Attention-Deficit / Hyperactivity Disorder: ADHD/ADD Overview

July 12, 2021

Attention-Deficit / Hyperactivity Disorder is considered a common neurological disorder. According to recent studies it affects 8% to 12% of the global population.(1)

The predominance of American research into this disorder has led to the impression that ADHD is an American disorder much less prevalent elsewhere. There is a perception that it may stem from social and cultural factors cultivated by American society.

That is simply not true. An analysis of 50 studies suggests that the prevalence of ADHD is at least as high in non-US resident.(2)

This is why it is our duty as a community to raise awareness around ADHD  & Neurodiversity to help neurodivergent brains thrive.

We know how daunting reading articles from start to finish can be, especially when you have ADHD, so we added this clickable Table of Contents to easily navigate our articles 😉 :

What is the Difference between ADD & ADHD? 


ADD vs ADHD


The American Psychiatric Association (APA) released a new version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) in 1987, that’s when they added the word “hyperactivity”, officially changing the medical term Attention Deficit Disorder (ADD) to ADHD. 

Since then, it has been the official term for the condition — regardless of whether a patient demonstrates symptoms of hyperactivity. 


What is ADD?


Attention-Deficit Disorder (ADD), is the out-of-date term for the disorder we now call ADHD or Attention-Deficit / Hyperactivity Disorder.


A lot of people still use the old term ADD out of habit or familiarity. Some people use it to refer to the inattentive type of ADHD, without the hyperactivity but continuing to use a 30-year-old term is contributing to the confusion around ADHD. 


That confusion explains why many people, especially adults, never get diagnosed because they don’t fit with the perception people have of ADHD.


The bottom line is you can be diagnosed with ADHD whether you have or don’t have hyperactive or impulsive behaviors.


Nowadays, there is a consensus, both in the Medical &  Content Creator Community, that we should use only the term ADHD to avoid confusion.


My goal is to raise awareness around the condition and how it is multifaceted. Diagnoses can vary widely from one to the next, and I want hyperactive, impulsive, inattentive, and combined ADHD types to all feel that their traits are legitimate.


To me, we all belong to the same community, and we should support each other and be inclusive, no matter what our differences may be.😊


Even though ADHD is now the standard, and my content is built around it, I know a lot of people that still prefer to use the term ADD and I want everyone in our community to be respectful of their choice. 🙏


Considering my awareness goal around ADHD as a whole, I do not want to contribute to the confusion, but if you feel like Attention Deficit Disorder is a better fit for you than Attention-Deficit / Hyperactivity Disorder, do what is best for you! 😉

ADHD Definition & Meaning


ADHD stands for Attention-Deficit / Hyperactivity Disorder. It is a highly complex disorder that affects almost all areas of the brain. 


The technical definition as written in the current Diagnostic and Statistical Manual of Mental Disorders (DSM-V) is:


“A persistent pattern of inattention and or hyperactivity-impulsivity that interferes with functioning or development“.(3)


That’s the way the medical community defines it. If you visit the CDC’s website or the NIMH’s you’ll read all about how ADHD is a “mental disorder” or a “chronic condition”.


You know what I’m talking about… a lot of “disorder”: “neurodevelopmental disorder”, “neurobehavioral disorder”, “brain disorder” etc.


Thankfully there is a second way of considering ADHD that is gaining in popularity, revolving around the idea of neurodiversity. 🙏


In a nutshell, neurodiversity explains that brain differences are just that: differences. Conditions like ADHD and Autism are not mental illnesses, they’re simply variations of the human brain.


Between 30% and 40% of the population are thought to be neurodiverse. 👀 (4)

The remaining majority are neurotypical. Here is the entire Make-up of Neurodiversity:

Neurodiversity make-up


When we stop thinking about ADHD as a disorder, we can focus on what is really at stake, helping people thrive with the way their brain operates, instead of trying to have a one size fits all way of treating human beings.🙏

We need to educate employers, parents and teachers about the specificities of neurodivergent brains so that every individual gets the same chance to succeed. As a bonus it will alleviate a lot of frustration!

Frequently Asked Questions about ADHD

How common is ADHD?


According to the Center for Disease Control (CDC), an estimated 9.4% of children (5) and 2.5% of adults have ADHD in the US. (6) Even though most diagnoses occur during childhood, it affects adults as well, but usually manifests itself in different ways as people learn to adapt to their condition and mask traits


Multiple studies have concluded that 8 to 12% of the global population has ADHD,so even the US is still underestimating the prevalence of ADHD.  👀 (1)


Considering my experience it does not surprise me! Every day I get messages on my Instagram account from people like me that have been living with ADHD and experienced symptoms for years until they decide to start the official diagnosis process.


I get even more messages from people that are just starting to wonder if they could have ADHD. Most of them had no idea they could have this “disorder”. They just relate with FB/Insta posts, memes, and TikToks they see on their social media feeds



Comments on my Instagram posts @the_mini_adhd_coach



Even with new people realizing they could have ADHD every day, I know that most people are not even aware that it could be a possibility. 

They are not aware that some issues they are dealing with come from ADHD. 😌


For example, my brother just got officially diagnosed at 35, only because I got diagnosed (at 29) and pushed him to do the same. That took way longer than it should have 😕! 


The worst part is that he probably would have never known. He thought it was just the way he was. He would explain his tendencies to his character traits, not to a neurological difference.


I’m sure he is not alone and that there are way too many people that get frustrated with themselves and feel misunderstood because they don’t know enough about ADHD. 😌


There are also too many that are discouraged from pursuing a diagnosis. It can be a long, strenuous and costly process depending on where you live. 😞 


ADHD treatment options are also underrated, considering they can make a significant difference in the proper context.  


So, between a lack of awareness, stringent & outdated notions around what is and what isn’t ADHD, combined with a lot of prejudices and preconceived ideas against people with ADHD, no wonder only 2.5% of adults get diagnosed when 8% to 12% realistically have ADHD.


According to official numbers, men are diagnosed with ADHD at twice the rate of women (2.28 to be precise), but women are most often diagnosed with a predominantly inattentive presentation, which tends to be overlooked by doctors. (7)


Women with ADHD also have higher rates of comorbid conditions, (8) including internalizing conditions (such as anxiety and depression) and externalizing conditions (like oppositional defiant disorder and conduct disorder).

What causes ADHD?


In 2021, we do not know the exact cause of Attention-Deficit / Hyperactivity Disorder, but there are two things the medical community has identified:


  1. ADHD runs in families, and the genes we inherit from our parents are a significant factor in developing the condition. 👀
  • Studies have shown that if you have ADHD, your children have about a 35% chance of getting it.
  • A child with ADHD has a 50% chance of having at least one parent with it too. (9)


  1. Different brain function and structure, research has identified several differences in the brains of people with ADHD (cf. the definition of neurodiversity)


If we consider neurological differences across the neurodiversity spectrum, the medical community have identified the following causes for “neurodevelopmental conditions”:


  • Genetics
  • Infectious Disease
  • Immune disorders
  • Physical Trauma / Brain Injury (even brain damage that happened in the womb or after a severe injury later in life)
  • Trauma at birth
  • Premature birth (before the 37th week of pregnancy)
  • Low birth weight
  • Nutritional factors
  • Epilepsy

Interested in learning even more about what causes ADHD? You're in luck because we wrote an entire article dedicated to answering that exact question!


Is ADHD a Learning Disability?


Attention-deficit / hyperactivity disorder is not a learning disability, but it can make learning difficult 😔 ! It can be hard to learn when you struggle to focus on what your teacher is saying or get distracted by everything when doing your homework or reading your textbooks.


You also can have both. Learning disabilities (LD) and ADHD often co-exist.

How many types of ADHD are there, and what are they?


The American Psychiatric Association (APA) released a set of revisions to the fourth edition of the DSM (DSM-IV) in 1994 that established the three subtypes of ADHD used by healthcare professionals today:


  • ADHD predominantly hyperactive impulsive type 
  • ADHD predominantly inattentive type 
  • ADHD combined type 

 

ADHD predominantly hyperactive-impulsive type 


What is the attention deficit hyperactivity disorder hyperactive-impulsive type?


 It is characterized by impulsive and hyperactive behaviors without inattention and distractibility. It is the least common type of ADHD.


People with this type of ADHD can feel the need for constant movement; they may talk a lot, interrupt others, blurt out answers, and struggle with self-control.


What are the symptoms of the hyperactive-impulsive type of ADHD?


According to the APA’s diagnostic criteria, there are nine symptoms associated with the inattention characterization of ADHD:


  • Often leaves his/her seat in situations when remaining seated is expected.
  • Often runs around in situations where it is not appropriate. (Note: For Teens & Adults, they may be limited to feeling restless.)
  • Some activities cannot be carried out quietly.
  • Is often “on the go,” acting as if “driven by a motor” (uncomfortable being still for an extended time, as in restaurants or meetings; may be experienced by others as being restless or difficult to keep up with).
  • Often talks a lot.
  • Answers before questions are completed (finishes people's sentences; has trouble waiting for his or her turn in conversation).
  • Sometimes finds it difficult to wait for his or her turn. 
  • Often fidgets or squirms in his/her seat.
  • Often interrupts or intrudes on others (may start using other people’s things without asking or receiving permission; for adults, may take over what others are doing).


The American Psychiatric Association have the following diagnostic criteria:


  • Experience severe or chronic problems due to six or more of these nine symptoms (for at least six months)
  • Do not have other mental health disorder that could be a better explanation of these symptoms
  • Have few-to-no symptoms of inattention


Why 6 out of 9? That’s a great question, and I do not have the answer to that. It seems arbitrary to me and not scientific at all 😕 (I know it’s ironic coming from the scientific community 😅).

What I do know is that if even just a few of those sound like you, you may want to learn more about ADHD and see if there are other things you can relate to. 😊

At the end of the day, your brain may be slightly different than a neurotypical brain and you could learn how you can thrive just the way you are. 😃

ADHD predominantly inattentive type 

What is the attention deficit hyperactivity disorder inattentive type?


Adults and kids who have significant problems with inattention, but exhibit few or no symptoms of hyperactivity, are diagnosed with the predominantly inattentive presentation of ADHD. 


A person with this type of ADHD has difficulty paying attention to details. They can be easily distracted, struggle to finish tasks, or be disorganized.


What are symptoms of the inattentive type ADHD?


According to the American Psychiatric Association’s (APA) diagnostic criteria, there are nine symptoms associated with the inattention characterization of ADHD:


  • Often has trouble staying focused on tasks 
  • Frequently makes mistakes or fails to pay close attention to details
  • Often misses deadlines or fails to finish tasks
  • Has a tendency to get distracted easily
  • Often fails to complete work assignments or other activities or fails to follow through on instructions
  • Often forgets doing routine chores 
  • Frequently avoids tasks that require extended periods of mental focus 
  • Constantly misplacing and losing items
  • Does not seem to be listening when spoken to directly.


The American Psychiatric Association have the following diagnostic criteria:


  • Experience severe or chronic problems due to six or more of these nine symptoms (for at least six months)
  • Do not have other mental health disorder that could be a better explanation of these symptoms
  • Have few-to-no symptoms of hyperactivity or impulsivity


Like I said previously I do not know why it is 6 out of 9, or what you should do according to the APA if you “Experience serious or chronic problems due to” five or less of these nine symptoms. 


My advice is even if just a few of those sound like you, you may want to learn more about ADHD; you could learn how you can thrive just the way you are. 😃


ADHD combined type 


What is the attention deficit hyperactivity disorder combined type?


It is characterized by impulsive and hyperactive behaviors as well as inattention and distractibility. It is the most common type of ADHD.


What are symptoms of the combined type ADHD?


People with the combined-type ADHD demonstrate six or more symptoms of inattention, and six or more symptoms of hyperactivity and impulsivity.


Bear in mind that everyone is different. The way ADHD manifests itself varies greatly from an individual to the next, and some symptoms are still very much misunderstood. 


Adults with Attention-Deficit / Hyperactivity Disorder learn to deal with their “quirks” and can develop a second nature to fit in with what is perceived as being normal should be.

This is what we call “masking” in the ADHD community. 


How we learn, sometimes very young, to mask frowned upon behavioral characteristics and how tiring it can be to constantly adapt. It can be absolutely draining and lead to anxiety and depression. 😌


To sum up the 3 Different Types of ADHD:


ADHD in Childhood vs Adulthood


Although Attention-Deficit / Hyperactivity Disorder has been recognized as a disorder affecting children and adults alike, there is still a lot left to be desired on how we conceptualize it in adults, especially considering the wide range of ADHD symptoms & comorbidities. 😞


Children with ADHD can start showing traits as early as three years of age, but they are most likely neurodiverse from their very first day.


Everyone is different and this is where confusion stems from. Some have mild, others have moderate, or severe symptoms but they all may be neurodifferent. Technically they should be diagnosed with ADHD, just different types with different levels of severity.


During childhood, symptoms are more commonly identified with hyperactive and impulsive traits. They tend to become less pronounced over time as individuals grow up, but the symptoms of inattention persist and continue to cause impairment. 


ADHD affects more males than females, and behaviors can vary depending on gender. For example, Assigned Males At Birth may be more hyperactive and Assigned Females At Birth may tend to be quietly inattentive.


Is it a coincidence 🤔 ? I don’t think so!


I believe it is as common regardless of gender, but that hyperactive traits are more commonly diagnosed, especially with boys, because this is what we mostly look for. That’s the stereotype of ADHD, when we know it can take so many different shapes & forms. 


Let’s look at examples of how the same Attention-Deficit / Hyperactivity Disorder trait can look different in childhood vs in adulthood:


Child with ADHD vs Adult with ADHD

Impulsivity


Getting Bored Easily


Difficulties With Organization

Getting Easily Distracted

Forgetting Things


Difficulties Managing Emotions



ADHD Timeline: From Childhood to Adulthood

Reference: Faraone, S. V. et al. (2015) Attention-deficit/hyperactivity disorder Nat. Rev. Dis. Primers doi:10.1038/nrdp.2015.20 ; http://rdcu.be/gYyV

ADHD Diagnosis and Treatment


How is ADHD diagnosed?


Unlike most medical conditions, it can't be diagnosed with a physical test, like a blood test or an X-ray. Instead, a health professional uses an evaluation process to diagnose Attention-Deficit / Hyperactivity Disorder using the guidelines from the American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition (DSM-5). 


It makes ADHD hard to track. Not only do you need to be aware you might have Attention-Deficit / Hyperactivity Disorder, you need to have an Health Care Provider that is able to perform the evaluation process properly. On top of that, it has such a wide variety of manifestations that doctors too stringent may miss on less severe cases that still may legitimately need support. 😞


That may change soon, as new research suggests that brain magnetic resonance imaging (MRI) can be used to identify ADHD and even distinguish subtypes of ADHD. (10)

Who can diagnose ADHD?


For children, ADHD is diagnosed by general practitioners, pediatricians, psychiatrists, and mental health professionals.


For adults, an ADHD diagnostic evaluation should be conducted by a licensed mental health professional or a physician. 


Here’s a list of professionals that can give an official diagnosis:


-clinical psychologists

-physicians & GPs (including pediatricians)

-psychiatrist

-neurologist

-family doctor

-clinical social workers

How Important Is an Accurate ADHD Diagnosis?

If we exclude people that have never heard of it or simply are not aware of the broad spectrum that falls under ADHD, there are still a lot of people that are uncomfortable asking for an official diagnosis 😕!


Here’s why you may not want to be diagnosed:


  • You feel insecure about speaking to a professional about your struggles
  • Fear of being judged negatively by others 
  • You can worry about getting a negative diagnosis that would leave you with more questions than answers
  • You don’t know how to get diagnosed, which professional to see etc.
  • You could be afraid of the cost
  • You might not want to take medication
  • You may not want to seek professional help (once again due to cost, or inconvenience, or due to the stigma)
  • You may not be interested in behavioral therapy or other treatment options either


So why bother?


Well, even if you are all of the above, I think you should still consider getting officially diagnosed. At the very least, you should try to learn as much as you can about ADHD to improve your day-to-day life.


I can tell you that I’ve been feeling much better since I've been officially diagnosed by a specialist and plenty of my followers echo this sentiment every day.😊


Getting my official diagnosis pushed me to start posting about ADHD in the first place because I wanted to share my experience as I wish I would have known earlier in my life. 


It’s also why I created the “Could it be ADHD Self Assessment Workbook” to help everyone understand ADHD and how the symptoms of ADHD can affect them or someone they love.


I designed this workbook for those who are wondering if they have ADHD, to start getting answers and figure out whether it could be worth getting officially diagnosed.


ADHD Treatment Options

There’s no cure for ADHD, because it is not a disease; it is a neurological difference. 

It is classified as a "neurodevelopmental disorder with underlying biologic and neurologic mechanisms requiring chronic care”. (11)

ADHD behavior is not intentional and that your family and your workplace can make accommodations to help you thrive.

That being said, there are options that can help you manage your symptoms.😃

Treatments range from behavioral intervention to prescription medication. You need to talk to a specialist to figure out what is the best treatment option for you

Bear in mind that medication is not a magical solution. Multiple studies from The National Institute of Mental Health (NIMH) confirmed that medication alone is rarely an effective treatment for ADHD. (12) Combined medication and psychosocial treatment approaches are recommended as effective treatment for most patients with Attention-Deficit / Hyperactivity Disorder. (13)

This is what the studies say, everyone is different, though, and I’ve heard many great stories about how medication alone can truly make a difference.😊

Considering the different types of ADHD, the long list of symptoms and comorbid conditions, the way it affects children & adults as well as men & women differently, it is not surprising that there are A LOT of medication/treatment options. From stimulant medications to behavior therapy, there are multiple ways of “treating ADHD”. 

You must find a Healthcare Provider you trust that will help you figure out what option is right for you, considering your health history and potential side effects. If you even need treatment, sometimes just knowing you have it and getting some key accommodations can be enough to thrive with ADHD.

Summing up what you need to know about ADHD:


ADHD and neurodiversity in general are more common than you think.

A lot of people are not even aware they have ADHD. 

Between the lack of universal knowledge on the condition around the world, the confusion between the different types of ADHD (and between ADD & ADHD) and how common comorbidities are within the Neurodiverse community it is no surprise ADHD remains under the radar globally. 

Let’s be clear, our goal to raise ADHD awareness is not to promote that every neurodivergent brain should be medicated and/or treated by a specialist.

It is simply to reassure people like me who have spent all their lives wondering why they were different. 

You are not alone, and your differences do not make you any less smart or capable. In reality it is quite the opposite, once you’ll understand the inner workings of your neurodivergent brain you will thrive.


Recognition of the prevalence of Neurodiversity globally will have important implications for the psychiatric care of children all over the world.

Sources

1) "The worldwide prevalence of ADHD: is it an American condition?." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525089/


2) "The worldwide prevalence of ADHD: is it an American condition?." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525089/.


3) "Table 7, DSM-IV to DSM-5 Attention-Deficit/Hyperactivity Disorder ...." https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/


4) "Neurodiversity and other conditions - ADHD Aware." https://adhdaware.org.uk/what-is-adhd/neurodiversity-and-other-conditions/.


5) "Data and Statistics About ADHD | CDC." https://www.cdc.gov/ncbddd/adhd/data.html


6)  "Prevalence and correlates of adult attention-deficit ... - PubMed." https://pubmed.ncbi.nlm.nih.gov/19252145/


7) "Sex and age differences in Attention-Deficit/Hyperactivity Disorder ...." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3101894/


8) "Sex Differences in Comorbidity Patterns of Attention ... - PubMed - NIH." https://pubmed.ncbi.nlm.nih.gov/30768399/


9) "Is ADHD Hereditary? Experts Say Yes, Highly - ADDitude." 19 janv.. 2018, https://www.additudemag.com/is-adhd-hereditary-blog/.


10) "Brain MRIs Can Identify ADHD and Distinguish Among Subtypes." 29 nov.. 2017, https://www.ajmc.com/view/brain-mris-can-identify-adhd-and-distinguish-among-subtypes.


11) "ADHD: From childhood to young adulthood | CE Article ...." https://www.nursingcenter.com/ce_articleprint?an=00006205-201803000-00002.


12) "Treatment of adults with attention-deficit/hyperactivity disorder." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518387/


13) "Treatment of adults with attention-deficit/hyperactivity disorder." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2518387/

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Disclaimer: This article is for educational purposes only. If you are experiencing symptoms of ADHD, it’s best to see a professional for a diagnosis.

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