Dear Teen Parenting Coach

Q: Are My Child’s Worsening Symptoms Due to Puberty? Or a Chemical Imbalance?

Has your fun, spunky child turned into an angry, moody teen? It’s partially the impact of puberty, says our Teen Parenting Coach, and partially the changing nature of ADHD symptoms as the brain matures. Learn how to bring out your child’s good side during the tumultuous teen years.

Q: “At age 10, my happy, hyper, smart son began taking ADHD medication to help him maintain focus, and it worked — perhaps a little too much. It took away his spunk. Almost 5 years later, he is not on meds. And he is now ADHD George of the Jungle! Hyper, nasty, ODD, OCD, aggressive — all attributes he did not display as a younger child. Can ADHD symptoms change during puberty? Did placing him on meds at age 10 alter his brain chemistry whereby making him dependent on meds, and impossible to control off of them?” —Maximillion

Dear Maximillion,

Attention deficit disorder (ADHD or ADD) is a condition marked by challenges of self-regulation, so it is not unusual to see symptoms worsen as a child ages and is required to manage greater pressures and responsibilities.

While ADHD varies from individual to individual, some children absolutely can be as you describe your young son: hyper, happy, and great students. When most of their lives are managed for them, and there is very little for them to handle independently, kids with ADHD can be playful, fun, exuberant, and joyful.

When life begins to get complicated and the demands of school and home increase, ADHD may begin to interfere with a child’s ability to succeed. Medication can help a child increase focus or decrease impulsivity. But it is not a cure for ADHD. The purpose of the medication is to minimize some symptoms so that the person with ADHD can better understand when his symptoms flare up, and learn strategies and tactics for self-management. In fact, the American Academy of Pediatrics recommends that children take ADHD medication alongside behavior therapy, which is parent training in behavior management. This complementary therapy aims to teach adults how to create environments where kids with ADHD can learn to be successful, and how to help them learn strategies for self-management.

[Free Resource: Transform Your Teen’s Apathy into Engagement]

Parent training is still recommended for teens, and direct therapy (like CBT, DBT or talk therapy) may be considered for treatment as well.

So it’s not exactly right to say that ADHD changes in puberty — although raging hormones definitely complicate matters. Rather, it’s more accurate to say that the responsibilities that come with aging, and the changes that accompany puberty, can be extremely difficult for a child with ADHD to manage, especially if he or she has never learned effective strategies for managing symptoms at school and at home.

When a child begins to feel the pressure of being out of sync — when he doesn’t know how to manage himself and do all the things that the adults in his life expect of him — it’s not uncommon to see the behaviors you describe: aggression, ODD, etc. It’s not that puberty caused these behaviors, necessarily. It’s more likely that your son didn’t feel he had the tools to handle life when it got complicated. He couldn’t scrape by just being cute, fun, and playful. Things were expected of him, and when he failed to rise to the occasion, he got overwhelmed, stressed, or angry. Any teenager gets tired of feeling like a failure all the time.

You also asked whether placing him on medication altered his brain chemistry, making him dependent on medication. I’m not a doctor, and I expect a very in-depth, personal response is warranted here. But what I can tell you is that neuro-plasticity is one of the brain’s greatest gifts for people with ADHD. It means they can learn strategies and behaviors that effectively re-wire their brains to improve self-management.

[Your Mantra For Raising a Tween with ADHD]

That said, it’s not likely that your son became “dependent on meds” as a child. It’s more likely that he never learned strategies for self-management once he started taking medication, so when the medication was removed, he had nothing else to fall back on for support.

I want to close by saying this most clearly: It’s not too late to help your son understand his ADHD and take control of his life. It’s not always easy to start with a 16-year-old, but slow and steady wins the race. Take it one step at a time, reach out for support, and you can help your son learn to reach his potential.

Do you have a question for ADDitude’s Dear Teen Parenting Coach? Submit your question or challenge here.

The opinions and suggestions presented above are intended for your general knowledge only and are not a substitute for professional medical advice or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your own or your child’s condition.