Is my teenage son hyperactive or is this normal?

Parenting teenage boys is always an adventure. As parents we become particularly attuned to his behavior, looking for changes and anticipating difficulties before they turn into something more serious. As our sons get older, move into adolescence, and start to develop their own interests and behavior styles, we may see them act in ways that are confusing to us as parents.

One of our sons was playing video games in his room one day when we heard a loud thud. After going to check on him, he said, “Yeah, I got kind of frustrated so I tossed my phone across the room and it hit the wall.” A small hole in the wall above where his phone landed did not seem to demonstrate small frustration but when we asked why he had done it, his reply was one we, as parents, were used to hearing, “I don’t know.” Teenage boys tend to make decisions that leave us shaking our head. They seem impulsive. They seem hyperactive. But just because teenage boys demonstrate these behaviors does not mean they have ADHD.

Our culture has grown increasingly aware of mental diagnoses and criteria which can help minimize stigma and allow people, especially teenage boys, get the help that they need for serious disorders that often respond really well to treatment. However, awareness of diagnostic criteria can also lead to parents assuming that their son’s normal teenage behavior is something more severe like ADHD. According to the most recent statistics from the CDC, 13% of children ages 12-17 are diagnosed with ADHD and boys typically outnumber girls 2:1. Recent reports of Adderall shortages in the news have brought to the forefront interest in the diagnosis and treatment of ADHD. Review of the diagnostic criteria for ADHD (such as hyperactivity, impulsivity, difficulty paying attention) reveals behaviors that individually may be common or typical in teenage boys. The diagnosis of mental health conditions like ADHD is reserved for doctors and psychologists. But if, as a parent of a teenage boy, you start to notice behaviors that seem similar to ADHD, then how do you know if the behaviors are normal or if you should seek out professional assistance? Here are five questions to consider:

1) What is “normal” impulsivity?

In order to understand the impulsive risk-taking behaviors your teenage son is demonstrating, like staying out late, you must appreciate the developmentally appropriate behaviors that are a part of adolescence. It is, in fact, normal for teenage boys to test the limits and perhaps break an occasional rule. It is normal for teenage boys to, at times, act before truly thinking about the consequences. These behaviors may be difficult for you, as a parent, to anticipate but it is part of the movement from childhood into adulthood.

2) How severe are the behaviors?

Families have different expectations for their teenage sons, meaning a behavior, like swearing, that is normal in one family may be considered inappropriate by another. During adolescence, when boys are developing their own identities, parents need to clarify their expectations while also emphasizing that others may not share the same beliefs. If you have a son who is always moving around, cannot focus to get his homework done, or makes poor choices, think about how you think these would compare with others and how severe you think they are. As parents of teenage boys we need to remember the developmental process of adolescence and that most problematic behaviors, when not befitting a disorder, are generally normal. Behaviors that are more severe, perhaps with poor grades or criminal activity, may necessitate professional intervention.

3) Who notices the behaviors?

Parents may not know that mental diagnoses in children and adolescents impact their behavior and functioning in more than one area of their life. A true diagnosis of ADHD involves a series of behaviors that may occur at home, where parents notice the behaviors, but also at school, where teachers notice, or in social settings, where friends may see and respond to the behaviors. With normal teenage boy behavior, he may be able to demonstrate normal behavior at school but test the limits at home. Or he may be impulsive and hyperactive with his friends but be helpful and cooperative at home. If you are concerned about your son’s behaviors, talk to others in his life and see if they see what you see.  

4) Where is the impact?

In addition to teachers or friends noticing the behaviors, if the symptoms are truly indicative of a disorder like ADHD you can expect that there would be obvious consequences like a decline in his grades or friends getting frustrated and no longer wanting to hang out with him. But you also would expect, if the symptoms are in fact related to a behavior disorder, that the problematic behaviors and symptoms would have been around since earlier in childhood. Typical teenage behavior can appear to come out of nowhere, even if it has a significant impact and raises concern.

5) What do you want from diagnosis?

As a parent who is closely examining their teenage son’s behavior, it is likely you see a problem but you should remember to leave the diagnosis to a trusted mental health provider, either a psychologist, psychiatrist, pediatrician or a family doctor. In today’s world it is also important to protect the integrity of the diagnosis, respecting those who struggle every day, and not armchair diagnose your son. And certainly do not use a mental health disorder to describe your son (“Oh, he’s so ADD…”). If you notice problematic behavior, seek professional advice and try to understand your son as he is navigating this time in his life. But remember that some behaviors, while troublesome to you as a parent, are not indicative of an overall disorder.