Dear Dr. Sharon: “Why Is My Teen So Moody?” Understanding Emotional Dysregulation in Neurodivergent Adolescents
Struggling with your teen girl’s mood swings? Emotional ups and downs are common in girls with ADHD—especially during big transitions. This week, learn how to understand and support her through emotional dysregulation with practical, compassionate strategies.
Dear Dr. Sharon -
My teen daughter was diagnosed with ADHD at age 11. At that time, our family circled the wagons and worked hard to arrange the supports and strategies she needed. I was really proud her successes at school and at home. Now that she is 14, though, I feel like we are back at square one as adolescent hormones and pushback have set in. I worry that all the progress we made towards managing her ADHD symptoms will be undone by her teenage brain, given how moody and irritable she can be. How can we help her cope with her ADHD-related challenges in a positive way?Please help me - I want her to be happy, to enjoy her summer break, and most importantly to learn to manage her ADHD in a positive way.
-Vera, Vermont
Dear Vera,
First, thank you for writing so honestly and bravely. Your love for your daughter is obvious in every word—and so is your fatigue. Parenting a neurodivergent teen girl can feel like walking on the sand by the ocean: just when things feel settled, a new wave of change rolls in.
Let me reassure you: you're not alone. The behavior you're seeing isn't a failure of parenting—or a loss of progress. It's part of the unique emotional and neurological terrain that many teenage girls with ADHD must learn to navigate.
With some tweaks to her existing supports and strategies, and adding some new ones tailored to the teenage brain with ADHD, I know that those moments of happiness, independence and success you want for her are on the horizon.
Stormy Moods and Silent Struggles: ADHD in Adolescent Girls
The teenage years can be stormy, especially for girls with ADHD. Teen girls, in particular, often struggle with fitting in, finding their “voice” amongst internal ADHD chatter, and carving out a space for themselves to practice connected independence. All periods of developmental transitions have their ups and downs, but ADHD tends to introduce more intense levels of moodiness, anxiety, and opposition in both boys and girls. If moods, anxiety, and low self-esteem are left unchecked, many teens with ADHD can develop depression. In fact, a 2021 study found that nearly 75% of teenage girls with ADHD also report symptoms of anxiety and/or depression. That’s why it’s so important for parents, caretakers, and school staff to keep a watchful eye on their kids, noticing sadness, worrying, or social isolation - just like you are doing Vera!
How ADHD Manifests Differently in Teen Girls
ADHD in girls is frequently underdiagnosed and misunderstood - research from the CDC shows that girls are diagnosed with ADHD an average of five years later than boys, often not until adolescence. And unlike boys, whose hyperactivity may be more outwardly visible, girls often internalize their symptoms—struggling quietly with inattention, disorganization, anxiety, and emotional intensity.
Once puberty hits, the hormonal fluctuations of adolescence amplify the symptoms of ADHD in ways that can feel overwhelming for both parents and their children. Estrogen directly impacts dopamine—a key neurotransmitter involved in attention and regulation—which means that during puberty and the menstrual cycle, girls with ADHD may experience even more intense emotional highs and lows.
So when your daughter seems like she’s “in a fog” or lashes out unexpectedly, her brain may be in overdrive—struggling to regulate her feelings, process social information and keep up with various tasks.
This Isn’t a Summer Setback—It’s a Shift
Vera, what you’re seeing isn’t the undoing of progress—it’s the next developmental stage in your daughter’s life. Her struggle is common. By age 14, girls with ADHD are more than twice as likely to experience significant emotional dysregulation compared to their neurotypical peers. As she enters these teen years, your daughter is also entering a phase of identity formation, social comparison, academic pressure, and hormonal change—all while working with a brain that’s wired for intensity and sensitivity.
Vera, you’ve certainly dedicated a lot of time, energy and love towards helping your daughter manage the symptoms of ADHD since her diagnosis. Now, its time to build on what you’ve learned and practiced about ADHD and neurodivergence, and tailor it to her “new” teen brain. This is not starting over but rather adjusting your approach to meet this next version of who she’s becoming
What Can You Do?
Here are five strategies to support your daughter—and yourself through this adolescent period of emotional ups and downs:
1. Validate Her Experience, Even When It’s Tough to Witness
Teen girls with ADHD often feel misunderstood, especially when their mood shifts quickly or doesn’t match the situation. What may seem like overreaction to you might feel huge and unmanageable to her in the moment. You can say:
“I see that you’re overwhelmed right now. It’s okay to feel big things—we’ll figure it out together.”
Validation doesn’t excuse the behavior, but it opens the door to connection and problem-solving. When she feels seen rather than corrected, she’s more likely to calm down and stay open to support. Over time, this teaches her to label emotions instead of lashing out from them.
2. Keep a Predictable Rhythm
Too much unstructured time can spike anxiety and irritability in neurodivergent teens. Without built-in transitions, their nervous systems struggle to shift gears or stay regulated. Co-create a flexible daily routine with your daughter that includes:
Regular wake/sleep times
Limits around using screens
Moving her body
In person connections with peers or family
Blocks of time dedicated to specific tasks or projects
Even if it’s just a loose framework posted on the fridge, having a rhythm to the day gives both of you an anchor and reduces arguments. Expect her to resist (that’s developmentally appropriate) and hold the line with warmth and consistency.
3. Create a Personalized "Reset Plan"
Teens with ADHD often struggle to de-escalate once they’re dysregulated. In the moment, their brains go into fight, flight, or freeze—making it hard to access logic or empathy. That’s why they need a “reset plan” before emotions take over. Together, identify what helps her feel safe and grounded such as:
Listening to music
Going for a walk
Journaling or doodling
Contacting a friend
Watching a tv show or YouTube video
Ask her to write this down on her phone while you post it somewhere visible. Having options reduces the helplessness both of you may feel in heated moments and gives her a sense of agency.
4. Choose Curiosity
When she’s irritable or withdrawn, it’s tempting to dive in with questions or corrections. That often adds fuel to the fire. Instead of saying, “What’s wrong with you?”, try a softer, more curious approach:
“You seem a bit off today. Want to talk about it? I’m hear to listen whenever.”
Teen girls with ADHD often ruminate and feel shame after emotional outbursts. When you give her space and choice, you communicate that she’s not in trouble. By offering a lifeline, you build trust and increases the likelihood for future conversations.”
5. Model Emotional Regulation
Thanks to the mirror neurons in our brains, your calm nervous system helps stabilize hers. When you lose your cool, focus on repair and accountability. Showing your daughter how to rebound without shame is a very powerful lesson. You might say:
“I got frustrated and I wish I had handled that differently. I’m sorry.”
This demonstrates self-awareness (metacognition) and self-control–two key executive functioning skills. You are showing her that emotional regulation includes being honest, owning your behavior and giving a genuine apology.
Final Thoughts
Vera, your daughter is growing—not regressing. She’s testing limits, processing emotions, and learning to self-regulate in entirely new hormonal and social landscapes. Your work with her since her diagnosis has build a solid foundation to build upon - just remember that her ADHD brain hasn’t failed her, it just needs different scaffolding right now. You already know how to show up for her and she knows you’re there. This is what really matters.
Warmly,
Dr. Sharon