A Very Important Note: I’m aware of the debate surrounding the efficacy of the DSM-5, and really, all editions of the manual. I recognize that it’s not The Rule Book of all manifestations of every psychiatric and neuropsychological disorder. It’s a guidebook at best. However, I believe it’s a good starting point for anyone who wants to learn about common manifestations of each ADHD type and how it’s classified today by most professionals in the fields of psychiatry and psychology.
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), ADHD is broken into three types (or, more formally, “presentations”):
- Inattentive Type
- Hyperactive Type
- Combined Inattentive-Hyperactive Type
Maybe you’ve been diagnosed as one of the types, or maybe you’re still doing some exploration before you pursue diagnosis (professional or self).
This brief review may help you better understand what are the typical manifestations and behaviors associated with each type.
Most Common: Combined Type
Combined inattentive-hyperactive type is essentially what it sounds like – a combination of behaviors and difficulties related to both attention and hyperactivity.
Combined type is the most commonly diagnosed, but don’t let the name mislead you – it’s not necessarily more or less “severe” a diagnosis than the other two types. For many people, it means that their manifestations are fairly evenly split between inattention and hyperactivity; it does not mean that you are entirely unable to control yourself!
The Invisible Child: Inattentive Type
I like to call this type “the invisible child” because it’s often overlooked for other diagnoses or explanations, especially in girls.
As compared to the hyperactive-impulsive manifestations, children, teens and adults with this type often experience manifestations that are more internalized – thus easier to miss because they aren’t easily observable.
Some studies have shown that inattentive type is more common in women than in men, but inconsistencies in research methods and classification of hyperactive manifestations may prove this to be untrue.
Rarest of All: Hyperactive Type
This is the currently least-diagnosed type of ADHD. It’s marked by having mostly hyperactive-impulsive manifestations, and little to no inattentive manifestations. This type of ADHD is most commonly observed in young children, as teens and adults often internalize their restless impulses.
The DSM-5 lists that these conditions must be met to receive a diagnosis of any type of ADHD:
- Six or more manifestations of each type must be observed in children up to age 16
- Five or more manifestations of each type must be observed in people older than 17
- Manifestations must be persistent for at least six months
- Manifestations need to have been present before age 12
- Manifestations must be observable in more than one setting, for example home and school
- Manifestations should not be easily explained by any other psychiatric or neuropsychological disorder
- Manifestations must several interfere with a person’s ability to perform necessary functions in school, at work and at home
Below I’ve listed many common manifestations, though it’s not an exhaustive list and should not be exclusively used for diagnosis.
Below is the list of inattentive diagnostic criteria from the DSM-5 (in shortened form via the CDC):
- Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.
- Often has trouble holding attention on tasks or play activities.
- Often does not seem to listen when spoken to directly.
- Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g., loses focus, side-tracked).
- Often has trouble organizing tasks and activities.
- Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a long period of time (such as schoolwork or homework).
- Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, mobile telephones).
- Is often easily distracted
- Is often forgetful in daily activities.
Below is the list of hyperactive-impulsive diagnostic criteria from the DSM-5 (in shortened form via the CDC):
- Often fidgets with or taps hands or feet, or squirms in seat.
- Often leaves seat in situations when remaining seated is expected.
- Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).
- Often unable to play or take part in leisure activities quietly.
- Is often “on the go” acting as if “driven by a motor”.
- Often talks excessively.
- Often blurts out an answer before a question has been completed.
- Often has trouble waiting their turn.
- Often interrupts or intrudes on others (e.g., butts into conversations or games)
Uh… This Sounds Familiar…
If the criteria for any ADHD type above sound like they may be a good fit with your life experiences, you’re not alone! Studies estimate anywhere from 5% to 9% of the global population of adults has ADHD.
If you’re newly diagnosed, check out my post on what to do next.
If you’re old hat at this, check out what you may not know about the history of ADD/ADHD.
If you’re looking for a diagnosis, here’s a free ADHD self-assessment via ADDitude Magazine that you can complete online.