking out of the house and skipping school
Increased tolerance to drugs and alcohol
Experiencing withdrawal symptoms when not drunk or high

Substance use and mental health disorders like depression and anxiety often co-occur. In fact, some teens use drugs and alcohol to self-medicate instead of getting the proper assistance with ADHD or other concerns. Teens with ADHD are particularly prone to substance abuse as they struggle with self-regulation. If you suspect that your teen or emerging adult has a substance abuse issue, talk with them about your concerns and then seek out help together.

Disordered Eating

Eating disorders are more common for girls and young women with ADHD than for those without it. In fact, they co-occur with ADHD almost four times more often. Eating disorders typically begin during adolescence and can continue into adulthood without effective treatment. While disordered eating is perceived as a problem for girls and young women, boys and young men can also have an unhealthy relationship with food – one which can go undetected or underdiagnosed.

Adolescents become more aware of their changing bodies during their teen years and the concept of body image can take center stage. There is a seemingly never-ending stream of images of models and celebrities with “ideal” bodies which are unattainable for most of us. Kids with ADHD who often compare themselves to neurotypical peers are especially prone to seeing themselves as less than. They also may feel a sense of powerlessness and overwhelm due to executive functioning challenges. These and many other concerns can lead to troubled relationships with food.

Here are some common symptoms of eating disorders which can develop into bulimia, anorexia, and binge eating disorder:

Denying and suppressing hunger
Refusing to eat
Over exercising
Binging and purging
Excessive eating and large portions
Significant weight loss or weight gain

Eating disorders affect your child’s overall health: specifically nutrition and physical and emotional development. If your teen or emerging adult is struggling with excessive weight gain, weight loss, or body image issues, discuss your observations about their relationship to food and reach out to a medical professional as soon as possible.

Strategies for Support and Prevention

Social isolation and overconsumption of social media contribute significantly to the mental health challenges facing teens. While we can’t escape the dominant culture entirely, we can help teens develop healthy habits for a balanced life. Since we can’t get rid of technology, we want to teach them to use it as an adjunct to their lives instead of the main focus. For example, when kids with ADHD are away from their devices, they need plenty of non-digital options for exercise, recreation and socializing listed for them in plain sight. Otherwise, it can be too hard to remember. Perhaps most importantly, focus on building their confidence. When kids have a strong sense of support and a healthy dose of self-esteem, they are more likely to make positive choices for themselves when it comes to safety. As the saying goes, “an ounce of prevention is worth a pound of cure”.

Here are a few tips to get you there:

Set limits around technology use and stick with them. Make a regular time to turn off devices that give you a screen-free hour before bed. Offer your kids alternatives to video games and social media by doing something together: playing a board game, doing a puzzle, cooking, playing tennis or basketball, taking the dog for a walk or going to a movie. Even watching a favorite show on tv together, while it’s a screen, is something you’re sharing and likely talking about during commercials. Have teens turn their phones into your care each night and give them back at a set time in the morning.
Remind your child that what they see online doesn’t necessarily reflect the truth. No one ever posts pictures of themselves mid-breakout or shares the news that they failed an algebra test. Help your ADHD teen get out of the “compare and despair” trap by building up their social skills. And remind them that face-to-face connections will help them see and understand what’s really going on with someone.
Guide your teen with ADHD toward self-acceptance. Remind them that we are all perfectly imperfect and have our own unique set of talents, flaws and quirks. When your teen feels loved and supported, they are more likely to make good decisions for themselves. That directly affects the types of friends they have, how they care for their bodies, and how they will manage potentially dangerous situations. Help your teen or emerging adult nurture a positive mindset and gratitude for all that they have and everything that’s going right. A strong sense of self and a resilient attitude will help them get through those dramatic ups and downs of daily life and set them up for health and success well into adulthood.