You will definitely notice when your pre-teens or teenagers hit puberty. Males and females will have different experiences based on their biology and the specific hormones that they produce in their bodies. Looking at ADHD first informs us that these kiddos are more likely to be emotional due to difficulties with emotional control and regulation and both males and females may also struggle with impulsivity, risk-taking behaviors, substance abuse, and co-morbid disorders. But overall, there are differences between the genders and the significant changes they potentially experience as they reach puberty.
Children who are biologically male will begin to experience increased levels of testosterone as they develop through puberty. As outlined by Dr. Joel Nigg of Oregon Health and Science University, “testosterone interacts in complex ways with dopamine and other hormones that are relevant to ADHD.” This may lead to increased risk-taking behaviors, impulsivity, and substance use or abuse. ADHD teens may attempt to mask or reject their diagnosis in order to fit in with preferred peer groups. In addition to some of the risky behaviors that may occur, pre-teens or teens may be more susceptible to co-morbid disorders between the ages 8-12. Most commonly noted are anxiety and mood disorders. It is also important during this time to be aware of any possible antisocial characteristics or hostile behaviors that may lead to conduct or oppositional disorders.
Children who are biologically female will begin to experience increased levels of estrogen and progesterone as they develop through puberty. This leads to rebellious and risky behaviors often starting around age 9 and possibly increasing at the onset of the first period. According to Dr. Stephen Hinshaw of University of California Berkeley, it has been “found that [ADHD girls] in their early teens have more academic problems, more aggressive behavior, earlier signs of substance-related problems, and higher rates of mood disorders.” They often internalize their emotions rather than externalize them like most males are observed doing. During the first two weeks of an ADHD female’s period cycle, when the brain releases happy neurotransmitters-serotonin and dopamine, teens are likely to experience less mood fluctuations. However, during the following two weeks, progesterone rises which reduces the estrogen levels. This can reduce the effectiveness of stimulant medication and can be very detrimental for ADHD females. There is also a potential for increased feelings of anxiety. Some researchers have indicated that ADHD females may experience premenstrual syndrome (PMS) more significantly than females who do not have ADHD.
How can parents help their developing pre-teens and teenagers? It can be helpful for them to understand the changes they are experiencing. Knowledge and understanding can reduce anxiety and give them a sense of control over the major changes that are occurring. Have patience and compassion for them since this experience is very difficult and NEW! The emotions and impulses can be very overwhelming and they will need your help and guidance throughout this time period. Provide them with tools so they feel equipped to manage any unhealthy behaviors; a therapist might be helpful in this area. Hear them out, truly listen to them and utilize a collaborative approach when walking through this process. Focus on healthy habits, sleeping well, exercise, and stress-management, while promoting their abilities and self-esteem. For females, a consult with an OB/GYN and psychiatrist may be prudent for medication regulation. And prior to the onset of puberty, consider talking to a trusted medical professional to prepare for the specific biological changes and also appropriate language to use to support your teens. Lastly, it might be the right time to discuss medication options or alternatives if your teens are already medicated.