What’s the difference between ADD and ADHD?
What’s the difference between ADD and ADHD?
For years, people believed ADD and ADHD were two separate diagnoses. I’ve had clients, bright, successful professionals, walk into my office saying, “I think I have ADD, not ADHD. I’m not hyper.”
But here’s the truth: ADD is no longer a medical diagnosis. It hasn’t been for decades. And that confusion? It’s not harmless. It leads to misdiagnosis, missed opportunities, and years of silent struggle, especially for women and adults who fly under the radar.
If you’re wondering what exactly changed, and whether ADD still exists, this article will break it down, simply, clearly, and with real-life insight from ADHD coaching.
What Do ADD and ADHD Actually Mean? (And Why the Confusion?)
Many of my coaching clients are surprised to learn that ADD is no longer an official diagnosis.
In reality, these two terms, ADD and ADHD, refer to the same underlying set of executive function challenges, but the terminology has changed over time.
A Brief History:
- In the 1980s (DSM-III): The term ADD (Attention Deficit Disorder) was introduced with two subtypes, one with hyperactivity, one without.
- But since 1994 (DSM-IV onward): ADD was removed and replaced by the umbrella term ADHD (Attention-Deficit/Hyperactivity Disorder).
- Instead of ADD vs. ADHD, we now talk about three ADHD presentations:
- Predominantly Inattentive Type – what people often still call “ADD.”
- Predominantly Hyperactive-Impulsive Type
- Combined Type – the most common among adults.
Why Does This Matter?
When people still use the term ADD, they may misunderstand or misidentify themselves or others.
For example:
- A person who’s easily distracted but not hyper may think they “don’t really have ADHD.”
- Worse, they might never get properly diagnosed or supported, especially if they’re an adult or a woman with high functioning.
Consequences of This Confusion:
- Delayed or missed diagnoses
- Anxiety or depression due to untreated symptoms
- Internalized shame or a false belief of being “lazy”
- Years of struggling with something that could have been managed, if only the right label had been used.
The 3 Types of ADHD: What They Look Like in Real Life
Understanding the three presentations of ADHD is crucial, especially for adults who may have been missed as kids. Let’s break them down, not just by definition, but by how they show up in everyday life.
- Predominantly Inattentive Type (What people still call “ADD”)
- Often quiet, daydreamy, or “lost in thought”
- Misses details, forgets things, disorganized
- May seem “lazy” or “not trying hard enough”
- Common in girls, women, and high-IQ individuals
- May not get diagnosed until adulthood, if at all
Coach Insight:
One of my clients, a brilliant 39-year-old woman, went undiagnosed for decades. Her teachers praised her for being quiet, but no one saw how much she was struggling inside. ADHD wasn’t even on her radar until she had kids, and realized she was overwhelmed by everything.
- Predominantly Hyperactive-Impulsive Type
- Restless, fidgety, interrupts often, talks a lot
- Acts without thinking, trouble waiting their turn
- Seen more often in young boys
- Can be easier to recognize, but often mislabeled as “bad behavior”
- Combined Type
- Has both inattentive and hyperactive symptoms
- Most common among adult clients
- Often internalized, they’ve spent years trying to “mask” or “push through”
- Prone to burnout, anxiety, and self-doubt
Coach Insight:
Many of my adult clients with the combined type are high achievers on the outside, doctors, engineers, business owners. But inside, they feel like they’re holding it all together with duct tape. Coaching helps them finally connect the dots and create sustainable systems.
What ADHD Looks Like in Adulthood (Hint: It’s Not Just Fidgeting)
If you think adult ADHD just means getting distracted at work or forgetting your keys, think again. The adult experience of ADHD is often more subtle, and more painful, than people realize.
Common Signs of ADHD in Adults:
- Constant mental noise — like a dozen browser tabs open at once
- Difficulty starting or finishing tasks (even “easy” ones)
- Chronic procrastination followed by frantic last-minute work
- Time blindness — underestimating how long things take
- Emotional dysregulation — feeling overwhelmed, irritable, or ashamed
- Relationship struggles — forgetting things, interrupting, zoning out
- Burnout — especially in high achievers who are masking symptoms
Coach Insight:
Many clients come to me thinking they’re just “lazy” or “bad at life.” Once they understand their brain wiring, everything changes. We stop shaming and start strategizing.
How ADHD Hides in Plain Sight (Especially in Women & High Achievers)
ADHD isn’t always loud. In fact, many people, especially women, girls, and high performers, go undiagnosed for decades because their symptoms don’t “look like” ADHD.
Here’s how ADHD often goes unnoticed:
- Internalized symptoms: Instead of acting out, you shut down. You daydream, zone out, or silently panic.
- Masking and overcompensating: You work twice as hard to appear “on top of things,” even if it exhausts you.
- People-pleasing and perfectionism: You try to stay liked and organized to avoid being seen as “too much.”
- “Smart but scattered”: You’re bright, but your forgetfulness or inconsistency confuses others, and frustrates you.
- Emotional overwhelm: You feel things deeply and intensely, but you’ve learned to hide it well.
Coach Insight:
I often work with brilliant women and gifted professionals who say, “I thought I was just anxious or sensitive.” Once we explore their story, ADHD explains so much.
The Neuroscience of ADHD: It’s Not About Willpower
One of the most harmful myths about ADHD is that it’s a motivation problem, that people with ADHD are lazy, careless, or just not trying hard enough. This couldn’t be further from the truth.
ADHD is a brain-based executive function disorder. It affects how the brain manages time, attention, memory, emotions, and tasks. Here’s what neuroscience tells us:
What’s really going on in the ADHD brain?
- Dopamine dysregulation: The ADHD brain struggles with dopamine, the “reward” neurotransmitter that helps with motivation and focus. Tasks that are boring, routine, or don’t offer instant gratification are painfully hard to start or finish.
- Delayed frontal lobe development: The prefrontal cortex, the part responsible for planning, organization, and impulse control, develops more slowly in people with ADHD.
- Time blindness: ADHD brains perceive time differently, often leading to chronic lateness, procrastination, or “hyper focusing” on the wrong thing.
Coach Perspective:
It’s not about laziness. It’s about brain wiring. When we understand this, we stop blaming ourselves and start building smarter systems.
ADHD in Adults: The Signs You Might Miss
When most people think of ADHD, they imagine a hyperactive little boy bouncing off the walls. But adult ADHD often looks completely different, and it’s far more common than people realize.
Many adults with ADHD go undiagnosed for decades. Why? Because their symptoms don’t always match the stereotype. Instead of bouncing, they’re burning out. Instead of daydreaming, they’re drowning in distractions.
Subtle Signs of Adult ADHD
- Chronic procrastination, even on things you care about
- Starting tons of projects — finishing few
- Always running late, underestimating time
- Trouble staying organized despite best intentions
- Emotional overwhelm or overreaction to stress
- Frequent career or relationship changes
Real Talk:
Many of my clients were high achievers who felt like they were “secretly broken” inside. ADHD wasn’t holding them back, not knowing it was ADHD was.
ADHD in Women: The Misdiagnosed Majority
For decades, ADHD was seen as a “boy’s disorder.” As a result, millions of girls grew up undiagnosed, misdiagnosed with anxiety or depression, or simply labeled as lazy, emotional, or dramatic.
Why? Because women and girls often present ADHD differently. They may not be disruptive or hyperactive. Instead, they’re quietly struggling, internally overwhelmed, and constantly trying to keep it all together.
What ADHD Looks Like in Women
- People-pleasing and perfectionism as coping tools
- Extreme emotional sensitivity and rejection sensitivity
- Internalized anxiety that masks attention issues
- Chronic guilt for “not doing enough”
- Exhaustion from masking or overcompensating
Insight from Coaching:
So many of the brilliant women I coach have spent their lives blaming themselves. When they realize it’s ADHD, there’s often a mix of grief, and profound relief.
ADHD and the Executive Function Puzzle
At the heart of ADHD isn’t just attention, it’s executive dysfunction. That’s why people with ADHD can hyperfocus for hours on something interesting, but struggle with starting a simple task like replying to an email.
Executive functions are the brain’s “management system”, they help you:
- Organize and prioritize
- Manage time effectively
- Regulate emotions
- Initiate and complete tasks
- Remember what to do (working memory)
When these systems are out of sync, daily life can feel chaotic, even when you’re intelligent, motivated, and capable.
Coaching Perspective:
ADHD isn’t a problem of knowing what to do, it’s a problem of doing what you know. That’s where coaching helps reconnect intention with action.
Executive Function and ADHD: The Core Challenge
ADHD isn’t just about attention; it’s primarily about executive function difficulties. Executive functions are the brain’s management skills, helping us organize, plan, manage time, control emotions, and follow through on tasks.
When executive function is impaired, even simple daily activities become overwhelming, despite motivation or intelligence.
As a coach, I often say: ADHD isn’t about knowing what to do; it’s about doing what you know. Coaching bridges that gap between intention and action.
Practical Coaching Strategies for Managing ADHD
When working with clients struggling to differentiate between ADD and ADHD, and more importantly to manage their symptoms, I’ve found several practical strategies that truly make a difference. Here’s a step-by-step guide grounded in evidence-based approaches and real-world coaching experience:
- Clarify ADHD Presentation
First, identify whether the client’s challenges fit predominantly inattentive, hyperactive-impulsive, or combined presentations. This helps tailor strategies effectively.
- Build Structure with Flexibility
Rigid schedules often fail people with ADHD. Instead, I recommend creating flexible routines that offer consistency but allow room for spontaneity — a balance that helps maintain engagement without feeling trapped.
- Break Tasks into Small Steps
Large projects can overwhelm. Breaking them into bite-sized tasks makes goals feel achievable and reduces procrastination.
- Use External Tools
Calendars, alarms, reminder apps, and visual planners act as “external brains,” helping clients track tasks and deadlines more reliably.
- Foster Emotional Regulation
Helping clients recognize emotional triggers and practice mindfulness or grounding techniques (based on research like Murrell et al., 2015) improves self-control and focus.
- Encourage Self-Compassion and Growth Mindset
ADHD coaching thrives on reducing stigma and shame. Encouraging clients to view challenges as manageable and to celebrate small wins promotes motivation.
Understanding the difference between ADD and ADHD, and recognizing how ADHD affects executive function, is the first step toward managing your challenges effectively.
Remember, ADHD is not a limitation but a unique wiring that, with the right strategies and support, can lead to creativity, resilience, and success.
As your coach, I’m here to help you transform knowledge into action, build habits that stick, and unlock your full potential.
Ready to take control? Let’s start this journey together. Reach out today and discover how coaching can change your life.
Are you ready to take charge of your ADHD journey and unlock your true potential? Don’t wait any longer, reach out today for personalized coaching that empowers you to thrive. Let’s work together to build strategies tailored to your unique strengths and challenges.
Contact me now and start transforming your life!