Content reviewed and updated: 03/12/21
What’s the Difference Between ADD and ADHD?
Attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) used to be distinct diagnoses. ADD was characterized by an inability to pay attention or manage time effectively, while ADHD was characterized by hyperactivity and impulsivity.
Nowadays, however, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is a go-to resource for diagnosing mental health conditions, lists ADD and ADHD as the same condition. To be more exact, ADD is now considered a specific presentation of ADHD. The term “ADD” is no longer used. Rather, “ADHD” is now considered the appropriate medical label for symptoms of inattention as well as hyperactivity and impulsivity.
Continue reading to learn more about ADD versus ADHD, what exactly ADHD is, and the different subtypes (or presentations) of ADHD.
How are ADD and ADHD different?
ADD and ADHD are no longer different diagnoses. In fact, “ADD” is actually an outdated term. The symptoms formerly attributed to ADD are now attributed to a specific subtype of ADHD (more on the different subtypes of ADHD later).
The diagnosis of “attention deficit disorder (ADD) with or without hyperactivity,” or simply “ADD,” was introduced by the American Psychiatric Association in the DSM-3 in 1980. In 1987, in an updated version of the DSM-3, the standard name of this disorder was changed from ADD to ADHD. In 1994, three subtypes of ADHD were introduced in the DSM-4. The current version, the DSM-5, which was published in 2013, describes these different subtypes as presentations of symptoms that develop and change throughout a person’s lifetime. By today’s standards, what was once diagnosed as ADD would be diagnosed as the inattentive presentation of ADHD.
Someone with inattentive ADHD does not tend to exhibit hyperactivity or impulsivity. Instead, they typically experience symptoms like trouble focusing or an inability to listen effectively. A provider may now consider a diagnosis of ADHD if someone exhibits symptoms of inattention, not just hyperactivity or impulsivity, which was previously the case.
What is ADHD?
ADHD is a chronic mental and behavioral condition. For instance, an adult with ADHD may find it difficult to focus on tasks or stay organized at work. ADHD may also affect someone’s relationships and social skills.
There are 3 presentations (or subtypes) of ADHD: inattentive, hyperactive-impulsive, and combined type.
Inattentive ADHD is the name now used for the neurological disorder previously known as ADD. ADHD may be overlooked in children who show symptoms of inattention, such as being easily distracted or unable to focus on schoolwork. In adults, inattentive ADHD often goes undiagnosed or is misdiagnosed as another mental health condition, such as anxiety or depression, especially in women.
Someone with inattentive ADHD may find it difficult to focus on tasks at work, causing them to become unorganized and fall behind on various projects. These difficulties can also affect other areas of life and strain relationships with friends and family.
According to the DSM-5, inattentive ADHD may be diagnosed in someone under 17 years of age with 6 or more of the following symptoms for at least 6 months, or in someone over 17 years of age with 5 or more of the following symptoms for at least 6 months:
- Lacks attention to detail or makes careless mistakes
- Has trouble sustaining attention in daily activities
- Fails to listen when spoken to directly
- Is often unable to follow instructions or complete tasks
- Has difficulty staying organized
- Dislikes or avoids tasks that require sustained attention and focus
- Tends to lose things that are necessary for activities and tasks
- Is easily distracted by external stimuli or unrelated thoughts
- Is often forgetful in daily activities
When people think of ADHD, they probably imagine someone with hyperactive-impulsive ADHD. Hyperactive-impulsive ADHD, which is most commonly diagnosed in children (particularly in young boys), may cause someone to fidget excessively or interrupt conversations.
Someone with hyperactive-impulsive ADHD might talk excessively or engage in activities at inappropriate times. For example, an adult with hyperactive-impulsive ADHD may always be on the move or appear extremely restless.
According to the DSM-5, hyperactive-impulsive ADHD may be diagnosed in someone under 17 years of age with 6 or more of the following symptoms for at least 6 months, or in someone over 17 years of age with 5 or more of the following symptoms for at least 6 months:
- Fidgets with or taps their hands or feet, or tends to squirm in their seat
- Leaves their seat at times when remaining seated is expected
- Experiences feelings of restlessness
- Has trouble engaging in leisure activities quietly
- Is always “on the go” or acts as if “driven by a motor”
- Talks excessively
- Blurts out answers before a question is completed
- Has trouble waiting their turn
- Interrupts or intrudes on others
Combined type ADHD
Someone may be diagnosed with combined type ADHD if they meet the criteria for both inattentive ADHD and hyperactive-impulsive ADHD.
Mental health providers, including psychiatrists, psychologists, and mental health nurse practitioners, among others, can diagnose ADHD based on particular symptoms and their severity. ADHD is primarily diagnosed in children, adolescents, and young adults. Almost 6 million children in the United States have been diagnosed with ADHD, and many children with ADHD continue experiencing symptoms well into adulthood.
In fact, approximately 3 to 6% of adults have ADHD. Although ADHD is more commonly seen in men, it is also prevalent in women, with women typically showing signs and symptoms of inattentive ADHD (formerly known as ADD).
To be diagnosed with any of the ADHD subtypes, the following conditions must be met:
- Symptoms are present in 2 or more settings, such as at school, work, or home
- Symptoms are clearly interfering with quality of life and daily functioning
- Symptoms developed before 12 years of age
- Symptoms are not the result of another mental health condition, such as persistent depressive disorder, generalized anxiety disorder, or other mood disorder
If a person has a 6-month history of primarily inattentive ADHD symptoms, then they may be diagnosed as having a predominantly inattentive presentation. If a person has a 6-month history of primarily hyperactive-impulsive ADHD symptoms, then they may be diagnosed as having a predominantly hyperactive-impulsive presentation. Symptoms of inattention, hyperactivity, and impulsivity can change over time, and they may even occur together.
ADHD is typically treated with medicine, talk therapy, and/or lifestyle or behavioral changes.
The most common drugs for treating all subtypes of ADHD are stimulants. Adderall (dextroamphetamine-amphetamine) is a commonly prescribed ADHD medicine for both children and adults. Like other ADHD medicines, Adderall is available in immediate- and extended-release forms, with effects that can last for varying amounts of time depending on the individual.
Talk therapy and lifestyle changes may also be recommended for people with ADHD. These options and other treatment methods can be discussed with a mental health provider, who will help identify the most appropriate therapeutic approach for each individual. For instance, a provider may help someone with inattentive ADHD learn organizational skills to help improve their focus and attention.
Too often, ADHD goes undiagnosed or is misdiagnosed, especially in adults. Inattentive ADHD (previously known as ADD) is particularly overlooked in both children and adults. It helps to be aware of the various ADHD subtypes, the symptoms of which may overlap. Certified mental health providers understand such nuances, so they can help people get the best treatment possible.
If you think you have ADHD, then you may wish to see a professional who can provide an accurate diagnosis and treatment. A healthcare provider can also rule out other mental health conditions and/or diagnose ones that often occur along with ADHD, such as anxiety and depression. By working with a professional, you can bring yourself one step closer to where you want to be.