The 3 Different Types of ADHD and How They Differ

Treatment for all three types of ADHD includes medication and behavioral therapy. Attention-deficit hyperactivity disorder (ADHD) is a condition that can affect your attention and impulse control. 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. 

There are three kinds of ADHD: predominantly inattentive type, predominantly hyperactive-impulsive type, and combined type. 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 are the 3 types of ADHD, and what are their symptoms?

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

• Predominantly inattentive ADHD (ADHD-PI)

• Predominantly hyperactive-impulsive ADHD (ADHD-HI)

• 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 symptoms of both, which is the combined type. Knowing the type of ADHD you have can help you choose the right medications and therapy. 

Symptoms of 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 to 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. 

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Symptoms of predominantly hyperactive-impulsive type ADHD

People who have ADHD-HI 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. 

Symptoms of combined type ADHD

Some people meet the criteria for both types of ADHD (inattentive and hyperactive-impulsive ADHD). These people have combined type ADHD. 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 (ADHD-PI) is the most common type of ADHD.

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. 

Preschool-age children are more likely to be diagnosed with predominantly hyperactive-impulsive type ADHD. But older children, teens, and adults are more likely to be diagnosed with predominantly inattentive type ADHD. 

Which type of ADHD is the least common?

Predominantly hyperactive-impulsive is the rarest type of ADHD. But people with this type of ADHD are very likely to seek treatment, especially when compared with people who have predominantly inattentive 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 get 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. 

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How do you diagnose each type of ADHD?

Healthcare professionals 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, a healthcare professional 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 a healthcare professional 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’s 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 nonstimulants. 

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).

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

• Atomoxetine (Strattera) 

• Guanfacine (Intuniv) 

• Clonidine (Kapvay) 

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. 

Adults with ADHD can benefit from cognitive behavioral therapy (CBT), which focuses on thoughts 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 when used with therapy and medications. Some CAM therapies that have been studied include:

• Acupuncture

• Mindfulness meditation

• Exercise

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 (ADHD-PI) may:

• Have a short attention span 

• Get easily distracted

• Make careless mistakes in their work 

• Get behind on tasks

• Have a hard time carrying out instructions

• Lose things easily  

People with predominantly hyperactive-impulsive ADHD (ADHD-HI) may:

• Always be on the move

• Have trouble sitting still for long periods of time

• Be quick to get angry and have a “short fuse”

• Be impulsive

• Have trouble waiting their turn

• Speak out of turn

• Engage in reckless behavior

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

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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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