Do you have trouble focusing? Do you find yourself tapping or fidgeting, unable to sit still? If so, you might have what’s called combined attention-deficit/hyperactive-impulsive disorder (ADHD). It’s one of the ways ADHD can present itself, but what exactly is combined ADHD?
In short, combined ADHD is when a person experiences both inattentive and hyperactive-impulsive symptoms simultaneously. Keep reading to learn more about this condition, what causes it, and how it’s treated.
ADHD can show up in three different ways:
Research shows that the inattentive type is the most common, followed by the hyperactive-impulsive type and then the combined type. Since combined ADHD includes traits from both categories, it can make life a bit more challenging.
Some signs and symptoms of combined ADHD may be easy to spot (frequently interrupting others), and others (daydreaming) may not be as obvious. However, both are important when it comes to treatment. Here’s how the symptoms break down:
Inattentive ADHD symptoms can be attributed to executive dysfunction, which makes it harder to plan, prioritize, and follow through. Common signs include:
Hyperactive-impulsive symptoms are more visible, but they can also include mental restlessness. Adults with ADHD are also more likely to overestimate the benefits of a decision, which can lead to riskier behaviors. Signs may include:
ADHD is caused by several different factors, starting with genetics. It’s one of the most heritable psychiatric conditions, with siblings having twice the risk compared to the general population. Environmental influences, like smoking during pregnancy, also contribute to a higher risk of developing ADHD.
Researchers have also found differences in certain parts of the brain that help explain the symptoms seen in combined ADHD, including:
All of these factors can interact, making it more likely for inattentive and hyperactive-impulsive symptoms to appear together in the combined presentation.
According to the DSM-5, a diagnosis requires that:
Healthcare providers may use interviews, self-report scales, and input from parents, teachers, or partners. It’s also important to rule out other possible explanations, like anxiety or depression.
While ADHD is sometimes criticized as being overdiagnosed, research shows the opposite is more common in adults. In fact, fewer than 20% of adults with ADHD are properly diagnosed and treated for their symptoms.
From medications and lifestyle changes to psychotherapy and coaching, there are several ways to treat ADHD. It may take trial and error to find what works best for you as not every treatment fits every person.
Medication is usually a part of treatment for combined ADHD, with stimulants being the first-line option. However, non-stimulants may be used when stimulants aren’t a good fit.
Stimulants, like methylphenidate and amphetamines, increase dopamine activity, which plays a role in motivation and executive function. They have a 70-80% success rate in reducing core ADHD symptoms.
Non-stimulants, on the other hand, target norepinephrine, another neurotransmitter responsible for attention and self-control. These are prescribed when stimulants don’t work well or cause side effects such as increased anxiety or sleep problems.
Therapy may also be recommended, especially if symptoms overlap with anxiety or depression. Two types used to treat ADHD include:
Psychotherapy can also address co-occurring conditions. Children with ADHD are at a higher risk of developing additional behavioral or emotional issues. Without treatment, these challenges can follow individuals into adulthood.
While therapy can help you process your emotions, ADHD coaching can teach you the skills you need to work through your other symptoms. Coaches help with time management, organization, accountability, and building systems that make everyday life easier. Coaching is not a licensed profession; however, many ADHD coaches choose to take additional learning courses or earn credentialing to better support their clients’ needs.
A coach will start by learning which symptoms are the biggest challenge and which areas of life are affected. From there, they’ll work with clients to create a treatment plan that addresses inattentive, impulsive, and hyperactive symptoms. It may help improve:
ADHD coaching is a newer approach to treating ADHD, but it’s been showing promise: a recent review of 19 studies found 17 improvements in symptoms. Six showed better overall well-being and three found improvements lasted over time.
Professional treatment can only help you so much in treating combined ADHD, which is why it’s important to build a lifestyle that aligns with your mental health goals. Helpful strategies include:
If you’re feeling like you’re constantly juggling ADHD symptoms that make you feel scattered and exhausted, it may be time to seek professional support. At Cura Behavioral Health, our therapists and prescribers work with you to address the challenges that come with combined ADHD. We take the time to understand your goals and create a plan that fits your needs. If you’re ready to find strategies that actually help, give us a call today.
Attention Deficit Hyperactivity Disorder – StatPearls
Inside the ADHD Brain: Structure, Function, and Chemistry – Attention Deficit Disorder Association
Changing between stimulant and non-stimulant ADHD medication: What you need to know – Understood
Determining if TMS therapy suits your mental health journey should involve consultation with a qualified professional. At Cura Behavioral Health, we provide comprehensive assessments to help you make informed treatment decisions.
Don’t let a mental health condition hold you back any longer. Schedule a consultation with Cura Behavioral Health today. Our experienced team is ready to answer your questions and create a personalized treatment plan tailored to your unique needs.
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Dr. Kevin Simonson, an esteemed Medical Director at Cura Behavioral Health, brings over 15 years of experience in psychiatry. A graduate from a top medical school, he specializes in the treatment of mood disorders and anxiety, employing a patient-centered approach. His dedication to evidence-based care and his commitment to advancing mental health practices have made him a respected figure in the field. Dr. Simonson’s leadership ensures the highest standard of care for the community at Cura Behavioral Health.
