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Types of ADHD in Adults: Understanding the Differences

The world of ADHD contains a vast diversity of experiences. Each individual faces a unique set of symptoms and challenges, but the types of ADHD provide a framework for finding the most helpful strategies.

So while hyperactive behavior is commonly perceived as a core feature of ADHD, an adult can still have ADHD even if they’re not hyperactive.

If you’d like to learn more about ADHD or connect with people who have had similar experiences, check out ADDA’s resource hub. 

Getting a diagnosis and timely support for ADHD is life-changing in many cases. Knowing more about the exact type of ADHD you have can help you create targeted strategies to overcome the unique challenges you face. 

The American Psychiatric Association has defined three main types of attention-deficit/hyperactivity disorder (ADHD) in adults.[1] Each type of ADHD presents with a different set of symptoms. 

Continue reading to explore the three types of ADHD in adults, their symptoms, and how they’re diagnosed and treated. 

What Are the Different Types of ADHD?

The three main types of ADHD are: 

  • Hyperactive and impulsive type ADHD: This type of ADHD predominantly presents with symptoms of hyperactivity and impulsivity. 
  • Inattentive type ADHD: This ADHD type mainly presents with symptoms of inattention and distractibility. Inattentive type ADHD is what is often referred to as ADD.
  • Combined type ADHD: This is the most prevalent type of ADHD and is characterized by symptoms of inattention and distractibility in addition to hyperactivity and impulsivity. 

Hyperactive and Impulsive Type ADHD

If an adult has at least five of the nine symptoms below, they may be diagnosed with hyperactive and impulsive type ADHD.

Symptoms of hyperactivity are as follows:[2]

  • Fidgeting with hands and feet, being unable to sit still
  • Leaving their seat unexpectedly, for example, during meetings
  • Often feeling restless
  • Unable to take part in leisure activities quietly
  • Perceived as restless, hard to keep up with, or “always on the go”
  • Tendency to talk excessively

Symptoms of impulsivity are as follows:[2]

  • Blurting out answers before a question or sentence is complete
  • Difficulty waiting their turn
  • Interrupting or intruding on what other people are doing

Inattentive Type ADHD 

A doctor may diagnose an adult with inattentive type ADHD if they experience at least five of the following symptoms:[2]

  • Losing or misplacing important items
  • Often distracted by unrelated thoughts 
  • Often forgetting to complete daily activities 
  • Short attention span and difficulty remaining focused 
  • Poor listening skills and inability to pay attention when spoken to directly 
  • Unable to finish tasks or follow instructions
  • Avoiding work that requires sustained attention and mental focus 
  • Unable to pay close attention to details, resulting in careless mistakes 
  • Difficulty organizing tasks, time, or workspace 

Combined Type ADHD 

An adult may exhibit symptoms that don’t exclusively fall under the category of hyperactive and impulsive behavior or inattentive behavior. In that case, they may be diagnosed with combined type ADHD. 

Adults with combined type ADHD display symptoms of inattention as well as hyperactivity and impulsivity. 

For this type of ADHD to be diagnosed, an adult should experience five or more symptoms in each of the two categories.[2]

How Are the Different Types of ADHD Diagnosed?

The best way to get your condition diagnosed is to seek the advice of a specialist. 

There’s no single test to diagnose ADHD. So, your physician may ask about your symptoms or use a behavioral rating scale to measure them. They’ll likely also ask about your symptom history and the age at which you first started experiencing them. 

Healthcare professionals typically use the Diagnostic and Statistical Manual of Mental Disorders (DSM) 5 to diagnose the three types of ADHD. The DSM-5 contains the diagnostic criteria for ADHD to help physicians make more reliable diagnoses. 

According to the DSM-5, adult ADHD may be diagnosed in the following cases:[2]

  • Hyperactive and impulsive type ADHD: At least five symptoms of hyperactivity and impulsivity for more than 6 months without meeting the diagnostic criteria for inattentive behavior. 
  • Inattentive type ADHD: At least five symptoms of inattention for more than 6 months without meeting the diagnostic criteria for hyperactive or impulsive behavior. 
  • Combined type ADHD: At least five symptoms of hyperactivity and impulsivity and at least five symptoms of inattention for more than 6 months. 

Additionally, the following criteria should also be met for adult ADHD to be diagnosed:[2]

  • Symptoms should be present in two or more settings, such as home, work, or school. 
  • Symptoms should clearly interfere with or reduce the functioning of a person in social, work, or school-related activities.
  • Symptoms experienced cannot be better explained by another mental health condition, such as depression or anxiety. 
  • Symptoms should not only occur during the course of a psychotic disorder like schizophrenia. 

It’s also important to note that ADHD is not an adult-onset disorder. That means that people develop ADHD in childhood, which they may or may not get properly diagnosed.[3]

For some, as they get older, symptoms diminish or disappear. Others, however, may still struggle with ADHD symptoms into adulthood. 

Your doctor may ask you about any ADHD-related struggles when you were a child. In addition, they may ask for information about your behavior from your parent, teacher, or anyone who may have known you well when you were younger. 

They can then make a diagnosis after confirming that some symptoms of ADHD were already present before the age of 12.[3]

What Does Each Type of ADHD Look Like in Daily Life?

People diagnosed with ADHD may show varying behavioral traits, habits, and tendencies throughout their daily lives.

It might be difficult to imagine what each symptom looks like in a real-life setting. So we’ll explore how different types of ADHD can manifest in a person’s day-to-day life. 

Hyperactive and impulsive type ADHD in adults may present in the following ways:

  • Talking or humming songs to themselves 
  • Talking too much and being rather loud 
  • Interrupting other people by finishing their sentences, blurting out answers, or talking over them
  • Intruding or butting into conversations or activities they’re not involved in
  • Difficulty waiting for their turn in queues or conversations 

Inattentive type ADHD in adults may involve the following behavioral characteristics:

  • Forgetting to complete routine tasks like paying bills, buying groceries, or finishing chores
  • Missing deadlines and forgetting meetings or appointments
  • Difficulty concentrating during work or meetings and needing to fidget, sip on a drink, or chew gum to remain focused 
  • Zoning out while other people speak and having trouble keeping up with uninteresting conversation topics 
  • Often losing their cellphone, keys, project notes, wallet, etc. 
  • Placing items where they don’t belong (i.e., milk in the cupboard, keys in the dishwasher, and plates in the bedroom) 

Adults with combined type ADHD will have a mix of the above behavioral traits. They may find it hard to focus during work, tasks, and conversations. They may also display impulsive behaviors, such as interrupting another person or butting into conversations. 

Treatment for the Different Types of ADHD 

All types of ADHD can be treated using therapy and medication. Research has shown that combining both treatment methods typically results in more effective outcomes. 

Medications help to increase the levels of specific chemical messengers (neurotransmitters) in your brain. Stimulant medications are most commonly used to treat all types of ADHD, as they work for many people. Your doctor will monitor your response closely and may adjust the dosage of your medication throughout your course of treatment. 

If stimulants are ineffective or lead to troublesome side effects, your doctor may recommend non-stimulant medications instead. Non-stimulant ADHD medications also work by boosting the levels of two neurotransmitters (dopamine and norepinephrine) in the brain, which help regulate brain activity. 

The most common form of therapy recommended for all types of ADHD is called cognitive behavioral therapy (CBT).

CBT empowers you to identify unhealthy thinking patterns and habits and implement unique strategies to regulate your emotions, thoughts, and actions. Ultimately, this therapy helps you recognize negative behaviors and replace them with positive ones. 

Other non-drug methods to manage ADHD symptoms include:

  • Support groups: ADHD support groups help you build meaningful connections and seek advice from individuals who have similar experiences to yours. If you’re interested, check out ADDA’s list of virtual support groups. 
  • ADHD coaching: An ADHD coach collaborates with you to form strategies that help you overcome your daily ADHD struggles. You may work on a wide range of areas, from time management and organization to listening and social skills. 

ADHD Does Not Look the Same for Every Adult 

An ADHD diagnosis shouldn’t be ruled out too quickly just because a person shows no symptoms of hyperactivity. Some adults with ADHD may only display inattentive behaviors, while others may only experience hyperactive and impulsive symptoms. 

What’s important is getting your symptoms assessed by an experienced healthcare professional, as this opens up the door to proper diagnosis, treatment, and support. 

ADDA’s adult ADHD test is a great first step in making the decision to talk to a doctor about their symptoms. This screening test serves as a checklist to help you gauge whether you may be experiencing symptoms of ADHD, so that you can take the necessary next steps. 

Ultimately, you can learn to manage your symptoms and achieve your goals without your ADHD symptoms holding you back. 

References

[1] American Psychiatric Association. (2022, June). What is ADHD? https://www.psychiatry.org/patients-families/adhd/what-is-adhd

[2] Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 7, DSM-IV to DSM-5 Attention-Deficit/Hyperactivity Disorder Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/

[3] Volkow, N. D., & Swanson, J. M. (2013). Clinical practice: Adult attention deficit-hyperactivity disorder. The New England journal of medicine, 369(20), 1935–1944. https://doi.org/10.1056/NEJMcp1212625

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ADDA delivers reliable information on ADHD. But ADDA’s content and services are no substitute for professional mental health or medical advice. Nor is it an alternative to ADHD diagnosis or treatment. Seek advice from your physician or qualified health provider for any medical condition.

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