Types of ADHD

Introduction to ADHD

ADHD (Attention Deficit Hyperactivity Disorder) is a lifelong neurodevelopmental condition that encompasses a wide variety of experiences. Each individual with ADHD will face a unique set of symptoms and challenges.

Due to largely inaccurate stereotypes perpetuated by the media, ADHD is often thought to be a condition defined only by hyperactivity and impulsivity. As is also the case with autism, there are many misconceptions surrounding ADHD and unfortunately, people with ADHD are frequently stereotyped as being ‘disruptive’, ‘lazy’ or ‘rude’. Such misconceptions imply that the behaviours associated with ADHD are choices and contribute to the stigma surrounding the condition. Therefore, in order to challenge this stigma, it’s vital to develop an accurate understanding of ADHD and its many presentations.

There are thought to be three types of ADHD, including Inattentive ADHD, Hyperactive-impulsive ADHD, and Mixed ADHD. ADHD can also exist alongside autism (sometimes referred to as AuDHD). Each type of ADHD generally encompasses the following traits:

Inattentive ADHD:

·      Easily distracted

·      Often misses deadlines or forgets to complete tasks on-time

·      Often has trouble organising tasks and activities

·      Often indecisive and easily overwhelmed by multiple options

·      Often struggles to commit to a single focus

·      Prone to making careless mistakes

·      Prone to losing items

·      Prone to boredom

·      Prone to frequent daydreaming

·      Slow processing speed

·      Difficulty following instructions

·      More prevalent in females

Hyperactive-impulsive ADHD:

·      Difficulty sitting still

·      Prone to fidgeting and stimming

·      Often very talkative

·      Often ‘on-the-go’

·      Often impatient

·      Can be reckless

·      Prone to speaking before thinking

·      Prone to making impulsive decisions

·      Prone to acting or speaking out-of-turn

Combined ADHD:

·      Exhibit multiple traits of both inattentive and hyperactive-impulsive ADHD

·      The most common type of ADHD

Whilst hyperactive ADHD isn’t uncommon, most people with ADHD have a combination of both hyperactive and inattentive ADHD. Inattentive ADHD is also more common in women and girls, and due to its quieter nature, often slips under the radar.

AuDHD

Autism and ADHD can, and often do, co-exist. Whilst traits such as executive dysfunction, hyper-focus and social/emotional difficulties are aspects of both autism and ADHD, many traits of autism and ADHD contradict each other. For example, autistic people often need routine, predictability, familiarity and clear instructions to function. However, people with ADHD often find it very difficult to stick to routines and need spontaneity. For somebody with AuDHD, they may need routines in order to function, but really struggle to implement and commit to them due to their distractibility. They may also need spontaneity and excitement for their mental wellbeing, but become very distressed and experience physiological reactions when faced with any kind of change. For this reason, it can be very difficult for people with AuDHD to find a balance between meeting the needs of their ADHD whilst avoiding overstimulation, distress, meltdowns and shutdowns.

My journey to diagnosis

I was diagnosed with inattentive ADHD at the age of 21.

At first, I was convinced that this was a misdiagnosis. I never even considered the fact that I could have ADHD until my therapist brought it up during one of our sessions. My diagnosis of autism was never so difficult for me to believe; after all, I’ve always exhibited many of the more ‘stereotypical’ traits associated with autism spectrum condition. I probably wouldn’t have found any reason to go for an ADHD assessment if my therapist hadn’t highlighted how gaining an insight into the condition could help me to manage my symptoms. Thankfully, I was referred through the ‘right to choose’ scheme and was able to get an assessment within a year (which I’m very grateful for!). Following the assessment, the outcome was very clear: I’ve most definitely always lived with inattentive ADHD.

Many of the questions that I was asked by the psychologist seemed scarily relevant; I’ve always been known for having a shocking short-term memory, losing things (losing 4 sets of house keys within a year is my personal best), being late due to distraction, finding it almost impossible to see projects through to the end (unless I become hyper-fixated, then I struggle to focus on anything but that one thing), changing my mind about important decisions at least 10 times per day, and finding myself in states of decision paralysis where I find it impossible to choose the simplest thing, such as what to watch on TV. In the latter occasion, I often become so overwhelmed by options that I end up doing nothing but ruminating on every possible outcome whilst rotting in bed. I always did wonder why I’ve always struggled to get through TV series and films…

Until my diagnosis, I incorrectly assumed that ADHD was defined by physical hyper-activity. As a quiet person who has always preferred to live slowly, I could relate to little of the diagnostic criteria for hyperactive-impulsive ADHD. The only times in which I become hyperactive are when I’m stimming due to excitement over a special interest or experiencing anxiety due to an overwhelming trigger. However, since researching the condition, I’ve found that many of the stereotypes associated with ADHD are derived from a set of behaviours present in a narrow (and predominantly male) population – as is the case with autism.

Challenging harmful misconceptions:

There are many harmful misconceptions and stereotypes associated with ADHD. Some of these include:

·      Only children can have ADHD (false)

·      ADHD is a choice (false)

·      ADHD is a ‘new’ condition (false)

·      You can ‘grow out’ of ADHD (false)

·      All people with ADHD are hyperactive and impulsive (false)

·      People with ADHD are rude, lazy and disruptive (false)

·      Medication is the only treatment for ADHD (false)

·      Only boys can have ADHD (false)

In actual fact, the ADHD brain is wired differently to the neurotypical brain. Any individual of any gender, race, ethnicity and background can have ADHD. ADHD has always existed, the only reason why some individuals believe that it’s a ‘new’ condition is because the term ‘ADHD’ wasn’t coined until the 1980’s. Even following the formal recognition of ADHD, there was little awareness of the condition until fairly recently.

One thing is certain: ADHD is not a choice. A key difference between an ADHD brain and a neurotypical brain is the level of norepinephrine, a neurotransmitter. Norepinephrine is produced from dopamine, and since they are closely related, it is believed that lower levels of dopamine and norepinephrine are associated with ADHD. An imbalance in dopamine transmission in the brain may be linked to ADHD symptoms, such as inattention and impulsivity. This imbalance may also affect the dopamine reward pathway, altering how the ADHD brain experiences reward and pleasure. The structure of the brain’s frontal cortex, limbic regions, and basal ganglia can differ between an ADHD brain and a neurotypical brain. In ADHD, the DMN (default mode network) is often more active than in a neurotypical brain. The DMN activates during daydreaming and when a person is unable to concentrate on a task or activity.

While ADHD medication can enhance attention, focus, and impulse control, it doesn’t ‘cure’ ADHD. It’s also not suitable for everyone, including those with certain physical health conditions like heart issues. Although medication can be helpful, it is possible to improve areas such as productivity, time management, and impulse control naturally. This doesn’t imply that individuals with ADHD can manage these areas as easily as neurotypical individuals—we’ve already established that ADHD is not a choice and results from concrete differences in the brain. It simply means that people with ADHD might benefit from discovering techniques that are effective for their brains.

Some strategies that might assist in managing ADHD include:

·      Setting alarms that signal when to start and finish a task. For example, in the morning, a person could have alarms indicating when to get up, brush their teeth, get ready, have breakfast, and leave the house.

·      Having visible calendars and reminders displayed around the house.

·      Utilising time-management apps.

·      Utilising fidget toys.

·      Creating to-do lists for each day.

·      Relying on meal prep, ready-made ingredients (such as ready-made pasta sauces) and frozen/pre-prepared foods.

·      Planning weekly meals ahead of time.

·      Planning outfits the night before.

·      Informing loved ones of ways in which they can help.

·      Seeking support for co-occurring mental health conditions.

Summary

ADHD is a lifelong neurodevelopmental condition that encompasses a wide range of experiences. There are a lot of misconceptions about ADHD, and it’s vital to challenge these misconceptions in order to prevent the perpetuation of harmful stereotypes. People with ADHD are often very creative and bring fresh perspectives, and with the right support, the more distressing symptoms of ADHD can be managed.