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ADD or ADHD: Are They Different?

Why Do Some People Have ADD and Others ADHD? Learn More about Both

Weston Boyd, derived by Minh Nguyễn
Source: Weston Boyd, derived by Minh Nguyễn

You’ve probably heard someone say they have ADD. Others have ADHD. So what does ADD look like? How about ADHD? Are they different? In today’s blog, we’ll look a little deeper at ADD, ADHD, and the link between them.

While ADD is short for “attention deficit disorder,” ADHD is the abbreviation for “attention deficit hyperactivity disorder.” Both have been clinical diagnoses in the past, but ADHD is the official name for the syndrome these days. ADD and ADHD are actually both more recent labels for the condition. Decades ago, it went by such names as Hyperkinetic Disorder of Childhood and Minimal Brain Dysfunction.

Whatever the title, ADHD has been recognized for about the past 200 years. For most of that time it was considered a childhood problem that kids grew out of. Early on, ADHD symptoms such as hyperactivity and poor focus in kids were attributed to moral defects or willfulness. But those simplistic explanations gradually gave away to more sophisticated models of ADHD. Additionally, in the past decade or so, it’s become clearer that aspects of ADHD can linger on into adulthood.

The labels of ADD and ADHD both came from the American Psychiatric Association. Every decade or two a new manual of official psychiatric diagnoses comes out. It’s called the DSM, as in Diagnostic and Statistical Manual. The manual is published by the American Psychiatric Association and it’s widely used by mental health clinicians and researchers. The last version of the DSM (DSM-5) was released in 2013. Both ADHD and ADD come from previous editions of the DSM.

ADD made its debut in 1980. It was the official name in DSM-III for what has since become ADHD. The reason for using ADD was that at the time it was thought that inattention and poor focus were the main problems in the disorder, rather than hyperactivity. Before that, hyperactivity was seen as the core problem. More recently, hyperactivity and impulsivity have been regarded as equally important as inattention in ADHD.

By 1987, the title of ADD was renamed ADHD, and it’s remained so ever since. A few tweaks have been made here and there on symptoms and age onset, but the concept of what ADHD is and is not have remained pretty stable.

In the current view, there are three forms of ADHD: the kind with inattentive symptoms; the kind with hyperactive and impulsive symptoms; and the kind with all of these: inattentive, hyperactive, and impulsive symptoms.

ADD is no longer part of the official language for ADHD, but it is used as a kind of shorthand for the inattentive subtype of ADHD among both clients and treatment providers. It means the type of ADHD that involves things like inattention, procrastination, frequently lost items, and distractibility. So ADD, while no longer an official diagnosis, refers to the inattentive type of ADHD.

Treatments for both ADD and ADHD are similar, with medication and cognitive-behavioral therapy or specialized skills coaching as probably the most common interventions. Very broadly speaking, all three forms of ADHD are commonly seen in boys, while girls and adults are a bit more likely to show the inattentive symptoms of ADHD (ADD).

Both ADHD and ADD can look like other neurologic or psychiatric conditions. Moreover, ADHD and ADD frequently present with other problems, such as substance abuse, depression, anxiety, learning disabilities, and tic disorders.

Although there are brief 5-10 minute screening tools available to help diagnose ADD and ADHD, they have a number of serious drawbacks. For instance, they tend to be self-report in format, do a poor job of eliminating other possible explanations for the symptoms endorsed, rely heavily on past recollections, and do little if any assessment of systematic over- or under-reporting of symptoms. At best these are a rough sketch of what might be going on concerning possible ADHD or ADD, much like an online IQ test versus the real thing.

Because of the complexity of ADHD, its similarities to other conditions, and its frequent co-occurrence with still other disorders, there is really no substitute for a detailed and solid clinical evaluation to establish the diagnosis and develop an effective treatment plan. This involves a thorough clinical interview and series of cognitive and psychological tests. That is currently the best way to know if ADHD or ADD is really present, and whatever else might be along with it.

More from Larry Maucieri Ph.D., ABPP-CN
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