| UNDERSTANDING THE TEENAGE BRAIN & ADHD DURING PUBERTY
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April 2023
Did you know that big and important changes happen in the brain during adolescence? The early years are a critical time for brain development, but the brain still goes through a lot of changes during adolescence before it functions as an adult brain. |
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These changes happen intensively during adolescence, and continue into the mid-20s. This Snapshot explores some of the changes in the teenage brain as well as a common childhood brain-based disorder Attention-Deficit/Hyperactivity Disorder (ADHD)
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The teen years are all about fine-tuning how the brain works. The main change is that unused connections in the thinking and processing part of a child’s brain are ‘pruned’ away. At the same time, other connections are strengthened. This is the brain’s way of becoming more efficient. The classic “use it or lose it” principle applies to adolescence—those circuits that are actively engaged may remain, those underutilized may be subject to pruning.
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For an adolescent, this means that if they want to learn a foreign language, learn to paint or be proficient at a sport, engaging in those activities before and during adolescence is an optimum time to do so. The brain moves from being a sponge and absorbing everything in childhood, to specialization during adolescence. | This pruning process begins in the back of the brain. The front part of the brain, the prefrontal cortex, is re-modelled last. The prefrontal cortex is the decision-making part of the brain, responsible for an adolescent's ability to plan and think about the consequences of actions, solve problems and control impulses. Changes in this part of the brain continue into early adulthood.
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Because the prefrontal cortex is still developing, teens might rely on the part of the brain called the amygdala to make decisions and solve problems more than adults do. The amygdala is associated with emotions, impulses and instinctive behavior. That‘s why when teens have overwhelming emotional input, they can‘t explain later what they were thinking. They weren‘t thinking as much as they were feeling.
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The adolescent brain also begins laying down more myelin. Myelin enables neurons to communicate with each other with more coordination and speed. Neural firing becomes three thousand times quicker with myelination. This essentially makes teens super learners!
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The limbic system, which regulates emotion and reward, is linked to the hormonal changes that occur at puberty. It is also related to thrill seeking and a shift toward interacting with peers.
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The earlier development of the limbic system and the later development of prefrontal cortex can result in risky behavior, poor decision making, and weak emotional control for the adolescent. Risk taking can also be positive, such as talking to a new classmate or joining a new club or sport.
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In addition, teens often take more risks than adults because their brain is highly sensitive to dopamine which is involved in reward circuits, so the possible rewards outweigh the risks. The adolescent brain is also affected by oxytocin which facilitates bonding and makes social connections more rewarding.
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| With both dopamine and oxytocin engaged, their developing brains are literally telling them they must seek social interaction with peers, new opportunities and take chances. Parents play an important role in providing the boundaries that allow for necessary trial and error and help teens to become resilient, capable young adults.
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Studies on the teenage brain are revealing why adolescence can be such a vulnerable time for anxiety. Researchers believe it may be due to the rapid development of the amygdala, involved in emotional expression, compared to the slower development of the prefrontal cortex and the connections between the two. These connections are essential for controlling emotions, including fear, a core symptom in anxiety disorders.
Recognizing possible triggers and practicing effective coping techniques can help teens deal with stress and anxiety.
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During adolescence, sleep patterns change because of hormonal changes in the brain. Research shows that the levels of the sleep hormone melatonin stay high later at night and drop later in the morning, which may explain why teens may stay up late and struggle with waking up early. Many teens do not get enough sleep which is important for their brain development and overall health.
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| Ongoing changes in the brain can make teens more likely to experience mental health problems such as schizophrenia, anxiety, depression, bipolar disorder, and eating disorders. In fact, 50% of mental illness occur by the age 14 and 75% occur by age 24. The pruning process may be one reason the teen brain is so vulnerable to mental health problems. Researchers believe it may uncover any existing genetic or environmental vulnerable circuits.
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Despite the stresses and challenges that come with adolescence, most teens go on to become healthy adults. Some changes in the brain during this critical phase of development actually help support resilience and mental health over the long term.
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ADHD is one of the most common neurodevelopmental disorders. One out of every twenty-one people in Canada has the disorder. Although some children can grow out of ADHD, the majority of children who are diagnosed with ADHD still have it as teens and into adulthood.
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Children and youth with ADHD have challenges with regulating their attention (having too much or too little focus). Many children and youth with ADHD also struggle with restlessness and impulsivity (having impulsive actions, thoughts, or feelings).
ADHD is diagnosed in males more than females, especially for children who have higher levels of impulsivity and hyperactivity.
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ADHD causes a variety of problems in young children, but is usually only diagnosed after they start school. Some children manage to cope with the symptoms, but during teen years as the hormonal changes of adolescence are going on and the demands of school and extracurricular activities are increasing, ADHD symptoms may get worse.
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The cause of ADHD is not fully understood, but research shows in most cases it is thought to have a genetic component as it runs in families. Scientists have shown that there are differences in the brain size, networks, neurotransmitters, and brain development of children with ADHD, but they do not fully understand how these lead to the cause and the symptoms of ADHD.
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The environment may also play a role (for example, prenatal exposure to toxins or premature birth). Diet, video game use, and parenting style do not cause ADHD.
There are two groups of ADHD symptoms - inattentive symptoms and hyperactive/impulsive symptoms. Most children and youth living with ADHD have some symptoms from both groups.
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A child or youth with inattentive symptoms may:
- have a hard time staying focused on tasks they find boring
- make unintentional mistakes at school
- appear not to be listening when spoken to
- have a hard time following directions
- lose or misplace things
- have difficulty organizing thoughts or belongings
- dislike tasks where they have to be focused for a longer time
- appear forgetful
| A child or youth with hyperactive/impulsive symptoms may:
- have problems sitting still
- look very restless or fidget often
- have a hard time playing quietly
- climb and run a lot
- seem to be always 'on the go'
- talk too much
- blurt out answers before you finish a question
- interrupt tasks or conversations
- have a hard time waiting for their turn
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Other conditions that can exist along with ADHD include:
- anxiety disorders
- mood disorders like depression
- specific learning disorder
- autism spectrum disorder
- developmental coordination disorder
- sensory processing difficulties
- oppositional defiant disorder
- substance use challenges
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| In adolescence, ADHD is associated with a set of distinct and measurable challenges — executive dysfunction, increased risk for substance misuse and automobile accidents, emotional dysregulation, high-risk behaviors, and more. Robust, long-term studies confirm that, if unaddressed, these teenage challenges can impact quality of life and general functioning well into adulthood.
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Many of the problems at home, school, and in social settings arise due to neurological delays. On average, executive skills that help teens regulate behavior, recognize the need for guidance, set and achieve goals, balance desires with responsibilities, and learn to function independently don‘t fully develop until the early 20‘s. The timeline is 3 to 5 years longer for adolescents with ADHD. In the meantime they are often unfairly labeled lazy or oppositional because these neurological deficits are largely invisible and misunderstood
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As their bodies grow and change, teens with ADHD tend to lag behind their peers in emotional maturity as well. Experts say a young person with ADHD will not achieve the emotional maturity of a neurotypical 21-year-old until they reach their mid or late 30s due to developmental delays in the brain‘s frontal lobes.
For best outcomes, adolescents and their families must understand how ADHD impacts the teen brain specifically, and how early care and interventions can have positive effects.
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If the conversations and interventions begin early, and a family‘s vigilance remains high, teens with ADHD will grow and launch into remarkable young adults.
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It's empowering for young people to know and understand more about their brain.
They should understand why they might be particularly self-conscious or susceptible to peer-influence, or more likely to take risks.
It's important for teens to understand the biological reasons why that might be finding it challenging to cope with different feelings and possibly mental health problems.
This poster highlights 3 of the outcomes that are a result of the changes in the adolescent brain.
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FamilySmart - Dr Ross Greene May 4 - Join us for a presentation and Q & A with Dr. Ross Greene as he speaks about how Collaborative and Proactive Solutions can help us show our kids we care about them. Solving problems together creates connection and allows our children to be a part of finding solutions to what is causing their concerning behaviour. Dr. Greene‘s work reminds us that things go better for everyone, when we solve problems together and that kids do well if they can.
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The content provided through the Snapshots is for information purposes only. The Snapshots include information that is general in nature and cannot address the many individual child rearing challenges parents and caregivers may experience. Therefore it is the readers‘ responsibility to determine the suitability of the information for their specific needs.
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