Hyperactive vs inattentive

From my previous posts, we know that ADHD can present itself differently in everyone – most commonly hyperactive-impulsive in males and inattentive in females – but most are diagnosed with “combined ADHD”. So what do these things mean, and how are they different?

Individuals with hyperactive-impulsive ADHD may have difficulties staying still for long periods of time; often fidgeting, constantly moving or talking excessively and interrupting others. They will struggle with self-control, their impulses taking over more often – in school, they are more likely to answer a question without raising their hand and waiting to be called upon. This presentation of ADHD is easier to spot and is most often diagnosed in boys during childhood. They can also have difficulty engaging in tasks, become impatient quickly, and even struggle with social interaction.

Inattentive ADHD, or ADHD-PI (formerly ADD) is characterised by difficulties in sustaining information, following detailed instructions, and organising tasks. They may appear forgetful, often lose things, or seem distracted, even forgetting to respond to a message until an embarrassing amount of time has elapsed. They may find it difficult to focus on a 1-to-1 conversation if their environment is too stimulating. They can become more easily lost in their own thoughts, especially on those days where their thoughts are too loud – imagine that lizard hitting the button repeatedly while someone is trying to explain something to you, nothing goes in and it’s just “lizard lizard lizard.”

Combined ADHD is what it sounds like – the individual presents both hyperactive-impulsive and inattentive symptoms. This is the most common diagnosis of the disorder and can make daily life particularly difficult for those individuals due to the constant tug of war between a mix of attention difficulties and impulsivity.

I was diagnosed with Combined ADHD on January 2nd, 2026. Personally, I struggle with verbal and written instructions and would prefer to be shown how to complete a task; a lot of information goes in one ear and out of the other, like when my mum used to ask me to take some meat out of the freezer to defrost or do the washing up before she got home; I struggle to sit still for prolonged periods of time and I tend to interrupt conversations, laughing at inappropriate times; even thinking “Yeah, I can buy that.” when I should probably be saving my money for more important things. On a daily basis I have the common symptoms of ADHD too – executive dysfunction being the main antagonist, making the thought of washing the dishes or getting in the shower almost unbearable and impossible. I like to have a “body double” while completing tasks, which means that doing housework is much easier for me when I have someone helping out and shorten my list of jobs. I struggle with communication (especially about important things) and making eye contact during conversation, which have been major issues in the past. Music is my biggest lifeline in times of overstimulation, requirement to focus, or frustration.

Caffeine doesn’t wake me up, I can easily sit in bed with a cup of coffee and sleep like a rock, but it can sharpen my focus for a short time by slowing down my brain. Antidepressants don’t anti my depressy, they just make me feel more fogged up, slow me down making me feel numb to any emotion at all. I don’t have a driver’s license because I don’t trust that I can stay calm or focused behind the wheel. Sometimes I wake up with enough energy to be productive for a full day, other days I’ll only have enough energy for a couple of productive hours before I crash and the executive dysfunction kicks in – the ADHD community call this our “spoon repository”, we wake up with an unknown daily amount, some tasks require us to spend more spoons than others until we completely run out. So if you ever hear someone say “I don’t have enough spoons for that.” it means they don’t have the energy to spend on doing something – you can help by saying, “let’s give it a go, and if it’s too much, I can take over.”

Many people with ADHD of any presentation struggle with daily life, causing a percentage to turn to addiction. Alcohol slows the brain and the body, nicotine can sharpen focus and steady overstimulation, gambling starts as an impulse but can grow into something destructive – all of these addictions can, of course. The disorder can affect someone’s ability to stay in one job for too long as they can grow bored, the same may apply to romantic relationships and hobbies too. A person with ADHD can have an idea that they think is great in the moment, they will spend money on everything they need to complete it, work on it for a couple of weeks, then abandon it – wash, rinse, repeat.

If you’re reading this and wondering if you have ADHD, and you’re starting to tick boxes and thinking “I do/feel/experience that too”, please have a read through my post “The Diagnosis”. It doesn’t have to take years to get the answers you need, Dear Reader, but it takes the courage to take the first step… asking for help.

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