Attention Deficit Hyperactivity Disorder or ADHD is referred to as a behavioral condition that involves challenges relating to either difficulty in paying attention or overactivity to the point that it becomes extremely difficult for an individual to go about their normal day-to-day life.
ADD or Attention deficit disorder was also used in referring to this behavioral condition but with extensive research and studies done on the condition, experts and health professionals have replaced the term ADD as an outdated term since it does not cover all the symptoms of this mental condition.
However, till today there is much more confusion surrounding the two terms and more often than not, these terms get used interchangeably to refer to the same condition. Many people consider Attention Deficit Disorder or ADD as a subtype of ADHD, but if we look at the current medical timeline, these subtypes no longer exist.
In this comprehensive article, we will clear the cloud over the two medical terms, discuss the subtypes of Attention Deficit Hyperactivity Disorder, shed light on the fact why the term ADD is no longer used, and will also highlight the situations when the term ADD is used unofficially.
ADHD vs ADD
In earlier times, Attention Deficit Disorder or ADD was used to refer to the behavioral condition of challenges that stem from either overactivity or difficulty in paying attention. The name of this condition changed several terms, primarily due to advancements in scientific research and study.
Today, this behavioral or mental condition is known as Attention Deficit Hyperactivity Disorder or ADHD but unofficially we still find the term ADD being loosely thrown around.
As over the years, the terms have changed multiple times, there is still some confusion even after ADD was officially replaced by ADHD.
History of ADHD & ADD
Since all medical conditions prevail globally, there has to be a standardized term, a fixed diagnosis, and proven techniques of treatment for each of them.
The American Psychological Association or APA is the primary organization that does the same for mental health conditions. In the year 1980, a behavioral disorder called the Hyperkinetic Reaction of Childhood was officially replaced by the term ADD when the classification of the condition was redefined.
The term ADD or Attention Deficit Disorder first came into the picture in the third edition of the DSM (DSM-3) or “Diagnostic and Statistical Manual of Mental Disorders”, which is basically a reference manual to guide mental health professionals in diagnosing and treating mental health conditions.
In 1987, the American Psychiatric Association, which releases this reference manual, released a revised edition of it where they combined the two subtypes of ADD namely, ADD with hyperactivity and ADD without hyperactivity, and called it one condition of Attention Deficit Hyperactivity Disorder or ADHD.
Similarly, in the year 1987, the term ADD was officially replaced by ADHD. However, this change was a bit controversial, and therefore, to date the confusion exists.
Let us look at the timeline of changes in the terms for behavioral disorder –
- It was 1968 when the first term for behavioral disorder or condition came to the floor and it was called Hyperkinetic Reaction of Childhood.
- In 1980, some distinct classification was brought to the condition when the term ADD got introduced and it replaced Hyperkinetic Reaction of Childhood.
- In the year 1987, ADD was replaced with Attention Deficit Hyperactivity Disorder or ADHD because hyperactivity was introduced to the condition and classification of ADD.
- In 1994, three typical subtypes were added to the condition of ADHD.
- Again in 2013, the three subtypes of ADHD got replaced with presentations of ADHD.
Primarily due to all these changes over the years, in terms and classification, the confusion around the terms ADD and ADHD still exists. It’s important to remember that the term ADD is not officially used anymore but many individuals still use it to refer to a similar mental condition.
Some people use the terms ADD and ADHD interchangeably while others use the term ADD to address a presentation of ADHD which came to the forefront only in 2013. They use the term ADD to describe Inattentive ADHD presentation or inattentive and distractible presentation of ADHD.
ADHD Subtypes and Presentations
In 1994, the three distinct subtypes of ADHD were introduced. These are as follows:
Impulsive & Hyperactive ADHD
Primarily this subtype includes a mental condition that makes an individual experience challenges with organizing things, listening attentively, and paying attention or focusing on a particular thing.
People who are diagnosed with hyperactive and impulsive type ADHD feel a constant need to move from one place to the other. They often squirm, fidget, and find it extremely difficult to stay seated.
In the case of children, it seems they are ‘driven by a particular motor’ for they keep on running around excessively and without any exhaustion. In adults, ADHD symptoms of this type show up as non-stop talking, lack of self-control, and continuously interrupting others as struggles to stay still become difficult to control.
This type of attention deficit hyperactivity disorder is more recognizable in children, along with men, who are more susceptible to this type.
Inattentive & Distractible ADHD
This subtype of ADHD deals with the difficulties of being extremely quiet, still, waiting, or daydreaming. Since this mental disorder does not involve the state of hyperactivity.
People who have the inattentive type ADHD are prone to making careless mistakes as they face challenges in sustaining attention, organizing tasks, following detailed instructions or directions, and performing activities that require focus and attention.
These people suffer from a weak working memory as they get easily distracted by any external stimuli and as a result, they keep losing their stuff and belongings. More often than not, this particular type of ADHD is found in adults and girls.
As the name of this subtype suggests, this type of mental disorder includes both Impulsive and Hyperactive ADHD with Inattentive and Distractible ADHD. In fact, according to experts and mental health professionals, this is the most common type of ADHD that could be found among individuals.
Generally speaking, people who are diagnosed with combined-type ADHD exhibit six or more symptoms of either inattention or impulsivity and hyperactivity.
According to the symptoms and their stage of them, a medical professional diagnoses ADHD by quantifying the condition of the mental health condition as either mild, moderate, or severe.
It was not till 2013 that the three subtypes of ADHD got replaced by presentations of ADHD. This simply implies that instead of diagnosing a person with a specific type or condition of ADHD, medical professionals now approach the mental disorder as if someone is diagnosed with ADHD, the condition or the symptoms could show up in different ways.
In other words, people who are diagnosed with ADHD can exhibit different types of symptoms but that does not mean that they have got a different type of condition or ADHD.
Symptoms of Impulsive & Hyperactivity Type ADHD
People whose ADHD diagnosis show they have this particular type or presentation of the mental health condition, exhibit the following symptoms:
- Excessive fidgeting with feet and hands
- A constant or higher degree of squirming
- Struggles to stay seated calmly in one particular place
- Difficulty in doing leisure activities or playing without making a noise
- Excessive talkativeness and continuous interruption of others during conversations
- Struggles to wait in long queues or gets irritated waiting for appointments
- Difficulty in waiting for their turns
- Struggles to keep quiet as they often blurt out answers even before the question is complete
- Continuous intruding on others or interrupting people during their work
Symptoms of Distractible & Inattentive Type ADHD
Usually, ADHD symptoms vary from one individual to the other depending on the subtype or presentation of ADHD.
People who experience the ADHD symptoms of inattentiveness and distractions by external stimuli, show the following signs:
- Often commit frequent mistakes as they struggle considerably to pay attention to details
- Struggles paying continuous focus on activities and tasks such as listening to conversations or reading a book
- More often than not these individuals appear to be not listening at all
- Struggles to follow directions
- Because of inattentiveness, they find it troublesome to keep things organized
- They are often clumsy with their work and show poor time management skills
- Easily gets frustrated when performing a task or activity that requires some level of mental effort
- Easily gets distracted because their attention does not stick to one object, one task, or a single activity
- Keep misplacing items because of their disorganization or failing to pay attention to details
- Keep on forgetting daily tasks as they not only get distracted easily but also, struggle to put in the mental effort
Symptoms of Combined Type ADHD
People with combined-type ADHD experience a combination of symptoms from both spectrums as they show signs of inattentiveness along with tendencies of impulsivity and hyperactivity.
Since the term ADD is still loosely thrown around to refer to the mental health condition of ADHD without the components of impulsivity and hyperactivity, the symptoms of ADD are more or less common with the symptoms of the inattentive type of ADHD.
How the Three Different Types of Attention Deficit Hyperactivity Disorder is Diagnosed?
Before making a diagnosis of this mental condition, a mental health professional must rule out the following mental health conditions:
- The individual is suffering from a type of mood disorder
- The individual is experiencing issues from anxiety disorders
- The individual is subjected to some kind of substance abuse
- The Individual is suffering from mental disorders that deal with personality
- The individual is experiencing dissociative disorders
Once all these possibilities are ruled out through thorough scrutiny, tests, and examinations, then only a mental health professional can look into the ADHD symptoms as described by the American Psychiatric Association in their 5th edition of “Diagnostic and Statistical Manual of Mental Disorders” or DSM-V and start identifying the problems that the individual experience.
According to the DSM-V, there are nine symptoms that suggest whether the ADHD is Primarily Impulsive and Hyperactive. There are nine other symptoms that suggest whether the ADHD is Primarily Distractible and Inattentive type.
A mental health professional can only diagnose a child or an adult with ADHD if they exhibit at least six or more of the symptoms listed on the chart. Another condition that has to be kept in mind is whether the symptoms are noticeable for at least six months in at least two different settings; for example, at the office and at home for adults and in school and at home for children.
Also, in the case of a child’s symptoms, they must interfere with the child’s functioning and cause them some kind of developmental disorder. In addition to this, it has to be observed whether some of the symptoms become apparent before the age of 12.
In the case of adults and older teens, the rule is slightly different as they need to exhibit at least five of the nine symptoms in more than one setting.
Adults or children who are diagnosed with inattentive type ADHD often go under the radar, especially girls, for they are seen to be as quiet characters both by their parents and teachers. This is why the diagnosis comes very late instead of early intervention. ADHD masking is also very common for children who wish to hide their symptoms in public.
On the other hand, symptoms of combined type ADHD are easily recognizable as all their behaviors and reactions get aligned with the most prominent symptoms of ADHD. As they are known to many people. This is why these people or children get diagnosed at a very early stage.
Generally speaking, the adult ADHD symptoms are more or less similar to the children’s symptoms. But as adults have more responsibilities in life, their symptoms could have a more serious impact than the case of a child.
For example, a child might get away with a little scolding if he or she keeps on losing things but as an adult, if you keep on forgetting the details of presentations, it could very well cost your job.
Attention Deficit Disorder or ADD might be an obsolete term but it still gets used in the medical field by some people to address the Attention Deficit Hyperactivity Disorder or ADHD without the element of hyperactivity.
In fact, according to the accepted global norms, the term ADD should no longer be used to classify any type of ADHD.
The three types of Attention Deficit Hyperactivity Disorder differ from each other in their symptoms. They are also diagnosed differently depending on the age, gender, and severity of the symptoms.
However, all three types are serious mental health conditions that need to be dealt with carefully. The sooner the diagnosis is made, the better it is for the individual as they can start receiving treatment and help to cope with the symptoms.
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