Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder that causes symptoms of hyperactivity, inattention, and impulsivity. These symptoms are severe enough to interfere with the patient’s daily activities. ADHD develops in childhood, and often the symptoms continue into adulthood.
Adults with ADHD often struggle with impulsive behaviors, have difficulty paying attention, and are overly active. The symptoms of ADHD may vary from one person to another depending on the different types of this disorder. So, how many types of ADHD are there? Let’s find out and explore ADHD categories and other related aspects.
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Three Main Types of ADHD
There are three main types of ADHD in adults: predominantly hyperactive, predominantly inattentive, and combined. Below, you will find these ADHD types explained, including an overview of their accompanying symptoms.
Predominantly Hyperactive ADHD
This ADHD type is typically marked by hyperactive and impulsive behavior. Adults diagnosed with it present fewer symptoms of inattentiveness but often experience the following:
- Fidgeting, tapping hands or feet, or squirming in the seat.
- Talking excessively.
- Inability to settle in one place and remain still for an extended period without feeling discomfort. A person can stand up or leave their seat at work or in other situations that require them to remain seated.
- Feeling restless in most situations.
- Inability to engage in leisure activities or hobbies quietly.
- Blurting out answers before the question is complete.
- Inability to wait for their turn, such as when queuing.
- Interrupting or intruding into conversations, activities, or games.
This type of ADHD is more commonly diagnosed in males, particularly in childhood. Boys often exhibit more hyperactive and impulsive symptoms compared to girls, leading to a higher incidence of this ADHD presentation. However, the manifestation of hyperactivity can change with age, often presenting as restlessness or difficulty relaxing in adults.
Predominantly Inattentive ADHD
Previously called ADD (attention deficit disorder), ADHD of the inattentive type is characterized by distractibility and lack of attention. Common symptoms of inattentive ADHD include:
- Inability to pay close attention. Making careless mistakes at work.
- Daydreaming and difficulty sustaining attention. Inability to remain focused for extended periods.
- Inability to listen when being spoken to, even without obvious distractions.
- Inability to follow instructions or complete assigned tasks.
- Inability to organize tasks and activities.
- Struggling to manage time and meet deadlines.
- Reluctance to engage in activities that require extensive mental concentration.
- Distractibility by external stimuli, including unrelated thoughts.
- Extreme forgetfulness.
This type of ADHD is more evenly distributed between males and females compared to the hyperactive-impulsive presentation. It is commonly observed in adults and adolescents, as inattention symptoms which often become more prominent with age. However, anyone, regardless of age or gender, can have this type of ADHD if the specific criteria are met.
As the name suggests, the combined ADHD type has the symptoms of both hyperactive-impulsive and inattentive behaviors. The doctor or physician will diagnose patients with combined ADHD if they present with enough symptoms of each of the above-mentioned ADHD types.
It is the most common form of ADHD and is typically more prevalent in males. This type of ADHD is often diagnosed in childhood, as the combination of inattention, impulsivity, and hyperactivity tends to be more noticeable in this age group. However, as with all kinds of ADHD, it can persist into adulthood and affect individuals of any age or gender.
Other Types of ADHD
While the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) categorizes ADHD into the three types discussed above, alternative models have been proposed. Psychiatrist Dr. Daniel Amen, for instance, has proposed seven forms of ADD in his clinical practice (though it is not approved by the American Psychiatric Association). Let’s review them below.
Classic ADD (Classic ADHD)
This type is similar to the combined type of ADHD defined in the DSM-5. It is characterized by both inattentiveness and hyperactivity/impulsivity. People having it struggle with focus, attention, impulsivity, hyperactivity, and organization. Classic ADD is usually detected in early childhood, often when a child starts school and is more commonly diagnosed in boys.
This type is similar to the predominantly inattentive presentation of ADHD defined in the DSM-5. Individuals with inattentive ADD struggle primarily with attention, focus, organization, and forgetfulness, and often daydream. Unlike the other attention deficit hyperactivity disorder types, these individuals are typically not impulsive or hyperactive.
Inattentive ADD tends to be more common in females and often becomes more noticeable during the later school years when academic demands increase.
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In addition to typical ADHD symptoms, individuals with over-focused ADD tend to get stuck in negative thought patterns or behaviors. They may have difficulty shifting attention, switching from one task to another, and often worry excessively.
Over-focused ADD can be found in both children and adults. It is not exclusive to one gender or age group.
Temporal Lobe ADD
In addition to classic ADHD symptoms, temporal lobe ADD may include issues with learning and memory, behavioral problems, and aggressive behavior. These individuals may struggle with reading and following directions.
Temporal lobe ADD is not gender-specific or age-specific; it can affect both males and females across various age groups.
Along with classic ADHD symptoms, individuals with limbic ADD often exhibit chronic low-level sadness (not depression), low energy, and decreased interest in activities they once enjoyed. These symptoms are different from the sadness or depression caused by specific life events.
Like other subtypes of ADHD, limbic ADD can affect individuals across their lifespan. It is not specific to a certain gender or age.
Ring of Fire ADD
Beyond typical ADHD symptoms, those with ring of fire ADD may also exhibit periods of excessive talkativeness, hyperactivity, and unpredictability. They may have periods of calm followed by periods of high energy and impulsivity.
Ring of fire ADD can affect any age or gender, but the fluctuating and often intense symptoms might be more easily identified in school-aged children and adolescents.
Along with classic ADHD symptoms, individuals with anxious ADD often exhibit nervousness, tension, and physical stress symptoms like headache and stomach discomfort. People with this type tend to be less impulsive and hyperactive but struggle with inattention and high levels of anxiety.
Anxious ADD is not limited to a specific gender or age group. However, high anxiety levels may become more noticeable in adolescence and adulthood when life stressors increase.
Discuss any disturbing ADHD symptoms and types with our licensed MDs.
Causes of ADHD
Although the exact causes of ADHD subtypes are not entirely understood, they are believed to stem from several interrelated factors:
- Genetic influence.
Studies [1*]have shown that specific gene variants, particularly those involved in dopamine transmission, may be related.
- Brain structure and function. Individuals with different types of ADHD have neuroanatomical differences. Particularly, these include changes in the prefrontal cortex, basal ganglia, and the connections between these regions—all areas responsible for executive functions, attention, and impulse control.
- Prenatal factors. Exposure to alcohol, nicotine, or drugs during pregnancy can increase the risk of a child developing ADHD. Such substances can interfere with fetal brain development, affecting areas responsible for attention, impulse control, and hyperactivity.
- Environmental toxins. Exposure to certain toxins, including lead and certain pesticides, especially during critical early developmental periods, can contribute to the risk of ADHD. These toxins can interfere with the normal development of the brain, leading to long-term cognitive and behavioral issues.
- Early childhood trauma or stress. Traumatic experiences or high stress levels during early childhood can increase the risk of developing ADHD. These situations can cause changes in brain function and development, leading to problems with attention, impulsivity, and hyperactivity.
- Socio-cultural factors. Educational environment, cultural expectations, and family dynamics can contribute to the development and presentation of ADHD.
How is ADHD Diagnosed?
Healthcare providers use the symptoms provided in the
Clinicians can diagnose ADHD in adults only if they present with at least five of the nine primary symptoms. The symptoms should also be visibly present for six months or longer in more than two settings, such as at home and at work. Additionally, the levels of ADHD are important in making a diagnosis as the symptoms should be severe enough to interfere with the adult’s daily activities.
What Doctor Can Treat ADHD/ADD?
The healthcare professionals you can turn to for evaluation and treatment of all ADHD types include:
- Psychiatrists. They can diagnose ADHD, prescribe medication, and provide psychotherapy.
- Neurologists. Neurologists can provide a comprehensive assessment and prescribe medication if necessary.
- Primary care physicians. They can assess symptoms, take a comprehensive medical history, and rule out any physical conditions that might be causing the symptoms.
- Nurse practitioners & physician assistants. They can provide assessments and prescribe medication. Psychiatric nurse practitioners (PMHNPs) can also offer counseling or behavioral therapy.
- Psychologists. While psychologists cannot prescribe medication, they can provide psychological testing to confirm an ADHD diagnosis and offer psychotherapy to help patients and their families manage the challenges associated with ADHD.
Treatment of ADHD
Healthcare providers can suggest different treatment options for patients diagnosed with ADHD. Treatment plans may vary depending on ADD types, specific symptoms, and their impact on daily functioning. In general, all of them involve psychotherapy, medication management, or both.
Behavioral therapy helps adults with different ADHD degrees find ways of replacing inappropriate behaviors with positive ones. It also helps them learn new ways of expressing their feelings.
Medications for ADHD help reduce hyperactivity, impulsivity, and improve the patient’s ability to focus. The two common types of medications used for the treatment of different forms of ADHD are:
- Stimulants. These are the more commonly prescribed medicines for ADHD because of their increased efficacy. These medications increase the production of norepinephrine and dopamine in the brain, the key neurotransmitters that regulate the thought process and attention. Examples of stimulant medications for ADHD include Adderall, Focalin, Ritalin, Concerta, Vyvanse, and Dexedrine.
- Non-stimulants. These drugs take longer to act but are effective in improving the patients’ attention and focus. They are recommended for patients who can’t tolerate stimulants, those with past addiction issues and those who do not gain the desired effect from them. Examples of non-stimulant drugs for ADHD include Strattera, Clonidine, and Intuniv.
Regardless of its type, the symptoms of ADHD can make life challenging. The disorder may affect relationships, work, academic performance, and other areas if left untreated. And while there’s no cure for ADHD, medications and psychotherapy can help manage it effectively. Contact MEDvidi today for a thorough assessment and receive a personalized treatment plan.