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ADHD: Combined Type. What to Know About It

ADHD combined type
Written by:

Rabia Khaliq

MSc in Applied Psychology

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The medications listed on this website are provided for informational purposes only. Their inclusion does not guarantee that they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. This list is not exhaustive, and healthcare providers may prescribe other medications, including non-stimulant options, based on the patient’s unique health circumstances and needs.Read more

ADHD affects about 4.4% of the adult population [1*] in the US. Any ADHD definition describes it as a neurodevelopmental disorder marked by a persistent pattern of inattention and/or hyperactivity and impulsivity.

It is often diagnosed in childhood, but the ADHD symptoms may also carry into adulthood. Still, many individuals only get diagnosed when being adults. Signs of ADHD in adults usually resemble those of children to a large extent, the difference being how they handle them and the environments.

Several treatment options are available to manage the symptoms, but first, the diagnosis should be made. And while there are clearly inattentive and hyperactive-impulsive types of ADHD, there is also a combined type, so let’s learn more about it.

Start with a free online assessment for ADHD via SmartCare to check if you have ADHD symptoms.

What is ADHD of Combined Type?

Symptoms of adult ADHD usually present themselves in three forms of ADHD. These are:

  • Predominantly inattentive ADHD type. A patient struggles with problems paying and keeping attention.
  • Predominantly hyperactive-impulsive ADHD type. It is characterized by impulsive and hyperactive behavior like fidgeting, blurting out answers, interrupting conversations, etc.
  • Combined ADHD type. This one has the features of both above-mentioned options.

The Diagnostic and Statistical Manual of Mental Disorders, edition 5 (DSM-5), calls these three forms presentations. It also outlines 18 symptoms of ADHD, 9 for the predominantly inattentive ADHD presentation, and 9 for the predominantly hyperactive-impulsive presentation. In the International Classification of Diseases version 10, the ICD-10 code for ADHD combined type is F90.2.

For adults to get diagnosed with a combined ADHD type, they need to meet the following criteria set by the DSM-5:

  • People aged 17 years and more need to present at least five symptoms of each of the other presentations.
  • The symptoms should have manifested for a minimum of six months.
  • ADHD symptoms in adults should be present in two or more settings like at college, home, or work.
  • Several symptoms should have been present before age 12, even though they may not have been diagnosed.
  • It is not possible to better explain the symptoms using another mental disorder like anxiety disorder.
  • The symptoms should affect the patient’s ability to perform at their best, whether in work, social, or academic setups.

Consult a mental health professional to know whether you have ADHD and get proper treatment.

Symptoms of Combined ADHD

People with the ADHD of a combined type can get a diagnosis if they represent the symptoms of the two groups. To know what the signs of inattentive and hyperactive ADHD are, let’s review them in detail.

Inattentive symptoms:

  1. One makes frequent mistakes at work, college, or home, largely due to failure to pay attention to details on assignments.
  2. Difficulty keeping attention in different activities, whether academic, leisure, or work.
  3. One appears not to listen when being talked to, even during one-on-one conversations, and instead appears distracted.
  4. Difficulty in following through on tasks and instructions. Patients are easily sidetracked or lose focus, often making it hard to complete a task from beginning to end.
  5. One tries to avoid tasks and chores that require prolonged attention.
  6. One gets easily distracted by external events.
  7. The patient often loses things like keys, wallet, documents, gadgets, etc.
  8. One is often forgetful during daily chores and tasks.
  9. The patient tends to avoid tasks requiring mental effort for extended times.

Symptoms of hyperactive-impulsive ADHD:

  1. One struggles to stay still, often squirming or fidgeting by moving feet and hands.
  2. The patient finds it hard to stay seated, often getting up to move around even when sitting down is expected or socially appropriate, like at work.
  3. They may experience constant internal restlessness even when still.
  4. One rarely takes part in leisure hobbies or activities quietly.
  5. One seems to be constantly energetic and always on the go.
  6. Constantly talking and maybe perceived as a chatterbox.
  7. The patient often answers the questions before they are asked.
  8. They find it difficult to wait for their turn.
  9. They tend to intrude on the activities and conversations of others.

A MEDvidi doctor will examine your symptoms, rule out other disorders, and develop a personalized treatment plan.

Combined ADHD symptoms in adults

What Causes the Combined Type of ADHD

The causes of ADHD are the same across all three presentations of the condition. However, scientists are not sure about the precise cause. They have, however, identified common risk factors. These include:

  • Hereditary. Several studies [2*] have found that ADHD may run in families and that certain genes [3*] are more likely to make people develop ADHD.
  • Brain injury. Having a traumatic brain injury can increase the risk of ADHD.
  • Low-birth weight or premature delivery. One study in the Pediatrics journal [4*] showed babies born underweight or prematurely can have a high risk of developing ADHD.
  • External factors during infancy/pregnancy. The use of alcohol or tobacco during pregnancy increases the risk of a child developing ADHD. Exposure to toxins can also increase the chances of the baby being born with ADHD or developing it later.

Treatment for the Combined Type of ADHD

Treating a combined type of ADHD involves using the same kinds of medications as for other types of the disorder. These include stimulant drugs like Adderall and Ritalin or non-stimulant medications like Strattera and Intuniv. Also, psychotherapy can be used in addition to pharmacological treatment or alone. The most common options, in this case, are behavioral and cognitive-behavioral therapy. Both aim to change a patient’s behavior patterns and strengthen their good habits. These also help to develop excellent coping habits with unwanted symptoms and behavior.

Conclusion

ADHD in adults can have significant costs on the individual as it affects many spheres of life, from careers to relationships to self-development. However, with proper treatment chosen based on the symptoms and diagnosis, one can successfully manage the disorder’s signs. It may be a bit more challenging for people with ADHD of combined type due to a variety of symptoms. But with a personalized treatment plan, achieving great results is possible. Contact MEDvidi doctors to get your mental health checked and know more about ADHD treatment.

Sources

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+4 sources
  1. Attention-Deficit/Hyperactivity Disorder (ADHD)
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  2. Candidate gene studies of ADHD: a meta-analytic review. (2009)
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  3. Polymorphisms of the Dopamine D4 Receptor, Clinical Outcome, and Cortical Structure in Attention-Deficit/Hyperactivity Disorder. (2007)
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  4. Low and High Birth Weight and the Risk of Child Attention Problems. (2015)
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Written by:

Rabia Khaliq

MSc in Applied Psychology
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This article is based on scientific evidence, written by experts and fact checked by experts.

Our team of experts strive to be objective, unbiased, honest and to present both sides of the argument.

This article contains scientific references. The numbers
in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.