Have you ever felt like your brain was on overdrive? Or found it impossible to concentrate even when you feel super-motivated? If this sounds familiar, you might be one of many adults living with ADHD, which has become increasingly common in recent years.

However, ADHD in adults isn’t a one-size-fits-all diagnosis, which is part of the problem many people face in both recognising and accepting their symptoms.

The 7 types of ADHD proposed by Dr Amen are a progression of traditional DSM-5 classifications that highlight the unique challenges that can be faced in adults with ADHD.

While it’s not uncommon to struggle with focus, there can also be profound difficulties in other areas of cognition and behaviour such as with emotional regulation and impulsivity.

Being aware of the differing expressions of the condition opens up the doors to a more person-centred approach to managing your symptoms and getting on with your life.

Being aware of the differing expressions of the condition opens up the doors to a more person-centred approach to managing your symptoms and getting on with your life.

If your ADHD journey feels confusing or misaligned with some of the general symptom sets, exploring these 7 different types could offer you clarity and validation.

The 3 Types of ADHD in Adults (According to DSM-5)

Before we dive into the 7 types of ADHD, it’s first important to gain a grounding in what the current accepted standard is for diagnosis. According to the DSM-5, Attention Deficit Hyper Activity Disorder (ADHD) is classified into three types; Inattentive, Predominantly Hyperactive-Impulsive and Combined Presentation. Each form has its own variation of symptoms and behaviours that can influence individuals’ daily lives in various different manners.

ADHD: Predominantly Inattentive Presentation

Predominantly inattentive ADHD is characterised by difficulties in maintaining attention and focus. These symptoms may include:

• Difficulty focusing on specific tasks
• Distractibility and easy boredom with routine activities
• Forgetfulness in daily activities
• Poor organisational skills and time management
• Failure to follow through on instructions and tasks
• Tendency to lose items necessary for tasks or activities
• Avoidance or dislike of tasks requiring sustained mental effort

Real-Life Example: Alex constantly loses track of important tasks at work and procrastinates on projects that he’s involved in.

Even though he’s highly intelligent and skilled at his job, organising his workload is a struggle, leading to missed deadlines that impact both the quality of his relationship and reputation.

Alex’s situation is a common example of how difficulties with focus can affect job effectiveness, a hurdle encountered by many adults dealing with ADHD [3].

ADHD: Predominantly Hyperactive-Impulsive Presentation

Individuals with the Predominantly Hyperactive-Impulsive presentation of ADHD exhibit mainly hyperactive and impulsive behaviours. Symptoms may include:

• Fidgeting or tapping hands or feet, or squirming in their seat
• Inability to stay seated in situations where it is expected
• Restlessness or difficulty engaging in activities quietly
• Excessive talking and interrupting others
• Difficulty waiting for one’s turn
• Acting without much consideration for consequences

Real-Life Example: Jordan has enormous difficulties sitting still during meetings, feeling jittery and restless in the constant need to be “on the go.”

His impulsivity often sees him cutting people off during conversations, which is extremely agitating for his coworkers. Both of these behavioural tendencies combined make it extremely difficult for Jordan to be productive in traditional office settings.

These struggles are fairly typical for someone with hyperactive impulsive ADHD, further highlighting the occupational difficulties associated with ADHD.

ADHD: Combined Presentation

The Combined Presentation of ADHD is when individuals exhibit both inattentive and hyperactive-impulsive symptoms equally. Symptoms include a mix from both categories:

• Difficulty sustaining attention and following detailed instructions
• Fidgeting, restlessness, and an excess of energy
• Poor organisational skills coupled with impulsive decision-making
• A tendency to lose things and forget important dates or obligations
• Difficulty remaining seated and completing tasks quietly
• Interrupting others and inability to wait turns

Real-Life Example: Sam shows signs of both inattentiveness and hyperactivity-impulsiveness. His patterns tend to see him initiate projects with huge excitement, but he can then easily get distracted quite by the next most exciting thing, leaving a trail of unfinished projects.

Sam is also prone to interrupting his colleagues as soon as he feels he has something of greater importance to say after daydreaming in his own inner world.

This can see him oscillating between inattentiveness and hyperactivity, affecting his ability to both regulate his nervous system and remain focused, not just in work, but in many other areas of his personal life.

The 7 Types of ADHD in Adults (Dr. Amen’s Model)

Dr. Daniel Amen’s model identifies seven distinct types of ADHD in adults, expanding the conventional understanding beyond the typical presentations recognized by the DSM-5.

This updated model provides a more nuanced view tailored to individuals specific experiences and symptoms rather than prescribing a predetermined template.

Here’s a brief overview before we dive into the specifics:

1. Classic ADHD: Characterised by hyperactivity, impulsiveness, and distractibility.
2. Inattentive ADHD: Marked by lack of focus and disorganisation, without notable hyperactivity.
3. Overfocused ADHD: Involves difficulty shifting attention from one task to another, with tendencies toward worry and obsession.
4. Temporal Lobe ADHD: Linked to memory issues, aggression, and mood instability, often with learning and auditory processing difficulties.
5. Limbic ADHD: Resembles chronic low-grade depression, with negativity, low energy, and low self-esteem.
6. Ring of Fire ADHD: Describes a more severe, highly irritable, and aggressive form of ADHD.
7. Anxious ADHD: Features prominent anxiety alongside typical symptoms of ADHD.

This diversified approach aids in creating more personalised treatment plans, addressing the specific needs and challenges of each type, ultimately leading to better outcomes for adults living with ADHD.

1. Classic ADHD

The classic subtype is what most people would think of as ADHD, which is characterised by increased levels of hyperactivity, impulsiveness and difficulty focusing on daily tasks.

Individuals with this form of ADHD are usually disorganised and unable to sit still for long periods of time in situations that call for presence and attentiveness.

Their actions can often be spontaneous and driven more by impulse rather than considered thought, leading to acting without considering the consequences.

Classic ADHD in adults is often thought to be the result of decreased blood flow in the prefrontal cortex, cerebellum, and basal ganglia.

Cognition

The cognitive patterns of the classic ADHD type are characterised by:

• Difficulty maintaining focus on tasks, conversations, or reading.
• Jumping from one idea to another without logical progression or conclusion.
• Struggling to gauge how much time tasks will take; frequently late or behind schedule.
• Challenges in keeping thoughts, tasks, and physical items in order.
• Regularly misplacing items or forgetting appointments, obligations, or instructions.

Behavior

The behavioural patterns of the classic ADHD type are characterised by:

• Constant fidgeting, restlessness, or an inability to stay still.
• Making hasty decisions or actions without considering consequences.
• Frequently cutting off conversations or speaking out of turn.
• Starting projects with enthusiasm but failing to follow through to completion.
• Misreading social cues or struggling to maintain relationships due to impulsive or inappropriate behaviour.

2. Inattentive ADHD

Individuals, with Inattentive ADHD, previously known as ADD struggle with focusing and paying attention without the more impulsive behaviours commonly seen in ADHD.

People with this form of ADHD often feel tired, and are often prone to daydreaming, as they have incredibly rich inner worlds and could often be seen as introverts.

They frequently get absorbed in their thoughts during conversations and also when receiving other external stimulus, retreating into an inner reflective mode rather than focusing on external circumstances and what’s being presented to them.

The inattentive subtype is also associated with slower cognitive processing times, which can lead to difficulty in responding to complex requests.

Cognition:

The cognitive patterns of the inattentive ADHD type are characterised by:

• Difficulty in sustaining attention on tasks or play activities
• Often seeming not to listen when spoken to directly
• Struggling to follow through on instructions and failing to finish schoolwork, chores, or duties
• Difficulty organising tasks and activities
• Avoidance or reluctance to engage in tasks that require sustained mental effort
• Losing things necessary for tasks and activities
• Being easily distracted by extraneous stimuli
• Forgetfulness in daily activities

Behavior:

The behavioural patterns of the inattentive ADHD type are characterised by:

• A tendency to daydream and drift away even in the middle of conversations
• Slowness in processing information, often misinterpreted as laziness or lack of intelligence
• Misplacing or losing things like tools, assignments, eyeglasses, or mobile phones
• A general sense of disorganisation and a lack of follow-through on commitments or assignments
• Quietly sitting in class or meetings while mentally being miles away

Real World-Example: Emily often finds herself gazing out of the window, lost in her thoughts at work, completely in her own world. From the outside looking in, to her colleagues, it can look like she’s disinterested or unfocused, not realising she’s struggling to maintain her focus.

Despite her best attempts, Emily finds herself frequently overlooking important details and deadlines, which has led to her gaining an unfair reputation for being unreliable. These struggles are fairly typical of someone living with inattentive ADHD.

3. Overfocused ADHD

The overfocused subtype of ADHD in adults tends to get caught up in the finer details of a task, finding themselves getting bogged down in the minutiae of setting things up before they can begin, leaning into slightly compulsive tendencies.

In a way, they’re in constant formulation. Always in the mind. Always in the planning phase.

They can also somewhat live in their own inner world, as the over-functioning of their perfectionism may be serving as an avoidant tendency and self-sabotage, preventing them from beginning a task they know will help them progress to their next level of success.

They can also find it a struggle to transition from one task to another, or to adjust to a change in schedule. The quality of their focus can often be hindered by focusing intently on details or regulations which can hinder their ability to grasp the bigger picture or prioritise tasks effectively.

Cognition:

The cognitive patterns of the over-focused ADHD type are characterised by:

• Difficulty shifting attention away from current thoughts or activities
• Tendency to get stuck on negative thoughts or experiences
• Obsessive or compulsive thinking patterns
• Struggling with cognitive flexibility, leading to difficulties in adapting to new situations or changes in routine
• Over-focusing on specific details, leading to challenges in prioritising tasks effectively

Behavior:

The behavioural patterns of the overfocused ADHD type might look like:

• Excessive worrying or dwelling on the same topic
• Difficulty moving on to new tasks or letting go of past mistakes
• Rigid adherence to rules or routines
• Becoming upset or anxious when routines are disrupted
• Perfectionism that leads to procrastination or avoidance of tasks due to fear of failure

Real-World Example: Lucas often spends hours organising his desk and files to ensure that everything is perfectly arranged before he begins work. This obsession with keeping everything in order often results in neglecting his actual work and falling behind schedule.

In collaborative situations, he can often focus and fixate on minor details, which don’t have the return on investment (ROI) he assumes they do, frustrating the people he’s working with.

Despite his obvious intelligence and dedication, Lucas’s inability to prioritise effectively and the ease through which he experiences distress over small changes or errors in his workflow often hinder his productivity and overall output.

4. Temporal Lobe ADHD

Individuals with this type of ADHD exhibit abnormal activity in the temporal lobe, which is responsible for emotional regulation, memory processing, sensory input, coordination and integration.

This can often result in difficulty recalling details or processing information as quickly as other people. I.e. increased cognitive processing time.

Despite their tendency to engage in emotional outbursts, they might possess a deep empathetic understanding of those around them, although it may not always appear that way.

They also most often have reduced activity in their prefrontal cortex, which is responsible for decision-making, attention and concentration, creating an overlap with the symptoms of classic ADHD.

Cognition:

The cognitive patterns of temporal lobe ADHD type are characterised by:

• Difficulty with memory, especially short-term or working memory.
• Problems with processing and understanding language.
• Sensitivity to emotional stimuli, leading to intense emotional responses.
• Challenges in interpreting social cues and facial expressions accurately.
• Potential for misinterpreting words or actions as hostile or personal.

Behavior:

The behavioural patterns of temporal lobe ADHD type are characterised by:

• Exhibit quick, intense emotional reactions, often disproportionate to the situation.
• Struggle with anger management or have frequent outbursts.
• Show aggressive tendencies or become easily frustrated.
• Have difficulty maintaining stable relationships due to emotional volatility.
• Experience anxiety or depression, stemming from their intense emotional experiences.

Real-world example: Maria is often at the heart of conflict in her workplace. She misinterprets constructive criticism received from her colleagues as personal attacks and finds herself often reacting instead of responding.

Her fiery nature coupled with her overt sensitivity can make it difficult for her to both form and maintain connections with others, as her emotional reactions often tend to overshadow her true personality.

In her interpersonal relationships, Maria often finds herself misinterpreting social cues, as she interprets jokes as personal insults causing her to retreat and isolate herself, feeling excluded and not welcome by her friends.

5. Limbic ADHD

The limbic subtype of ADHD describes individuals who are greatly impacted by their surroundings. It can see people oscillating between classic ADHD symptoms and chronic sadness – not depression – but low mood and energy.

This form of ADHD in adults is linked to the limbic system, a part of the brain involved in emotion and memory, which influences their heightened emotional responsiveness and mood variability.

There can also be a sense of feeling burdened by the world’s problems, which can cause individuals to withdraw socially or feel isolated.

Despite appearing sad or disinterested on the surface, those with limbic ADHD are often dealing with emotional struggles that make daily activities and social interactions difficult to fully engage with.

Cognition:

The cognitive patterns of limbic ADHD type are characterised by:

• Persistent feelings of sadness or low mood that are not solely due to external circumstances.
• Increased sensitivity to rejection or criticism.
• Difficulty maintaining a positive self-image and combating negative self-talk.
• A tendency towards rumination and dwelling on past events or mistakes.
• Challenges in experiencing pleasure or joy from activities that were previously enjoyable.

Behavior:

• Withdrawal from social situations and a preference for solitude.
• Decreased energy and motivation, leading to a sense of lethargy or apathy.
• A strong empathetic response to others’ emotions, often taking on their feelings as their own.
• Difficulty in establishing or maintaining boundaries in personal relationships.
• A tendency towards melancholy, even in situations that typically evoke happiness in others.

Real-world example: Sarah often feels overwhelmed by the emotions of people around her. During family gatherings. She can feel the waves of tension in the room relating to unspoken conflicts, which leave her feeling exhausted and disheartened by the end of the evening.

She’s in a constant state of battling self-doubt due to past criticisms that she just can’t seem to let go of. She’s perceived as being caring and sensitive by those who are closest to her, but most are unaware of the extent of her internal struggles.

Sarah’s Limbic ADHD complicates her ability to distinguish between her emotions and those of others resulting in a recurring cycle of sadness and withdrawal that illustrates the challenges faced by empaths.

6. Ring of Fire ADHD

“Ring of Fire” ADHD is viewed by many as a more severe form of the disorder characterised by irritability mood swings and a tendency towards quite extreme oppositional behaviours.

People with this type of ADHD face an unusual level of brain hyperactivity, which leads to feelings of anxiety, anger or agitation.

This constant mental stimulation makes it hard for them to manage their emotions and reactions in a manner that often results in extreme responses to everyday situations.

The increased brain activity linked to Ring of Fire ADHD in adults can cause challenges in maintaining relationships, regulating emotions and remaining present in daily activities.

Cognition:

The cognitive patterns of Ring of Fire ADHD type are characterised by:

• An incessant flow of ideas and thoughts, making it hard to focus or rest.
• Extreme variability in mood and attention, from hyperfocus to complete disinterest.
• Sensitivity to environmental stimuli, leading to overstimulation and distress.
• Difficulties in regulating emotions and reactions, contributing to impulsive decision-making.
• A tendency toward black-and-white thinking, struggling to see the nuances in situations.

These cognitive patterns may arise from abnormal activity across various brain regions, leading to heightened sensitivity and emotional intensity.

Behavior:

The behavioural patterns of Ring of Fire ADHD type are characterised by:

• React explosively to minor provocations or frustrations.
• Show intense passion and enthusiasm that can quickly shift to disinterest or irritability.
• Struggle with maintaining consistent relationships due to their unpredictability.
• Engage in risk-taking behaviours without considering the consequences.
• Exhibit a high degree of creativity and energy when engaged in tasks they find stimulating.

Real-world example: James is known for his brilliant yet often erratic contributions at work amongst his colleagues.

At times, he’s overflowing with innovative ideas, but he can suddenly switch into his antagonistic over-functioning expression, finding himself embroiled in intense debates over minor details.

This inconsistency and volitilty keeps his coworkers on their toes, as they’re never quite sure which side of James they will encounter.

Although James has undeniable talent, his sudden mood swings can affect team morale significantly creating a tense working environment, as people feel like they constantly need to walk on eggshells around him.

7. Anxious ADHD

Those with anxious ADHD, experience both intense anxiety and typical ADHD in adults symptoms. This combination often results in an intense mixture of worry and stress, making it harder to stay focused and avoid external distractions.

The constant fear of making mistakes to make decision-making difficult, known as ADHD paralysis, leading to increased procrastination as the fear of negative outcomes overshadows their ability to focus and take positive action.

This can lead to a cycle in which their stress leads to a decrease in productivity, which leads to more anxiety and further self-doubt, which in turn leads to more stress.

Cognition:

The cognitive patterns of anxious ADHD type are characterised by:

• Persistent worrying that disrupts concentration and focus.
• Fear of making mistakes or failing, leading to indecision or procrastination.
• Overanalysing situations and potential outcomes.
• Difficulty with memory and recall, exacerbated by anxiety.
• Struggling to relax and clear the mind, leading to sleep disturbances.

Behavior:

The behavioural patterns of anxious ADHD type are characterised by:

• Exhibit perfectionist tendencies, often spending excessive time on tasks.
• Avoid situations or tasks where they fear failure or judgement.
• Ask for reassurance repeatedly or struggle with decision-making.
• Show signs of physical anxiety, such as restlessness, sweating, or a rapid heartbeat.
• Withdraw from social interactions or activities due to fear of embarrassment or failure.

Real-world example: Emma, a college student with anxious ADHD Often finds herself staring at a blank document on her laptop fixating on the cursor blinking unable to take action.

Although she understands what’s being asked of her, her mind is overwhelmed with worries about saying the wrong thing and failing the entire assignment, making it impossible for her to start her essay.

In lectures, she avoids making eye contact with anyone, especially the lecturer worrying that she may be called on and that any questions asked of her might expose her lack of intellect even though she knows the answers deep down.

This fear also affects her social interactions where she rehearses dialogues endlessly before choosing to remain quiet.