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What is ADHD?

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Researched by our in-house Journalist Paul Joubert
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Paul Joubert
Neuroscience, brain imaging, and clinical research tell us a few important things: ADHD is not a behavior disorder. ADHD is not a mental illness. ADHD is not a specific learning disability. ADHD is, instead, a developmental impairment of the brain’s self-management system. Both adults and children can be diagnosed with ADHD.

ADHD Symptoms

Common ADHD symptoms include:

inattention

lack of focus

poor time management

weak impulse control

exaggerated emotions

hyperfocus

hyperactivity

executive dysfunction

ADHD symptoms vary by individual. You or your child may experience all or just some of the above symptoms, along with others detailed in the DSM-V.

Many patients and clinicians describe ADHD as an iceberg, where most symptoms lay hiding under the surface — out of sight but ever present. If you think you or a loved one might have ADHD, take one of our free, anonymous tests below to see if you should seek a formal diagnosis.

What Are the 3 Types of ADHD?

The Diagnostic and Statistical Manual of Mental Disorders (DSM)  previously identified three types of ADHD:

Primarily hyperactive-impulsive type

Primarily inattentive type (formerly called ADD)

Primarily combined type

Primarily Hyperactive-Impulsive ADHD

People with primarily hyperactive-impulsive ADHD act “as if driven by a motor” with little impulse control — moving, squirming, and talking at even the most inappropriate times. They are impulsive, impatient, and interrupt others.

Primarily Inattentive ADHD (Formerly ADD)

People with the inattentive subtype of ADHD have difficulty focusing, finishing tasks, and following instructions. They are easily distracted and forgetful. They may be daydreamers who lose track of homework, cell phones, and conversations with regularity.

Experts believe that many children with the inattentive subtype of ADHD may go undiagnosed because they do not tend to disrupt the learning environment.

Primarily Combined Type ADHD

Individuals with combined-type ADHD display a mixture of all the symptoms outlined above. A physician will diagnose patients with this Combined Type ADHD, of they meet the guidelines for Primarily Inattentive ADHD and Primarily Hyperactive-Impulsive ADHD. That is, they must exhibit 6 of the 9 symptoms identified for each sub-type.

How Do Physicians Diagnose the Type of ADHD?

These subtypes are now considered “presentations” in the most recent version of the DSM, the DSM-V. Researchers determined that people often move from one subtype to another. For example, a child may present as primarily hyperactive-impulsive in preschool, and  lose much of the hyperarousal in adolescence to fit the primarily inattentive presentation. In college and adulthood, the same individual may transition to combined presentation.

The subtypes were primarily based on overt behavioral symptoms, and ignored less visible symptoms like emotional dysregulation, cognitive patterns, and sleep difficulties. Behavioral symptoms imperfectly capture the defining features of ADHD. Non-behavioral characteristics are increasingly recognized in research and diagnosis.

What Are the Symptoms of Each ADHD Subtype?

The symptoms of ADHD are spelled out in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), which lists nine symptoms that suggest ADHD–Primarily Inattentive and nine that suggest ADHD–Primarily Hyperactive/Impulsive. A child may be diagnosed with ADHD only if he or she exhibits at least six of nine symptoms from one of the lists below, and if the symptoms have been noticeable for at least six months in two or more settings — for example, at home and at school. What’s more, the symptoms must interfere with the child’s functioning or development, and at least some of the symptoms must have been apparent before age 12. Older teens and adults may need to consistently demonstrate just five of these symptoms in multiple settings.

What Are the 9 Symptoms of ADHD – Primarily Inattentive Type?

Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or during other activities (e.g., overlooks or misses details, work is inaccurate).

Often has difficulty sustaining attention in tasks or play activities (e.g., has difficulty remaining focused during lectures, conversations, or lengthy reading).

Often does not seem to listen when spoken to directly (e.g., mind seems elsewhere, even in the absence of any obvious distraction).

Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., starts tasks but quickly loses focus and is easily sidetracked).

Often has difficulty organizing tasks and activities (e.g., difficulty managing sequential tasks; difficulty keeping materials and belongings in order; messy, disorganized work; has poor time management; fails to meet deadlines).

Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (e.g., schoolwork or homework; for older adolescents and adults, preparing reports, completing forms, reviewing lengthy papers).

Often loses things necessary for tasks or activities (e.g., school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).

Is often easily distracted by extraneous stimuli (for older adolescents and adults, may include unrelated thoughts).

Is often forgetful in daily activities (e.g., doing chores, running errands; for older adolescents and adults, returning calls, paying bills, keeping appointments).

What Are the 9 Symptoms of ADHD – Primarily Hyperactive-Impulsive Type?

Often fidgets with or taps hands or feet or squirms in seat.

Often leaves seat in situations when remaining seated is expected (e.g., leaves his or her place in the classroom, in the office or other workplace, or in other situations that require remaining in place).

Often runs about or climbs in situations where it is inappropriate. (Note: In adolescents or adults, may be limited to feeling restless.)

Often unable to play or engage in leisure activities quietly.

Is often “on the go,” acting as if “driven by a motor” (e.g., is unable to be or uncomfortable being still for extended time, as in restaurants, meetings; may be experienced by others as being restless or difficult to keep up with).

Often talks excessively.

Often blurts out an answer before a question has been completed (e.g., completes people’s sentences; cannot wait for turn in conversation).

Often has difficulty waiting his or her turn (e.g., while waiting in line).

Often interrupts or intrudes on others (e.g., butts into conversations, games, or activities; may start using other people’s things without asking or receiving permission; for adolescents and adults, may intrude into or take over what others are doing).”

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