What’s the Difference Between ADD and ADHD?

When the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-3) was published in 1980, this reference manual, which provides mental health professionals with diagnostic criteria, listed ADD (attention deficit disorder) as a potential diagnosis.

The publishers further separated ADD into two subtypes:

1. ADD with hyperactivity
2. ADD without hyperactivity

When the American Psychiatric Association (APA) published a revised edition in 1987, they did away with ADD, instead combining the two subtypes into one condition: ADHD (attention-deficit/hyperactivity disorder).

Now, ADD is merely an outdated term for ADHD; there’s no clinical difference.

At RapidRecovery TMS, board-certified psychiatrist Dr. Anand Joshi and his expert team offer services for many mental health conditions, including ADHD, for their patients in Wilmington, North Carolina. As many people ask about the difference between ADD and ADHD and what each entails, the team is taking this opportunity to discuss the condition and its diagnosis.

Types of ADHD

The DSM-5 lists three types of ADHD based on the main symptoms involved:

1. Inattention
2. Impulsivity and hyperactivity
3. Combination of inattention and hyperactivity

Inattention

ADD originally described the inattentive type of ADHD, which includes persistent symptoms of inattention and distractibility but little indication of hyperactivity or impulsivity. The current diagnosis would be ADHD with a predominantly inattentive presentation.

Symptoms of the inattentive type include:

• Easily distractible
• Frequently forgetful
• Difficulty paying attention to details or listening when other people speak
• Difficulty concentrating on tasks or activities
• Difficulty following instructions and completing tasks as directed
• Tendency to lose focus or get sidetracked
• Difficulty staying organized or managing time
• Tendency to put off or avoid tasks that require long periods of mental effort, including homework or work tasks
• Often loses vital things needed for daily routines and activities

These signs can show up in all aspects of the person’s life.

Hyperactivity and impulsivity

Also called the hyperactive-impulsive type, this diagnosis combines symptoms of both hyperactivity and impulsivity.

Key symptoms include:

• Difficulty remaining still or staying in one place
• Excessive talking
• Difficulty waiting patiently or taking turns
• Frequent fidgeting
• Persistent feelings of restlessness, which lead to body movement
• Difficulty playing quietly or participating in relaxing activities
• Habit of finishing others’ sentences or giving an answer before someone finishes the question
• Habit of interrupting others and intruding on conversations and activities

With this type of ADHD, it’s common to move or pace a lot, make impulsive decisions, and have emotional outbursts.

Combination

People who have the combined type display symptoms from both the inattentive and hyperactive-impulsive categories.

To be diagnosed with combination ADHD, children under 17 need to have at least six symptoms from each category, and adults 17 and older need to display at least five symptoms.

It’s unclear if the combined type of ADHD is more common than the other two types, particularly in adults.

A 2009 study published in the Journal of Clinical Psychology looked at 107 adults with ADHD and found: 

• 62% of adults with ADHD had the combined type
• 31% had the predominantly inattentive type
• 7% had the hyperactive-impulsive type

While this would appear to indicate that combination ADHD is most prevalent, the data are considered outdated at this point.

A more recent review explored the prevalence of ADHD in African children and adolescents and found evidence to suggest that combination ADHD was the least common type.

Because prevalence comes from reported symptoms and diagnoses, some researchers believe the real prevalence of ADHD could be higher than these studies found. Clearly, more research needs to be conducted.

If you suspect you or your child exhibits signs of ADHD, your next step should be to get an accurate diagnosis that leads to effective treatment, and RapidRecovery TMS can help. To learn more or to schedule a consultation with Dr. Joshi, call the office at 910-593-4016 or book online with us today.