ADHD, Unfiltered: Beyond the Hyperactivity
"You just need to try harder."
"Everyone's a little ADHD these days."
"ADHD isn't real—it's just an excuse."
If you’ve heard any of these before, you’re not alone. In my therapy practice, I hear versions of these statements all the time—often from clients talking about themselves. After years of absorbing these messages, many people come in carrying a lot of shame, self-doubt, and confusion about why things feel so hard.
These myths aren’t just annoying. They actively keep people from understanding their brains and getting the support they deserve.
So let’s slow things down and talk about what it actually is—and what it isn’t.
ADHD or ADD — So Which One Is It Anyway?
You’ll often hear people use Attention-Deficit/Hyperactivity Disorder (ADHD) and Attention-Deficit Disorder (ADD) interchangeably. That can be confusing, so let’s clear it up.
ADHD is the official medical diagnosis. What many people still call Attention-Deficit Disorder (ADD) is now considered a type of ADHD—specifically the predominantly inattentive presentation. In other words, ADD didn’t disappear; the name changed. People are still describing the same lived experiences, even if the terminology sounds different.
So if you’ve ever thought, “I relate to ADD, but not ADHD,” you’re not wrong. You may simply relate to a form of ADHD that doesn’t include obvious hyperactivity.
Attention-Deficit/Hyperactivity Disorder isn’t one single experience. It shows up in different ways, and learning about those differences can be incredibly validating—especially if you never saw yourself in the stereotypical, hyperactive version that’s often portrayed.
At its core, ADHD is an executive functioning difference. Executive functions help us plan, initiate tasks, manage time, regulate emotions, and shift attention. When these systems don’t work smoothly, daily life becomes harder—not because someone isn’t trying, but because their brain is wired differently.
Understanding ADHD this way helps move us away from moral judgments and toward something far more useful: compassion and clarity.
The Three Presentation Types: A Quick Overview
Here's the thing about ADHD that trips people up: it doesn't look the same in everyone. In fact, there are three distinct presentation types, and understanding them can be the difference between spending decades thinking you're "just lazy" or "too much" and finally getting the support you need.
According to the DSM-5, ADHD is categorized into three distinct presentations:
Predominantly Inattentive Presentation (formerly called ADD)
Predominantly Hyperactive-Impulsive Presentation
Combined Presentation (both inattentive and hyperactive-impulsive symptoms)
These clinical terms are useful for diagnosis, but they don't always capture what it's actually like to live with ADHD day to day. Let's explore what each presentation looks like in real life.
ADHD, Predominantly Inattentive Presentation
This presentation tends to fly under the radar, particularly in adults—and especially in women and those socialized as female.
What It Actually Looks Like
You’re not bouncing off walls. You’re the person who:
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Starts reading an email and realizes five minutes later you’ve absorbed exactly zero words.
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Has a graveyard of half-finished projects you were so excited about.
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Misses details even when you’re trying desperately to pay attention.
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Zones out in conversations and has to ask people to repeat themselves.
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Loses things constantly—keys, phone, that important document you just had.
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Feels like you’re moving through life in a mental fog.
The Big Misconception
“You can’t have ADHD, you’re so calm and quiet!”
This is one of the most damaging myths about inattentive ADHD. When you don’t look hyperactive, your struggles often go unnoticed—or misunderstood.
Real Life Impact
Sarah, 34: “I thought I was just bad at being an adult. Everyone else seemed to remember appointments and finish things. I felt like I was failing at the basics of existence.”
Years of being misunderstood can take a real emotional toll, often contributing to anxiety, depression, and deep internalized shame.
ADHD, Predominantly Hyperactive-Impulsive Presentation
This presentation is the one most people picture when they think “ADHD”—but in adults, it often looks less like running around and more like a nervous system that won’t fully settle.
What It Actually Looks Like
You might be the person who:
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Feels restless even when you’re “resting” — like your body is on standby but your mind is sprinting.
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Feels a constant urgency — everything is right now, even when it isn’t.
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Talks fast, interrupts by accident, or finishes other people’s sentences (not to be rude — your brain is just ahead).
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Blurts things out and immediately thinks, “Why did I say that?”
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Struggles with waiting, slow processes, long meetings, or anything that feels painfully understimulating.
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Experiences quick emotional spikes — irritation, excitement, or frustration that hits hard and passes fast.
The Big Misconception
“You’re just intense.” “You’re so impulsive.” “You need to calm down.”
A lot of adults with hyperactive-impulsive ADHD have spent their lives getting negative feedback for traits that are actually about regulation — not character. When your nervous system runs “fast,” you can end up being labeled as dramatic, difficult, irresponsible, or “too much,” even when you’re trying hard to manage it.
Real Life Impact
Jay, 29: “I’m not trying to be chaotic. My brain jumps ahead, and my mouth follows. By the time I slow down, I’ve already interrupted or agreed to something I don’t have time for.”
Over time, this can affect relationships, work, self-esteem, and burnout. Many people start avoiding situations where they feel “too much,” or they over-mask until they crash.
ADHD, Combined Presentation
Combined presentation ADHD includes traits from both inattentive and hyperactive-impulsive patterns. For many adults, this means dealing with multiple kinds of regulation challenges at the same time.
What It Actually Looks Like
You might recognize yourself as someone who:
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Feels pulled in two directions at once — mentally foggy and overwhelmed, yet internally restless.
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Struggles to start tasks, but once started, has trouble stopping or shifting gears.
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Has racing thoughts and difficulty organizing or prioritizing those thoughts.
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Experiences emotional intensity alongside shutdown, overwhelm, or mental exhaustion.
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Can be highly productive in bursts, followed by periods of burnout or avoidance.
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Masks heavily to appear “functional,” even when things feel chaotic internally.
The Big Misconception
“You’re inconsistent.” “You have so much potential.” “Just pick a system and stick to it.”
People with combined presentation ADHD are often judged for being “all over the place,” when in reality, they’re navigating multiple executive functioning challenges at once. The inconsistency isn’t a lack of effort — it’s a nervous system trying to regulate competing demands.
Real Life Impact
Maria, 37: “Some days I can do everything. Other days, even simple tasks feel impossible. I kept thinking I was the problem, instead of realizing my brain just doesn’t work the same way every day.”
Over time, this can lead to deep frustration, burnout, and self-blame. Many adults with combined presentation spend years feeling like they’re failing at consistency, when what they actually need is support that adapts.
Understanding your ADHD presentation isn’t about collecting labels.
It’s about self-compassion and learning what actually works for your brain.
Do You Think You Might Have ADHD?
If this post felt uncomfortably familiar, you may want to start with a brief self-assessment. It isn’t a diagnosis, but it can help you notice patterns and decide whether seeking further support feels right.
👉 Take the ADHD assessment here:
https://neuroish-sdc-app.web.app/Assessment0
Learning more about your brain is information—not a verdict.
When you recognize inattentive ADHD, you can stop blaming yourself for zoning out and start using strategies that fit how you function. When you notice hyperactive-impulsive traits, you can create healthy outlets for that energy instead of feeling ashamed of it. And when you see yourself in the combined presentation, it can finally explain why things feel inconsistent without assuming you’re the problem.
You’re not broken. You’re not lazy. And you’re not failing at adulthood.
Your brain works differently—and understanding how can make life feel a lot more manageable.
In Part 2, we’ll dig into common ADHD myths and why they matter, especially when it comes to shame, misdiagnosis, and self-blame.
