ADD and AD/HD: What’s the Difference?

When I refer to AD/HD while speaking to patients, many of them say, “I think I just have ADD, I’m not very hyperactive.”  So, what’s the difference between ADD and AD/HD?

 

Attention Deficit/Hyperactivity Disorder (AD/HD) is the official name used by the American Psychiatric Association; it is the preferred term because it encompasses both primary aspects of the condition: inattention and hyperactive-impulsive behavior. 

 

However, the most meaningful difference comes with the three basic types of AD/HD: Predominantly Inattentive, Predominantly Hyperactive-Impulsive, and Combined. 

 

The type that most people think about when they think of AD/HD is the Hyperactive – Impulsive Type, as these are the individuals who are overactive, fidgety, talkative, impulsive, and who often exhibit behavioral problems.  This type is much easier to recognize because the symptoms are often obvious and overt.  However, there is also an Inattentive Type of AD/HD that is characterized by difficulty organizing and completing tasks, focusing on details and paying attention to instructions or conversations, etc.  Although underlying distractibility and forgetfulness can have a significant impact on daily routines and performance, the absence of behavioral issues frequently causes this subtype to be overlooked.  Finally, there is the Combined Type of AD/HD, which presents with a combination of the behavioral and attention deficits from the other two subtypes. 

While the name ADD vs. AD/HD is of little significance, knowing your subtype is quite important.  For instance, while the treatment options are generally the same for all three types, some are typically more effective for certain subtypes as opposed to others.  For example, individuals with the Inattentive type of AD/HD typically do not respond as well to stimulant medications and, if they do respond, they typically do so at a lower dosage than do individuals with the Hyperactive/Impulsive or Combined types.  Therefore, a non-stimulant medication alternative may be a more appropriate choice of medication to address the Inattentive type.  Furthermore, as I like to tell my testing patients, ‘it’s good to know your strengths, but it’s also good to know your weaknesses;’ knowing your subtype helps you better understand your weaknesses.  Individuals with the Hyperactive-Impulsive type tend to display hyperactive and impulsive actions, just like the name implies.  As a result, they often make poor decisions while driving or blurt out things they never actually meant to verbalize.  The sheer knowledge that you have these tendencies can help you moderate them (e.g. making a conscious effort to pay more attention or be more deliberate about making decisions while driving, thinking before you speak in general conversation, etc). 

After you are tested for AD/HD, your doctor should go over the results with you and, in the process, tell you what subtype best describes you.  If you are not told what subtype you have, feel free to ask; once again, knowing your subtype can help you more effectively treat or self-moderate your difficulties.