Understanding the Different Types of ADHD

ADHD is both incredibly common and incredibly complex. It is a disorder that impacts nearly 1/10 kids, but its symptoms vary a great deal according to age and gender. And while ADHD stands for attention deficit hyperactivity disorder and many of us hear the label and think of the child who can't sit still or focus, the name and stereotype don't always apply to what ADHD actually looks like in children or adults. That's why Braintrust was thrilled to speak with pediatric neuropsychologist Dr. Matt Pagirsky about the three most common types of ADHD and how they are expressed in children.

[@brett7398]

What I find funny about this video (great video btw) is just all the distractions in the background. I couldn't help but to hear the buzz of the person's phone near the end, the ambulance sirens throughout.

[@braintrust8396]

Yes! Attention and focus can be hard to regulate with distractions, but that's also what people with ADHD experience in just about everything they do!

[@matthewleitch1]

How can you tell the difference between someone with ADHD and someone who does not understand why they should focus on something or disagrees that they should and isn't even trying?

[@braintrust8396]

An evaluation with a neuropsychologist is the best way to identify the difference between ADHD and a lack of motivation, drive, or simple stubbornness. I'd also add that often times ADHD comes hand-in-hand with anxiety, or avoidance is driven by anxiety, so that's another potential source of difficulty when it comes to taking on new challenges. Again, a neuropsychologist is the best expert to consult in order to understand the source of difficulties related to these types of behaviors!

[@matthewleitch1]

@@braintrust8396 But what does the neuropsychologist do to distinguish between these cases? Just to be clear; I'm not denying the reality of ADHD. I know someone who has the inattentiveness without the hyperactivity and he is a different person since he began medication. I'm just wondering what is done to manage the risk of over-diagnosis.

[@braintrust8396]

@@matthewleitch1 Typically there are a range of tests and interviews that are done to identify the underlying cause of one's challenges. That being said, ADHD presents differently across cases (as noted in the video), exists on a spectrum in terms of how impactful/disruptive the behaviors are, and often only gets in the way during specific activities. And some neuropsychologists are better at testing and diagnosing than others, as is true with any profession.

[@matthewleitch1]

@@braintrust8396 That's a bit discouraging actually. What about response to medication? If someone is helped by it does that help to confirm there was a chemical deficit in the first place rather than something else?

[@braintrust8396]

@@matthewleitch1 Most people will be able to focus better with medication, regardless of whether or not they have ADHD. However, for those with ADHD, medication will make it possible for them to focus and attend in situations where they werer otherwise very hampered with/frustrated by their difficulty with self-regulation.

[@DavidSupina]

I have been diagnosed with inattentive type, but I would like to know about sluggish cognitive tempo, and how that fits in. Some of those descriptions sound like me. I wonder about the nomenclature, though, as “sluggish cognitive tempo” sounds like a euphemism for stupid.

[@braintrust8396]

We agree that it certainly isn't the kindest sounding name as any label with "sluggish" isn't going to make anyone feel good. Maybe that's why more often than not it's referred to as SCT ...

[@themetalorian2268]

Sluggish feels like the right word however.

[@Lilylowkeylily]

@@themetalorian2268 rude

[@themetalorian2268]

@@Lilylowkeylily To clarify I am fairly sure I have this. Honestly I feel the term fits, if do have it. If not my brain feels sluggish, definitely not as sharp as a lot of my peers.

[@DavidSupina]

@Patricia Johnson I’m glad your son is doing better, and I am open to alternative methods of healing, but please understand that when you use words like “cure” for those of us that have struggled for a lifetime with ADHD you may be selling false hope because like other conditions it is complex and what works for one person may not for another. There is no known cure for ADHD, and effective treatment is not the same as a cure. If there is some sort of herbal cure, I still want it to go through the vetting process that western psychiatric treatments go through.

[@CommandoTM]

Has there been discussion about transition between different types or maybe evolution into a subtype? I've been diagnosed, and I can definitely classify my childhood self as being the hyperactive-impulsive type. By the early 20s, I am neither of those, very physically composed and also being very thought out and deliberate in my choices to the point of near-indecision. But meanwhile still having the common traits of ADHD. See previous paragraph.

[@braintrust8396]

One major challenge of many children with ADHD is executive function skills. This set of competencies relates to our ability to set goals big and small, create plans to achieve them, monitor our progress as we work to meet them, and shift our strategies as needed. These abilities are driven by our prefrontal cortex, which is the last part of our brain to develop, and an area of the brain that typically develops with a delay in children with ADHD. As a result, challenges with those executive function skills tend to decrease as children grow up. On top of that, we tend to build better self-control as we mature, plus we spend more of our time on high interest activities. Taken together, this means a lot of changes in the way that ADHD looks from childhood to adulthood!

[@brian-jv1nw]

Someone watching this most likely has symptoms of ADHD and the editor is making them listen to this guy and read the text at the side at the same time.

[@braintrust8396]

Hi Brian, the goal of including the text along with the audio was to make the video supportive for those who struggle with auditory processing. Our tutoring audience includes a lot of children and adults who have ADHD in addition to other learning differences, and so having text to go along with the audio makes it more accessible to all. Hopefully it wasn't too distracting for you.

[@drkmgic]

Definitely combined.

[@elizabethtorres1169]

That is where they are wrong. The different types of Adhd can be hyper active yes and not being able to Attentively focus but there are others where the hyper activity lies within the brain and nervous system. Meaning hyper senses and reactions, fast reflexes able to think of many more things at once compared to others and once focused, controlled can both be able to think of everything and nothing. Choosing thru all thoughts to focus on. Pushing all thoughts at once to the side but clear, focus and control the mind and will. Where you can think faster than normal of many different things, being able to Attentively see, hear and notice things normal others can't. Also, once controlled one side of hemisphere where you push and control your thoughts to run in the background and still see, hear focus on both. Being and meaning within the mind/body as well as what goes around you. Then choosing which catches your interest to focus on.

[@elizabethtorres1169]

To react to.

[@elizabethtorres1169]

Also causes many idiosyncrasies. As for example adrenaline does not have the same affect with people like us, instead it slows everything and puts us to sleep. Then with another example, tranquilizers have averse affects as to what adrenaline would normally do for people, keeping us up and rapidly quickening the mind and actions

[@elizabethtorres1169]

All that have Adhd it is not at all as what either society or "normal" people deem an illness or dysfunction at all. It can be if left uncontrolled. But no medicines can do that. Only the will and mind can. Meaning once you are able to instead of doing what society, doctors and normal people inform, instruct and want us to do and be as like with them being only able to focus outside the mind, will and body is wrong. Cause we were not built, made nor created to be, do that. But rather instead like with the examples of idiosyncrasies, we are first meant to take control within us, our mind, will, attention, reactions and focus not the other way. It is not at all a dysfunction but an evolution and gift for and towards others. Especially if able to look within and take focus, control and will to be act and do so