ADHD & Stress

What Is The Relationship Between Teenage ADHD & Stress?

Author: Colin Foley, National Training Director for the ADHD Foundation

It is commonly accepted that teenagers with ADHD can experience high levels of stress in their lives. If we understand the key features of the symptomology of ADHD, attentional dysregulation, poor impulse control, memory and organisational challenges, it is easy to see how this might cause stress on a regular basis. All of these symptoms could lead to feelings of frustration and even helplessness. This is a sure sign of high levels of stress.

What is stress?

Medical definitions of stress highlight the physical, mental or emotional factors that cause bodily or mental tension. Stress can be the result of external influences, for example, the impact of the environment or particular social situations or it can be caused by internal influences such as neurodevelopment or mental health conditions. In its more extreme form, stress can initiate the “fight or flight” response. When the “fight or flight” response is activated, hormones such as adrenaline, cause immediate physical reactions, for example, acceleration of heart and lung action, digestion slows down or stops, constriction of blood vessels in many parts of the body, pupil dilation, relaxation of the bladder, tunnel vision (loss of peripheral vision) and shaking. The effect of the constant presence of stress in a teenager’s life can lead to other conditions such as depression, including persistent negative thinking, impaired sleep and anxiety

You might be thinking, what’s the problem?

Everyone experiences stress and some stress is positive. Stress helps you to focus on something that requires your attention. It can make you work harder and react quicker. However, stress becomes a problem when it overwhelms your ability to act and when it remains high for long periods of time. It is clear that when we listen to the experience of people living with ADHD, that there is a connection and that ADHD presents ongoing challenges that can make stress and frustration become out of control. This can often have developed in early childhood. Young children with ADHD can be highly stressed and anxious. Children who are exposed to chronic stress become accustomed to living in a constant state of stress and become conditioned to having higher levels of adrenaline. This leads to elevated levels of cortisol which can further exacerbate executive functioning abilities and self-regulation, which are already impaired by ADHD. Comments recently on an online forum for people with ADHD collated by CHADD, a leading organisation representing people living with ADHD throughout the United States bears this out;

“Stress always makes my ADHD symptoms worse.”

“When my ADHD isn’t under control, that creates more stress.”

It would appear then that there is a significant interrelationship between stress and ADHD in teenagers. Difficulties caused by ADHD can cause a young person to feel stressed and stress can make those symptoms worse.

Research from the American Institute of Stress concluded that 77% of the people living with ADHD in one study reported feeling the physical symptoms of stress, with 73% experiencing the psychological symptoms. Stress affects the prefrontal cortex of the brain. This is an area of the brain significantly affected by ADHD and the last region of the brain to develop fully during adolescence. Research has found that stress also impacts upon executive functioning, which is also one of the main impairments of ADHD, linked to poor working memory and organisational difficulties.

However, it is not all bad news, there are a number of techniques that teenagers with ADHD can adopt to help them to control or reduce their stress levels and which will also help to manage the symptomology of ADHD.

Techniques such as Mindfulness and deep breathing can help to reduce stress as it arises. Creating and maintaining routines can help to reduce the stress caused by having too many decisions to make within a teenager’s daily life. Developing personal interests and hobbies, regular exercise and structuring time into every day solely for unwinding in a calm, relaxing environments. Cutting back on the amount of activities planned when feeling particularly stressed. Reducing caffeine which will aid sleep or reducing the consumption of alcohol.

In some cases, it might mean a more significant re-evaluation of life choices, for example, are all friendships and relationships really positive and healthy? For some teenagers, it may be adherence to an ADHD treatment plan, either medication or behaviour therapy.

Finally, for some teenagers the therapeutic route may be most appropriate with definite goals identified, such as building self-confidence, anger management, better sleep hygiene, assertiveness training or problem-solving skills. Therefore, the picture isn’t all gloomy. There are many ways in which a teenager can take more control of their life and develop skills to self-manage their ADHD symptoms and their levels of stress