Types of ADHD: Understanding the 3 Presentations

Types of ADHD: The 3 Presentations Explained

"Are there different types of ADHD?" is one of the most common questions people ask. The short answer is yes - ADHD presents in three distinct ways, and understanding these presentations helps explain why ADHD looks so different from person to person.

How Many Types of ADHD Are There?

Clinically, there are three presentations of ADHD:

1. Predominantly Inattentive Presentation (formerly ADD)
2. Predominantly Hyperactive-Impulsive Presentation
3. Combined Presentation

These aren't separate conditions - they're different ways the same underlying neurodevelopmental difference manifests.

Type 1: Predominantly Inattentive ADHD

This presentation was previously called ADD (Attention Deficit Disorder) and is characterised by:

Core Symptoms

• Difficulty sustaining attention on tasks
• Easily distracted by unrelated thoughts or stimuli
• Trouble following through on instructions
• Difficulty organising tasks and activities
• Avoiding tasks requiring sustained mental effort
• Frequently losing things
• Forgetfulness in daily activities
• Appearing not to listen when spoken to

What It Looks Like

• Daydreaming during meetings or conversations
• Missing deadlines or appointments
• Starting many projects but finishing few
• Losing track of time
• Difficulty with paperwork and admin tasks
• "Spacing out" during activities

Who Gets This Diagnosis

• More commonly identified in women and girls
• Often diagnosed later in life
• Frequently missed because no "hyperactive" behaviour

Type 2: Predominantly Hyperactive-Impulsive ADHD

This is the "classic" ADHD presentation that most people picture:

Core Symptoms

• Fidgeting or squirming when seated
• Leaving seat when expected to remain seated
• Running or climbing inappropriately (in adults: restlessness)
• Unable to engage in leisure activities quietly
• "On the go" or "driven by a motor"
• Talking excessively
• Blurting out answers before questions are completed
• Difficulty waiting turn
• Interrupting or intruding on others

What It Looks Like in Adults

• Restlessness and inability to relax
• Always needing to be busy
• Talking over others in conversation
• Making impulsive decisions
• Difficulty sitting through films or meals
• Risk-taking behaviour
• Impatience in queues or traffic

Who Gets This Diagnosis

• More commonly identified in boys/men
• Often diagnosed in childhood
• Most likely to be noticed by teachers and parents

Type 3: Combined Presentation ADHD

The most common type, combining features of both:

Characteristics

• Meets criteria for both inattentive AND hyperactive-impulsive presentations
• At least 6 symptoms from each category
• The "full package" of ADHD traits

What It Looks Like

• Difficulty focusing AND restlessness
• Forgetfulness AND impulsivity
• Disorganisation AND talking too much
• Daydreaming AND fidgeting

What Type of ADHD Do I Have?

You might identify with one presentation, but only a professional assessment can determine your specific type. Consider:

Mostly Inattentive if you:

• Struggle more with focus than sitting still
• Are internally restless rather than physically
• Often feel "foggy" or mentally scattered
• Have been called a daydreamer

Mostly Hyperactive-Impulsive if you:

• Find it physically hard to sit still
• Speak before thinking
• Make quick decisions without considering consequences
• Feel driven to always be doing something

Likely Combined if you:

• Relate strongly to both sets of symptoms
• Experience varying symptoms in different contexts
• Feel scattered AND restless

Does Your ADHD Type Change?

Yes, presentations can shift over time:

• Childhood to adulthood: Hyperactivity often decreases, becoming internal restlessness
• Life circumstances: Stress can bring out different symptoms
• Hormones: Particularly for women, presentations may shift with hormonal changes
• Diagnosis may update: Clinicians may revise type based on new information

Does Type Affect Treatment?

All ADHD types respond to similar treatments, but there may be nuances:

Medication

• Stimulants work across all presentations
• Choice of medication may consider side effect profiles
• Dosing might differ based on symptom pattern

Therapy and Coaching

• Inattentive: Focus on organisation, time management, focus strategies
• Hyperactive-Impulsive: Emphasis on impulse control, channeling energy
• Combined: Comprehensive approach addressing all areas

Lifestyle Strategies

• Inattentive: External reminders, body doubling, environmental design
• Hyperactive-Impulsive: Movement breaks, physical outlets, pause techniques
• Combined: Combining strategies from both approaches

Beyond the Three Types

Some researchers and clinicians describe additional subtypes:

• Sluggish Cognitive Tempo (SCT): Dreamy, slow-moving, low energy
• Emotional Dysregulation: Intense emotional reactions as primary feature
• With Anxiety/Depression: Significant overlap with mood conditions

These aren't official diagnoses but recognise the diversity within ADHD.

Understanding Your Brain

Knowing your ADHD presentation helps you:

• Understand your specific challenges
• Find targeted strategies
• Explain your experiences to others
• Access appropriate support

Whatever type you have, ADHD is treatable and manageable with the right understanding and support.