Despite the growing conversation and awareness around ADHD, many people still wonder about the difference between ADD and ADHD. While the simple answer is that experts consider ADD either an outdated term or a subtype of ADHD, it's still important to learn a little more about why that is so that you can get the most from your diagnosis and care.
What Is ADHD?
Also known as attention deficit hyperactivity disorder, ADHD is one of the most common mental disorders in the world, with roughly 4.4% of all adults worldwide diagnosed with some form of the condition. That said, some studies estimate that up to 80% of adults with ADHD are undiagnosed, so the number of people living with ADHD may be much higher.
Typically, individuals with ADHD struggle with things like inattentiveness, forgetfulness, restlessness, or impulsivity.
What Is ADD?
In many circles, ADD (or attention deficit disorder) is considered an outdated term that doesn't get much use in modern diagnosis. According to the DSM-5, which is the diagnostic and statistical manual of mental disorders published by the American Psychiatric Association, ADD and ADHD are the same diagnosis. Previously, many mental health professionals separated the two by diagnosing ADD rather than ADHD in children or adults who exhibited no hyperactivity-related symptoms.
Fortunately, this move to a single term was a step forward for people living with the disorder, as it went hand in hand with efforts to dispel outdated, stereotypical ideas of what ADHD symptoms "looked" like.
ADD vs. ADHD: Key Differences
As we've already mentioned, ADD and ADHD are functionally the same overall diagnosis in modern mental health practice. When talking about "differences" between the two, we're really discussing the differences between the three types of ADHD presentations commonly diagnosed today.
Typically, a mental health professional will note a certain presentation when diagnosing a patient, and this designation will help inform treatment options and give the individual a chance to better understand their specific condition.
These three presentations are as follows:
- Predominantly Inattentive ADHD: Previously, inattentive-type ADHD was separately diagnosed as ADD. This presentation primarily includes inattentive symptoms with few or no hyperactive symptoms whatsoever.
- Predominantly Hyperactive-Impulsive ADHD: Of the presentations, hyperactive-impulsive ADHD most closely resembles the "stereotypical" type of ADHD. With this presentation, individuals may struggle to sit still and manage their bodily movements or exhibit risk-taking behavior.
- Combined-Type ADHD: Combined-type ADHD is the most common among all age groups and simply means that an individual shows both inattentive and hyperactive-impulsive symptoms.
Each presentation of ADHD comes with its own set of symptoms and behaviors. While ADHD symptoms can appear in unique and uniquely personal ways for each person, we've included a list of some of the most common for each type of ADHD.
An individual with inattentive ADHD may demonstrate symptoms such as:
- Struggling to follow along to lectures or conversations
- Needing to have directions repeated
- Dislikes, avoids, or struggles to engage with organization-related tasks
- Is easily distracted
- Loses or misplaces things often
- Stops or loses interest halfway through a project or task
An individual with hyperactive-impulsive ADHD may demonstrate symptoms such as:
- Excessive fidgeting, pacing, or other motion
- Talking too much or too loudly
- Interrupts others during conversation
- Feelings of restlessness
- Struggling to pause or relax
Although previous generations took a more one-size-fits-all approach to ADHD medications and treatment, modern research recognizes that the most effective treatment plan is often based on a patient's specific needs.
And although you may expect different presentations of ADHD to respond better or worse to different treatment options, even the most current research has yet to concretely establish a direct relationship between specific treatments and the various presentations. This means that mental health professionals will typically develop a treatment plan based on the patient's needs, wants, and how they respond to certain medications.
Impact on Daily Life
When most of us think of common struggles or complications related to ADHD, a few things usually jump to mind: difficulty paying attention in work, school, or social settings, a frustrating amount of forgetfulness, and loss of productivity. While these may all hold true for a person with ADHD, there are actually many more potential ways that the disorder can impact daily life, including:
While the symptoms of hyperactive ADHD are typically more obvious to the average observer, symptoms related to impulsivity can also have a significant impact on a person's daily life. Often, this impulsive behavior can manifest in forms such as compulsive eating, drug or alcohol misuse, or other "thrill-seeking" activities.
Additionally, researchers have found that ADHD presentations with more physical symptoms may contribute to poor sleep, sleep apnea, and restless leg syndrome that complicates falling asleep. This relationship is so impactful, in fact, that research suggests ADHD can disrupt a person's circadian rhythm, making it that much more difficult to maintain a healthy sleep schedule.
According to the Centers for Disease Control, children with ADHD are more likely than their peers to also develop an anxiety-related mental health disorder during their lifetimes. Often, these anxiety disorders can follow a person well into adulthood, compounding or worsening their ADHD symptoms.
As mentioned above, most people know the negative impact inattentive ADHD can have on a person's life, from difficulties paying attention during important work meetings and missing deadlines to struggling to study or follow along during academic lectures. The less recognized aspect of these struggles, however, is the effect of the stress and frustration they can cause a person.
When an individual has been living with ADHD-related inattentiveness for years or decades, that constant level of stress, embarrassment, and frustration can often have wide-ranging effects on your overall health.
For adults, money can be a common issue for those struggling with impulsivity-related symptoms of ADHD. In day-to-day life, this can mean a tendency to impulse buy unnecessary items, difficulties building or maintaining a budget, missing payment deadlines, or falling into debt. The more complicated and severe these money issues become over time, the more a person struggles with getting out from under them.
According to recent studies, about 40% of adults with ADHD experience some degree of adverse symptoms related to sexual health in their day-to-day lives. For some, these symptoms are related to the stress or frustrations of dealing with symptoms throughout the day, but others struggle to remain present with their partners in the bedroom. Sometimes, these struggles can contribute to larger relationship issues when left unchecked.
When mental health professionals diagnose ADHD, they almost always look at a person's childhood behaviors and the potential symptoms they may have experienced while growing up. One of the more complicated aspects of both hyperactive-impulsive ADHD and inattentive ADHD (ADD), however, is the way in which symptoms change and evolve as a person ages.
With hyperactive-impulsive ADHD, experts find that outward signs of restlessness often develop into less obvious, internal manifestations. In adults, this can mean anything from restless leg syndrome to constant muscle tenseness or extreme difficulty relaxing. Perhaps most problematic is the tendency for hyperactivity to resemble extreme "productivity," with some individuals struggling to differentiate between work ethic and the inability to take a break.
For inattentive ADHD (ADD), symptoms can often become more obvious in adults than they are in children. Typically, this is due to the fact that inattentiveness has a more negative or severe impact on an adult's life than it would on children. Rather than struggling to follow along with a lesson plan or focus on homework, an adult may face very real problems meeting deadlines at work, managing a budget, or even maintaining employment. This change is so severe, in fact, that some studies estimate individuals with ADHD are 60% more likely to be fired from a job.
Types of Treatment and Management
As we mentioned earlier, experts still hesitate to say that certain types of medication or treatment work better or worse with different presentations of ADHD. That said, many more treatment options exist now than in previous years, and mental health professionals typically work with their patients to find a treatment or combination of treatments that work best for their specific circumstances.
In the 21st century, ADHD medications are generally broken into three distinct categories and are prescribed based on an individual's symptoms, any other conditions they may have, and how well they respond to certain drugs.
Stimulants are, by far, the type of medication most commonly prescribed by medical professionals. These drugs work by stimulating dopamine and norepinephrine production in the brain, both of which play crucial roles in helping us pay attention or focus on a task.
While stimulants have a long history of helping children and adults manage symptoms, it's important to note that they aren't without their complications. Specifically, stimulants are strictly controlled due to their potential for abuse and addiction. This means that obtaining a prescription for stimulant-based medications may be more difficult for some, and those with a history of misuse may want to explore other options.
Finally, stimulants may interact poorly with other medications or previously existing medical conditions, such as heart issues. For this reason, patients should always undergo a medical screening with a qualified physician before beginning stimulant medications for ADHD.
When an individual doesn't respond well to stimulant medication, experiences unpleasant or dangerous side effects, wants to avoid stimulants, or even wants to increase the benefits of a stimulant with additional medication, healthcare providers may prescribe various non-stimulant drugs. These options generally come with their own set of advantages and drawbacks but can be very effective for certain individuals.
One of the primary advantages of a non-stimulant medication for ADHD is the fact that they are often not controlled substances, meaning a prescription can be much easier to obtain. Additionally, those with a history of substance misuse or issues with stimulants can avoid the issue entirely by opting for a non-stimulant medication.
In terms of disadvantages, most non-stimulants take much longer to begin fully working than stimulant drugs. This means that rather than experiencing dramatic symptom relief only hours after taking a medication, some non-stimulant options take weeks to build up in the system and provide full benefits.
Although the FDA has not yet approved antidepressants specifically for the treatment of ADHD, they can sometimes be prescribed to supplement the effects of a stimulant medication. Additionally, up to 80% of individuals diagnosed with ADHD will also be diagnosed with another mental health condition during their lifetime.
These other mental health conditions include anxiety disorders, depression, sensory processing disorder, and others. In these cases, an antidepressant prescription may help manage secondary symptoms and improve outcomes.
As we continue researching and understanding more and more about ADHD, both inattentive and hyperactive-impulsive, experts increasingly support the use of cognitive behavior therapy in treating the disorder.
In practice, this type of therapy serves two main purposes. The first is to establish habits and techniques for managing symptoms, whether that means learning ways to physically or mentally relax in high-stress scenarios or how to build sustainable habits to reduce forgetfulness and increase focus. Often, this type of habit-building can give individuals the tools they need to take control of their symptoms and significantly reduce their negative day-to-day impact.
The second benefit of behavioral therapy is its potential to mitigate the self-esteem or confidence issues often associated with ADHD, especially in adults who have gone undiagnosed for much of their lives. This typically involves techniques to reshape the way you think about yourself or your actions, mindfulness exercises, and deliberate effort to rebuild self-confidence.
Regardless of which type of medication or treatment you ultimately choose, it is impossible to overstate the importance of personalized treatment to ensure the best possible outcomes. Just like you are a unique person with unique life experiences, your ADHD also comes with unique considerations that may demand a more nuanced approach. For this reason, it's vital to find a licensed mental health professional or service that treats you as an individual and takes the time necessary to understand your circumstances.
How ADHDAdvisor.org Can Help
As the conversation around ADHD (and ADD) continues to evolve, more and more adults are taking their lives into their own hands and seeking answers. For the roughly 80% of adults with ADHD who have gone undiagnosed, this can be a life-changing process with far-reaching benefits. Unfortunately, the traditional route for seeking a diagnosis and treatment can often come with unnecessary roadblocks and complications.
By taking your diagnosis and treatment online, you can circumvent these issues and find the easiest, most reliable path toward results. When you trust ADHDAdvisor.org for your care, you gain access to a carefully vetted network of licensed mental health professionals dedicated to helping you find answers. Even better, you can pursue treatment options from the comfort of your own home, whether that's guidance on different medications or therapy and coaching sessions fit to your busy schedule.
Frequently Asked Questions
If you’re interested in learning more, check out popular FAQs below.
Are ADD and ADHD symptoms the same?
While ADD and ADHD were previously regarded as separate diagnoses, they're largely considered the same condition by modern experts. That said, individuals with ADD typically demonstrate fewer hyperactive or impulsive symptoms compared to those with ADHD.
What are three major signs of ADHD?
The three primary signs or presentations of ADHD are impulsivity, hyperactivity, and inattentiveness. Among these three areas, symptoms can vary depending on other aspects of a person's life or personality.
Why is ADD no longer a diagnosis?
Today, most mental health professionals no longer differentiate between ADD and ADHD. Instead, ADD is either viewed as a subcategory of ADHD (similar to inattentive ADHD) or is not used at all.