You’ve heard about ADD and also ADHD and have previously searched for your symptoms online, only to wonder if you have either of both conditions? You are not alone. This is an almost universal question that I hear in my New York psychiatry practice and it’s completely understandable.
The short answer? ADD is no longer an official diagnosis. However, the long answer is more important – particularly if you are an adult who is trying to understand why they feel a certain way and why they focus on certain things.
What Is ADD? What Is ADHD? Understanding the Terminology
Previously 1986 it was called Attention Deficit Disorder (ADD). It referred to those individuals who were unable to maintain their attention and focus but who did not exhibit hyperactivity.
Managing ADD was combined with other hyperactive behaviors, and the American Psychiatric Association’s (APA) revised Diagnostic and Statistical Manual (DSM) referred to it as ADHD (Attention-Deficit/Hyperactivity Disorder). The terms ADD vs ADHD in adults are not a medical issue, but rather a product of an old language and the latest diagnostic criteria.
But there is still a difference. Most adults who self-identify as “ADD” are stating they have ADHD, Predominantly Inattentive Presentation – where the difference in approach to treatment can make a big difference.
The 3 Presentations of ADHD in Adults
According to the DSM-5, there are three presentations of ADHD. Understanding which one is best suited for you is very important to support yourself.
1. ADHD, Predominantly Inattentive (formerly “ADD”)
- Persistent problems with attention deficit in intellectual pursuits or interpersonal interactions
- Losing things or missing deadlines or appointments often
- Within meetings or conversations, mental “zoning out” even during important meetings or discussions
- Evading activities that demand extended periods of focused thought work
2. ADHD, Predominantly Hyperactive-Impulsive
- Impatience, inability to remain quiet, over talkativeness
- Impulsivity, inability to listen, emotionality
- Being somewhat ‘in the motor’ when lying still
3. ADHD, Combined Presentation
- Symptoms from both categories (with clinical threshold)
- The most common clinical presentation
If adults state that they “think” they have “ADD” not “ADHD”, they are typically referring to the type of the disorder marked by inattention, the less noticeable of the two types, and rarely diagnosed especially in women, for decades.
Adult ADHD Symptoms: Why They Look Different Than in Kids
Hyperactive kids don’t display adult ADHD symptoms! Presentation in adults is often more internal, more subtle, and masked over the years of coping.
Common symptoms of adult ADHD are:
- Prolongs working – struggles to get started on work projects; not starting things on time
- Irritability, frustration, mood swings – are all symptoms of emotional dysregulation.
- Excessive proliferation of attention-capturing work and/or inadequate work on obligations.
- Lacking working memory – (forgetting what read or heard just a moment before)
- Time blindness – under estimate task time valued by over and over again
- Impulsive or inattentive management of relationships – e.g. fighting, getting into trouble in class, bullying others, not playing well with others, etc
The adult may also have co-occurring disorders that can make the diagnosis difficult if not performed properly, such as anxiety/depression and sleep disorders.
ADD vs. ADHD in Female Adults: A Critical Distinction
One aspect needs to be taken into account in relation to the question of ADD vs. ADHD in female adults: the conversation needs to be passed. Research has been uncovering this fact over and over: Women don’t get diagnosed the same as men, for the same reasons, and not at half the rate.
Women with ADHD (particularly the inattentive type) often:
- Take their problems personally, living in fear or with negative self-perception
- Establish good masking practices – look on the outside like they’re in control but on the inside feel out of control
- Isolate and highlight reports of emotional dysregulation and rejection sensitivity more
- May be misdiagnosed with anxiety or depression before diagnosed with ADHD
If you are a female in New York who has received treatment for anxiety or depression but still, you feel you are not “right,” do consider getting checked for ADHD in adults. The most underdiagnosed is the inattentive one (previously called ADD) in adult women.
What an ADHD Assessment for Adults Actually Involves
But an adequate ADHD evaluation in adults in New York isn’t a simple checklist. The proper psychiatric assessment should include:
- Clinical evaluation including history of childhood and current symptoms and functional impairment in life domains (work, relationship, finances).
- Rated scale that uses a standardized scale, such as the Adult ADHD Self-Report Scale (ASRS) or Conners’ Adult ADHD Rating Scales
- Other conditions may have similar symptoms to ADHD, including thyroid disorders, sleep apnea, bipolar disorder, and anxiety.
- If available, a few notes on your “collateral history” ( somebody you know who has seen your behavior over time)
In complicated cases, neuropsychological testing may be ordered and in some cases, is not mandatory to make a clinical diagnosis of ADHD.
Long waiting periods for evaluations are the norm in New York City. Be proactive by detailing specific examples on how symptoms are interfering with your life prior to the appointment, if you think you may have ADHD.
Does the ADD vs. ADHD Label Matter for Treatment?
You should use the label only as a guideline, more as a gauge for your treatment plan. For most individuals, the best treatment for ADD or ADHD will involve:
Medication Options
- Amphetamines and methylphenidate (also known as Ritalin and Adderall) are still the standard medication used for the majority of adults and are highly effective.
- Non-stimulant options (atomoxetine, viloxazine, guanfacine) These can also be considered in individuals who cannot tolerate the stimulants or other co-occurring conditions.
Therapy and Coaching
- CBT for ADHD strategies focus on dealing with procrastination, regulating emotions, and managing time
- The coach shares practical systems and accountability structures about ADHD
- Children who are having a hard time with their relationships might benefit from couples/family therapy
Lifestyle Strategies
- Consistent sleep schedules (sleep deprivation worsens every ADHD symptom)
- Exercise is important for improving the regulation of dopamine regularly, which is demonstrated to improve
- Timmer and planning, body doubling and environmental design, outside the body
Historically “ADD” is the inattentive presentation and it may react differently to the dosage of medication than the combined type. For this reason, it’s important not to focus on the ADD vs ADHD label debate but to have an accurate diagnosis according to the presentation.
When to See a Psychiatrist in New York for ADHD
If the following statements apply, you might want to consider an evaluation:
- You have suffered from lack of focus, organization and/or follow-through from a young age
- You’ve heard you’re not smart enough, but you’re lazy or you’re not living up to your potential
- Anxiety and depression treatments from the past have not been successful
- You’re a woman who connects with the inattention symptoms of ADHD.You are one of the females who identify strongly with the inattentive symptoms descriptions of ADHD
- Your symptoms interfere with your work, money or relationships
An accurate diagnosis and individualized ADHD treatment plan will be given by a board-certified psychiatrist who has experience treating the disease in adults. In New York look for specialists who specialize in adult ADHD evaluation.
Frequently Asked Questions (FAQs)
Q: Is ADD the same as ADHD in adults?
Clinically, yes. The term ADD is too dated and now refer to the term ADHD. Predominantly Inattentive Presentation as mentioned in the current DSM-5. The majority of adults who identify as “ADD” have been classified as having this subtype.
Q: Is it possible for adults to be diagnosed for the first time with ADHD?
Absolutely. Many grow past their 30s, 40s and beyond without ever being diagnosed, particularly women. If you make a late diagnosis, it is acceptable and it can be life-changing.
Q. What is the difference between ADD and ADHD for an adult?
It’s no different on the clinical side today. In 1987, ADD was no longer allowed to be diagnosed separately. What most people are describing is the difference between the inattentive vs hyperactive-impulsive sub-type of ADHD.
Q: How do I know if I have ADHD or anxiety?
Often happen at the same time and anxiety may induce attention problems that can mimic ADHD. They are the only two to be distinguished and/or the only two to be found by comprehensive psychiatric evaluation.
Q: Do women with ADHD present differently than men?
Yes. The inattentive presentation is more frequently seen in women, they have more binding behaviours and women are more likely to be initially diagnosed with anxiety or depression.
Q: What signs of ADHD in adult women get overlooked most?
Persistent person pleasing, emotional ‘masking’ and rejection sensitivity, and family disorganisation. Very few of these are associated with ADHD, hence so many women may not ever be diagnosed.
Q: Can ADHD affect relationships and marriage?
Yes. Stress arises from forgetfulness, emotional impulsiveness, and the tendency to inconsistent follow-through. Even your partner may not realize these are patterns, which they might interpret as lack of interest.
Q: Can adults have ADHD and depression at the same time?
Yes – this is common. Persistent poor schoolwork due to undiagnosed ADHD often results in depression. Failure to treat ADHD will result in treatment failure unless the depression is treated.
Q: What causes ADHD to be a different condition that is not being stressed/ busy?
ADHD is chronic and universal. Which means that if you’ve had trouble focusing, organizing work, regardless of stress, its been a pattern that must be looked at for a clinical evaluation.
Q. Will the medicine for ADHD alter my personality?
It shouldn’t. With interference eliminated, effective medication brings adults back to themselves – not different. If the person shows a lack of emotion or flat affect it’s time to adjust dosage or certain medications.
Q: Can ADHD affect work even if I seem high-functioning?
Yes. There are many high functioning grown-ups with ADHD who manage to get through on work, however end up without any desire to get through. One common red flag is when there is a big difference between what you can do and what you actually produce.
Q: Is ADHD treatment covered by insurance in New York?
Usually yes. Mental health parity laws mandate equal coverage of mental health services. Print out your plan outline first – many NYC psychiatrists will also offer out-of-network superbills.