Understanding the Difference Between ADD and ADHD

Understandably, the severity of ADHD symptoms can vary from person to person. Some people have milder inattention symptoms than others and may not experience hyperactivity or impulsivity.

ADD became a formal diagnosis in 1980, and the APA officially changed it to ADHD in 1987. Several years later, the APA broke down the disorder into three different types or presentations.

Symptoms

Although everyone gets distracted or fidgety occasionally, you may have ADD if these symptoms interfere with your daily life and last more than six months. People with classic ADD are easily distractible, disorganized and need help to follow instructions. They forget things, have trouble finishing tasks and are prone to accidents and failure at work or school. SPECT scans show reduced blood flow to their prefrontal cortex and basal ganglia, associated with dopamine production. Treatment for classic ADD involves increasing dopamine levels.

Children with ADD often have difficulty sitting still in class or doing their homework. They need help staying focused on tasks and get into trouble with teachers and parents. They have difficulty remembering assignments and can’t keep track of their belongings. They also tend to talk too much and need help waiting for their turn in the conversation. Symptoms are usually evident in kindergarten and early childhood.

Hyperactivity in ADD is less common and can be harder to diagnose in adults than in children. It can take the form of talking excessively, being unable to wait for their turn in conversations or getting up from a seat or game early. Symptoms can be seen at work or home, but in adulthood, they are less visible than in children. Instead of using subtypes, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) now refers to presentations to explain how an individual perceives ADHD symptoms.

Diagnosis

It was probably no surprise when your seventh-grade friend told you that ADD was not the official term anymore, and the new name was ADHD (attention deficit hyperactivity disorder). Since then, a lot has changed, and the diagnosis criteria have shifted. However, the fact remains that people with ADD vs ADHD can still struggle in their daily lives and that early diagnosis is key. A person must exhibit six or more signs of impulsivity, hyperactivity, and inattention that interfere with daily functioning to be diagnosed with ADHD. The symptoms must also have been present for at least six months, be persistent, and occur in various settings. The severity of the symptoms must also be considered.

A doctor can diagnose ADD or ADHD with a careful evaluation of the individual’s history, feedback from teachers and other professionals, and a physical examination. Additionally, the symptoms must persist over time and be unrelated to those of any mental health issue, such as anxiety or mood disorders.

People with predominately inattentive ADHD are more forgetful, disorganized, and have trouble following instructions. They are often daydreamers and may appear disengaged from school work or the workplace. In contrast, those with predominately hyperactive-impulsive ADHD align more closely with the classic understanding of attention deficit disorder and are characterized by fidgeting, squirming, tapping and talking excessively. Children and teens are prone to running around or climbing in inappropriate situations.

Treatment

ADD/ADHD treatment can include psychosocial interventions, such as family therapy, play therapy and behavioral coaching. It’s also important to address any co-existing disorders. Children with ADD/ADHD often have other conditions, such as oppositional defiant or conduct disorders, anxiety, depression, tic disorders or Tourette syndrome and substance abuse issues. In some cases, these other disorders can make symptoms of ADHD worse.

Treatment can include medication. There are both stimulant and non-stimulant options. Stimulants help improve focus and reduce impulsiveness. They can cause side effects such as nausea or changes in heart rate and blood pressure. Finding the right medication and dosage takes time for each individual.

They are often forgetful and disorganized at school or work. They don’t have the hyperactivity or impulsivity in the Predominantly Hyperactive-Impulsive ADHD type of condition.

Kids who have Combined Type ADHD, as described by the current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), have six or more symptoms of both ADD inattention and hyperactive/impulsive behavior. This is the more commonly recognized form of the disorder because it’s what most people think of when they hear “ADD.” Children with this disease may be fidgeting and bursting with energy but still struggle to pay attention in school or at home.

Medication

If your child daydreams in class, is easily distracted or has trouble focusing on tasks, they may have ADHD. The disorder affects children as well as adults, and it can lead to difficulty at school, work and relationships. Treatment involves behavior therapy, education and medication. Mental health professionals can help children and their parents learn new skills, attitudes and ways of interacting with each other. They can also help reduce frustration, blame and anger that sometimes builds up in families when a child has ADHD.

In 1994, doctors decided that all forms of attention deficit disorder would be called ADHD. People still use the term ADD to refer to the non-hyperactive presentation of the disease. Still, many psychiatrists no longer use ADD as part of the diagnosis and instead prefer to call it ADD/ADHD combined type.

Those with Predominantly Hyperactive-Impulsive ADHD align more with the stereotypical image of the fidgeting, impulsive child that appears in classrooms and workplaces, constantly interrupting others. They may run, climb or play excessively in inappropriate situations. They often blurt out answers before they’ve been asked and have trouble playing or doing leisure activities quietly.

Medications for these individuals include long-acting stimulants such as Ritalin, Concerta or Adderall and long-acting antidepressants such as Wellbutrin (bupropion) and Effexor (venlafaxine). Non-stimulant medications are also available, and they increase levels of the brain chemical norepinephrine. These medications take longer to start working, but they usually provide more consistent results and last 24 hours.