The Same but Not Really: Here’s the Difference Between ADD and ADHD

ADHD is characterized by ongoing inattention and/or hyperactivity and impulsivity that interferes with daily functioning or normal development.

In a nutshell, ADD and ADHD are basically the same. Only, they’re not… because “ADD” is an outdated term that was used to describe someone who struggled to focus but didn’t have hyperactivity.

ADHD affects an estimated 2.5 percent of adults and 8.4 percent of children in the United States. According to the American Psychiatric Association, it’s one of the most common mental health conditions affecting kids.

It’s also often overlooked — especially in women — because people assume the symptoms are the result of hormones, burnout, and being tired or stressed.

A history lesson in the terminology

In May 2013, the American Psychiatric Association published the DSM-5, which included updated criteria for diagnosing someone with ADHD.

It wasn’t the first time (or the second) that the condition’s name changed. In the DSM-2 from 1968, it was called Hyperkinetic Reaction of Childhood, with an emphasis on high levels of activity and movement.

In the DSM-3, published in 1980, the focus shifted to the symptoms of inattention, impulsivity, and hyperactivity, and the condition was called either Attention Deficit Disorder with Hyperactivity or Attention Deficit Disorder without Hyperactivity.

The DSM-3-R in 1994 eliminated the diagnosis “ADD without hyperactivity” and introduced the term “ADHD.”

And in 1994, the DSM-4 categorized ADHD into three subtypes: “predominantly inattentive,” “predominantly hyperactive-impulsive,” and “combined.” It also included ADHD “not otherwise specified.”

The final shift from ADD to ADHD happened in 2013 with the release of the DSM-5. What changed this time?

First, the criteria for diagnosing ADHD changed slightly. The APA clarified how and when symptoms can manifest, since ADHD shows up differently in adults and kids (there’s a difference between ADHD in men and in women too).

Back in the day, a diagnosis of ADHD required “clinically significant” severity, but now the DSM acknowledges that symptoms are legit if they “reduce the quality” of life at work, school, or home or in social settings.

Plus, ADHD can now be diagnosed as mild, moderate, or severe and can even be classified as being in “partial remission” if symptoms are reduced enough.

ADHD is categorized into three types: predominantly inattentive, predominantly hyperactive-impulsive, and combined.

Here’s what those terms mean:

Inattentive

Inattentive ADHD is usually what people mean when they say “ADD.”

Someone with this type of ADHD might feel spacey, unable to focus, or generally distracted — but not hyperactive or impulsive. This might be the friend who invites you to go to yoga class and then stands you up.

People experiencing symptoms of inattentive ADHD might:

• becomes easily distracted
• struggle to pay attention to details needed to complete tasks (like school or work assignments)
• ignores someone speaking to them
• has issues following instruction
• seem forgetful, distant in conversations, or disorganized
• have poor time management skills or trouble meeting deadlines or making appointments
• lose track of personal items (keys, phone, etc.)
• not finish what they start
• dislike activities that may take a long time or a lot of effort and focus

Hyperactive-impulsive

This type of ADHD shows up as symptoms of hyperactivity and impulsivity but not as much inattention.

People experiencing this type of ADHD tend to be fidgety and constantly moving. They act first and think later. This could be your co-worker who always overshares (hello, TMI!) and seems to be hyped-up on caffeine.

People experiencing symptoms of hyperactive-impulsive ADHD might:

• not consider the consequences of their actions
• have trouble staying seated
• fidgets or moves a lot
• say whatever comes to mind (no filter!)
• interrupts a lot in conversation
• has trouble waiting their turn
• struggle to control their emotions (like crying easily or oversharing)
• always needing to move onto the next task or activity

Combined

Combined ADHD shows up as the trifecta of inattention, hyperactivity, and impulsivity. This type of ADHD is a mash-up of the two other types. According to the National Institute of Mental Health, most children who have ADHD have this type.

For someone to be diagnosed with ADHD, their symptoms must:

• interfere with daily life for at least 6 months
• present before age 12 (but diagnosis can happen at any age — even much later)
• happen in more than one setting (such as at home and at school or work)
• not be linked to another mental health condition (a diagnosis of depression or anxiety often accompanies ADHD)

Symptoms of ADHD can vary by age and sex. They can appear as early as age 3, but it’s also common for the condition to go unnoticed until adulthood.

In little kids, the most common symptom is hyperactivity/impulsivity. In elementary school, the inability to focus becomes more common.

By the teen years, hyperactivity usually diminishes (or shows up as restlessness or fidgeting), while impulsive or inattentive behaviors remain.

ADHD symptoms in children include:

• aggressive or disobedient behavior
• dislike of school and structured activities
• difficulty listening to instructions
• forgetfulness
• frequent fidgeting or inability to sit still
• overbearing, loud, or disruptive personality
• trouble paying attention in school or at home

In adults, symptoms of ADHD are different. They can be similar to the effects of stress, hormones, or burnout and might include:

• a short temper or inability to control emotions
• disorganization or clutter
• inability to manage finances, school, or work
• lack of resilience (low stress threshold)
• poor time management skills
• trouble with multitasking

Women may have other ADHD symptoms that are often mistaken for chronic stress or impostor syndrome as a result of gender stereotypes. Symptoms may be brushed off as “life stuff” or “just hormones.”

Women also tend to experience more inattentive than hyperactive symptoms, which can make ADHD in women even more difficult to spot.

In women, symptoms may manifest as:

• anxiety and/or depression
• chronic exhaustion
• lack of attention to detail
• low self-esteem
• sleep issues
• working “all the time” but still falling behind

These symptoms can vary throughout the month due to fluctuating hormones throughout a woman’s menstrual cycle.

Plus, according to the Anxiety and Depression Association of America, about half of all adults living with ADHD also have some type of anxiety disorder.

See why it’s so hard to diagnose? Given the range of symptoms that can masquerade as something else, this condition is sneaky — but treatable!

While there’s no cure for ADHD, you can definitely manage the symptoms. Treatment usually focuses on improving quality of life personally, professionally, and/or academically.

Treatment options include:

• behavior therapy
• central nervous system stimulants (like Adderall, Aptensio, Concerta, Daytrana, Dexedrine, Dyanavel, Evekeo, Focalin, Metadate, Methylin, ProCentra, Quillivant, Ritalin, or Vyvanse) to increase dopamine and norepinephrine, which help with focus and concentration
• nonstimulant medications (such as Intuniv, Kapvay, and Strattera) containing norepinephrine to help with attention and memory
• psychotherapy
• classes on social or parenting skills
• support groups