Is staying focused at work or school a challenge—more so because you feel the need for constant motion?
If you relate to this, you may be living with combined type attention-deficit/hyperactivity disorder (ADHD).
There are three main types of ADHD:
- Predominantly inattentive ADHD
- Predominantly hyperactive/impulsive ADHD
- Combined type ADHD
Combined type ADHD is the most common. Research has found that this type of ADHD is around twice as prevalent as inattentive type and about eight times more common than hyperactive-impulsive type ADHD.[1]
Any kind of adult ADHD diagnosis will likely lead to questions, and that’s perfectly normal.
Learning more about your unique mix of symptoms empowers you to seek the treatment and support you need.
We’ll cover what combined type ADHD looks like in everyday life and how you can manage it through medication and other approaches.
What Is ADHD Combined Type?
Combined type ADHD is a neurobehavioral condition that affects your brain and, in turn, your behavior. Combined type ADHD presents with both hyperactive-impulsive and inattentive symptoms.
The symptoms of ADHD are divided into two main categories: hyperactivity/impulsivity and inattention.
If you experience symptoms in both categories, you may have combined type ADHD.
A diagnosis can be made based on the criteria outlined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)—a guide that helps healthcare professionals classify and diagnose mental health disorders accurately.
According to the DSM-5, you may be diagnosed with combined type ADHD if all of the following criteria are met:[2]
- Five or more symptoms of inattention for at least 6 months
- Five or more symptoms of hyperactivity/impulsivity for at least 6 months
- Symptoms interfere with your performance at work or school
- Symptoms are present in two or more settings, such as at work, school, or home
- Other mental health disorders, such as anxiety or depression, cannot better explain your symptoms
- Some symptoms were present before the age of 12
Having combined type ADHD does not mean that your ADHD is more severe.
Instead, the severity of your ADHD depends more on the rating (mild, moderate, or severe) given by your specialist.
Combined type ADHD can be categorized into different severity levels, which are:[2]
- Mild: Few symptoms are present other than the ones needed to meet the minimum diagnostic criteria. ADHD-related impairment is minimal.
- Moderate: The number of dominant symptoms and degree of impairment lies between “mild” and “severe.”
- Severe: There are many symptoms present, or a few that are particularly severe. Your ADHD symptoms are serious enough to cause significant trouble at work, school, or in social settings.
Signs and Symptoms of Combined Type ADHD in Adults
For a diagnosis of combined type ADHD, adults have to display symptoms of inattention and hyperactivity/impulsivity.
All types of ADHD have a range of symptoms and different intensities. If you have combined type ADHD, you might experience some (or all) of the symptoms in the lists below. You may also notice that some are more prominent than others.
Inattentive Symptoms
Based on the DSM-5, the nine symptoms of inattention in ADHD include:[2]
- Difficulty focusing on tasks
- Inability to follow through with instructions and complete tasks
- Getting distracted by unrelated thoughts
- Making careless mistakes and overlooking important details
- Difficulty listening when spoken to
- Unable to organize tasks and manage time
- Hesitating to take on tasks that require sustained focus
- Losing important items
- Forgetfulness (missing events, meetings, or deadlines)
Hyperactive-Impulsive Symptoms
The DSM-5 has also outlined the symptoms of hyperactivity and impulsivity in ADHD. They include:[2]
- Fidgeting, tapping your hands and feet, or moving in your seat
- Unable to stay seated
- Feeling restless
- Struggling to stay quiet while participating in activities
- Constantly “on the go” and hard to keep up with
- Talking excessively
- Interrupting others and having trouble waiting your turn in conversations
- Getting impatient when waiting your turn or standing in line
- Intruding on other people’s conversations and activities
Learning about the symptoms can help you separate what’s part of your personality and what’s actually due to your ADHD.
It’s an opportunity to view yourself in a new light –and form better strategies to overcome challenges.
Treatment for Combined Type ADHD
While there is no cure for ADHD, treatment is readily available – and often effective enough to help you thrive and succeed.
Treatment for combined type ADHD usually involves both medication and behavioral therapy and targets symptoms of inattention and hyperactivity/impulsivity.
Your specialist may prescribe any of the following medications to treat your symptoms:[3]
- Stimulant medications: These are usually the first choice for treating any type of ADHD because they’re effective for most people. Stimulant medications help increase chemical messengers (neurotransmitters) in your brain and regulate brain activity.
- Non-stimulant medications: If you do not respond well to stimulant medications or cannot tolerate their side effects, your doctor might recommend non-stimulant medications instead.
Some non-drug management options for combined-type ADHD in adults include:
- Cognitive behavioral therapy (CBT): CBT helps you recognize, address, and change habits and thinking patterns that prevent you from achieving your goals. This therapy can help you improve your organization, planning, focus, time management, and problem-solving skills.[4]
- Mindfulness therapy: Mindfulness-based techniques can help reduce mind-wandering and distractability, enhance your attention, and help regulate your emotions.[5]
- ADHD support groups: Support groups connect you to people with ADHD, giving you assess to helpful advice, encouragement, and comfort from those who understand your struggles. ADDA’s ADHD virtual support groups are a fantastic place to grow, learn, and journey alongside people who have walked in your shoes.
- ADHD coaching: An ADHD coach works with you to create structures and strategies that help you stay on track, manage your commitments, and hone valuable skills like organization and time management.
Getting the right support and treatment can be life-changing. So, it’s best to get a proper diagnosis from a trained professional, preferably a specialist with experience with adult ADHD.
Combined Type ADHD Is Common and Treatable
Combined type ADHD can be trickier to manage, due to its wide range of possible symptoms. But don’t be discouraged by the label on your diagnosis. It isn’t necessarily more severe or disruptive than other types of ADHD.
Keep in mind that treatment and support are readily available.
Your doctor will work with you to find the best course of action based on your symptoms and treatment goals. And with the right advice and support, you’ll set yourself up for success in your work, school, and relationships.
If you’re concerned that you may have ADHD, you can take ADDA’s ADHD test. This questionnaire helps you recognize the signs of ADHD and determine the best next steps to take.
A proper diagnosis is a step in the right direction to living your life to its fullest!
References
[1] Wilens, T. E., Biederman, J., Faraone, S. V., Martelon, M., Westerberg, D., & Spencer, T. J. (2009). Presenting ADHD symptoms, subtypes, and comorbid disorders in clinically referred adults with ADHD. The Journal of clinical psychiatry, 70(11), 1557–1562. https://doi.org/10.4088/JCP.08m04785pur
[2] Substance Abuse and Mental Health Services Administration. DSM-5 Changes: Implications for Child Serious Emotional Disturbance [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2016 Jun. Table 7, DSM-IV to DSM-5 Attention-Deficit/Hyperactivity Disorder Comparison. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/
[3] Antshel, K. M., Hargrave, T. M., Simonescu, M., Kaul, P., Hendricks, K., & Faraone, S. V. (2011). Advances in understanding and treating ADHD. BMC medicine, 9, 72. https://doi.org/10.1186/1741-7015-9-72
[4] Sprich, S. E., Knouse, L. E., Cooper-Vince, C., Burbridge, J., & Safren, S. A. (2012). Description and Demonstration of CBT for ADHD in Adults. Cognitive and behavioral practice, 17(1), 10.1016/j.cbpra.2009.09.002. https://doi.org/10.1016/j.cbpra.2009.09.002
[5] Bachmann, K., Lam, A. P., & Philipsen, A. (2016). Mindfulness-Based Cognitive Therapy and the Adult ADHD Brain: A Neuropsychotherapeutic Perspective. Frontiers in psychiatry, 7, 117. https://doi.org/10.3389/fpsyt.2016.00117
