Understanding ADHD Subtypes: Impact on Children and Adults

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder affecting both children and adults. It is characterised by persistent patterns of inattention, hyperactivity, and impulsivity, which can significantly impact daily functioning, with severity classified as mild, moderate, or severe. Though more often associated with children, ADHD symptoms can persist into adulthood, manifesting differently throughout the lifespan. Not everyone experiences ADHD in the same way, and it is important to recognise the different presentations so it can be dealt with more effectively. This article explores the three ADHD subtypes — Predominantly Inattentive, Predominantly Hyperactive-Impulsive, and Combined — and their effects on children and adults.

ADHD Subtypes

Predominantly Inattentive (ADHD-PI): Individuals with ADHD-PI mainly struggle with inattention. Previously known as ADD, this subtype is marked by difficulty maintaining focus and distractibility without significant hyperactive or impulsive behaviours. Symptoms include:

• Difficulty paying attention to details or making careless mistakes
• Easily distracted and difficulty staying focused
• Appearing not to listen when spoken to
• Often failing to follow instructions and complete tasks
• Difficulty staying organised
• Forgetfulness and often losing things

Predominantly Hyperactive-Impulsive Presentation (ADHD-PH): This subtype features hyperactivity and impulsivity without symptoms of inattention. Some symptoms of this subtype include:

• Fidgeting, tapping feet or hands, and difficulty staying seated
• Restlessness and being constantly "on the go"
• Excessive talking and interrupting others
• Blurting out answers before questions are completed
• Difficulty waiting for their turn

Combined Presentation (ADHD-C): ADHD-C is the most common subtype, involving both inattentive and hyperactive-impulsive symptoms. As the name suggests, individuals with this subtype experience a mix of challenges from both categories.

How ADHD Affects Children

ADHD can manifest differently across individuals and cause various challenges in daily life. The next section will explore how ADHD symptoms can impact key areas of a child’s life - academic performance, social interactions, and emotional regulation.

Academic Performance: Children with ADHD often struggle more academically compared to peers without ADHD. Due to difficulties with attention, impulse control, and completing assignments, it can be harder for them to focus and acquire new knowledge. This can result in lower grades, behavioural issues, and an increased risk of early dropout.

Social Interactions: Social difficulties are common among children with ADHD. They may struggle with reading social cues, learning appropriate social behaviours through observation, and managing their hyperactive or impulsive behaviours. This can lead to misunderstandings, rejection, and difficulty making and maintaining friendships, contributing to feelings of isolation and low self-esteem. These social challenges can lead to more negative outcomes later in life, such as delinquency, substance abuse, as well as psychological issues.

Emotional Regulation: Children with ADHD often have more trouble managing their emotions, leading to heightened emotional reactivity and difficulty with emotion regulation. In other words, they tend to feel emotions more intensely and find it more difficult to control them. This can result in mood swings, frustration, and tantrums. Poor emotional regulation can exacerbate other challenges, such as social relationships and daily functioning, and increase the risk of developing comorbid mental health conditions.

How ADHD Affects Adults

The challenges faced by children with ADHD may extend into adulthood, although they may present differently as life stages change. While academic performance and peer relationships are primary concerns for younger individuals, adults may face difficulties in areas such as employment, romantic relationships, and overall mental health and wellbeing.

Employment and Career: Adults with ADHD may experience more challenges in the workplace. ADHD symptoms have been linked to struggles with job performance, time management, organization, and workload management. This can lead to lower occupational status, higher unemployment rates, and increased absenteeism. Workplace relationships may also suffer due to poorer social skills, increasing interpersonal conflicts and making it harder to work effectively with colleagues.

Relationships: ADHD can impact social relationships in adulthood, affecting overall well-being. Adults with ADHD may experience lower relationship satisfaction, more conflicts, and difficulty with positive conflict resolution. Forgetfulness and impulsive remarks can cause friction, and partners often need to compensate for these difficulties, which can cause more strain in relationships.

Mental Health: Many individuals with ADHD also experience comorbid mental health conditions such as depression, anxiety, substance use disorders, and personality disorders. Managing ADHD symptoms alongside these conditions can be challenging. For example, some ADHD medications can exacerbate depressive symptoms, complicating simultaneous treatment. Even without a formal comorbid diagnosis, people with ADHD often experience heightened negative emotions due to social and career challenges and overall lower quality of life, further impacting their mental health.

Conclusion

Recognizing the different presentations of ADHD is crucial for effective management and support. Although there is no cure for ADHD, interventions such as medication and behavioral therapy can significantly reduce symptoms and improve daily functioning. Tailoring treatment to the individual's age, symptom type, and severity is essential. By understanding the unique challenges associated with each ADHD subtype, we can better support individuals with ADHD in reaching their full potential.