ADD vs ADHD: What Are the Differences?

Attention deficit disorder (ADD) is an outdated term that is no longer officially used. The correct term now is attention deficit hyperactivity disorder (ADHD). However, there is a lot of confusion between these terms. Some people use the terms "ADD" and "ADHD" interchangeably, and others consider ADD a subtype of ADHD.

The word "subtype" is no longer used by the Diagnostic and Statistical Manual of Mental Disorders (DSM) for ADHD. Instead, the DSM talks about "presentations."

Learn about ADHD, the former subtypes of ADHD and why they are no longer officially used, how the term "ADD" is unofficially used, and more.

ADHD Subtypes

"ADHD" is the abbreviation for "attention deficit hyperactivity disorder"—the current, official term used to describe a behavioral condition that causes hyperactivity and difficulty paying attention. The name has changed multiple times; "attention deficit disorder," or "ADD," is one of the previous names. It is still sometimes used unofficially.

The current Diagnostic and Statistical Manual of Mental Disorders (DSM) does not include ADHD "subtypes." Instead, it uses the word "presentation" to describe the different ways that ADHD may manifest in a person. This means people with ADHD are no longer diagnosed as having a subtype. Instead, they are diagnosed with ADHD and a certain presentation of symptoms.

The change from subtypes to presentations was made because people can experience different sets of symptoms as they develop, which fits more with a presentation than a subtype. For example, a child may experience symptoms of overactivity and difficulty paying attention during childhood. Then, as a teen or adult, they may no longer experience overactivity.

ADHD is diagnosed based on the presentations of inattention, hyperactivity, and impulsivity. These presentations have the same names as the former subtypes.

It is possible to experience symptoms of multiple presentation categories.

Inattentive

Inattentive ADHD is sometimes unofficially called ADD. People with an inattentive presentation have difficulty with organization, paying attention, or listening. They do not typically have hyperactivity as a symptom.

Hyperactive

People with hyperactive-presenting ADHD have difficulty being still, waiting, or remaining quiet. They may also have problems with impulsivity.

Combined

Combined ADHD includes both hyperactive ADHD and inattentive ADHD, and is the most common presentation of ADHD.

APA Classification of Symptoms

To understand the presentation of ADHD, symptoms are divided into those related to inattention and distractibility and those related to hyperactivity and impulsivity.

Diagnosis

It is no longer possible to be diagnosed with "ADD" because the term has been replaced with ADHD. Some people may refer to the inattentive presentation of ADHD as ADD, but that is not an official term. ADHD cannot be diagnosed with medical testing. Instead, healthcare professionals such as pediatricians, psychiatrists, and psychologists assess the symptoms to diagnose ADHD.

Depending on the nature of the symptoms, it may be determined that there's a presentation of:

• Predominantly inattentive: To be diagnosed with ADHD with inattentive presentation, a person must show symptoms of difficulty focusing. Children must experience six of the inattentive symptoms listed in the table above during the previous six months. People 17 years of age or older must experience five of the symptoms.
• Predominantly hyperactive-impulsive: A person must show symptoms of inappropriate overactivity or a frequent tendency to act without thinking. Children must experience six of these symptoms during the previous six months, and people 17 years of age or older must experience five of the symptoms.
• Combined: A person must show symptoms of inattention and hyperactivity/impulsivity. Children must experience at least six inattentive and six hyperactive/impulsive symptoms during the previous six months and people 17 years of age or older must experience at least five inattentive and five hyperactive/impulsive symptoms.

When diagnosing ADHD, healthcare professionals may consider:

• An assessment or evaluation
• Conversations with the patient
• Information from parents (if the person being evaluated is a minor)
• Observations during appointments in an office setting
• Notes or assessments from teachers or childcare providers, if relevant
• Medical testing to rule out other possibilities
• Information provided by other healthcare professionals, such as a primary care provider
  

ADHD in Adults

ADHD is often diagnosed in childhood. Some people outgrow the condition when they reach adulthood, but many don't.

Like children with ADHD, adults with ADHD have trouble with focus, planning, and decision-making. If you have ADHD, you may struggle with inattention in the workplace, and you may make what other people describe as "careless" errors.

You may also have trouble listening to what other people are saying, which can lead to difficulty remembering instructions or completing a task correctly. You may have problems staying organized and may lose things like keys and important papers.

In adults with ADHD, hyperactivity is less obvious and can manifest as impulsivity. Adults with hyperactive presenting ADHD can be restless, excessively talkative, and have problems with self-control. Sometimes, they engage in risky behaviors such as fast driving, drug and alcohol use, and compulsive shopping.

Treatment

ADHD can be treated with:

• Skills training for parents of children with ADHD
• Psychotherapy (talk therapy) for children or adults with ADHD
• Education services and accommodations at school
• Medications, which are usually one of two broad categories—stimulants and non-stimulants
• A combination of these treatments

Treatment options for ADHD partially depend on the age of the person with ADHD. For example, it is recommended that children under the age of 6 years old receive non-medication treatments only, while adults and children 6 years and older are recommended to be treated with medications along with other options.

Therapy

Therapy treatment options for ADHD may include training for parents of children with ADHD, training for adults and children with ADHD, and support at school.

Talk therapy is a conversation-based intervention that can help adults, children, and parents learn about factors that impact symptoms and outcomes of ADHD, including:

• Environmental problems, such as aspects of home or school that are not supporting growth
• Difficulty forming or nurturing friendships or relationships
• Not feeling able to express thoughts or feelings
• Co-occurring mental health conditions such as depression, anxiety, or post-traumatic stress disorder (PTSD)
• Other needs related to health, such as sleeping well, eating a healthy diet, and exercising

The types of talk therapy that work well for children with ADHD are parent training and behavior management and child behavior therapy. Skills training and cognitive behavioral therapy (CBT) can help adults with ADHD.

Medication

Medications can be used to treat ADHD in people who are 6 years old or older. It is recommended that people be treated with non-medication options such as therapy at the same time. Medication options for ADHD include stimulants and non-stimulants.

Summary

Attention deficit hyperactivity disorder, or ADHD, is a behavioral condition that may include difficulty paying attention, hyperactivity challenges, and issues with impulsiveness. "Attention deficit disorder" and "ADD" are outdated terms for the condition that was replaced by "ADHD" in 1987. However, the change was controversial and some people still use the term "ADD."

"ADD" is unofficially used to describe the presentation of predominantly inattentive ADHD. However, some use "ADD" and "ADHD" interchangeably, and there is confusion about how the terms are used.

Suspecting, being diagnosed with, and living with ADHD can be challenging. If you or someone you know has or may have ADHD, help is available. Reach out to a healthcare professional, such as a primary care practitioner or mental health professional, for support. This condition is treatable. It is possible to be successful in school and work, and live a happy, fulfilled life with ADHD.