Are there specific challenges faced by teenagers with ADHD regarding mood swings?

PostedOctober 28, 2025

UpdatedOctober 29, 2025

ByMy Patient Advice

Author: Phoebe Carter, MSc | Reviewed by: Dr. Rebecca Fernandez, MBBS

Adolescence is already a time of emotional ups and downs, but for teenagers with ADHD, these changes can be more intense and harder to manage. According to NICE guidance on ADHD (NG87), emotional regulation difficulties are common in young people and may become more noticeable during puberty, when hormonal and social factors heighten impulsivity and frustration.

Why mood swings are more pronounced

A 2022 PubMed ecological study found that teens with ADHD experience greater day-to-day emotional fluctuation than their peers, with stronger links between irritability and overall functioning. The Mayo Clinic (2025) notes that these mood changes often stem from difficulty managing stress and delayed development of executive control.

Hormonal shifts also play a role. A BMJ Paediatrics Open review (2022) found that puberty-related hormonal fluctuations can worsen behavioural instability and emotional lability in ADHD, especially among girls. These biological changes interact with social pressures like fitting in, handling criticism, and increased school demands creating a perfect storm for mood volatility.

Overlap with mood and anxiety conditions

Research consistently shows higher rates of anxiety and depression among teenagers with ADHD. A 2025 PubMed review reported that emotional impulsivity and low self-esteem are key mediators between ADHD and mood symptoms. The Royal College of Psychiatrists (2024) highlights that irritability and sadness in ADHD can often be mistaken for oppositional behaviour rather than emotional distress.

How it affects home and school life

According to NHS and BMJ Mental Health (2023), emotional reactivity in ADHD often leads to conflict with parents or teachers, sensitivity to feedback, and fluctuating self-esteem. These patterns can strain relationships and lead to withdrawal or frustration. Consistent structure, calm communication, and predictable routines are essential to reduce emotional overload.

Managing mood swings in ADHD

Evidence supports cognitive-behavioural and skills-based interventions. A 2025 PubMed RCT by Strålin et al. showed that structured CBT improved both attention and emotional control in adolescents with ADHD. NICE guidance recommends CBT or DBT modules alongside medication and family psychoeducation for persistent mood symptoms.

The NHS CAMHS framework further encourages parent involvement, peer group support, and psychoeducation to help teens recognise and manage emotional triggers effectively.

Community-based behavioural services such as Theara Change are also developing structured coaching programmes for emotional regulation helping young people apply evidence-based skills in real-life settings.

Key Takeaway

For teenagers with ADHD, mood swings aren’t just part of “being a teenager”, they reflect how brain, body, and environment interact during development. With structured therapy, supportive parenting, and consistent routines, most young people can learn to understand and manage these emotions, building stronger confidence and healthier relationships over time.

Phoebe Carter, MSc

Author

Phoebe Carter is a clinical psychologist with a Master’s in Clinical Psychology and a Bachelor’s in Applied Psychology. She has experience working with both children and adults, conducting psychological assessments, developing individualized treatment plans, and delivering evidence-based therapies. Phoebe specialises in neurodevelopmental conditions such as autism spectrum disorder (ASD), ADHD, and learning disabilities, as well as mood, anxiety, psychotic, and personality disorders. She is skilled in CBT, behaviour modification, ABA, and motivational interviewing, and is dedicated to providing compassionate, evidence-based mental health care to individuals of all ages.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the author's privacy.

Dr. Rebecca Fernandez, MBBS

Reviewer

Dr. Rebecca Fernandez is a UK-trained physician with an MBBS and experience in general surgery, cardiology, internal medicine, gynecology, intensive care, and emergency medicine. She has managed critically ill patients, stabilised acute trauma cases, and provided comprehensive inpatient and outpatient care. In psychiatry, Dr. Fernandez has worked with psychotic, mood, anxiety, and substance use disorders, applying evidence-based approaches such as CBT, ACT, and mindfulness-based therapies. Her skills span patient assessment, treatment planning, and the integration of digital health solutions to support mental well-being.

All qualifications and professional experience stated above are authentic and verified by our editorial team. However, pseudonym and image likeness are used to protect the reviewer's privacy.