ADHD-I, ADHD-H, ADHD-C, ADD.... or am I just HSP?
For many people, it is still unclear what exactly the terms ADD, ADHD and HSP mean and what the differences and similarities are. Hence this article in which I try to explain to you as clearly as possible what these terms mean, what they stand for and what they have in common.
For a start, ADD stands for Attention Deficit Disorder, which is actually an outdated term you will read more about in a moment. ADHD stands for Attention Deficit Hyperactivity Disorder and HSP for High Sensitive Person, also known as High Sensitive Personality and in Dutch as Hoog Sensitief Persoon simply reduced to high sensitivity.
The names actually indicate immediately that ADD and ADHD involve a "disorder" or dysfunction. At least, that is how it has been defined in the psychiatric manual the 'DSM-3' (Diagnostic and Statistical Manual of Mental Disorders) since 1987. This describes all mental disorders with their associated symptoms. Think of it as the bible for psychiatrists. By the way, the first DSM book was already published in 1952 and we have now reached the DSM-5, which came out in May 2013. So more and more labels ;)
The term HSP (High Sensitive Person/Personality) already indicates that this is not a disorder or condition but an innate personality trait. It appears that some 20% of the world's population is affected to a greater or lesser extent.
What types of ADHD do we know?
There are 3 types of ADHD. So in all cases, you will be diagnosed with ADHD. But depending on your symptoms, you will fit into one of the types below:
- Type 1 | ADHD - I (ADHD - Inattentive)
In Dutch, we say the "ADHD - Predominantly Inattentive" type. For convenience, we also call this type ADD. This is because there is no hyperactivity that makes the H go away. This is not at all to say that someone with ADD can never be busy. The difference is just that you are not predominantly hyperactive as in the other types. The term ADD has actually been abolished but it talks a lot easier don't you think?
- Type 2 | ADHD - H (ADHD - Hyperactive/Impulsive)
In Dutch, this is the "ADHD - Predominantly Hyperactive and Impulsive" type. Since there is thus no "Attention Deficit", but only hyperactivity and impulsivity, this is also sometimes called for convenience HD named.
- Type 3 | ADHD - C (ADHD - Combined)
This is the combined type we refer to in Dutch as the "ADHD - Predominantly Inattentive and Hyperactive" type. This type of ADHD is the most common and is popularly called simply ADHD called. So this involves predominantly inattentive as well as hyperactivity and impulsivity. If you are sometimes busy but generally inattentive, chances are you will be diagnosed with ADHD - I (ADD) and not the combined type. You only fall under this type 3 if the hyperactivity and impulsivity are excessive in combination with all the characteristics of type 1.
So it does not matter which type applies to you for the diagnosis of ADHD. In all cases, you will be diagnosed with ADHD, but depending on the symptoms you have, the diagnosis will be ADHD-I, ADHD-H or ADHD-C. So for all the ADDers among us, officially we are ADHD-I'ers ;)
Do I still have your attention? ;) If you can still handle it, read on below about the differences between these ADHD types and their overlap with HSP.
The difference between ADD and HD/ADHD
The difference of type 1 ADHD (ADD) from types 2 (HD) and 3 (ADHD) is that in type 1 (ADD) there is no continuous external or physical hyperactivity. In type 1, the hyperactivity is mainly in the mind. This is characterised by being constantly in thought as if the brain just won't stop. There is no calmness in the mind. These individuals generally like to withdraw for a while due to having to process too many stimuli and information. You also often notice fidgeting and fidgeting with things.
Type 2 (HD) and 3 (ADHD) express the busyness in the head mainly in a hyperactive way outwardly. Generally, they cannot sit still and so are constantly getting up from their chairs, walking back and forth, like to interfere with everything around them and talk a lot. They tend to have a much more conspicuous presence. No one escapes the presence of an ADHD type 2 and 3. Just think of Jochem Meyer to give an example. He clearly seems like an ADHD type 2 or 3 to me ;)
Are ADDs always quiet and introverted?
Some people think that ADDs (type I) are always quiet introverts and dreamers. This is not true. It depends on your character and the environment you grew up in. Like all people, they too can be busy and enthusiastic at times.
So people with ADHD type I (ADD) can also appear busy. You usually see this in forms such as difficulty sitting still without doing anything. As if there is always a sense of restlessness in the person. Something is quickly fiddled with. For example, things or hair etc. You can also notice that they quickly jump from one thing to another. Both during conversations and when performing tasks. This is because the brain is constantly coming up with new thoughts. With this type 1, however, you will not notice continuous hyperactivity.
Difference between HD and ADD/ADHD
The difference between type 2 (HD) and type 1 (ADD) and 3 (ADHD) is really only that HD'ers do not suffer from concentration problems. People with type 1 and type 3 ADHD, on the other hand, suffer enormously from this and quickly wander off in thought if the subject does not interest them 100%. This is enormously noticeable at school, during conversations, at work, etc. For them, it is as if their concentration is on the entire environment and not on the one subject that requires their attention at that moment. So all stimuli come in equally hard and this regularly causes intense over-stimulation which can make a type 1 and 3 person feel very tired and out of sorts.
The differences and similarities between the 3 ADHD types summarised
To simplify the above a bit, I will list below the biggest differences and similarities between the 3 ADHD types:
Differences in ADHD types
Differences type 1 ADHD - Inattentive (ADD) and type 3 ADHD - Combined (ADHD)
- Type 1 is more likely to withdraw sight while type 3 will be hyperactive on stimuli
- As a result, type 1 tends to come across as quiet while type 3 comes across as hyperactive and cannot sit still and usually talks a lot
Differences type 2 ADHD - Hyperactive/Impulsive (HD) with type 1 (ADD) and 3 (ADHD)
- Type 2 does not suffer from concentration problems
- Type 2 does not suffer from excessive overstimulation
Similarities in ADHD types
Similarities type 1 ADHD - Inattentive (ADD) and type 3 ADHD - Combined (ADHD)
- All stimuli from the environment come in equally hard
- Constantly many thoughts and busy-ness in the head
- Quickly overexcited
- Seeks external distractions
- Difficulty sitting still and doing nothing
- Regular impulsive outbursts
Similarities type 2 ADHD - Hyperactive/Impulsive (HD) with type 1 (ADD) and 3 (ADHD)
- Looking for external distractions
- Difficulty sitting still and doing nothing
- Regular impulsive outbursts
Let me not forget to mention that these are guidelines and, of course, there are always exceptions. In the end, everyone remains a unique person in their own right. Also of influence are the environment you come from, your intelligence, your own character, your genes and so on. In addition, additional diagnoses such as Autism, Asperger's, High Sensitivity, ODD, Dyslexia and you name them all often come into play. But there are also often secondary complaints a role such as social anxiety, burnout and depression. All these factors also affect a person's behaviour.
It also sometimes happens that someone was very busy and impulsive in childhood and was diagnosed with ADHD-C, while in later life the hyperactivity is no longer present. All the other characteristics are then usually still there, which is why someone then gets ADHD-I type in later life.
For comprehensive features of ADHD, find here is a list of characteristics of ADD (ADHD - I) type 1 and a list of characteristics of ADHD (ADHD - C) type 3 can be found here.
The relationship between HSP, ADD and ADHD
Now that I have discussed ADHD and ADD, I will tell you what is the overlap in this with HSP. This is the biggest question for many people. From now on, I will only refer to ADHD types 1, 2 and 3 simply as ADHD.
As I mentioned earlier, ADHD is officially listed in the DSM as a psychiatric condition. With HSP, this is not the case and we are talking purely about a trait that occurs in about 20% of the population.
It turns out that a lot of people who have ADHD are also highly sensitive. You see this a lot in families and households. For example, the mother has ADD, the father ADHD. The son is high-sensitive and has ADHD, one daughter is only high-sensitive and the other daughter has ADD. It is a mix that occurs in many families. In addition, it is also not rare for other labels to be present in the family such as Dyslexia, PDD-NOS, etc.
I think this is largely because people with HSP and ADHD attract each other because they are more on the same wavelength than other people. Thus, in turn, you create children with the same traits.
But why do these people attract each other and what do they have in common? You can read more about this below.
The similarities and differences between ADHD and HSP
A highly sensitive person has much stronger senses, so to speak than the average person. Hearing, seeing, smelling, tasting and feeling are experienced more intensely. This sensitivity quickly causes overstimulation. Associated complaints often include fatigue, inability to think clearly, feeling stressed, difficulty concentrating, memory problems, restlessness, tension, etc.
People with ADHD often know these symptoms all too well and, like HSPs, also have the characteristic that stimuli are experienced much more harshly. Not so much because they have stronger senses but rather because they receive all stimuli equally loudly and therefore become overstimulated.
The big difference between ADHD and HSP is, that someone with only HSP, generally does manage to concentrate well. They also suffer less from continuous crowding and chaotic behaviour. To a greater or lesser extent, this only comes into play when an HSP person becomes very overstimulated. Only then does this cause restlessness and concentration problems. Something an ADHD person almost always experiences.
Features in both ADHD and HSP
Other traits common to both ADHD and HSP that make these people attract each other are shown below:
- A strong sense of justice
- Quickly getting through to people
- Lots of daydreaming and/or fantasising
- Often perfectionist in nature
- Often happy to stand by others
- A well-developed intuition
- Thinking often in images and pictures
- Often very creative
Besides, it is also often the people with HSP and ADHD who face depression, burn-out, anxiety disorder and similar symptoms in their lives. This, too, makes them understand each other better and relate more to each other.
A complete overview of HSP characteristics and more information on HSP can be found here.
When do you talk about ADHD and when about HSP?
You will now understand that people with ADHD and HSP attract each other because there are many similarities in the way they view the world. As a result, they will find it easier to get along and can understand each other better than the average person. This ensures that for generations new children have been born who often have both ADHD, and high sensitivity traits.
Bear in mind that this absolutely does not mean that someone with ADHD is also always highly sensitive and vice versa. In practice, you do often see this overlap. Especially if you look at it at family level. But unfortunately, I often hear around me that ADHD is wrongly diagnosed while the child turns out to be highly sensitive.
Would you like to know whether your child is actually HSP or perhaps has ADHD? Then read on.
The difference between HSP and ADHD
You can tell the difference between HSP and ADHD by a number of characteristics. The most important is concentration and attention. If you notice that your child constantly wanders off, does not listen well and quickly loses interest, this points in the direction of ADHD, especially type 1 or 3. What you also often see here is that these people constantly switch their activities. They start something, halfway through they see something else to do and start there. Once that is done, something else pops into their head to do and before they know it, they have started 10 things but nothing has been completed. This is also typical of ADHD.
Do you feel that concentration and attention are generally good, but it appears that the child withdraws quickly, seems quickly overexcited or out of sorts and precisely because of this become restless, busy and have concentration problems, then in many cases this could be due to high sensitivity.
Some final comments and tips for ADHD and HSP
I do think it is important to mention that nutrition can also play a huge role in the characteristics of ADHD and HSP. More information on nutrition tips/diets for ADD, ADHD and HSP can be found here.
Also read about the natural supplement LTO3 which so many people with ADHD and HSP appear to benefit from. For many, it helps very much with concentration, hyperactivity and fussiness in the head. It also tends to make people feel a lot more relaxed and in better spirits.
And what is your take on all these forms of ADHD? Maybe you have something to add? Be sure to let us hear from you in a comment below....