Table of ContentsView AllTable of ContentsTypes of ADHDDiagnosisInattentive SymptomsHyperactive-Impulsive SymptomsImportanceWhat It MeansProgression Over TimeFind the Right Type of Support

Table of ContentsView All

View All

Table of Contents

Types of ADHD

Diagnosis

Inattentive Symptoms

Hyperactive-Impulsive Symptoms

Importance

What It Means

Progression Over Time

Find the Right Type of Support

Close

Some people with ADHD struggle to focus (inattentive type), while others have a hard time staying still (hyperactive/impulsive type). For some people, it’s both.

Of the three presentations of ADHD, the combined type is the most common.According to some research, approximately 70% of adults with ADHD have the combined type.

Let’s take a closer look at how combined type ADHD is diagnosed and why getting an accurate diagnosis is beneficial. We’ll also explore some treatment options to help people manage inattentive, hyperactive, and impulsive traits.

The 3 Types of ADHD

There are three forms of attention deficit hyperactivity disorder (ADHD). These are:

These different forms of ADHD used to be called ADHD subtypes. Then, when thefifth edition of the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5) was published in 2013, the term “subtype” was changed to “presentation.“For example, a person could bediagnosedwith attention deficit hyperactivity disorder, combined presentation.

Even though the official term is now presented, many people still use the terms “subtypes” and “types.” Occasionally, combined ADHD might be referred to as ADHD-C.

How Combined Type ADHD Is Diagnosed

All ADHD types are diagnosed in the same way. An experienced healthcare professional performs a detailed evaluation. This clinician gathers information from various sources, including an interview with you (or your child), your medical history, your family medical history, and your school experiences.

The assessment might also include intellectual screening, memory testing, attention and distraction tests, and an interview with your spouse. If a child is being assessed, the child’s parent will most likely be interviewed.

At the end of the evaluation, the clinician will determine if the criteria for ADHD outlined in the DSM-5 have been met. If they have, then a diagnosis of ADHD can be made. You or your child will be diagnosed with an ADHD presentation. This will be either inattentive, hyperactive-impulsive, or combined ADHD.

ADHD Diagnostic Criteria

The DSM-5 identifies 18 symptoms of ADHD: nine symptoms of inattention and nine symptoms of hyperactivity-impulsivity. To possibly warrant a diagnosis of combined ADHD, the following conditions must be met:

RecapInattentive traits all come down to one key factor: attention. Because it’s so hard to focus, these inattentive characteristics make it hard to pay attention, follow instructions, and stay on task.

Recap

Inattentive traits all come down to one key factor: attention. Because it’s so hard to focus, these inattentive characteristics make it hard to pay attention, follow instructions, and stay on task.

The Relationship Between Depression and ADHD

RecapHyperactive-impulsive symptoms are all about energy and the ability to control impulses. These characteristics make it tough to sit still. This means they have lots of energy, but it’s often hard to control and restrain in certain situations.

Hyperactive-impulsive symptoms are all about energy and the ability to control impulses. These characteristics make it tough to sit still. This means they have lots of energy, but it’s often hard to control and restrain in certain situations.

Top ADHD Resources for Adults

Why Getting a Combined Type ADHD Diagnosis Matters

As with many topics, knowledge is power. The more you know about your neurotype and your presentation of ADHD, the more empowered you feel. This, in turn, means you can get the righttreatment, accommodations, and support that can help you manage your ADHD characteristics.

Knowing what ADHD presentation you have means you can distinguish between what is an ADHD symptom and what is part of your unique personality. Sometimes, people struggle for years with an aspect of ADHD they think is just part of who they are, only to find later that it is related to ADHD and that treatment is available to help.

In addition to the practical benefits, there are psychological benefits to knowing how ADHD affects you. There is a lot of moral judgment around behaviors that result from having ADHD. For example, being unable to sit still in a meeting might be “disrespectful.”

A person who makes what seems like careless mistakes at school may be labeled “unmotivated.” Unfortunately, these labels are often internalized and affect a person’s confidence and self-worth. Adults and children with ADHD often call themselves lazy or stupid, when they are neither.

What It Means to Have Combined Type ADHD

Having combined type ADHD does not automatically mean your ADHD is more severe compared to someone who is diagnosed with the predominantly hyperactive type or predominantly inattentive type.

For example, a person who has predominantly hyperactive-impulsive type might still experience some symptoms from the inattentive symptom list. However, they would not have the full five or six symptoms to be given a combined ADHD diagnosis. Being diagnosed with combined type ADHD means your symptoms are more likely to be evenly distributed between the two types.

Anyone diagnosed with ADHD after May 2013 (when the DSM-5 was published) is told how severe their ADHD is. It could be mild (while still meeting the ADHD criteria), moderate, or severe. This rating is a more accurate way to knowthe severity of your condition, rather than judging it based on the type of ADHD you have.

How Combined Type ADHD Progresses Over Time

When the DSM-5 was published, it replaced the term ADHD subtypes with ADHD presentations. This change reflected the new understanding researchers have of ADHD. Rather than being a fixed and stagnant condition that could be neatly divided into subtypes, we now know that a person’s ADHD presentation and severity are more fluid and can change with age and the setting.

ADHD characteristics alsotend to change with age. Predominantly hyperactive presentation could be an early developmental stage of combined ADHD. Symptoms of hyperactivity and impulsivity tend to decline as a person ages.

People diagnosed with hyperactivity will develop sufficient symptoms related to attention regulation in three to five years. These new symptoms will be strong enough that these people will meet the requirements to be diagnosed with ADHD combined presentation.

For example, a person who experienced hyperactivity as a child and found it hard to sit still might be able to sit still when required as an adult but will feel internal restlessness and discomfort.

Treatments and Support for Combined Type ADHD

If you or your child have combined ADHD, it is important to address both the inattentive and the hyperactive and impulsive symptoms.

ADHD is a form ofneurodivergence, which involves a difference in how a person’s brain processes and interprets information.It does not need to be cured, but there are strategies that people can use to help them manage different characteristics of their ADHD.

As with all types of ADHD, the most effective treatment plan for combined ADHD is usually medication plus behavioral treatments liketherapy, accommodations, social skills, and lifestyle changes.

There are no specificADHD medicationsthat work best for certain types of ADHD.

Instead, finding the right medication and dose is something that your doctor will be able to help with. You might try several ADHD medications until you find one that helps your ADHD symptoms and has minimal side effects.

Takeaways

Understanding your presentation of ADHD can help you better explore different ways to manage the traits that affect your ability to function in homework, school, and relationships. Finding ways to cope with certain behaviors, such as restlessness and difficulty focusing, can keep ADHD characteristics from creating disruptions in different areas of your life.

5 People on What ADHD Actually Feels Like

8 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wilens TE, Spencer TJ.Understanding attention-deficit/hyperactivity disorder from childhood to adulthood.Postgrad Med. 2010;122(5):97-109. doi:10.3810/pgm.2010.09.2206Virginio Salvi, Giovanni Migliarese, Viviana Venturi, et al.ADHD in adults: clinical subtypes and associated characteristics.Rivista di Psichiatria. 2019;(2019March-April). doi:10.1708/3142.31249Zayats T, Neale BM.Recent advances in understanding of attention deficit hyperactivity disorder (ADHD): how genetics are shaping our conceptualization of this disorder.F1000Res. 2019;8:F1000 Faculty Rev-2060. doi:10.12688/f1000research.18959.2Epstein JN, Loren REA.Changes in the Definition of ADHD in DSM-5: Subtle but Important.Neuropsychiatry. 2013;3(5):455-458. doi:10.2217/npy.13.59American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Franke B, Michelini G, Asherson P, et al.Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan.Eur Neuropsychopharmacol. 2018;28(10):1059-1088. doi:10.1016/j.euroneuro.2018.08.001Honkasilta J, Koutsoklenis A.The (un)real existence of ADHD-criteria, functions, and forms of the diagnostic entity.Front Sociol. 2022;7:814763. doi:10.3389/fsoc.2022.814763National Institute of Mental Health.Attention-deficit/hyperactivity disorder in adults: What you need to know.

8 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Wilens TE, Spencer TJ.Understanding attention-deficit/hyperactivity disorder from childhood to adulthood.Postgrad Med. 2010;122(5):97-109. doi:10.3810/pgm.2010.09.2206Virginio Salvi, Giovanni Migliarese, Viviana Venturi, et al.ADHD in adults: clinical subtypes and associated characteristics.Rivista di Psichiatria. 2019;(2019March-April). doi:10.1708/3142.31249Zayats T, Neale BM.Recent advances in understanding of attention deficit hyperactivity disorder (ADHD): how genetics are shaping our conceptualization of this disorder.F1000Res. 2019;8:F1000 Faculty Rev-2060. doi:10.12688/f1000research.18959.2Epstein JN, Loren REA.Changes in the Definition of ADHD in DSM-5: Subtle but Important.Neuropsychiatry. 2013;3(5):455-458. doi:10.2217/npy.13.59American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Franke B, Michelini G, Asherson P, et al.Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan.Eur Neuropsychopharmacol. 2018;28(10):1059-1088. doi:10.1016/j.euroneuro.2018.08.001Honkasilta J, Koutsoklenis A.The (un)real existence of ADHD-criteria, functions, and forms of the diagnostic entity.Front Sociol. 2022;7:814763. doi:10.3389/fsoc.2022.814763National Institute of Mental Health.Attention-deficit/hyperactivity disorder in adults: What you need to know.

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Wilens TE, Spencer TJ.Understanding attention-deficit/hyperactivity disorder from childhood to adulthood.Postgrad Med. 2010;122(5):97-109. doi:10.3810/pgm.2010.09.2206Virginio Salvi, Giovanni Migliarese, Viviana Venturi, et al.ADHD in adults: clinical subtypes and associated characteristics.Rivista di Psichiatria. 2019;(2019March-April). doi:10.1708/3142.31249Zayats T, Neale BM.Recent advances in understanding of attention deficit hyperactivity disorder (ADHD): how genetics are shaping our conceptualization of this disorder.F1000Res. 2019;8:F1000 Faculty Rev-2060. doi:10.12688/f1000research.18959.2Epstein JN, Loren REA.Changes in the Definition of ADHD in DSM-5: Subtle but Important.Neuropsychiatry. 2013;3(5):455-458. doi:10.2217/npy.13.59American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Franke B, Michelini G, Asherson P, et al.Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan.Eur Neuropsychopharmacol. 2018;28(10):1059-1088. doi:10.1016/j.euroneuro.2018.08.001Honkasilta J, Koutsoklenis A.The (un)real existence of ADHD-criteria, functions, and forms of the diagnostic entity.Front Sociol. 2022;7:814763. doi:10.3389/fsoc.2022.814763National Institute of Mental Health.Attention-deficit/hyperactivity disorder in adults: What you need to know.

Wilens TE, Spencer TJ.Understanding attention-deficit/hyperactivity disorder from childhood to adulthood.Postgrad Med. 2010;122(5):97-109. doi:10.3810/pgm.2010.09.2206

Virginio Salvi, Giovanni Migliarese, Viviana Venturi, et al.ADHD in adults: clinical subtypes and associated characteristics.Rivista di Psichiatria. 2019;(2019March-April). doi:10.1708/3142.31249

Zayats T, Neale BM.Recent advances in understanding of attention deficit hyperactivity disorder (ADHD): how genetics are shaping our conceptualization of this disorder.F1000Res. 2019;8:F1000 Faculty Rev-2060. doi:10.12688/f1000research.18959.2

Epstein JN, Loren REA.Changes in the Definition of ADHD in DSM-5: Subtle but Important.Neuropsychiatry. 2013;3(5):455-458. doi:10.2217/npy.13.59

American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.

Franke B, Michelini G, Asherson P, et al.Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan.Eur Neuropsychopharmacol. 2018;28(10):1059-1088. doi:10.1016/j.euroneuro.2018.08.001

Honkasilta J, Koutsoklenis A.The (un)real existence of ADHD-criteria, functions, and forms of the diagnostic entity.Front Sociol. 2022;7:814763. doi:10.3389/fsoc.2022.814763

National Institute of Mental Health.Attention-deficit/hyperactivity disorder in adults: What you need to know.

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