ADD Vs. ADHD: What Is The Difference?

What Is ADHD?

Attention-deficit/hyperactivity disorder (ADHD) is one of the most commonly diagnosed neurodevelopmental conditions. Symptoms of ADHD typically develop in childhood and persist into adulthood. However, presentations may change with age, as some individuals can shift from childhood hyperactivity to inattentive behavior in adulthood.

What Is ADD?

Attention-deficit disorder (ADD) is an outdated diagnosis for children who primarily struggle with sustaining attention and focus. In 1987, the DSM-3 removed the term after experts recognized hyperactivity as an integral part of ADHD. Some individuals with ADHD will have hyperactive behaviors, while others experience mainly inattentive symptoms. The diagnosis of ADHD will remain the same for both.

ADD Vs. ADHD: What Is the Difference?

Attention-deficit disorder (ADD) is a diagnosis that the DSM-5 no longer recognizes. It was originally used to describe individuals who struggle with attention deficit but not hyperactivity. Changes were made to the diagnosis of attention-deficit/hyperactivity disorder (ADHD), breaking it into three separate subcategories, therefore no longer needing the term ADD.

Below are the differences between symptom presentations in ADHD:

What Are the Types of ADHD?

The three types of ADHD include inattentive ADHD, hyperactive-impulsive ADHD, and combined ADHD. While not individual diagnoses, these types help categorize symptom presentation in those with the condition. Still, not everyone will experience a distinct list of symptoms, as ADHD differs depending on the person, their environment, and many other factors.

Inattentive ADHD

Inattentive ADHD (formerly ADD) includes symptoms such as a lack of concentration, poor organization skills, and difficulty following instructions. Inattentive ADHD is most prevalent in women with ADHD.¹

Common symptoms of inattentive ADHD include:

• Difficulty listening to others
• Disorganization
• Forgetfulness
• Lack of attention to detail
• Task avoidance

Hyperactive-Impulsive ADHD

Hyperactive-impulsive ADHD often results in excessive activity and poor impulse control. Individuals with this type of ADHD may struggle to wait their turn, talk over others, or make quick decisions without considering the consequences.

Common symptoms of hyperactive-impulsive ADHD include:

• Being unable to concentrate on tasks
• Fidgeting
• Excessive talking or interruption
• Impulsivity
• Moments of rage and aggression
• Risk-taking behavior
• Difficulty with self-control

Combined ADHD

Combined ADHD
Combined ADHD refers to a mix of inattentive and hyperactive-impulsive symptoms. An individual may exhibit both abundant energy and trouble concentrating, sustaining attention, or staying organized. Some evidence suggests this type of ADHD is more prevalent in boys than girls.¹

Common symptoms of combined ADHD include:

• Difficulty focusing on tasks
• Inability to wait for one’s turn
• Engaging in excessive activity
• Restlessness
• Poor time management

Do ADHD Types Vary in Severity?

The differentiation of ADHD into three categories is not because of symptom severity, as inattentive, hyperactive-impulsive, and combined ADHD can be equally impactful. ADHD varies from person to person due to multiple factors, including genetics, environment, and even nutrition.

Initially, when the DSM separated ADHD into three distinct presentations, many considered combined ADHD the most severe because of the increased number of possible symptoms. However, researchers today do not believe in this differential level of severity.

ADHD in Childhood Vs. Adulthood

ADHD symptoms may shift from childhood to adulthood. In many cases, children primarily exhibit hyperactivity through impaired school performance and social interactions. Over time, hyperactive behavior might decrease in adulthood, with inattentive (or ADD) symptoms becoming more prominent.

Additionally, ADHD may decrease in severity with treatment. Alternatively, children and adults with ADHD may develop anxiety and depression without proper support. For example, undiagnosed adults may attribute their symptoms to laziness and struggle with debilitating negative self-talk.

Childhood ADHD

The onset of childhood ADHD is often between the ages of six and twelve. Professionals may diagnose more severe cases earlier if symptoms are apparent or impactful. In many cases, children with ADHD exhibit more hyperactive behavior than inattentive or formerly ADD symptoms. ADHD may impact the ability to engage in school work, form friendships, or engage at home.²

Common symptoms of childhood ADHD include:

• Difficulty listening to others: Children with ADHD may have difficulty following instructions or paying attention to others due to racing thoughts or external distractions.
• Poor time management skills: Children with ADHD may struggle with task completion and time management for many reasons, including executive dysfunction, time blindness, and forgetfulness.  
• Fidgeting: Many children with ADHD experience restlessness, which they may exhibit by pacing the classroom or fidgeting with objects.
• Fatigue: Some kids with ADHD feel worn out by managing their ADHD symptoms.
• Struggle with relationships: Children might struggle with forming peer relationships because other kids may not understand their unique mannerisms or behavior.

Adult ADHD

Adults with ADHD may notice their childhood symptoms change with age. Hyperactivity can shift to more inattentive symptoms that negatively impact their romantic relationships, careers, and home life.² Because ADD is an older term, adults diagnosed before the DSM-5 recategorization of ADHD may still refer to themselves as having ADD. 

Common symptoms of adult ADHD include:

• Low frustration tolerance: Adults often feel overwhelmed by navigating a neurotypical world with ADHD. Living in a world designed for individuals without their differences can result in a low frustration tolerance, sometimes contributing to increased irritability and anger.
• Poor self-image: A person with ADHD might struggle with low self-esteem because of their difficulties with remaining focused, organized, or on task.
• Relationship issues: Some adults with ADHD struggle to communicate their needs. In other cases, they may forget about dates, responsibilities, or other important tasks. These issues can contribute to relationship problems.
• Forgetfulness: Adults with ADHD are prone to forgetfulness. These difficulties can make simple tasks challenging, such as grabbing their car keys, wallet, or phone on the way out the door.
• Lack of motivation: ADHD procrastination is a common experience for those with the diagnosis, as many struggle to maintain motivation. These challenges are not due to laziness. Instead, they reflect the overwhelm those with ADHD feel about tackling endless to-do lists and responsibilities.

ADD Vs. ADHD: Receiving a Diagnosis

ADD is no longer a recognized condition, meaning those with symptoms will receive an ADHD diagnosis if they meet the DSM criteria. A typical diagnostic process includes a comprehensive evaluation from a medical provider. A childhood ADHD assessment usually engages other parties, such as parents or teachers, whereas an adult diagnosis typically involves more self-reporting tests.³

What If I Was Diagnosed With ADD?

A person diagnosed with ADD can seek re-assessment if they are unsure about their ADHD symptom presentation. Understanding the type of ADHD you have can ensure you receive the best available treatment and care. Speak with a medical doctor or a psychiatrist if you have questions about your diagnosis.

Treatment for ADHD

Various treatments are available for ADHD. Support will look different depending on the severity of symptoms, age, and other individual characteristics. A combination of therapy and medication is best, but finding the right option for you may take some trial and error. 

Treatment options for ADHD include:

• Cognitive behavioral therapy (CBT): CBT for ADHD is a short-term and goal-oriented behavioral therapy focusing on shifting the negative thoughts contributing to symptoms.
• Mindfulness-based cognitive therapy (MBCT): MBCT combines mindfulness with cognitive therapy to encourage individuals to approach their thoughts with non-judgmental acceptance.
• Social skills training: Social skills training can help those with ADHD learn to communicate their needs and improve social interactions. This approach can assist children in adopting proper playground and classroom etiquette so they feel more confident in school.
• Natural remedies: Natural remedies for ADHD can be great additions to therapy and medication. Exercise, healthy eating, and sleep hygiene are some common examples.
• Medication: Depending on the severity of symptoms and age of the individual, a psychiatrist might recommend medication for ADHD. Medications can help improve focus and decrease hyperactivity.

ADHD Treatment for Adults Vs. Children

ADHD treatment for adults may differ because symptoms can shift with age. Additionally, adults face new responsibilities, so support often focuses on improving work productivity and home life stability. Those with ADHD are also at a higher risk of developing anxiety and depression, meaning therapeutic and pharmaceutical approaches will target co-occurring disorders as well.

How to Find Professional Support

Finding a neurodiverse-affirming therapist is important when seeking ADHD treatment. These providers understand the unique challenges associated with ADHD, and many may have experience with clients formerly diagnosed with ADD. An online therapist directory is a great place to locate a provider, and online therapy platforms are also available for more flexible support. Online psychiatrist options can help individuals complete an ADHD evaluation and find medication management.