ADD Vs. ADHD
Over 360 million adults worldwide were noted as having a diagnosis of attention-deficit hyperactivity disorder (ADHD) in 2020. Although initially studied mostly in children, ADHD can impact teens and adults, whether it starts in childhood or is noticed later in life, according to the American Psychiatric Association.
When researching ADHD, you may see the acronym "ADD" pop up. You may have heard someone using it to describe themselves in the past or seen it mentioned in the media, which may portray ADD and ADHD interchangeably. You may wonder if ADHD and ADD are similar, the same, or completely different psychiatric conditions.
Attention deficit disorder vs. attention-deficit/hyperactivity disorder
Criteria for ADHD have changed over time, and as psychologists learn more about the condition, the noted symptoms of ADHD continue to adapt. In the DSM III, released in 1980, ADD stood for "attention deficit disorder," whereas ADHD stood for and continues to stand for "attention-deficit/hyperactivity disorder." According to the Child Mind Institute, this condition was referred to as ADD until 1987, when “hyperactivity” was added.
Before the release of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (the DSM-4), ADD was often described as ADHD without symptoms of hyperactivity or impulsivity.
Medical professionals now consider the term ADD to be outdated, with the term ADHD now used to describe both conditions. The DSM now specifies different presentations of ADHD in the criteria for the condition.
Types of ADHD
While ADD is no longer used as a diagnosis, presentations of ADHD that are not dominated by symptoms of hyperactivity or impulsivity still exist.
According to the diagnostic criteria in the DSM presented by the Centers for Disease Control, An ADHD diagnosis requires six or more symptoms for children up to age 16 or five or more symptoms for those ages 17 and older. Symptoms must be present for at least six months and are inappropriate for the developmental level. Specific symptoms vary depending on the type.
There are three main "types" of ADHD, describing how the condition may present. They include the following.
Predominantly inattentive presentation (ADHD-PI)
If enough symptoms of inattentiveness or difficulty sustaining attention are present in someone who meets the criteria for ADHD but does not demonstrate symptoms of hyperactivity/impulsivity, this condition is referred to as the predominantly inattentive type of ADHD, inattentive type ADHD, or simply inattentive ADHD.
Predominantly hyperactive-impulsive presentation (ADHD-HI)
The ADHD-HI presentation is mostly an impulsive presentation, though it can also have a hyperactivity component. If enough symptoms of hyperactivity or impulsivity, but not inattentiveness, are present in someone who meets the criteria for ADHD, they may receive a diagnosis of hyperactive-impulsive ADHD or be medically referred to as a “hyperactive-impulsive type.”
Combined type presentation (combined ADHD)
If enough symptoms of hyperactivity/impulsivity and inattentiveness are present in a person who meets the criteria for ADHD, they may receive a combined presentation diagnosis.
ADHD symptoms
All the above presentations fall under the diagnosis of ADHD, and no one presentation is more authentic or severe than another. Although symptoms vary and present differently from person to person, they can all potentially impact a person's life.
Inattentive symptoms
People with inattentive ADHD tend to exhibit some of the following behaviors:
- Trouble paying attention to detail (for example, difficulty following instructions at work or school)
- Difficulty organizing tasks, such as chores or activities at work or school
- Frequently lose things
- Trouble listening
- Difficulty with time management
- Becoming easily distracted
- Avoidance of tasks or difficulty with tasks that require sustained mental effort
- Difficulty focusing on what someone is saying during a conversation or feeling that one is "spacing out"
Hyperactivity/impulsivity symptoms
Hyperactivity/impulsivity symptoms may include:
- Fidgeting (shaking one's leg, squirming in a seat, noticeably moving hands and feet, not being able to sit for long periods)
- Feeling restless or experiencing bursts of energy/hyperactivity
- Feeling as though one is "on the go" or "driven by a motor"
- Interrupting others
- Having trouble waiting for one's turn
- Difficulty engaging in leisure activities quietly
- Talking often or in a rushed manner
Combined type ADHD may simultaneously include symptoms from the hyperactive/impulsive symptoms list and inattentive list.
For an attention-deficit/hyperactivity disorder diagnosis to occur, a practitioner may first test to see if symptoms are attributed to another condition.
How is ADHD diagnosed? ADHD can be diagnosed in any person of any gender, age, or life experience. ADHD can interfere with work, interpersonal relationships, daily self-care activities, attending appointments and meetings on time, or household chores.
ADHD is a psychiatric condition that can significantly impact a person’s life. It goes beyond the experiences of a person who sometimes struggles to pay attention or makes careless mistakes. Behaviors such as these should not be referred to as “so ADHD” or through other language that may trivialize the condition.
If you believe you may have symptoms of ADHD, consider reaching out to a primary care practitioner for a referral for psychiatric testing.
- Here are some facts and statistics about ADHD:
- Attention-Deficit/Hyperactivity Disorder can impact people of all ages, genders, and backgrounds.
- Those with a parent or sibling with ADHD are statistically more likely to live with ADHD. Peer reviewed studies show a 74% hereditary rate for the condition.
- A person's age can affect their symptoms. Per research by the National Resource Center on ADHD, 4% of children in the United States are said to receive a diagnosis of ADHD at some point, whereas 8.4% have a current diagnosis. A child’s symptoms of ADHD may overlap with adult symptoms, but they may also demonstrate additional symptoms, such as behavior problems.
- About 4.4% of adults in the United States live with ADHD, according to the National Institute of Mental Health.
- Research demonstrates that people with ADHD struggle with sleep disturbances more often than the rest of the general population. This disturbance may include trouble falling asleep or difficulty staying asleep.
- Several comorbidities or co-occurring conditions may be more likely to present in those with ADHD than in the general population. These conditions include but are not limited to mood disorders, anxiety disorders, depression, autism spectrum disorder (ASD), and substance use conditions*.
- *Substance use conditions may feel isolating. If you or someone you know struggles with substance use or a substance use disorder, contact the SAMHSA National Helpline at 1-800-662-4357 or visit the SAMHSA website.
If you or someone in your care may have ADHD, you might wonder how to start the diagnostic process. Often, the diagnostic process for attention-deficit/hyperactivity disorder may involve mental health professionals who specialize in ADHD.
To find someone qualified to provide an ADHD diagnosis, you can:
- Search the web for centers or providers in your area
- Ask your general doctor, psychiatrist, or therapist to refer you to someone who can provide an ADHD evaluation
During your evaluation appointment, a provider may analyze your symptoms and medical history, which may be a lengthy process. However, a diagnosis can be valuable and potentially life-changing for someone previously living with undiagnosed ADHD.
A diagnosis may provide relief because it can give you a starting point to address your symptoms. With a diagnosis, you may be able to manage ADHD through treatment, a personal understanding of your symptoms and how they affect you, and potential accommodations at work or school.
Treatment for ADHD and other mental disorders
ADHD is often treated using medication or a combination of medication and therapy for children and adults. There are stimulant and non stimulants for ADHD medication. Consult your prescribing doctor or primary care physician when considering medication, primarily if you already take other medicines.
Symptoms of his condition may impact all areas of your life, and behavior therapy may be an effective ADHD treatment option. ADHD might affect work and school experiences, daily tasks, interpersonal relationships, stress levels, and a person's emotions. For example, many people with ADHD face increased rejection sensitivity. A counselor may help you learn to deal with these symptoms on an emotional level, as well as treat other conditions that may co-occur alongside ADHD, such as a mood disorder.
Studies show that online counseling is as effective as traditional counseling for those with ADHD. Online counseling could be a valuable alternative for someone who struggles to remember appointments or find the motivation to leave home.
Meeting with a counselor may benefit you if you struggle with ADHD symptoms, interpersonal relationships, life stress, or other mental health concerns. To find a therapist, you can ask your primary care physician for a referral, contact your insurance company to see who they cover, search the web, or sign up for a reputable online therapy platform such as BetterHelp.
Counselor reviews
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Takeaway
Although ADD is no longer a clinical term, there are several defined types of ADHD, and the inattentive type may exhibit symptoms similar to those initially outlined under ADD. When reading about this condition, you may want to consider using only high quality sources that refer to it by its correct name. If you're interested in learning more about this topic as it applies to your own potential diagnosis, or if you have a child with ADHD and are interested in parent training, consider reaching out to a counselor and taking the first step toward better self-understanding and behavior management.
The terms attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) are often used interchangeably, but there is a notable distinction in how they are viewed by the American Psychiatric Association (APA). According to the APA, the official diagnosis recognized is ADHD, and not ADD. This distinction is reflected in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the standard classification of mental disorders used by mental health professionals in the U.S.
ADHD is characterized by a pattern of behavior that includes difficulty maintaining attention, hyperactivity, and impulsivity. In earlier editions of the DSM, ADD was used to describe individuals who had trouble focusing but did not exhibit hyperactivity. However, with the release of the DSM-IV in 1994, ADD was integrated into ADHD and categorized into three types: predominantly inattentive, predominantly hyperactive-impulsive, and combined.
- Predominantly inattentive presentation (formerly known as ADD): This subtype is what was previously referred to as ADD. Individuals with this subtype struggle mainly with inattention and are less likely to display the hyperactive or impulsive behaviors commonly associated with ADHD.
- Predominantly hyperactive-impulsive presentation: Individuals in this category primarily show hyperactive and impulsive behavior, with less emphasis on inattention.
- Combined presentation: This is the most common subtype and includes symptoms of both inattention and hyperactivity/impulsivity.
The DSM-5 has done away with the term ADD and instead includes all three subtypes under the umbrella diagnosis of ADHD. This change was made to better reflect the range of symptoms and presentations observed in individuals with this condition.
Since the term ADD is no longer used in official diagnoses, it's important to focus on understanding ADHD and its subtypes. If you are experiencing symptoms of inattention, hyperactivity, or impulsivity, it's best to consult with a licensed mental health professional for an accurate diagnosis.
It's also important to note that everyone experiences ADHD differently. Some individuals may face more challenges with inattention, while others may require constant movement or display impulsive behaviors. It's not a one-size-fits-all condition; an accurate diagnosis can help you better understand your unique experience.
Why is ADD no longer a diagnosis?
New research and clinical practice guidelines have led to a better understanding of ADHD and how it presents in individuals. The term ADD was replaced with ADHD to more accurately reflect the range of symptoms and presentations observed in individuals with this condition.
However, it's essential to note that individual differences are still recognized within the diagnosis of ADHD. Inattentive and hyperactive-impulsive subtypes are still acknowledged and taken into consideration when diagnosing and treating individuals with ADHD.
The outdated term "ADD" was replaced with ADHD to better reflect the range of symptoms and presentations observed in individuals with this condition. The updated term allows for a more comprehensive understanding of ADHD, its subtypes, and how it affects individuals.
While ADD is more generalized, it fails to capture the various ways ADHD can manifest in individuals. By including hyperactivity and impulsivity in the name, it provides a more accurate representation of the condition and allows for more individualized treatment plans.
The right diagnosis can make a significant impact on your life, and it's essential to work with a licensed professional for an accurate assessment and diagnosis. With proper knowledge and understanding, individuals with ADHD can learn to manage their symptoms and thrive in all aspects of life. The updated terminology of ADHD serves as a step towards better understanding and destigmatizing this common condition.
ADHD and autism, or autism spectrum disorder (ASD), are distinct conditions, but there is a notable overlap between them. According to information from the National Institute of Health, a significant number of individuals with ASD also present with comorbid ADHD. Research suggests that 50 to 70% of individuals with ASD may have concurrent symptoms of ADHD.
While ADHD and ASD are separate neurodevelopmental disorders, they have some behavioral characteristics, such as difficulties with social interactions and communication, challenges in focusing and maintaining attention, and a tendency towards repetitive behaviors. However, the core features of these disorders differ: ASD is primarily characterized by challenges in social communication and interaction, along with restricted and repetitive patterns of behavior or interests. In contrast, ADHD is defined by persistent patterns of inattention and/or hyperactivity-impulsivity that can interfere with functioning or development.
The high rate of comorbidity between ADHD and ASD complicates the diagnosis and treatment of these conditions. The overlapping symptoms can make it challenging to distinguish between the two disorders, especially in children. Consequently, a comprehensive evaluation by healthcare professionals is essential to identify and address each condition accurately.
Understanding the relationship between ADHD and ASD is crucial for developing effective treatment plans. For individuals with both conditions, tailored approaches that address the unique challenges posed by the co-occurrence of ADHD and ASD are necessary to improve outcomes.
Only a licensed mental health professional can provide a definitive diagnosis of ADHD or autism. If you suspect that you may have one or both conditions, it's best to seek an evaluation from a qualified specialist who can diagnose ADHD and/or ASD accurately.
However, some common symptoms can help you identify whether you may have ADHD or autism. Individuals with ADHD may experience difficulty paying attention, hyperactivity, impulsivity, disorganization, forgetfulness, and procrastination. On the other hand, those with autism may struggle with social communication and interaction, sensory sensitivities or aversions, repetitive behaviors or interests, inflexibility in routines, or living in their own world.
Multiple symptoms must be present in two or more settings, such as at home, school, or work, for a diagnosis of ADHD or autism to be made. A licensed professional can also rule out other conditions that may mimic the symptoms of ADHD and/or ASD.
Remember, self-diagnosis is not reliable. Sometimes, a physical exam or other medical tests may be necessary to rule out any underlying medical conditions that may present with similar symptoms. Seeking professional help is the best and most accurate way to determine whether you have ADHD or autism and receive appropriate treatment for your unique needs.
Can you outgrow ADHD or ADD?
While many children with ADHD may find their symptoms improve as they grow older, it's a persistent and chronic condition that can continue into adulthood. Adults may experience the same symptoms they did as children, or they may develop new ones. However, limited information exists regarding the exact number or percentage of individuals who continue to have ADHD into adulthood.
While adults may learn to manage their symptoms better and develop coping mechanisms over time, it's unlikely that they will completely outgrow ADHD. Without proper diagnosis and management, adults with undiagnosed or untreated ADHD may continue to experience difficulties in their personal and professional lives.
It's important to remember that ADHD is not a character flaw or a result of poor parenting or lack of willpower. It is a neurodevelopmental condition that requires understanding, support, and effective treatment for individuals to reach their full potential. Seeking an accurate diagnosis and engaging in appropriate treatments can help individuals with ADHD thrive in all aspects of life.
When one or both parents have ADHD, there is a greater chance that their child will also have the condition. The formal heritability of ADHD is estimated to be about 80%, which is quite high. This statistic indicates that genetic factors play a significant role in the likelihood of developing ADHD.
The genetic component of ADHD involves multiple genes, and the inheritance pattern is complex. It's not a case of a single gene being passed down but rather a combination of genes that contribute to the risk of developing the disorder.
However, it's important to note that genetics is not the only factor at play. Environmental factors can also influence the development of ADHD. These can include issues during pregnancy (such as smoking, alcohol use, and stress), premature birth, and environmental toxins. Additionally, factors like family dynamics, educational approaches, and social interactions can have an impact.
In families where ADHD is present, understanding the genetic component can be helpful in managing expectations and planning. Early diagnosis and intervention can make a significant difference in managing ADHD symptoms. Appropriate intervention may include behavioral therapy, educational support, and, in some cases, medication.
Can ADHD develop later in life?
The concept of late-onset ADHD, where symptoms first appear in adulthood, is an area of growing research and interest. Traditionally, ADHD was considered a disorder that began in childhood, but recent studies have challenged this view. These studies claim that a significant proportion of adult ADHD cases do not experience symptom onset in childhood. Specifically, it's suggested that between 67.5% and 90.0% of adults diagnosed with ADHD may not have shown noticeable symptoms before adolescence.
Late-onset ADHD implies that some individuals may start exhibiting ADHD symptoms during adolescence or adulthood without a clear history of these symptoms in their early years. This challenges the earlier understanding of ADHD as primarily a developmental disorder that starts in childhood.
However, this concept is still a subject of debate among experts. Some argue that these late-onset cases might be the result of missed diagnoses during childhood or that symptoms were present but not recognized or reported. Others suggest that late-onset ADHD could be a distinct subtype or related to other psychological or lifestyle factors that emerge in adulthood.
Diagnosing ADHD in adults can be complex, as symptoms can overlap with other mental health conditions and life circumstances. Therefore, a thorough evaluation is necessary to distinguish late-onset ADHD from other possible causes of attentional problems and impulsivity that can begin in adulthood.
What age does ADHD peak?
ADHD is most commonly identified and diagnosed during childhood. According to the National Center for Biotechnology Information (NCBI), ADHD symptoms typically rise between preschool years and peak around the start of school. This pattern supports the traditional understanding of ADHD as a neurodevelopmental disorder.
In most cases, ADHD is diagnosed in children around the age of 7, coinciding with the time when its symptoms become more noticeable and potentially disruptive in a school setting. The increase in symptoms from preschool to school age can be attributed to the greater demands for sustained attention and self-control that school environments require, which can highlight difficulties in children with ADHD.
As children mature and learn to cope with their symptoms, they may experience a decrease in the intensity or frequency of their symptoms. However, this is not always the case for everyone with ADHD. While some individuals may see a reduction in symptoms, others may continue to experience challenges throughout their lives.
It's also crucial to distinguish ADHD symptoms from those of other conditions that can develop in adolescence and mimic ADHD, such as depression and anxiety. These conditions can cause difficulties with attention, focus, and impulsivity without necessarily indicating ADHD.
As with any developmental disorder, early identification and appropriate interventions can make a significant difference in managing ADHD symptoms and promoting positive outcomes. ADHD resources are available for parents, teachers, and healthcare professionals to support children with ADHD and help them reach their full potential.
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