What Are the Different Types of ADD and ADHD?

Difference between types of ADD and ADHD
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What is The Difference Between ADHD and ADD?

ADHD and ADD are two names used for the same condition. ADHD stands for attention deficit hyperactivity disorder. This is the official name used by the American Psychiatric Association. It encompasses hyperactive, impulsive, and/or inattentive behaviors. ADD stands for attention deficit disorder. It was the official name for this condition from 1980 to 1987.

 

Many people use ADD to describe someone who has inattentive ADHD symptoms, and ADHD to describe someone who has hyperactivity and impulsivity. Sometimes the two terms are used interchangeably to describe people who do or do not have symptoms of hyperactivity and impulsiveness. All of this can be confusing, particularly if you are learning about ADHD.

Types of ADHD

In 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was published. It is the standardized guideline that doctors and clinicians use to assess and diagnosis ADHD.  

With every new DSM, there are often changes to the name of the condition and the diagnosing criteria. These changes reflect the latest research and knowledge of ADHD. In 2013, ADHD was defined as a neurodevelopmental disorder that has three presentations:

  • Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation
  • Attention Deficit Hyperactivity Disorder, predominantly hyperactive-impulsive presentation
  • Attention Deficit Hyperactivity Disorder, combined inattentive and hyperactive-impulsive presentation.

Using the term ‘presentation’ rather than the previously used term ‘subtypes’ is a subtle but important change.

This change reflects that ADHD is not fixed or stagnant, as the previous diagnostic terms implied. ADHD symptoms differ from person to person. Also, the symptoms can vary in one person depending on the environment, such as a new setting, or when doing an interesting activity. In addition, as the brain grows and matures, symptoms can change to become less visible and more internal. This means symptoms can change over the course of a person’s life.

The DSM-5 also identifies that there are different levels of severity of ADHD. A person can be diagnosed with mild (while still meeting the ADHD diagnostic criteria), moderate or severe ADHD.  

Following are descriptions of the three presentations.

ADHD, Predominantly Inattentive Presentation

The symptoms for this presentation are primarily related to inattention. There are not any significant hyperactive or impulsive behaviors. People with this presentation may have trouble paying attention, finishing tasks, or following directions. They may be easily distracted, appear forgetful, careless and disorganized, and frequently lose things.

Unlike their hyperactive friends, they can seem rather sluggish and slow to respond and process information. They can appear daydreamy, spacey, or behave as though they are in a fog. They may seem shy or withdrawn.

They often have difficulty sifting information and deciding what is important and what is irrelevant. Their symptoms are less obvious and disruptive compared to an individual with hyperactive and impulsive symptoms. This means that the ADHD might be diagnosed later in life. As a result, these people may struggle through school, and be labeled lazy or stubborn. 

This presentation is more common in girls and women, but boys and men can have it too. This is the presentation that used to be called ADD.

ADHD, Predominantly Hyperactive-Impulsive Presentation

The symptoms for this presentation are primarily related to hyperactivity and impulsivity. People with this presentation do not meet the criteria for inattentive symptoms. They might appear restless, fidgety, overactive and impulsive. For example, they may “act before thinking” or “speak before thinking” by blurting out and interrupting others. They may play and interact loudly, have difficulty staying in their seat, and when sitting may tap their feet or squirm. They may talk excessively, and have trouble waiting their turn. 

As children, they may seem to be always “on the go,” and run and climb. In adulthood, they might enjoy vigorous exercise or extreme sports. In addition, someone with predominantly hyperactive-impulsive presentation feels the need to rush through tasks in order to get them done as quickly as possible. This often results in mistakes in tasks like homework, exams, and tax returns.

ADHD, Predominantly Combined Presentation

People with this presentation show both inattentive and hyperactive-impulsive symptoms.

 

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC:

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