ADD vs. ADHD: What Are the Differences?

Understanding the Types and Signs in Kids and Adults

You may have heard the terms ADD (attention deficit disorder) and ADHD (attention deficit hyperactivity disorder) used interchangeably. They are considered to be the same condition, but ADD is no longer used by clinicians. In fact, the American Psychiatric Association (APA) stopped using the term ADD in 1987.

ADHD is one of the most common neurodevelopmental disorders of childhood, but it can also affect adults. It can have an impact on emotions, behaviors, and the ability to learn new things. According to the Centers for Disease Control and Prevention, there are an estimated 6.4 million children diagnosed with ADHD in the United States.

ADHD is divided into three different types:

  • Inattentive type (the type most commonly referred to as ADD)
  • Hyperactive/impulsive ADHD
  • Combination type—when a person has symptoms of inattention, hyperactivity, and impulsivity

Learn more about the difference between ADD (inattentive ADHD) and hyperactive/impulsive ADHD, including symptoms in children and adults, causes, and treatments.

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Differences Between ADD (Inattentive ADHD) and ADHD

ADD (inattentive ADHD) means a person shows enough symptoms of inattention (or easy distraction) but isn’t hyperactive or impulsive. People with hyperactive/impulsive ADHD show a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.

ADD (Inattentive ADHD)
  • Misses details and becomes distracted easily

  • Trouble focusing on the task at hand

  • Difficulty learning or organizing new information

  • Problems sustaining attention on tasks, even fun ones

  • Resists, avoids, and procrastinates starting tasks that require mental energy

  • Loses belongings frequently

Hyperactive/Impulsive ADHD
  • Will continually squirm and move feet and hands

  • Remaining in a seated position is challenging 

  • Will dash around or climb in situations where it is inappropriate

  • Rarely takes part in leisure or play activities quietly

  • Will often be described as always "on the go" or "driven by a motor"

  • Has a hard time taking turns

ADHD has long been thought of as a condition affecting males. But more girls are being diagnosed as the understanding of the condition deepens.

Girls are more likely to have inattentive ADHD, in which daydreaming and shyness are common, whereas it is more typical for boys to have hyperactive-impulsive ADHD or a combined presentation.

ADHD Symptoms in Adults

As ADHD is a developmental disorder, it's believed that it cannot develop in adults without first appearing during childhood. But it's known that symptoms of ADHD often persist from childhood into adulthood.


Adult ADHD can manifest differently than ADHD in children and teenagers. Symptoms include:

  • Poor organizational skills
  • Inability to focus or prioritize
  • Restlessness and edginess
  • Mood swings, irritability, and a quick temper
  • Inability to deal with stress
  • Extreme impatience

Causes of ADHD

Researchers suspect there may be several elements that play a role in determining whether someone might develop ADHD. There is no single cause, but a combination of genes and environmental factors seem to play a part:

  • Genetics: Children with ADHD typically have a parent, sibling, or another close relative with ADHD. One study suggests that at least one-third of fathers who have or had ADHD will have children who will be diagnosed with ADHD.
  • Childhood abuse/neglect: Research has found higher rates of abuse/neglect among children with ADHD compared with those without an ADHD diagnosis.
  • Toxins: Exposure to lead (even low levels) can result in hyperactivity and inattention. Lead can be found in a variety of places, such as in the paint of homes built before 1978.
  • Exposure to substances in utero: There's evidence to suggest that using substances during pregnancy increases the risk that the child will develop ADHD. A 2018 study found a significant relationship between smoking during pregnancy and the likelihood of a child having ADHD.
  • Neurotransmitters: Neurotransmitters are chemicals that carry messages between nerves. One such neurotransmitter, dopamine, has an important role in sustaining attention, and research has found lower levels of dopamine to be associated with ADHD.
  • Brain damage: A small percentage of the population will manifest ADHD symptoms as a result of brain damage, such as an early brain injury, trauma, or another impediment to normal brain development.

What Doesn't Cause ADHD

Research does not support popular theories that ADHD is caused by a diet high in sugar, too much television time, or poor parenting.

Diagnosis of ADD (Inattentive ADHD) and ADHD

ADHD can't be diagnosed with a physical test, like a blood test or an X-ray. Instead, healthcare professionals use the guidelines in the APA’s Diagnostic and Statistical Manual, 5th Edition (DSM-5) to help diagnose ADHD. This diagnostic standard helps ensure that people are appropriately diagnosed and treated for ADHD.

ADD (Inattentive ADHD)

For children up to 16 years old, six or more symptoms of inattention must be present, while people 17 and older must exhibit five or more symptoms. These symptoms must be present for at least six months to suggest a diagnosis of ADHD:

  • Often makes careless mistakes or disregards details
  • Has difficulty staying attuned to specific tasks or activities
  • Does not seem to listen when spoken to
  • Fails to finish tasks or follow through on instructions
  • Difficulty organizing
  • Avoids or dislikes long-term tasks
  • Often loses track of important items (wallet, school materials, etc.)
  • Easily distracted
  • Often forgetful

Hyperactive/Impulsive ADHD

For children up to 16 years old, six or more symptoms of inattention must be present, while people 17 and older must exhibit five or more symptoms. These symptoms must be present for at least six months:

  • Regular fidgeting or squirming
  • Ignores instructions to remain seated or stay in one place
  • Moves about or feels restless in situations where such movement is inappropriate
  • Cannot participate in leisure activities quietly
  • Excessive talking
  • Blurts out answers before a question is finished
  • Trouble waiting for their turn
  • Often interrupts or intrudes in conversation

Regardless of the specific presentation of ADHD—inattentive, hyperactive/impulsive, or combined—several conditions must be met in order to arrive at an official diagnosis:

  • Several symptoms are present before age 12.
  • Symptoms are present in multiple settings (home, school, work).
  • Symptoms interfere with or reduce daily functioning.
  • Symptoms are not better explained by another mental health condition.

Comorbid Conditions

As many as two-thirds of children with ADHD have one or more coexisting, or comorbid, conditions. The most common of these are behavioral problems, anxiety, depression, and learning and language disabilities.


Adults with ADHD may also experience depression, bipolar disordersubstance use disorders, anxiety disorders, or eating disorders.

Treatment

There is no cure for ADHD, but the symptoms can be successfully managed and treated, usually with therapy, medication, or a combination of the two.

Medication

Medication is the most common treatment for ADHD. It can help manage symptoms in everyday life and can help control the behaviors that cause difficulties with family, friends, and at school.

Several different types of medications are approved by the Food and Drug Administration (FDA) to treat ADHD in children as young as 6 years of age:

Stimulants are the best-known and most widely used ADHD medications. They are used to improve the ability to ignore distractions and focus thoughts. The most commonly used psychostimulants are Ritalin (methylphenidate) and Adderall (dextroamphetamine).

Research shows that 70% of adults and 70% to 80% of children with ADHD have fewer ADHD symptoms when taking these medications.

Non-stimulants approved for the treatment of ADHD include Strattera (atomoxetine), Intuniv (guanfacine), and Kapvay (clonidine). They do not work as quickly as stimulants, but their effect can last up to 24 hours.

If you or your child is prescribed medication, it is important to monitor your symptoms and report any side effects to your physician.

Therapy

Different therapies can be useful in treating ADHD in children, teenagers, and adults:

  • Behavior therapy provides support for children with ADHD and may involve teachers as well as caregivers. Behavior therapy usually involves behavior management, which uses a system of rewards to encourage your child to try to control their ADHD.
  • Parenting skills training can teach you how to effectively structure your child's days and use quality time, stress-management techniques, and other tools to alleviate distress and improve your relationship.
  • Counseling and psychotherapy: Research has found cognitive behavioral therapy to be effective for people living with ADHD. It helps to develop new ways to cope with your ADHD symptoms in the world. Counseling or psychotherapy can also be helpful for people who are living with coexisting conditions, like depression and anxiety.

Prevention

To help reduce your child's risk of ADHD:

  • During pregnancy, avoid anything that could harm fetal development, such as smoking.
  • Protect your child from exposure to pollutants and toxins, including cigarette smoke and lead paint.

Summary

ADD is an outdated term for the form of ADHD now called inattentive ADHD, in which the person doesn't display hyperactivity. The causes of ADHD are not yet clear, although genetics appears to play a role. ADHD is diagnosed based on criteria from the DSM-5. Treatment is usually with medication but may include therapy.

A Word From Verywell

Many people (including clinicians) use the term ADD to mean inattentiveness and ADHD to describe someone with hyperactivity. Some people use ADD and ADHD interchangeably. However, if you use the correct term, ADHD, it will help avoid potential confusion.

Both inattentive and hyperactive/impulsive ADHD are treatable, so it's important to seek help rather than to allow the symptoms to overwhelm your life or your child's life.

Frequently Asked Questions

Does ADD still exist?

The group of behaviors that make up ADHD has been recognized since 1902, though the name has changed over time. Attention deficit disorder was first named in the Diagnostic and Statistical Manual of Mental Disorders in 1980 when hyperactivity was not seen as a key component of the disorder.

In 1987, as more research was carried out, the name changed to attention deficit hyperactivity disorder (ADHD) to reflect the hyperactive/impulsive subset of symptoms.

ADD is now an outdated term, although it is still sometimes used to describe people who have problems paying attention but aren’t hyperactive.

How do you tell the difference between ADD and ADHD?

ADD is a now outdated term that is typically used to describe inattentive-type ADHD, which has symptoms including disorganization, lack of focus, and forgetfulness. Hyperactive/impulsive ADHD is characterized by impulsive and hyperactive behavior.

When do the symptoms of ADHD begin in adults?

Although it's called adult ADHD, symptoms start in early childhood and continue into adulthood. In some cases, ADHD is not recognized or diagnosed until the person is an adult.

Adult ADHD symptoms may not be as clear as ADHD symptoms in children. In adults, hyperactivity may decrease, but struggles with impulsiveness, restlessness, and difficulty paying attention may continue.

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