How to recognize the 3 different types of ADHD and treat them
- There are three types of ADHD: impulsive/hyperactive type
ADHD, inattentive type ADHD, and combined type ADHD, which involves symptoms of both the first two types.
- People with impulsive/hyperactive type ADHD may fidget often, have temper outbursts, and may struggle with self-control.
- People with inattentive type ADHD have symptoms like forgetfulness, trouble with organization, and being easily distracted.
- This article was medically reviewed by Mayra Mendez, Ph.D., LMFT, a licensed psychotherapist and program coordinator for intellectual and developmental disabilities and mental
healthservices at Providence Saint John's Child and Family Development Center in Santa Monica, California.
Attention-deficit/hyperactivity disorder (ADHD), is a mental health condition that often develops in childhood, but people can also be diagnosed as an adult.
There are three main subtypes categorized by behavioral symptoms: predominantly inattentive, predominantly impulsive-hyperactive, and combined type.
Here's how to recognize them and manage the condition.
The three types of ADHD
There are three types of ADHD: impulsive/hyperactive type ADHD, inattentive type ADHD, and combined type ADHD, which is characterized by a combination of the symptoms of the first two types.
Impulsive/Hyperactive Type ADHD
This is the least common type of ADHD. It is most prevalent in boys and adult men. A person with impulsive/hyperactive type ADHD may fidget often, move about constantly, and feel restless.
This type of ADHD also causes impulsivity, which leads people with this type to take action without thinking it through. For example, they may finish other people's sentences or blurt out an answer to a question before it's completed.
Some symptoms of impulsive/hyperactive type ADHD include:
- Struggling with self-control
- Struggling to stay seated in a particular place
- Fidgeting often
- Intruding in other people's activities and conversations
- Temper outbursts
- Having difficulty waiting their turn
Inattentive Type ADHD
ADHD is generally twice as prevalent among boys than girls. However, inattentive type ADHD is more common in girls. It is also more prevalent in older children and adults.
People with this type of ADHD have symptoms stemming from not being able to focus properly. Unlike with impulsive/hyperactive ADHD, people with this type do not show any signs of hyperactivity or impulsivity. Instead, the main symptoms of this type are:
- Being easily distracted
- Reluctance to do tasks that require sustained mental effort, like schoolwork
- Fixation on activities that don't require sustained mental effort, like television
- Trouble with organization
- Often makes careless errors
Combined Type ADHD
This is the most common type of ADHD. People with this condition, experience a combination of symptoms found in people with inattentive and impulsive/hyperactive types. This means that a person with this condition will experience symptoms of inattention, impulsivity, and hyperactivity.
To recognize this type of ADHD, you should be on the lookout for some of these symptoms and behaviors:
- A short attention span
- Being easily distracted
- Frequently interrupting others
- Often acting without thinking
- Talking a lot
- Fidgeting excessively
- Losing things often
How to treat ADHD
A combination of medication and behavior therapy is often used to treat ADHD and are considered, "the two most evidence-based and effective treatments," says Ronald T. Brown MD, a medical expert on ADHD and Dean for the School of Integrated Health Sciences at the University of Nevada.
There's no cure for ADHD, but there are medications to help people who have the disorder manage their symptoms and live comfortably. The two main categories of medication for ADHD are:
- Stimulants: This is the most widely used option for treating ADHD symptoms in both children and adults. "Stimulant medication has been repeatedly shown to work efficiently. However, it doesn't cure the problem. It typically takes care of the symptoms," Brown says. Stimulants work by increasing the production of dopamine and norepinephrine in the brain. These chemicals help people with ADHD to maintain attention and reduce symptoms of hyperactivity and impulsivity. Examples include Methylin and Adderall.
- Non-stimulants: These are a less traditional form of ADHD medication and are also relatively new. Atomoxetine (Straterra) was the first non-stimulant medication to be approved by the Food and Drug Administration (FDA) for ADHD treatment in 2003. They don't work as quickly as stimulants but can have lasting effects. Most non-stimulants improve ADHD symptoms like hyperactivity and inattention by raising the levels of norepinephrine in the brain.
Non-stimulant medications like Atomoxetine and Guanfacine are usually recommended for people who experience severe side effects when using stimulants. Antidepressants like Wellbutrin XR and Effexor XR and antiviral drugs like Symmetrel can also be used as non-stimulant medications for ADHD.
However, when ADHD is diagnosed in children below the age of six, the Academy of Pediatrics (AAP) recommends behavior therapy as the first line of treatment, before medication.
This is because the effectiveness of medication in children below the age of six can be inconsistent. Side effects such as sadness, irritability, and insomnia are also more likely to occur.
Medication is usually only prescribed if behavior therapy provides no significant improvement and ADHD symptoms are severe enough to disrupt the child's function.
The premise of behavior therapy is that all behavior is learned, and we can unlearn certain behaviors with proper training. The point of behavior therapy is to strengthen positive behaviors and eliminate negative ones. Behavior therapy makes use of positive reinforcement like a compliment or a gift to reward good behavior, and negative consequences like giving extra chores in response to inappropriate behavior. This decreases misbehavior in the long term.
Behavior therapy is most effective in young children when it is done by their parents. The parents are trained by certified therapists, to learn positive ways to communicate with the child and use positive reinforcement and discipline to manage the child's symptoms.
In adults, behavior therapy looks a little different. It's usually considered as an additional treatment to supplement some form of ADHD medication. It's done with a licensed therapist and focuses on equipping adults who have the condition with the skills to manage their behaviors and symptoms.
It is important to know that for behavior therapy to be successful, it must be done consistently and may take several months for improvement to be seen.
ADHD presents in three subtypes - primarily inattentive, primarily hyperactive-impulsive, and combined. Determining your course of treatment highly depends on the type of ADHD you have. However, diagnosing ADHD can be difficult, as there is no specific test for it, and other problems like anxiety and certain learning disabilities can have similar symptoms.
"There's no single test for properly diagnosing ADHD, if you have concerns or notice multiple traits within two or more settings, consult your health care provider who specializes in ADHD such as a pediatrician, psychologist, and psychiatrist," Brown recommends.
The goal of ADHD treatment is to improve symptoms, therefore, identifying the specific type of ADHD you have and recognizing its symptoms is key to managing the condition.
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