What is combined ADHD?

Attention deficit hyperactivity disorder (ADHD) is a very common neurodevelopmental disorder affecting approximately 11% of school-age children. The DSM-5, a manual used by medical providers to diagnose mental health conditions, outlines three distinct manifestations of ADHD: primarily inattentive, primarily hyperactive-impulsive, or a combination.

Combined ADHD is the most common presentation. While it’s hard to say what percentage of people with ADHD have a mixed type, one small study estimated that about 70 percent of adults with ADHD have a mixed type.

Treating combined ADHD can be challenging because there are two distinct sets of symptoms. However, this type is not necessarily worse or more damaging than other ADHD manifestations.

This article will review the symptoms of ADHD combined, as well as treatment options and coping strategies.

Signs of combined ADHD

The DSM-5 ADHD criteria outline two groups of symptoms in people with ADHD. A diagnosis is made if a person under the age of 17 has had 6 or more of the above symptoms in one category in the past 6 months, or if an adult has 5 of these symptoms. People with combined ADHD meet the criteria for both groups of symptoms.

symptoms of inattention

People with ADHD who are primarily inattentive mostly have difficulty concentrating and following through. Symptoms of inattention include:

  • Difficulty concentrating or listening
  • Lost important items
  • easily distracted
  • forgetful
  • inattention
  • doesn’t seem to listen
  • make careless mistakes
  • Avoid tasks that require concentration

Hyperactivity-impulsivity symptoms

People with mostly ADHD or impulsive ADHD usually have more physical symptoms. These can include:

  • wriggling or irritability
  • inability to remain seated
  • running or climbing; or, as an adult, restless
  • Difficulty keeping quiet
  • Experience the feeling of being driven by a motor
  • very talkative
  • Can’t wait for their turn
  • frequent interruptions
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What to expect from someone with combined ADHD

People with ADHD complex are often impulsive and hyperactive. They may have difficulty reaching their full potential at school or work because their symptoms interfere with their ability to perform tasks. In other cases, they have difficulty making friends, although many children with ADHD make meaningful friendships.

Children with ADHD are at increased risk for other conditions, including learning disabilities, depression, anxiety, or behavioral problems. Therefore, the American Academy of Pediatrics recommends screening all children with ADHD for the additional condition. Knowing all of your child’s conditions can help you develop a treatment plan that’s right for them.

You should also work with your child and their therapist to develop healthy ways to deal with excess energy or urges. Children with ADHD have an increased risk of injury. Proactively discuss safety measures with your child, such as wearing a helmet at all times while riding a bike.

ADHD brain vs non-ADHD brain

How to Treat Mixed ADHD

Combined ADHD is treated with medications that can help reduce symptoms and behavioral adaptations that can help people manage their still-existing symptoms.

If you are the parent of a child with complex ADHD, you can also benefit from training and therapy that teaches you how to interact more effectively with your child. Additionally, you can ask their school to help with behavioral adjustments to help your child succeed.

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Is ADHD a disability?ADHD Accommodations and Benefits

medical treatement

  • Stimulants: these drugs, including Ritalin (methylphenidate) and Adlar (amphetamine and dextroamphetamine), can rapidly reduce ADHD symptoms in up to 80% of children with ADHD.
  • Non-stimulants: these drugs, including Stratella (atomoxetine), works slower, but the effect may last longer.

In some cases, your healthcare provider may recommend a combination of stimulant and non-stimulant treatments.

behavioral intervention

People with ADHD, especially children, can benefit from behavioral interventions that help them succeed in school and other settings. These can include:

  • Behavioral therapy: Aims to increase positive behaviors and reduce negative or risky behaviors.
  • Social skills training: Therapy to help people better understand and obey social cues.
  • Organizational skills training: Helping people develop ways to combat forgetfulness and confusion.

Types of mental health treatment


Combined ADHD is one of three ADHD presentations listed in DSM-5. To be diagnosed with combined ADHD, a person needs to exhibit symptoms of both hyperactivity/impulsivity and inattention.

Although people with ADHD combined have both symptoms, their ADHD is not necessarily more severe than those with a single manifestation. Medications and behavioral interventions can help people with complex ADHD succeed in school, work, and social settings.

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VigorTip words

Getting a diagnosis of combined ADHD can be a relief, or it can seem overwhelming. Remember, there are treatments—including medical and behavioral therapy—that can support people with ADHD to reach their full potential. The key is finding a treatment option that is right for you or your child.

Combination ADHD seems to be more complex than just one presentation. However, this does not necessarily mean that the symptoms are more damaging than those with only one manifestation. Talk to your healthcare provider to better understand what your diagnosis of combined ADHD means and how best to manage it.

Frequently Asked Questions

  • What Causes Combined ADHD?

    Researchers aren’t sure what causes ADHD, although both genetic and environmental factors are thought to play a role. There’s also no way to prevent combined ADHD, so once diagnosed, it’s best to focus on managing your symptoms and finding a treatment plan that’s right for you.

  • Can You Get Rid of Combined ADHD?

    Treatment can help people with ADHD complex manage their symptoms effectively. Unfortunately, ADHD has no cure. About one-third of people diagnosed with ADHD in childhood will surpass their symptoms in adulthood. For others, the presentation of symptoms may change as they grow.

  • How common is combined ADHD?

    Combined ADHD is the most common subtype. Overall, ADHD affects about 11 percent of school-age children and 4 percent of adults. A small study of adults with ADHD found that 70 percent had combined ADHD.