Despite what most people think, attention deficit hyperactivity disorder (ADHD) isn’t just a one-size-fits-all condition. There are 2 distinct types of ADHD, plus a third that’s a combination of the others. The first type, inattentive ADHD, is characterized by an inability to focus, being easily distracted, and finding it challenging to complete tasks. 

The second type, hyperactive-impulsive ADHD, is hallmarked with symptoms like being in perpetual motion, talking too much, and being unable to control thoughts, actions, or responses. This “classic” form is what most people think of when they hear the term ADHD. Despite it being well-known, when it presents without any signs of distraction or inattentive behavior, ADHD impulsive type is actually the rarest form of ADHD. 

There are distinct differences between the types of ADHD. Read on to learn more about the very specific ADHD impulsive and hyperactive type.

What is Hyperactive-Impulsive ADHD?

ADHD impulsive hyperactivity is characterized by frenetic activity, lack of impulse control, and constant talking. While adults can have this type of ADHD, hyperactivity tends to lessen as a person ages. 

While an impulsive action is normal every once in a while, someone who lives with hyperactive-impulsive ADHD typically seems to have little to no self-control and feels like they must be in constant motion. They might interrupt other people’s conversations, even if they don’t have anything valuable to say. They can also be drawn to risky behavior. This is a very recognizable form of ADHD and is more common in children, boys, and men. Studies have shown that those with ADHD have weaker prefrontal cortex circuits, which is the part of the brain that regulates attention, emotion, and behavior. 

How does it differ from other ADHD types?

ADHD impulsive hyperactivity is by far the most easy-to-spot type of ADHD, while the inattentive and distractible form is more subtle. Someone with inattentive ADHD isn’t necessarily active and fidgety. They do, however, have difficulty focusing on a project or task, finishing it, and turning it in on time.

As noted, some people have a combination of both types of ADHD. In fact, that’s the most commonly diagnosed type of ADHD in the United States.

“In hyperactive-impulsive type ADHD, a person struggles to sit still and focus on activities, has difficulty managing their impulses, and acts without thinking most of the time during activities. It’s different from the other kind of ADHD, where someone struggles with distraction and lack of focus.”

Talkspace therapist Dr. Muhammad Munir, MD

Symptoms of Hyperactive-Impulsive ADHD

While people can experience hyperactive-impulsive ADHD differently, some of the more commonly reported symptoms include:

  • An inability to sit still
  • Fidgeting
  • Talking too much
  • Interrupting others
  • Difficulty waiting in line or waiting their turn
  • Running, jumping, or climbing at inappropriate times

It’s important to note that these symptoms by themselves are not necessarily an indication of ADHD. For an accurate diagnosis to be made, symptoms must be extreme and occur over a period of at least 6 months. Only a mental health professional can diagnose ADHD. (Note: Adult ADHD symptoms are not easy to distinguish because they are not as obvious as childhood ADHD symptoms. For example, a young child with ADHD may be prone to make careless mistakes related to schoolwork while a person with adult ADHD would have trouble completing work.)

Examples of hyperactivity

Hyperactivity and lack of impulse control go hand in hand. A hyperactive child is the one who might always be shouting out the answers in class without raising their hand or jumping out of their seat dozens of times during class. This is the child who won’t stop talking and who has difficulty focusing on a task.

Causes of Hyperactive-Impulsive ADHD

We don’t fully know what causes ADHD. Researchers strongly believe there’s a genetic link though since ADHD tends to run in families. 

Other potential causes might include smoking and alcohol use during pregnancy, low birth weight or being born premature, and brain injuries. Exposure to toxins, such as lead, may also have something to do with a child developing ADHD, according to a 2016 study.

How to Diagnose Hyperactive-Impulsive ADHD

Only a professional, licensed psychiatrist, psychologist, or doctor can diagnose ADHD. Finding someone who has experience in diagnosing and treating ADHD can be helpful in ensuring that you get the right diagnosis and begin an effective treatment plan. 

During the assessment process, a mental health professional will interview you and review your mental records. They may also talk to family, close friends, or teachers.

The standard criteria that is used to diagnose hyperactive-impulsive ADHD is listed in the APA’s Diagnostic and Statistical Manual, Fifth Edition (DSM-5). It includes the following:

  • Must have exhibited symptoms of ADHD impulsive hyperactive type for 6 months or longer
  • Showed symptoms before age 12
  • Symptoms are present in more than 1 setting (for example, at home and at school)
  • Symptoms are clearly interfering with the basic ability to function and enjoy life
  • Symptoms can’t be explained by another mental health condition

Hyperactive-Impulsive ADHD Treatment

The good news for people with ADHD (and parents of children with the condition) is that many treatments are effective for hyperactive ADHD. Treatment plans are put together by a mental health team led by a psychiatrist or psychologist. Most plans include a combination of therapy and ADHD medication.

ADHD Treatment methods

Hyperactive ADHD is commonly treated with therapy for ADHD, particularly cognitive-behavioral therapy (CBT), which is used to teach someone with ADHD how to cope with their symptoms and develop effective communication and relationship skills. Therapy can also be useful for parents and families of children with ADHD to help them gain a better understanding of a child’s actions.

Medication used for ADHD patients aged 6 and older can be divided into 2 classes — stimulants and non-stimulants. 

Despite the name, stimulants actually work to calm someone with ADHD down. Some stimulant medications include: 

  • Ritalin-SR
  • Focalin XR
  • Concerta
  • Adderall-XR
  • Adzenys XR ODT
  • Focalin
  • Dexedrine  
  • Adderall 

Non-stimulants that might be prescribed to treat ADHD include: 

  • Atomoxetine
  • Clonidine ER 
  • Guanfacine ER

Occasionally, antidepressants might be used to treat comorbid depression or as an off-label treatment for some ADHD symptoms like aggression and hyperactivity. Antidepressants are used cautiously, though, as they’ve been linked to higher risk of suicide in adolescents. 

Tips for coping

It can be difficult to navigate symptoms of hyperactive impulsive ADHD, both for the individual with the condition as well as for parents, caregivers, friends, and family members. Below are just a few ideas that might help someone with ADHD.

  • Eliminate distractions. Turn off the television, turn the music down, and put phones and devices in a drawer when it’s time to focus on a task. That way there’s less chance for distraction.
  • Get plenty of sleep. One 2020 research study shows that lack of sleep can aggravate ADHD symptoms.
  • Deep breathing exercises. For adults and older children, deep breathing exercises can help improve focus, reduce anxiety, and give you a minute to think before acting.
  • Sit in the front of the class (or conference room). For kids and teens, sitting in the front of the class might help minimize distractions, allowing them to concentrate better on what’s being taught.
  • Exercise. Studies show that exercise can be very effective in managing ADHD. Primarily, research indicates it can reduce symptoms and improve executive functioning.  

Finding Support with Talkspace

If you or your child has been diagnosed with hyperactive impulsive ADHD, you don’t just have to accept the symptoms. There’s no known cure for ADHD, but getting treatment, especially through early intervention, can teach you ways to live a more fulfilling, enriching, happier life with ADHD. You can learn skills and tricks to help you cope. 

Talk with your primary care physician or pediatrician to get a recommendation for a psychiatrist or psychologist who has experience in working with people with ADHD. Getting the right diagnosis is key to managing any form of ADHD. 

Talkspace is an online therapy platform that makes getting ADHD help easy. Our therapists can determine what type of ADHD you’re dealing with, and then put a personalized, specific, effective plan into place. We make therapy easy and convenient, so you can begin your path toward wellness and health as soon as possible.