What type of ADHD do I have?

DSM-5-TR recognizes three presentations of ADHD, not separate types

The word type is common in everyday use, but the diagnostic manual used in Canada, DSM-5-TR, calls them presentations, and the choice of word matters. ADHD is one condition. The presentation describes which group of symptoms is prominent at the time of the assessment, and the same person can meet criteria for a different presentation at a later assessment. ICD-11, the World Health Organization's system, uses the same three categories.

Adults who were diagnosed as children may remember the older labels. ADD, which was used in DSM-III in the 1980s, roughly maps to the predominantly inattentive presentation. It is not a current diagnosis, and a clinician writing a report today will use one of the three presentations above, or the ICD-11 equivalent.

The presentation is decided by counting symptoms in each of the two domains

DSM-5-TR lists nine inattention symptoms and nine hyperactive-impulsive symptoms. For an adult aged 17 or older, at least five from a domain, present for at least six months and to a degree that interferes with functioning, is the threshold for that domain. Several symptoms also need to have been present before age 12, to show up in at least two settings such as work and home, and not to be better explained by another condition. The presentation follows directly from which domain or domains clear the threshold.

• Inattention items include difficulty sustaining attention, not seeming to listen, not following through, trouble organizing, avoiding tasks that need sustained effort, losing things, distractibility and forgetfulness in daily activities.
• Hyperactive-impulsive items include fidgeting, leaving your seat, feeling restless, difficulty with quiet activities, being on the go, talking excessively, blurting answers, difficulty waiting your turn and interrupting.
• Severity is recorded separately as mild, moderate or severe, based on how many symptoms beyond the minimum are present and how much they impair daily life.
• In partial remission is added when full criteria were met in the past, fewer than the required symptoms are present now, and symptoms still cause impairment. See What is remission in ADHD?.

This is why self-tests cannot settle the question. A screener such as the ASRS flags whether a full assessment is worthwhile; it does not count symptoms against the full criteria, check the childhood history, or rule out other explanations. The structured interview is where the presentation is actually determined.

Your presentation can change over time, especially from childhood to adulthood

Hyperactivity tends to become less visible with age. A child who climbed on furniture may, as an adult, feel an inner restlessness and a need to keep busy that nobody else sees. That shift is one reason a person diagnosed with combined presentation at eight may meet criteria only for the inattentive presentation at thirty, and why DSM-5 dropped the older subtype language in favour of presentations, which are expected to be reassessed rather than fixed for life.

It also helps explain why many adults, particularly women, were never flagged as children. Inattentive symptoms are quieter, and daydreaming or disorganization is easily read as something other than ADHD. Can you have ADHD without being hyperactive? goes into that pattern in more detail.

The presentation guides the conversation about treatment more than it dictates it

Treatment planning in Canada follows CADDRA's Canadian ADHD Practice Guidelines, which are organized around the person's symptoms, impairments and co-occurring conditions rather than around presentation alone. The presentation is still useful. It tells your clinician which problems to track, shapes the rating scales used at follow-up, and points toward the skills that therapy or coaching should work on, whether that is organization and task initiation or impulse control and emotional regulation.

What the presentation does not do is predict which medication, if any, will suit you, or how much of a role therapy should play. Those decisions are made with you, based on your health history, your preferences and how you respond. Two adults with the combined presentation can end up on quite different plans, and one adult's plan often changes after the first few months of follow-up. For the non-medication side, see What are the non-medication treatment options for ADHD?.

Finding out your presentation means having a full assessment, and an online clinic can do that

If you want to know which presentation applies to you, the route is a structured assessment with a clinician who can diagnose: a family doctor, a psychiatrist, a nurse practitioner or a registered psychologist. The assessment covers the eighteen criteria, your childhood history, your current functioning at work, school and home, and other conditions such as anxiety, depression or sleep problems that can look like ADHD. It can conclude that ADHD is not the explanation, and a good assessment will say so plainly.

Finding Focus provides online ADHD assessment and treatment for adults and teens in several Canadian provinces. After a short online intake, you have one consultation with a licensed Canadian clinician, with no referral needed, from $399. A written diagnosis names the presentation and severity in DSM-5-TR terms so that a family doctor, school or employer can use it. If you are in crisis or thinking of harming yourself, call or text 9-8-8, Canada's Suicide Crisis Helpline, before anything else.