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ADHD Combined Type: Symptoms, Causes & Treatments 2024
Updated on
- Written by Teresa Mboci, Pediatric Nurse, Nutritionist
Medically reviewed by
Chelsea Rae Bourgeois, MS, RDN, LD
Although it is more often diagnosed in children and adolescents, attention-deficit hyperactivity disorder, or ADHD, may affect individuals at any age.
A person with an ADHD combined type diagnosis may experience anxiety while preparing for the future. While you may be familiar with the term ADHD, you may be less so when it is paired with the term combined. If so, you may be interested in learning more about the characteristics that distinguish the ADHD combined type from other types of ADHD.
This article examines the inattentive, hyperactive, and impulsive symptoms of combined ADHD presentation, its causes, and available ADHD treatments.
Key Takeaways
- ADHD Combined Type shows both inattention and hyperactivity, with at least five symptoms in six months
- Its symptoms include inattention, hyperactivity, impulsivity, and difficulties in focusing, sitting still, and managing time.
- Prenatal alcohol or cigarette use, premature birth, traumatic brain injuries, and exposure to environmental toxins are the main contributors to its development.
- The treatments are medication, behavioral therapy, social skills training, and counseling.
What Is ADHD Combined Type?
The ADHD combined type is the most common form of ADHD and is characterized by symptoms of both inattention and hyperactivity/impulsivity. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, this subtype of ADHD is one of three distinct types. In the past six months, people with this diagnosis have had five or more inattentive and hyperactive/impulsive behavior symptoms.
ADHD Combined Presentation And Symptoms
Inattention, hyperactivity,[1] and impulsivity symptoms often characterize combined type ADHD, which can affect many areas of life. If you live with ADHD combined type, you may experience symptoms such as
- Trouble focusing on one thing for long periods without getting sidetracked.
- Difficulty sitting still,[1] waiting in line, or focusing on quiet activities.
- Trouble controlling your emotions and behaviors; having an anxiety or mood disorder.
- Poor time management and organization.
- Feeling overwhelmed and finding it difficult to finish tasks or difficulty waiting their turn.
Commitment to people or tasks may also be challenging for people living with ADHD because of their difficulties in both professional and social situations. Of course, symptoms will vary between individuals, so it’s important to discuss your experiences with your doctor.
Causes Of Combined ADHD Type
Despite extensive research, the causes of ADHD combined type remain unclear. A person’s vulnerability to developing combined ADHD may be influenced by various factors, including genes, environmental factors, and possibly nutrition.
Genetics
A family history of the disorder significantly increases the likelihood of developing any form of ADHD. Studies have shown that genetics can play a significant role in the onset of ADHD.[2] Genetics can explain most of the variation in ADHD characteristics with high heritability.
Use Of Alcohol Or Cigarettes During Pregnancy
Studies suggest[3] that expecting moms who smoke have a higher chance of having a child with ADHD.
Premature Birth
Evidence indicates that children born before their due date have an increased chance of acquiring ADHD combined type later in life.
Traumatic Brain Injury
Some children with catastrophic brain injuries may be diagnosed with ADHD combined type later in life. A study that examined the prevalence of ADHD in children with a history of traumatic brain injuries found that 62% of the study participants developed ADHD, compared to 15% of the control group who did not have a traumatic brain injury.
Exposure To Environmental Toxins
Environmental pollutants have been associated with ADHD,[4] especially ADHD combined type ICD-10, although the connection is complicated and poorly understood. Environmental toxins may have different effects on different people and ADHD subtypes, such as ADHD Inattentive Type in Adults. Toxins in the environment may have a role in the development of ADHD, but further study is required to determine the strength of this relationship and how it affects various age groups and ADHD subtypes.
Combined ADHD Type Treatments
Effective treatment for combined ADHD typically requires a multifaceted approach incorporating medication and non-medication methods. It’s crucial to work closely with a medical practitioner to develop a personalized treatment plan and to be flexible as you experiment with different approaches.
Options for treating combined ADHD symptoms include:
ADHD Medications
Stimulant medications may help patients with ADHD combined type manage inattentive ADHD and alleviate hyperactivity and impulsivity symptoms. Doctors may also recommend non-stimulant medications. Even though they work more slowly, these medications can effectively reduce the signs and symptoms of ADHD in some patients. Additionally, your doctor may prescribe a combination[5] of the two if they feel it is necessary.
Behavioral Therapy
People with ADHD combined type, especially children, may improve their academic and social functioning via behavioral therapy. Behavioral therapy encourages positive actions and discourages actions that work against your goals. Both you and your child will learn practical strategies for rewarding good behavior. Behavioral therapy[6] may be used by a parent, teacher, or therapist to help a child form positive routines.
Social Skills Therapy
This approach teaches people how to read and respond appropriately to social cues. Social skills training may enhance ADHD treatment if it helps individuals overcome hyperactive, impulsive symptoms. This training aims to improve social interaction, language competency, and understanding of nonverbal clues. This may assist individuals with combined type ADHD in better social interactions,[7] forming new connections, and coping more successfully with social situations.
Family Therapy
Family counseling can be helpful when navigating a new ADHD diagnosis. Some evidence suggests that family therapy can assist fellow household members in learning how to manage the effects[8] better. This also can improve communication and connection among families with adult ADHD or a family situation with both adult and child ADHD.
Organizational Skills Training
This ADHD treatment strategy[9] may assist a person in overcoming challenges of forgetfulness and disorganization. Treatment for organizational skills inadequacies focuses on prioritizing, work delegation, and general efficiency. It includes techniques for staying organized, creating routines, managing duties, and establishing priorities. By strengthening their ability to concentrate and accomplish activities, persons with combined ADHD type may become more confident in themselves, more productive at work, and happier in general.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy is often used to treat anxiety or mood disorders by providing individuals with tools to manage their emotions and behaviors. While this therapy might be helpful for individuals living with ADHD combined type,[10] further research is needed.
Talk Therapy
Standard talk therapy can also support your ADHD management efforts. Your therapist can help you recognize your challenges and work with you to develop more effective coping strategies.
Other Types Of ADHD
There are two additional types of ADHD. These are:
Hyperactive And Impulsive Type ADHD
Hyperactive and impulsive type ADHD is typically diagnosed when an individual has exhibited five or more symptoms for at least six months. These symptoms can include[11] fidgeting, inability to sit still, difficulty playing quietly, interrupting others, and talking excessively. This kind of ADHD appears more prevalent in younger children and men.
Inattentive Type ADHD
Inattentive type ADHD is typically diagnosed when inattentive symptoms such as poor attention to detail, forgetfulness in daily activities, poor listening skills, and lack of follow-through. Like hyperactive and impulsive ADHD, a diagnosis requires the presence of at least five symptoms over at least six months. Other symptoms include avoiding tasks that require mental effort, losing items necessary for essential tasks, and getting distracted easily.
The Bottom Line
ADHD combined type includes symptoms of hyperactivity and impulsivity with inattentiveness. The inability to concentrate on a single activity and the need to always be on the move are typically present in people with ADHD combined type.
Like other types of ADHD, combined type ADHD may vary in severity, and your treatment choices may include medication and psychotherapy. Medications are used to treat ADHD symptoms, while talk and behavioral therapy can help individuals develop tools to manage symptoms. Training and online therapy can help parents learn appropriate communication methods to use with their children diagnosed with combined-type ADHD.
Schools can also be an excellent resource for families learning to navigate a new ADHD diagnosis. And, of course, if you have questions about ADHD and its effects on your life, it’s best to discuss them with your doctor.
+ 11 sources
Health Canal avoids using tertiary references. We have strict sourcing guidelines and rely on peer-reviewed studies, academic researches from medical associations and institutions. To ensure the accuracy of articles in Health Canal, you can read more about the editorial process here
- Gawrilow, C., Kühnhausen, J., Schmid, J. and Stadler, G. (2014). Hyperactivity and Motoric Activity in ADHD: Characterization, Assessment, and Intervention. Frontiers in Psychiatry, [online] 5. doi:https://doi.org/10.3389/fpsyt.2014.00171.
- Faraone, S.V. and Larsson, H. (2018). Genetics of attention deficit hyperactivity disorder. Molecular Psychiatry, [online] 24(4), pp.562–575. doi:https://doi.org/10.1038/s41380-018-0070-0.
- Gustavson, K., Eivind Ystrøm, Stoltenberg, C., Susser, E., Pål Surén, Magnus, P., Gun Peggy Knudsen, George Davey Smith, Langley, K., Rutter, M., Aase, H. and Reichborn‐Kjennerud, T. (2017). Smoking in Pregnancy and Child ADHD. Pediatrics, [online] 139(2), pp.e20162509–e20162509. doi:https://doi.org/10.1542/peds.2016-2509.
- Moore, S., Paalanen, L., Melymuk, L., Andromachi Katsonouri, Marike Kolossa-Gehring and Tolonen, H. (2022). The Association between ADHD and Environmental Chemicals—A Scoping Review. International Journal of Environmental Research and Public Health, [online] 19(5), pp.2849–2849. doi:https://doi.org/10.3390/ijerph19052849.
- Geon Ho Bahn and Seo, K. (2021). Combined Medication with Stimulants and Non-stimulants for Attention-deficit/hyperactivity Disorder. Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology, [online] 19(4), pp.705–711. doi:https://doi.org/10.9758/cpn.2021.19.4.705.
- CDC (2020). Parent Training in Behavior Management for ADHD. [online] Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/ncbddd/adhd/behavior-therapy.html.
- Ole Jakob Storebø, Mette Elmose, Skoog, M., Signe Joost Hansen, Simonsen, E., Niels Wisbech Pedersen, Tendal, B., Callesen, H.E., Erlend Faltinsen and Gluud, C. (2019). Social skills training for attention deficit hyperactivity disorder (ADHD) in children aged 5 to 18 years. The Cochrane library, [online] 2019(6). doi:https://doi.org/10.1002/14651858.cd008223.pub3.
- Paidipati, C.P., Brawner, B.M., Eiraldi, R. and Deatrick, J.A. (2017). Parent and Family Processes Related to ADHD Management in Ethnically Diverse Youth. Journal of the American Psychiatric Nurses Association, [online] 23(2), pp.90–112. doi:https://doi.org/10.1177/1078390316687023.
- Bikic, A., Søren Dalsgaard, Kristoffer Dalsgaard Olsen and Sukhodolsky, D.G. (2021). Organizational skills training for children with ADHD: study protocol for a randomized, controlled trial. Trials, [online] 22(1). doi:https://doi.org/10.1186/s13063-021-05499-9.
- López, P., Torrente, F., Agustín Ciapponi, Lischinsky, A., Cetkovich-Bakmas, M., Juan Ignacio Rojas, Romano, M. and Manes, F. (2018). Cognitive-behavioural interventions for attention deficit hyperactivity disorder (ADHD) in adults. The Cochrane library, [online] 2018(3). doi:https://doi.org/10.1002/14651858.cd010840.pub2.
- CDC (2022). Symptoms and Diagnosis of ADHD. [online] Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/ncbddd/adhd/diagnosis.html.
Written by:
Teresa Mboci, Pediatric Nurse, Nutritionist
Medically reviewed by:
Medically reviewed by:
