The 3 Different Types of ADHD and How They Differ

If you have ADHD (attention-deficit hyperactivity disorder), you may have a hard time paying attention, sitting still, and controlling your behavior. There are three kinds of ADHD: predominantly inattentive type, predominantly hyperactive-impulsive type, and combined-type ADHD. Knowing which type of ADHD you have can help you find the best treatment options. Let’s take a look at the three different types of ADHD. 

What is ADHD?

Attention-deficit hyperactivity disorder (ADHD) is a condition that involves problems with paying attention, controlling impulses, and being overly active. If you have ADHD, you may have a hard time focusing and stopping yourself from doing things that other people might find disruptive. ADHD can affect many areas of life, including relationships, home life, and performance at work or school. 

Even though people of all ages have ADHD, it’s more common among children than adults. In the U.S., ADHD affects about 8% of children ages 2 to 17 and 2% of adults 18 and over.

In order to be diagnosed with ADHD, your symptoms must have started before age 12. The symptoms can vary from person to person depending on the type. And symptoms may change with age. 

What are the 3 types of ADHD, and what do they mean?

The term “attention-deficit hyperactivity disorder” implies that ADHD is just one condition. But there are three types of ADHD:

1. Predominantly inattentive ADHD

2. Predominantly hyperactive-impulsive ADHD 

3. Combined ADHD 

For most people, ADHD is a spectrum. That means they may have more inattentive symptoms than symptoms of hyperactivity and impulsivity (or vice versa). Other people have equal symptoms of both, which is the combined type. Knowing the type you have helps you choose which types of medication and therapy can best help. 

What is predominantly inattentive type ADHD?

People who have predominantly inattentive ADHD have trouble with focus, concentration, and task completion. They have few or no hyperactivity or impulsiveness symptoms. This type of ADHD used to be called “attention-deficit disorder” (ADD).  

People with predominantly inattentive ADHD usually notice that they:

• Miss details or make careless mistakes while doing tasks, like work or schoolwork

• Have trouble paying attention on things that require effort 

• Don’t always listen to others when they speak, like during lectures

• Don’t always finish tasks, like homework, work assignments, or household chores

• Have poor organizational and time-management skills 

• Strongly dislike or avoid tasks that require effort and patience 

• Lose things easily 

• Get easily distracted and sidetracked 

• Often forget things

In order to be diagnosed with this type of ADHD, children must have at least six of the signs of inattention, and adults must have at least five of the signs.

Children and adults with this type of ADHD may show similar signs of inattention. But they may deal with them in different ways. Children with the predominantly inattentive type can be easily distracted, forgetful, and disorganized. These signs may be especially noticeable in school. 

Over time, adults with attention problems may learn ways to cover them up. For example, they may seek jobs that allow them to be “on the go” rather than sitting still. In some cases, attention problems may appear less noticeable as people get older. 

What is predominantly hyperactive-impulsive type ADHD?

People who have this type of ADHD can feel the need to constantly move and fidget. They also have difficulty stopping themselves from engaging in disruptive behavior. 

People with predominantly hyperactive-impulsive type ADHD usually notice that they:

• Frequently squirm and fidget 

• Often get up in situations where it’s inappropriate to do so

• Have trouble participating in quiet activities or solo quiet play

• Blurt out answers 

• Interrupt others 

• Have difficulty waiting their turn 

• Often seem to be “on the go,” restless, and unable to sit still 

In order to have this type of ADHD, children must have at least six of the signs of hyperactivity and impulsivity. Adults must have at least five of the signs. 

Children and adults with this type of ADHD may show different signs. Children with the predominantly hyperactive-impulsive type may often move, jump, and run around. And they may have a hard time controlling themselves. On the other hand, adults are more likely to appear fidgety and talkative in situations that require patience and quiet, like in meetings or lines. 

What is combined-type ADHD?

Some people meet the criteria for both types of ADHD (inattentive and hyperactive-impulsive ADHD). These people have combined-type ADHD. For children, this means having at least six signs of both types. For adults, it means having at least five signs of both types. People with this type can find it challenging to keep both attention and control of their impulses or behavior. 

Which type of ADHD is the most common?

Research shows that predominantly inattentive ADHD is the most common type of ADHD. But people diagnosed with the combined type are more likely to seek professional help. 

ADHD is also more often diagnosed in males than females across all three types. Among children and teens under age 18, females are more likely to be diagnosed with predominantly inattentive type, while males are more likely to be diagnosed with predominantly hyperactive-impulsive type. 

When it comes to age, the predominantly hyperactive-impulsive type is more common among preschool-age children. And the predominantly inattentive type is most common among older children, teens, and adults. 

Which type of ADHD is the least common?

Predominantly hyperactive-impulsive is the least common type of ADHD. But people with this type of ADHD are very likely to seek treatment, especially when compared with people who have inattentive-type ADHD. People who have this type of ADHD tend to have more trouble in social situations, work, and school. That means others are more likely to react and give feedback on behaviors. This can prompt people to seek help sooner. 

Who is most affected by ADHD?

Children are more likely to be diagnosed with ADHD than adults. In the U.S., over 8% of children are diagnosed with ADHD compared to about 2% of adults. Beyond that, things tend to get a little murky due to bias in diagnosing ADHD.

Males are more likely to be diagnosed with ADHD than females. But researchers are quick to point out that this is likely due to gender bias and not because of true differences between different sexes. 

Another issue with ADHD diagnosis is racial bias. Studies suggest that some children are more likely to be diagnosed with ADHD because of their race or ethnicity, while others may be underdiagnosed for the same reasons. 

How do you diagnose each type of ADHD?

Healthcare providers can diagnose ADHD with a standardized ADHD evaluation. You can meet with a neurologist, psychiatrist, or psychologist who specializes in ADHD. Many primary care providers are also comfortable diagnosing and managing ADHD. 

During the evaluation, the provider will ask you a series of questions and have you complete some tests or rating scales. To get a better idea of your symptoms, they will also talk with family members, managers, or teachers. 

The evaluation process may take place over one or several appointments. Once your provider gathers enough information, they will be able to figure out if you have ADHD and, if so, which type. Getting diagnosed with ADHD is the first step forward.

How do you treat ADHD?

Treatment for ADHD can include a combination of medication, psychotherapy, and alternative treatments. The type of treatment that is best for you may depend on how your ADHD symptoms are affecting your daily life.

Medications

There are two types of medications available to treat ADHD — stimulants and non-stimulants. 

Stimulants increase levels of the neurotransmitter dopamine in the brain, which helps improve attention and motivation. Commonly prescribed stimulants for ADHD include amphetamine (Adderall and Vyvanse) and methylphenidate (Ritalin and Concerta).

Most stimulants are available in immediate-release or extended-release forms. These medications are effective at reducing ADHD symptoms in both children and adults.  

Non-stimulant medications are alternatives to stimulants. They affect the brain in different ways. Examples include: 

• Atomoxetine (Strattera) is a SSRI (selective serotonin reuptake inhibitor) that is approved to treat ADHD in children and adults. 

• Guanfacine (Intuniv) and clonidine (Kapvay) are non-stimulants approved for treating ADHD in children. 

When it comes to adults, several different medications are sometimes prescribed off-label for ADHD, including modafinil (Provigil), bupropion (Wellbutrin), and venlafaxine (Effexor). These medications may be good alternatives for people who experience side effects while taking stimulants. 

Behavioral therapy

Behavioral therapy is a type of evidence-based therapy for children with ADHD. This type of treatment helps children reduce inappropriate behaviors, like interrupting others, procrastinating, and acting out. Therapy can also help children display more positive behaviors, like waiting their turn, listening, and sitting still. 

Behavioral therapists teach children positive skills and coping mechanisms to overcome impulsive and inattentive behaviors. They also provide parents and teachers with guidance on how to address behavior at home and school. 

Adults with ADHD can benefit from cognitive behavioral therapy (CBT), which focuses on thoughts and behaviors. CBT can help you learn how your thoughts, feelings, and behaviors affect each other. Once you have this understanding, you can learn how to change your thoughts, which will help change your feelings and behaviors. CBT therapists will also teach planning, organization, time-management skills, and strategies for improving focus. 

Complementary and alternative treatments

Complementary and alternative (CAM) treatments can also help you manage ADHD symptoms, especially when used with therapy and medications. Some CAM therapies that have been studied include:

• Acupuncture: Research on acupuncture for ADHD shows that it can help reduce symptoms in children, especially when combined with medication and therapy.

• Mindfulness meditation: Mindfulness meditation is the experience of being aware of the present moment. It can be done alone or guided. One study found that people with ADHD who took an 8-week mindfulness course noticed improvements in their ADHD symptoms and also had less anxiety and depression. This approach to ADHD treatment can be helpful for children, teens, and adults. 

• Exercise: Exercise can help improve memory, focus, and mood. Research on ADHD and exercise has found that it can help improve symptoms in children, teens, and adults.

• Diet changes: Research on the relationship between diet and ADHD is mixed. In some cases, dietary changes can help improve some ADHD symptoms. Studies suggest it can help to eat a diet that combines complex carbohydrates, proteins, and essential fatty acids — like fish, nuts, and seeds. 

• Supplements: Dietary supplements are vitamins, minerals, or herbs that can treat specific symptoms. Unlike medications, the FDA doesn’t monitor supplements, and they do not undergo rigorous clinical trials. Some supplements that have been looked at for ADHD treatment include magnesium, vitamin B6, zinc, and fish oil. 

What does each type of ADHD look like in daily life?

While each person is different when it comes to their ADHD, there are common characteristics for each type of ADHD.

People with predominantly inattentive ADHD may have a short attention span and get easily distracted. They might make careless mistakes in their work, get behind on tasks, and have a hard time carrying out instructions. And they may lose things easily.  

People with predominantly hyperactive-impulsive ADHD are often on the move and unable to sit still for long periods of time. They may be impulsive. In children, this can look like difficulty waiting their turn or speaking out of turn. Adults may spend money or engage in more reckless behavior without first thinking of the consequences. Some people may be quicker to get angry and have a “short fuse.”

People with combined-type ADHD have symptoms of both. They may have more inattentive symptoms or more hyperactive-impulsive symptoms. 

Should you avoid any foods if you have ADHD?

There are two thoughts regarding diet and ADHD. One is to remove certain foods from the diet.  This is an elimination diet. The other is to add vitamins and supplements to the diet.  

Elimination diets may remove:

• Artificial dyes

• Sugar and artificial sweeteners

• Gluten

Nutrients that you may increase include:

• Amino acids

• Fish oil

• Minerals, such as iron and zinc

• Multivitamins

Studies on diet changes in ADHD have mixed results. Only some restriction in diets and the addition of fish oil have shown some promise. But even these need to be researched more before any recommendations can be made.  

The “few-foods diet” is another alternative approach to treating ADHD in children. Parents limit a child’s diet to only a few recommended foods and gradually reintroduce foods over the course of a few weeks. This helps parents figure out whether certain foods worsen their child’s ADHD. Then parents can develop an eating plan for their child that will help support their emotional well-being.

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Written by:

Jennifer Sample, MD

After a fellowship, Dr. Sample worked as the medical director at the University of Kansas Hospital Poison Center (The University Of Kansas Health System Poison Control Center), which served the state of Kansas for poison exposures. In 2007, she returned to Children’s Mercy Hospital in Kansas City, Missouri, as a consultant in clinical pharmacology and medical toxicology.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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