ADD vs. ADHD: Understanding the Difference

For years, people have used the terms ‘ADD’ and ‘ADHD’ interchangeably, which has led to a lot of confusion. Parents, teachers, and even adults who wonder about their own challenges with attention often ask: is there really a difference between the two?

While both terms point to the same condition, the way we describe it and the way doctors diagnose it has changed over time. This article breaks down ADD vs. ADHD, what they mean today, and how symptoms show up between the two.

The History of ADD vs. ADHD

The terms ‘ADD’ and ‘ADHD’ are only recent descriptions for hyperactive-impulsive or inattentive symptoms. Here’s how the conditions have evolved since their symptoms have been clinically recognized:

1940s: Doctors begin using the term ‘minimal brain dysfunction’ to diagnose children with behavioral symptoms (hyperactivity) that resemble those seen in children recovering from encephalitis (brain inflammation). During this time, behavioral disorders are attributed to possible brain injury.
1961: Ritalin is approved to treat behavioral issues in children.
Late 1960s: ‘minimal brain dysfunction’ breaks out into terms like dyslexia, brain disorders, and hyperactivity. Hyperactivity becomes widely used, especially in schools.
1980: The DSM-3 officially recognizes Attention Deficit Disorder (ADD) and expands the diagnosis to include adolescents. There are two subtypes: ADD with hyperactivity and ADD without hyperactivity.
1987: Subtypes are removed, and ADD is renamed Attention Deficit Hyperactivity Disorder (ADHD), to include both inattentive and hyperactive symptoms.
1994: The idea of adult ADHD enters mainstream discussion.

Over time, researchers and doctors have debated at length regarding ADD and ADHD. Research is ongoing to determine the exact causes of the conditions, whether or not they’re over- and under-diagnosed, and why diagnosis rates continue to rise.

Types of ADHD

The DSM-5 recognizes three types of ADHD: predominantly inattentive, predominantly hyperactive-impulsive, and combined presentation. Each type has its own characteristics and challenges.

ADHD Inattentive (Formerly ADD)

The inattentive ADHD presentation is often referred to as ADD. Everyone has trouble paying attention sometimes, but a person with ADD will experience the following symptoms more frequently and intensely, so much so that it interferes with their daily functioning:

Getting distracted easily or daydreaming frequently
Unable to focus on tasks or follow conversations
Making careless mistakes due to not paying attention to details
Missing appointments, forgetting to complete tasks, misplacing items
Avoiding tasks that require sustained mental effort, like taxes
Unable to manage time or meet deadlines

Women are more likely to experience inattentive ADHD; however, because inattentive symptoms are internalized, they’re harder to spot, potentially explaining why many women are overlooked and go untreated.

ADHD Hyperactive-Impulsive

ADHD with a hyperactive-impulsive presentation will cause people to experience more external symptoms. These can include:

Unable to stay seated in situations where sitting is expected
Interrupting others in conversations
Difficulty waiting for their turn in line
Fidgeting or squirming
Acting without thinking of consequences (risky behavior)
Blurting out answers before the question is finished

Boys and men are more likely to be diagnosed with this ADHD presentation as they frequently exhibit more hyperactivity and behavioral problems than females.

ADHD Combined Type

The combined type ADHD presentation includes both inattentive and hyperactive-impulsive symptoms, which can make daily living a bit more challenging. One study found that approximately 70% of adults with ADHD have the combined type.

How is ADD vs. ADHD Diagnosed?

To diagnose someone with ADD or ADHD, a doctor will follow specific ADHD criteria outlined in the DSM-5. These guidelines state:

Children up to 16 years old must show six or more symptoms of inattention and/or hyperactivity-impulsivity.
Adolescents ages 17 years and older and adults must show five or more symptoms of inattention and/or hyperactivity-impulsivity.
Both types of symptoms must have been present for at least six months and be inappropriate for a person’s age or development stage.
Several symptoms were present before 12 years old.
Symptoms appear in two or more settings, like home, work, or school
Symptoms interfere with daily functioning and reduce quality of life

Even if you check all of these boxes, your doctor will likely want to rule out any other conditions that might either be mimicking ADHD symptoms or co-existing with ADHD. Almost half of people with ADHD also experience another condition, with common comorbidities including:

Depression
Anxiety
OCD
Oppositional defiant disorder
Learning disabilities

ADD and ADHD Symptoms Across Age Groups

ADHD doesn’t look the same throughout a person’s life. Symptoms can change as children grow up, with hyperactive behaviors becoming less noticeable and inattentive symptoms taking over. Here’s how ADD and ADHD symptoms can look at different life stages:

Difficulty sitting still as a small child → becomes restlessness in the classroom during middle school → may evolve into being unable to relax or feeling on the go as an adult
Interrupting others during play or story time → turns into blurting out answers or jokes in class → may show up as talking over colleagues or partners in adulthood
Forgetting simple tasks like packing a backpack → turns into losing assignments → later becomes misplacing important items, missing deadlines, or double-booking commitments
Strong emotional reactions over minor frustrations → becomes mood swings or irritability in middle school → may develop into difficulty managing stress at work and in relationships
Grabbing toys without asking → becomes taking risks without thinking → may present as impulsive spending or risky driving

ADD vs. ADHD Treatment

Medication is often the first step in ADD and ADHD treatment. Stimulants work quickly and are proven to be more effective than other medications. When stimulants aren’t well-tolerated or are unable to be used for a different reason, non-stimulants are sometimes used instead.

Therapy is another option for support, with cognitive behavioral therapy (CBT) being the most common. CBT helps people:

Recognize unhelpful thoughts that drive distraction or procrastination
Build coping skills for stress and mood swings
Practice strategies that make daily life more manageable

Some people also work with ADHD coaches, who focus less on the emotional aspect of treatment and more on real-world applications. Coaching can help with:

Breaking down large tasks into smaller, doable steps
Keeping routines realistic and consistent
Staying organized and accountable during times of low motivation

Studies show that combining therapy with medication often yields the best results in the treatment of ADD and ADHD.

Get Started With ADHD Treatment Today

ADD and ADHD can affect everything from school performance and work deadlines to relationships and self-esteem. Effective treatment looks different for everyone, which is why we combine medication management with proven therapeutic strategies and coping skills you can use in your day-to-day life.

At Cura Behavioral Health, we take the time to listen, to understand your challenges, and to build a care plan that works. Don’t put it off any longer. Contact us today and get the treatment you deserve.

Sources:

ADHD: The History of a Diagnosis – JSTOR Daily

Inattentive ADHD in Women: How to Recognize Symptoms & Overcome Them – Attention Deficit Disorder Association

Adult attention deficit hyperactivity disorder: a comprehensive review – Annals of Medicine & Surgery

ADHD in adults: clinical subtypes and associated characteristics – Rivista di psychiatria

When It’s Not Just ADHD: Symptoms of Comorbid Conditions – Additude Magazine

Medications Used to Treat ADHD – UC Davis Health Mind Institute

Treatment of ADHD: Drugs, psychological therapies, devices, complementary and alternative methods as well as the trends in clinical trials – Frontiers in Pharmacology

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