ADHD, Depression, and Adolescent Females

Douglas Cowan Psy.D. MFT's picture
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Depression and ADHD in Teenage Girls

Several studies in recent years have looked into the impact of ADHD on the lives of teenage girls. MRI studies report that teenager’s brains are rapidly maturing, but that they are not fully mature until the early 20’s in females, and perhaps the early 30’s in males. Long-term studies on behavior and emotional health report that girls with ADHD may struggle through the teen years. And other studies report that depression is common among teens with ADHD, and is so common among adolescents that the use of medications for ADHD, antidepressants, anti-psychotics, and even sleep medications, is up sharply with adolescent females.

It has been reported that while many children and teens with ADHD also suffer from some degree of sadness or discouragement, as many as 25% are clinically depressed. Children and teens with ADHD are as much as 300% more likely to also suffer from depression than are children or teens without ADHD.

The co-morbid depression seems little associated with the ADHD symptoms such as inattention, impulsivity, hyperactivity, or academic problems. These problems might result in discouragement, sadness, or frustration, but not clinical depression.

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Rather, the depression seems to be most correlated to social awkwardness or interpersonal difficulties that are often a part of having ADHD. The lack of friendships, the sense of loneliness, or the sense of being a “social outcast” seemed to be behind the depression. And these feelings are, of course, much stronger in the teenage years.

In girls who were diagnosed with ADHD, and were followed by long-term studies through the years, it was observed that as they moved from childhood to adolescence their “outward” symptoms of ADHD, such as hyperactivity and impulsivity, tended to decrease.

We do want to note that most girls with ADHD do not have the symptoms of hyperactivity or impulsivity. Most girls with ADHD are inattentive, distracted, disorganized, or “space cadets,” which is why girls are so under-diagnosed for ADHD. Girls tend to just sit in the classroom, get distracted, and do poorly on the tests. But they don’t cause trouble in the classroom so they don’t get the attention that might lead to a diagnosis and treatment.

But for those girls were did have the symptoms of hyperactivity or impulsivity, and had been diagnosed as children, their “outward” symptoms tended to decrease as they reached the teenage years.

However, as these girls reached the teenage years, it was noted that their academic performance continued to be a problem, and that the academic gap between them and their non-ADHD peers continued to widen with each passing year.

These researchers also noted that, while some girls with ADHD actually “out-grew it” as they reached adolescence, for the most part the girls not only continued to suffer from it but many began to get into serious trouble. Both behavioral and emotional problems began to emerge in many of these girls, and the need for specialized treatment greatly increased.

There were increased problems with friends, which led to increased levels of depression. There were increased levels of substance abuse (both alcohol and drug abuse). School delinquency increased as the academic problems got worse. And, surprisingly, eating disorders became a serious problem among many of these girls.

All of these problems were at higher levels among these ADHD girls than among their non-ADHD peers.


As we have noted elsewhere, twice as many teens with ADHD will run away from home than teens without ADHD. About 16% of teens run away from home at some point, versus 32% of teens untreated for Attention Deficit Hyperactivity Disorder - ADD ADHD. And as many as 50% of all teenagers in juvenile facilities have Attention Deficit Hyperactivity Disorder but were untreated for ADHD.

Teenagers untreated for ADHD are ten times more likely to get pregnant, or cause a pregnancy, than those without ADHD, and teenagers untreated for Attention Deficit Hyperactivity Disorder are 400% more likely to contract a sexually transmitted disease than teens without ADHD: 16% to 4%.

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