ADHD Types: Hyperactive, Inattentive, Combined
The way attention deficit hyperactivity disorder (ADHD) impacts your functioning can vary quite a bit between individuals. When diagnosed with ADHD, you get classified into one of three types based on your main symptoms. Let’s explore each of the types, the criteria clinicians use to diagnose the groups, and how they look in everyday life.
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Types of ADHD
The three different groups of ADHD include:
ADHD Hyperactive-Impulsive Type
ADHD Predominantly Inattentive Type (formally known as ADD)
ADHD Combined Type
ADHD is diagnosed using standards laid out by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). In previous editions of the manual, ADHD was separated as either attention deficit hyperactivity disorder (ADHD) or attention deficit disorder (ADD). In the most recent update, all patients are diagnosed with ADHD and given a classification based on their type of presentation. Your type of ADHD can change over your lifespan in response to life events, circumstances or age-related changes.
Criteria for all types of ADHD
ADHD is a developmental disorder, meaning it is present throughout your life. As such, in order to get diagnosed with ADHD you must have experienced symptoms prior to the age of 12. It may be difficult to get an accurate history of your functioning before that age, so it’s perfectly fine to rely on parents, old report cards from school, or even your own vague memories. Don’t worry, your clinician will help you figure it out.
Your clinician will also ask about the history of your current issues. According to the DSM-5, in order to get a diagnosis, you must also have experienced significant symptoms that have negatively impacted your life for ≥ 6 months in ≥ 2 settings (e.g. work, home, school). It’s normal for ADHD to get worse during times of stress or even when things feel too stable (hello, new cubicle job!).
ADHD and daily symptoms
ADHD is a disorder that infiltrates pretty much every area of functioning over the lifespan. Understanding the way ADHD impacts you in your daily life can help amend or even prevent a lot of self-esteem issues, interpersonal conflict, and even career problems.
Let's take a deeper dive into each type of ADHD in adults.
Hyperactive-Impulsive Type of ADHD generally fits the stereotype most people have for ADHD of a hyperactive kid bouncing off of the walls. It’s less common in adulthood but definitely does occur at any time in the lifespan. You’ll receive this classification if you meet six out of nine symptoms below, or five out of nine if you’re over the age of 17.
Often fidgety or squirmy: You may often find yourself tapping your feet, moving your limbs, mindlessly wringing your hands, or doing other similar movements. Symptoms might also manisfest as destroying napkins or coasters at restaurants, doodling all over documents, or mindlessly chewing whatever object you’ve inserted into your mouth hole.
Marked Restlessness that is difficult to control: You have a hard time sitting or standing still and find it extremely difficult to relax. Some people feel a constant urge to “do something,” and others may just feel vaguely agitated with racing thoughts.
Hyperactive and appears to be “driven by a motor”: In children, this symptom is usually demonstrated by kids excessively climbing on things or running around in situations where it’s not necessarily appropriate. Adults may have a slightly more “refined” version of this but will frequently hear comments like “I don’t know where you get all of your energy” and regularly end up doing a million things at once.
Lacking the ability to engage in activities in a quiet manner: You may feel the need to fill the silence with sound or be a person who works noisily (self-talk, humming, or just simply being loud).
Incapable of staying seated: This symptom is most commonly problematic in a classroom setting. For adults, it might look more like getting up 12 times for no necessary reason while watching a movie.
Overly talkative: You may regularly find yourself buzzing with energy that comes out in the form of excessive talking. You might not necessarily be aware that it’s excessive until you see the visible fatigue grow on the faces of those around you. In other settings, it can get you viewed as the life of the party.
Difficulty waiting your turn: This symptom is often spotted during playtime in kids. For adults, it’s more frequently noticed in situations like line-ups where you feel near physical pain when asked to wait. The toll of waiting your turn can feel overwhelming, stressful, and leave you very agitated. Lines are your nemesis.
Interrupts or intrudes into conversations and activities of others: You may often jump in with your opinions, ideas or actions without thinking. You feel an urgency in expressing yourself, taking over activities, or acting without intending to be intrusive or rude. You may or may not have a moment of self-awareness after you’ve already acted.
Impulsively blurts out answers before questions are completed: You might frequently answer questions in an urgent manner as if you’re on a game show. As a result, you frequently miss the whole context. This symptom may cause issues in interpersonal relationships or work settings, as you find yourself completing the other person’s thoughts.
As someone living with hyperactive/impulsive ADHD you may carry a lot of nervous energy in your body. In adulthood, this can be exacerbated by office jobs and sedentary lifestyles. You may find yourself seeking out dangerous or thrill-seeking hobbies or activities due to feeling chronically understimulated by daily life. As we get older, the choices of activities tend to get a bit tamer (*insert a collective sigh from spouses of ADHD-ers*).
Your inability to hold your tongue or wait your turn can often impact relationships and create social anxiety over interactions, especially at work or during job interviews. It’s important to understand that the way your brain functions makes it extremely difficult to filter all of your actions, so self-acceptance and forgiveness are important to practice.
Although hyperactivity/impulsivity may present many challenges, people with these traits are often admired for their ability to dive headfirst into projects and live their lives with gusto. Seeking professional help allows you to learn how to better manage your symptoms and deal with any destructive energy that builds up so that you can experience more peace of mind. You can also learn strategies for minimizing impulsivity and boosting skills surrounding social interactions.
Predominantly Inattentive Type
Predominantly Inattentive Type of ADHD is most commonly diagnosed in adults and females. You’ll receive this classification if you meet six out of nine symptoms below, or five out of nine if you’re over the age of 17.
Difficulty organizing tasks and activities: You may find it hard to keep things in order, manage time or deadlines, or complete tasks that require being done in a specific sequence.
Displaying poor listening skills: You often zone out when spoken to or have a hard time tuning into people talking. There may not be obvious distractions, making it a little harder to explain why you didn’t hear a word from your co-worker’s 10-minute Ted Talk about project management software.
Frequently loses and/or misplaces items needed to complete activities: In childhood, this can look like losing instructions, school supplies, or textbooks. As an adult, you’re likely to lose things like reading glasses, keys, wallets, or pretty much any handheld necessity of daily life.
Sidetracked by external or unimportant stimuli: No matter how much you want to tune into a task, it’s common to get sidetracked by a thought, topic, or event that suddenly demands your internal attention. For instance, you might be attending a show by your favorite comedian and find yourself zoning out for 5 minutes to think about what pandas eat.
Forgetful in daily activities: The daily mundane (but necessary) activities seem to disappear into the abyss with inattentive type ADHD. Regularly forgotten tasks include chores, returning texts or calls, paying bills, and keeping appointments. The level of importance often has no bearing on how readily your mind will whisk it away into a forever forgotten land.
Diminished attention span: Staying focused during lectures, conversations, or long passages is extremely difficult and can feel almost painful. You may find yourself self-stimulating, zoning out, or feeling extremely stressed in these situations, especially when the topic is a little boring. For some people, even movies can feel nearly impossible to watch until the end.
Lacking the ability to follow instructions or complete schoolwork or other duties: You may often begin tasks and have trouble following them through. This can look like quitting, getting side-tracked, or skipping ahead to the end (which can have disastrous results in tasks such as recipes).
Avoiding activities requiring concentration: You may find yourself procrastinating or entirely avoiding tasks that demand sustained mental effort, such as completing reports, doing your taxes, or organizing/filing paperwork.
Failure to focus on details and/or makes thoughtless mistakes: Your attention to detail is often lacking, which means you often get things done quickly but miss crucial details or important steps. For instance, your relationship with assembling furniture may be one of do-overs, extra parts, and screaming into the abyss.
Many people with inattentive type ADHD go their whole lives without realizing they have ADHD. As such, many of the difficulties get attributed to “laziness”, “carelessness”, or being a “space case.” Getting diagnosed with this type of ADHD in adulthood can do wonders for rebuilding self-esteem and better understanding why you interact with your world the way you do.
The greatest struggles in your adult life generally come back to key issues with organization, follow-through, and the whole being a human Bermuda Triangle thing. Keeping track of important dates, birthdays, and other celebrations feels impossible and can often make you feel like a bad friend or spouse.
With some help, it’s possible to build important coping strategies that can ease many symptoms and allow you to feel more in control. Creating an inner dialogue of forgiveness will also give you space to lean into your strengths, such as your uniquely creative thought processes, problem-solving, and creative energy.
It’s very common for most people with ADHD to have symptoms of both hyperactive/impulsive and inattentive types. If you are a person who does not quite meet the criteria for a specific type but does have a significant number of symptoms across both types– you may have ADHD combined type.
You’ll receive this classification if you don’t meet the criteria in a specific category but do meet six out of 18 symptoms across both categories (or five symptoms if you’re over the age of 17).
You likely relate to elements of both daily symptoms sections above. It ’s normal for people with combined type to experience increased frustration and irritability due to restlessness and the way you are often misunderstood and mislabeled in the world around you.
You may be a person who juggles a million projects but struggles to see them through. You like shortcuts, hate waiting, and are eager to jump into any activity or conversation that appeals to your senses.
Your approach to life is refreshing to many but comes with challenges due to your symptoms. As such, you may have a great deal of interpersonal conflict, self-esteem issues, and trouble finding your direction. Fortunately, there are many strategies and tools you can access to help you better define a path that improves your wellbeing and leans into your unique strengths.
ADHD is a lifelong disorder that can change over time. Getting a diagnosis is essential for better understanding why your mind functions the way it does and how you can build effective strategies that help you overcome challenges and hone in on your strengths.
Getting a rapid diagnosis of ADHD through a service such as Frida can bring a great deal of relief if you’ve been living without a diagnosis. It’s important to remember that your experience is unique, and the way ADHD impacts your life depends on numerous factors. Talking to a professional will help you gain a thorough understanding of your presentation of ADHD and the best way forward for treating your symptoms.
You aren’t defective, you aren’t lazy, you aren’t “too much,” you are a unique and beautiful person with limitless potential. Reach out today for professional guidance and learn what it’s like to live in a world with acceptance and understanding of your unique condition.