Teenage boys are more than twice as likely to be diagnosed with ADHD than teenage girls. This is likely because the way that ADHD most commonly shows up in boys is external, disruptive, and obvious.

Many teenage boys, however, experience symptoms of ADHD, which are less noticeable and well-known. These symptoms quietly, and sometimes destructively, impact all areas of their lives, including academics, social interactions, and emotional well-being.

4 Missed Symptoms of ADHD in Teen Boys

1. Rejection Sensitivity: They may have an exaggerated fear of criticism or rejection, often perceiving neutral or ambiguous situations as hostile or negative. This heightened sensitivity can lead to social anxiety, reluctance to engage in new activities, and avoidance of situations where they may fear rejection. In other cases, they may react strongly or aggressively to perceived or actual rejection.

2. Excessive Gaming: They may spend copious amounts of time gaming. This may be because they struggle with in-person interactions and maintaining a conversation. Gaming may also provide feelings of accomplishment and confidence they do not experience at school or home. It also provides a sense of community and a social outlet.

3. Social Impairments: They might encounter challenges in social situations. They may struggle with social cues, interrupt conversations, or have difficulty waiting their turn during group activities. It is common for teenage boys to get bored, feel annoyed, and be impatient in social settings. This can lead to feelings of social exclusion or the perception of being rude and disruptive by others.

4. Risk-Taking Behaviors: They commonly participate in destructive and risky behaviors like speeding and underage drinking. This is partly due to their impulsivity but can also be explained by the mood and behavioral changes brought on by adolescence. Increased testosterone, combined with the behavioral challenges of ADHD, cause many teen boys to get involved in school misconduct.

How to Support Teen Boys with ADHD

Should your son or somebody you know be exhibiting any of these symptoms of ADHD, we recommend the following strategies to support them.

1. Find a Positive Mentor or Role Model

Research has found that at age thirteen, teenagers listen to external voices rather than their parents. That's why this is a great age to connect your son to a role model or mentor.

A life coach can be a great mentor and source of guidance for your son. Life coaching for teens has recently become very popular amongst parents. Many life coaches double as ADHD coaches and can offer strategies and help your son develop executive functioning skills during coaching sessions.

It is also meaningful to find a mentor or role model with ADHD. Many teen boys with ADHD have low self-esteem and limiting beliefs, and it's beneficial for them to see firsthand that they can be successful and that their ADHD does not have to get in their way of achieving success - whatever that may look like for them.

2. Collaborate on Gaming Limits

For teen boys with ADHD, gaming can be a beneficial source of community and achievement, but too much screen time can negatively affect sleep, mental health, and academic performance.

If you feel that your son spends a disproportionate amount of time in front of the screen, it could be helpful to set some limits.

Importantly, open the conversation with your teen and decide on limits together. Don't do this in a tense moment, like when you're dragging him away from the screen. Instead, choose a calmer moment.

Limits can include - what needs to be completed before gaming each night (homework, chores, routines, etc.), how many hours are spent gaming, and weekly vs. weekend hours. Gaming expert Jane McGonigal advises at most 21 hours per week.

3. Set and Communicate Clear Boundaries

Teenage boys naturally seek independence from their parents and family during adolescence and should be allowed to do so - to an extent. This will test their decision-making skills, and although it may be difficult, parents need to allow them to make mistakes and bad decisions (within reason).

Independence should, however, take place within boundaries. When setting boundaries, clearly communicate the rules and the reason. Most boys will push back and try to work around a boundary. The clearer you communicate the boundary, the less wiggle room for negotiation.

When it comes to swearing, for example, encouraging your teenager to feel and voice his anger or frustrations is helpful, but a firm boundary is drawn at swearing or physical violence.

4. Make Time to Connect With Them Daily

With the busyness of school schedules and extracurricular activities, it's not uncommon for kids and parents to live past each other. Setting aside time each today to chat with your teenager is incredibly important. Many teens with ADHD struggle with confidence, are navigating the pressures of adolescence (peer pressure, academics, bullying), and many are being dragged from one therapist to the next.

We like to remind parents - your child is not a problem to be fixed but a person to be loved. Check-in with them daily and stay in the loop with what's happening in their lives. Don't only ask questions about school. How are their friends? What video game are they playing at the moment? We recommend asking open-ended questions and letting them guide the conversation (although we all know this would be a miracle).

If all you get are shrugs, one-worded answers, or eye rolls, what matters most is that you were there.

Final Thoughts

ADHD does not look the same in everyone. It does not merely differ across lines of age and gender but varies from person to person. The most common symptoms in boys are hyperactivity, inattentiveness, and impulsivity. These symptoms are not present in all boys, though. Many exhibit the lesser-known symptoms of ADHD, such as rejection sensitivity, excessive gaming, social impairments, and risk-taking behaviors. By recognizing these missed symptoms of ADHD in teen boys, we can better empower them to thrive in their academic, social, and emotional endeavors.

Sources:

Skogli EW, Teicher MH, Andersen PN, Hovik KT, Øie M. ADHD in girls and boys--gender differences in co-existing symptoms and executive function measures. BMC Psychiatry. 2013 Nov 9;13:298.

Daniel A. Abrams, Percy K. Mistry, Amanda E. Baker, Aarthi Padmanabhan, Vinod Menon, "A Neurodevelopmental Shift in Reward Circuitry from Mother's to Nonfamilial Voices in Adolescence." Daniel A. Abrams, Percy K. Mistry, Amanda E. Baker, Aarthi Padmanabhan, Vinod Menon. Journal of Neuroscience, 18 May 2022, 42 (20) 4164-4173; DOI: 10.1523/JNEUROSCI.2018-21.2022